Clinical and surgical Dermatology. Cosmetic Dermatology procedures 

Villalón Dermatología 

Dermatologist

A series of small injections of a purified neurotoxin that temporarily blocks nerve impulses to muscles or other tissues, causing the muscles to relax.  When muscles relax, the overlying skin moves less, effectively reducing wrinkles.  Botulinum toxin injections can be strategically placed for various other indications, including rejuvenation of the upper and lower face, reducing sweating, and medical conditions such as migraine. The effects usually wear off after a few months.

Botulinum toxin injections

The most commonly used fillers today are non-permanent and consist of hyaluronic acid, a naturally occurring molecule found in skin, joints and in the eyes.  Several brands of hyaluronic acid filler are available.  They all comprise a clear, soft, sterile gel that is injected into the skin or beneath the skin to soften lines, contour facial features, or add volume.  Fillers may be injected under local anaesthesia, and results can last about 6-18 months.

Fillers

This surgical procedure helps make the eyes appear more youthful by removing excess skin, muscle and fat between the eyelids and brows. A small incision is made in the crease of the eyelid either under local or general anaesthesia. Fine stitches are used to close the incision and these are usually removed 5-7 days after surgery. Upper blepharoplasty rectifies the hooding that occurs with aging in some people.

Upper blepharoplasty

Fat is taken from one part of the body, such as the inner knee or lower tummy, using a mini-liposuction procedure, and injected into the face to add volume, contour, or define certain features.  The procedure requires careful technique to ensure as much of the fat as possible survives. The fat cells are injected using special blunt instruments called cannulas.  Fat grafting can provide a lasting effect in facial rejuvenation either performed on its own or in conjunction with other procedures.

Fat grafting

A peeling treatment that uses lasers, such as carbon dioxide and erbium lasers, to remove the outer skin layers precisely. The type of laser and settings used determine how the skin peels and heals. Laser skin resurfacing is used to reduce sun damage, pigmentation, and fine wrinkles. The treatment usually requires some form of anaesthesia and special skin care during the healing period after the treatment.

Laser skin resurfacing

A skin resurfacing or peeling treatment that uses chemicals, usually special acids, to remove the top layer of skin. A chemical peel is indicated to treat pigmentation, sun damage, acne, or fine wrinkles. The depth of peel, results, and recovery period depend on which chemical is used during the peel. Chemical peels can be superficial, medium depth, or deep peels. Peeling agents include salicylic acid, azelaic acid, glycolic acid and trichloroacetic acid (TCA).

Chemical peel

Lasers are powerful devices that emit light at certain wavelengths in order to have an effect on tissues in the skin or body. Ablative lasers vaporise or peel skin. Non-ablative lasers usually heat skin without peeling. Lasers can heat collagen effectively, causing improvement in texture, tightness and pores. Lasers can be used to rejuvenate by treating blood vessels, removing hair, stimulating biological processes or peeling the outer, unwanted layers of skin or tissue.

Laser rejuvenation

Microneedling is a treatment where numerous tiny needles penetrate the skin to stimulate collagen, resulting in tighter skin with fewer lines and improved texture. The needles are small, usually up to three millimetres in length, and arranged on a device such as a stamping tool, pen, or roller. Local anaesthesia may be used to numb the skin before microneedling is performed. The skin can appear pink after the treatment, which may be repeated several times for best results.

Microneedling

This treatment uses tiny needles to penetrate the skin and deliver heat at the same time.  Radiofrequency energy passes through the needles in order to provide heat, either through the whole needle or just the tip. Radiofrequency needling is designed to stimulate collagen and tighten tissues more than needling alone.  The treatment is usually performed using local anaesthesia.

Radiofequency needling

A non-ablative laser is a laser that does not peel away the outer layers of skin during treatment. The wavelength of non-ablative lasers does its job by heating specific targets in the skin or tissues, such as collagen, blood vessels, or hair follicles,  without vaporising the skins surface to any significant degree.  Non-ablative lasers usually do not have the recovery and downtime associated with ablative lasers.

Non-ablative laser

Light emitting diode (LED) devices produce light wavelengths that correspond to light in the visible spectrum, such as red and blue. LEDs may be placed over the face, shielded using eye goggles, to treat acne, wrinkles, redness and other conditions.  Blue light is purported to treat acne, whereas red light may be used for collagen stimulation or hair growth.

Cryolipolysis, also known as fat freezing, is a non-invasive body contouring treatment that uses cooling of subcutaneous tissues to cause the fat cells to die. This results in localised reduction of fatty areas in the body. A device is placed on the tissues for a period of time during the treatment. Specific areas only can be treated depending on the applicator used.

Fat freezing

A treatment used to tighten and lift areas of the face or neck non-invasively using a device that delivers sound waves through the skin.  The sound waves focus precisely, generating heat in tiny zones at different depths.  The heat creates tiny injuries that result in collagen stimulation, providing a tissue tightening effect.  There is usually minimal or no downtime and a single treatment is used to produce results that improve during the months following treatment.

High-intensity focused ultrasound (HIFU)

Vascular lasers can treat variety of conditions including dilated or unsightly blood vessels. The lasers employ a specific wavelength of light the targets the blood in blood vessels, heating the vessels and effectively destroying them. Vascular lasers include pulsed-dye lasers and NdYAG lasers.  They can be used for conditions such as leg telangiectasias or “broken veins”.  A number of treatments may be required for optimum results.   

Vascular laser

Definitive removal of something from the body through an incision and dissection, either under local or general anaesthesia. 

Surgical removal

This is used to remove unwanted skin cells by freezing them. The area is sprayed until temperatures are so low that the skin lesion freezes. More than one treatment may be necessary to remove the unwanted cells. Cryotherapy, or therapy that induces very low temperatures in tissues, may also be used to treat unwanted fat. This is called crylipolysis or “fat freezing”.

Cryotherapy

Lasers use a specific wavelength of light to exhibit their effects. The wavelength determines the target for that specific laser. Most lasers are designed to heat and destroy a specific target and leave surrounding tissue untouched and undamaged. Lasers can peel skin, remove hair, rejuvenate skin, treat vascular conditions and remove pigmentation and tattoos. Various safety protocols are required when lasers are used, such as eye protection with goggles or eye shields.

Laser

This is a blood product that is prepared by spinning a whole blood sample in a centrifuge in a special syringe. The blood separates into different components, including plasma rich in platelets, cell fragments that release growth factors. The gold-coloured platelet-rich plasma is used to rejuvenate tissues such as skin or hair, usually by injecting it in small droplets.

Platelet-rich plasma (PRP)

Skin tightening that occurs when collagen is stimulated due to heating of the tissues from radiofrequency (RF) electromagnetic energy. Usually a solution is applied to the skin and a probe passes over the surface, gently heating the tissues to the desired temperature. External RF is a non-invasive treatment. A number of treatments may be recommended.

Radiofrequency external skin tightening

Skin tightening that occurs when the undersurface of skin is heated to a certain temperature using probes that emit radiofrequency (RF) electromagnetic energy.  This treatment is usually performed using anaesthesia, allowing a small incision so the internal probe can be passed into the layers beneath the skin.  The internal probes heat and stimulate collagen, resulting in a tightening effect over time.

Radiofrequency internal skin tightening

Various technologies and devices are available on the market designed to help improve cellulite.  Non-invasive cellulite therapies include physical massage with rollers, shockwave therapy, ultrasound, and radiofrequency.  Most of these devices heat the tissues under the skin or manipulate the tissues physically in order to improve blood flow, release growth factors, and stimulate lymphatic drainage. The result is a smoother appearance. Regular treatments are usually advised.

Non-invasive cellulite therapy

Surgically improving the appearance of a pre-existing scar using various techniques. The existing scar is often removed using a separate, new incision. The edges of the new wound are brought together in a way that reduces tension on the healing incision, so that the scar becomes less obvious.

Scar revision

A powerful light source consisting of a range of light wavelengths depending on the chosen targets.  Intense pulsed light (IPL) devices can be used for hair removal, skin rejuvenation, and the treatment of rosacea, acne, and pigmentation.  Usually a gel is applied and the IPL device is applied to the skin.  The flashes of light target the top layer of skin whilst the skin is simultaneously cooled for protection.

Intense pulsed light (IPL)

A treatment that improves the skin’s condition using gentle techniques such as massage, exfoliation, the application of topicals, and masks. Numerous types of facials are available to improve hydration, smoothness, and radiance. Some devices are used in addition to manual techniques during skin facials, with tips that provide suction, peeling, and moisturising. There is usually little or no downtime after skin facials.

Skin facial

The peeling away of the outer layer of dead skin cells on the skin’s outermost layer. Most microdermabrasion devices use tiny particles, diamond-tipped grits, or patented tips to gently blast or scrape away the epidermal cells. Microdermabrasion is designed to give an instant smoothing effect, although a course of several treatments is often recommended to give better results over time. The skin may be pink after treatment but this usually resolves quickly.

Microdermabrasion

The outer layer of skin is removed by sanding it down using a rotating rough tip on a powered device called a dermabrader.  This is performed under general or local anaesthesia. Dermabrasion improves skin texture, wrinkles and scars by removing the top layers. There is redness and swelling after the treatment for a period of time.

Dermabrasion

Several small injections are made into the middle layer of skin in order to deliver agents such as vitamins, antioxidants, hydrating or other substances.  Mesotherapy is used in aesthetics to hydrate skin, improve radiance, or stimulate cells in hair follicles and fibroblasts to help improve collagen production.  Topical numbing may be applied and the substance is injected either manually or using a special injecting device called a mesogun.

Mesotherapy

Extracorporeal shockwave therapy (ESWT) is used in aesthetics to reduce fibrosis, improve cellulite, or encourage lymphatic drainage.  The non-invasive device is applied to the skin over a gel.  A pneumatic driven piston gyrates within the hand piece, delivering shockwaves that exert their effects. Shockwaves may encourage blood supply, release growth factors and enhance healing.