Jennifer Salsberg, MD, FRCPC

Products And Services

• BOTOX AND NEUROMODULATORS

  BOTOX® Cosmetic BOTOX® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. In addition to its cosmetic applications, it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back and jaw pain, and migraines. Applications For BOTOX Cosmetic Although originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, BOTOX Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of BOTOX Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines. BOTOX Cosmetic is used to treat the following: Forehead furrows Frown lines Crow's feet Skin bands on the neck According to Allergan, BOTOX Cosmetic has been "extensively researched, with approximately 2500 studies." BOTOX Cosmetic Procedure And Results Using a very fine needle, BOTOX Cosmetic is injected directly into facial muscles that are causing furrows and lines. Receiving the injections requires no anesthetic, but some doctors choose to numb the area to be injected with ice packs or a topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to four months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals. Side Effects Of BOTOX Cosmetic Injection-site side effects of BOTOX Cosmetic are usually mild and temporary, and include the following: Pain Infection Inflammation Tenderness Swelling Redness Bleeding Bruising Normal activities may be resumed immediately after receiving injections. BOTOX® Cosmetic FAQs BOTOX® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. BOTOX Cosmetic injections treat moderate-to-severe facial lines and wrinkles that are formed by continual muscle contraction. Treatment with BOTOX Cosmetic is the most popular physician-performed nonsurgical cosmetic procedure in the United States. What Does BOTOX Cosmetic Do? According to its manufacturer, Allergan, Inc., "BOTOX Cosmetic is the first and only FDA-approved prescription product that temporarily improves the appearance of both moderate-to-severe frown lines between the brows and moderate-to-severe crow's feet in adults." How Does BOTOX Cosmetic Work? Properly placed injections of BOTOX Cosmetic, which contains a purified and safe form of botulinum toxin A, block nerve impulses sent to muscles, weakening them to the point where they cannot contract. When Will I See Results From BOTOX Cosmetic? How Long Does It Last? Results from BOTOX injections are apparent within 24 to 48 hours, and are maximized by 30 days. Results often last between 3 and 4 months. Does BOTOX Cosmetic Have Medical Applications? Yes; it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back and jaw pain, and migraines. Who Is Qualified To Give BOTOX Cosmetic Injections? The manufacturer of BOTOX Cosmetic recommends that injections only be given by a doctor who has experience with BOTOX Cosmetic, and has a "medical practice that focuses on facial aesthetics and offers other facial aesthetic treatments." What Are The Possible Side Effects Of BOTOX Cosmetic? Side effects of BOTOX Cosmetic are usually mild and temporary. Possible injection-site side effects include pain, infection, inflammation, tenderness, swelling, redness, bleeding and bruising. What Are The Possible Cosmetic Side Effects Of BOTOX Cosmetic? Depending on where they are given, cosmetic side effects of BOTOX injections include eyelid drooping and swelling.

  Link: BOTOX AND NEUROMODULATORS

• DEOXYCHOLIC ACID INJECTIONS (BELKYRA)

  Deoxycholic acid injections provide a non-surgical option for the treatment of submental fullness, commonly referred to as a ‘double-chin’. In a series of 2-5 short, in office treatments, excess fat in the area is injected and then is slowly absorbed and excreted from the body.

  Link: DEOXYCHOLIC ACID INJECTIONS (BELKYRA)

• CHEMICAL PEELS

  Chemical peels remove damaged outer layers of skin to make skin smoother, reduce scarring and remove blemishes. Ranging from mild to strong, there are three types of chemical peels: alphahydroxy acid (AHA), trichloroacetic acid (TCA) and phenol. The strength of each peel is tailored to the patient. Peels can be combined with other procedures, such as facelifts, for additional improvement to skin. Chemical peels may be covered by insurance if they are performed for medical rather than cosmetic reasons. Chemical peels are performed in a plastic surgeon's or dermatologist's office, or an outpatient surgical center. Anesthesia is not required because TCA and phenol have anesthetic properties, and AHA produces only a slight stinging. Chemical Peel Procedure Chemical peels remove damaged outer layers of skin to make skin smoother, reduce scarring and remove blemishes. Ranging from mild to strong, there are three types of chemical peels: alphahydroxy acid (AHA), trichloroacetic acid (TCA) and phenol. The strength of each peel is tailored to the patient. Peels can be combined with other procedures, such as facelifts, for additional improvement to skin. Chemical peels may be covered by insurance if they are performed for medical rather than cosmetic reasons. Chemical peels are performed in a plastic surgeon's or dermatologist's office, or an outpatient surgical center. Anesthesia is not required because TCA and phenol have anesthetic properties, and AHA produces only a slight stinging. Side Effects Of Chemical Peels A phenol or TCA peel can result in tingling or throbbing, reddened skin, a crust or scab, and significant swelling that lasts, depending on the strength of the peel used, about a week. With a phenol peel, eyes may be swollen shut at first, and the patient may be put on a liquid diet and advised to keep talking to a minimum. Any tape used is removed after a day or two. AHA peels can cause temporary stinging, redness and irritation, as well as flaking or crusting. After a chemical peel, it is essential that the skin be protected from the sun. Chemical Peel FAQs What Do Chemical Peels Treat? Chemical peels remove damaged outer layers of skin, typically on the face, to make skin smoother, reduce scarring and remove blemishes. What Types Of Chemical Peels Are There? Ranging from mild to strong, there are three types of chemical peels: alphahydroxy acid (AHA), trichloroacetic acid (TCA) and phenol. What Is An Alphahydroxy Acid (AHA) Peel? An AHA peel is the gentlest of the three types of chemical peels. It contains glycolic, lactic and fruit acids that smooth and brighten skin, and is used to treat fine wrinkles, dryness, uneven pigmentation and acne. An AHA peel is typically applied once a week, or may be mixed in a milder concentration with a cream or cleanser to be used daily. Treatment takes less than 10 minutes. What Is A Trichloroacetic Acid (TCA) Peel? A TCA peel is commonly used for medium-depth peeling, although depth is adjustable. It treats fine surface wrinkles, superficial blemishes and pigment problems and, in addition to the face, can be used on the neck and other areas of the body. It is sometimes used in combination with an AHA peel. A TCA peel is the preferred peel for darker-skinned patients. Results do not last as long as those of phenol peels, and multiple treatments may be required. However, treatments take only 10 to 15 minutes, and recovery time is shorter. What Is A Phenol Peel? A phenol peel, which is the strongest chemical peel, treats deeper skin problems such as coarse facial wrinkles and precancerous growths, as well as areas of blotchy or damaged skin caused by sun exposure, aging or birth-control pills. Because phenol can lighten skin where it is applied, the patient's natural pigmentation is a factor in determining a phenol peel's suitability. Phenol is used only on the face because it may cause scarring elsewhere. Full-facial treatment can last an hour or two, and recovery can take a few months, with possible permanent lightening of the skin and removal of freckles. Where Are Chemical Peels Performed? Chemical peels are usually performed in a dermatologist's or plastic surgeon's office, or an outpatient surgical center. Is A Chemical Peel Painful? During a chemical peel, anesthesia is not required because TCA and phenol have anesthetic properties, and AHA produces only a slight stinging. With a TCA or phenol peel, when the solution is first applied, it may cause a brief stinging sensation. Post-procedure, a TCA or phenol peel can result in tingling or throbbing, reddened skin, a crust or scab, and significant swelling that lasts, depending on the strength of the peel used, about a week. After a phenol peel, eyes may be swollen shut at first, and the patient may be put on a liquid diet and advised to keep talking to a minimum.

  Link: CHEMICAL PEELS

• HYALURONIC ACID SOFT TISSUE FILLERS

  As we age, our facial structure changes due to loss of the support structures in the deeper layers of our skin. Hyaluronic acid occurs naturally in our skin and can be injected to re- contour and restore lost volume, to provide a lifted and more rested appearance. Hyaluronic acid can also be used to restore balance to facial features by adding small volumes to augment the lips, cheeks or chin. Injections are done in office by our expert physicians, who are skilled at providing natural yet dramatic results.

  Link: HYALURONIC ACID SOFT TISSUE FILLERS

• IPL PHOTOFACIAL

  Intense-Pulsed-Light Skin Rejuvenation Intense-Pulsed-Light (IPL) skin rejuvenation uses high-energy pulses of light to improve the skin's appearance. Also referred to as IPL photorejuvenation, photofacial therapy and pulsed-light therapy, IPL skin rejuvenation is a nonabrasive and noninvasive treatment option for removing red and brown pigment from the skin. IPL is used to treat age spots, birthmarks, freckles caused by the sun, symptoms of rosacea, spider veins, and scarring from acne; it is also an effective tool for hair removal. IPL penetrates below the surface of the skin, leaving the top layer of skin intact, which means that there is no post-treatment recovery period. The light is absorbed by the pigment in sunspots and the blood in the visible vessels, and converted to heat. The heat dissolves the cells that create the pigment and shrinks the vessels. The Intense-Pulsed-Light Skin Rejuvenation Procedure Prior to IPL treatment, a topical anesthetic gel is applied to the skin to reduce discomfort. The IPL machine is placed on the settings that best suit the patient's skin; among the factors considered are the condition being treated and, because IPL is absorbed differently by different skin colors, the amount of pigment in the skin. Protective coverings are placed over the patient's eyes, and the IPL handpiece is gently pressed to the skin as pulses of light are emitted. The light is absorbed by the skin's red or brown pigment and converted to heat, which dissolves the pigmented cells. After treatment, the topical anesthetic is removed with a warm cloth, and a moisturizer with sunscreen is usually applied. If there is any swelling, a cold pack is applied for 5 to 10 minutes. Three to six treatment sessions are usually required; sessions typically last from 30 to 90 minutes each, and are spaced approximately 3 weeks apart. Gradual improvement may be seen after each treatment, but optimal results appear only after several months. Recovery From Intense-Pulsed-Light Skin Rejuvenation There is no recuperation time following IPL treatment. A patient can return to work or resume normal activities on the same day. Although skin may be slightly reddened after the treatment, redness typically disappears within a day or two. As it heals in the days following treatment, skin often begins to flake. Over time, however, a gradual, natural-looking improvement in the skin becomes noticeable. Applying sunscreen regularly and avoiding sun exposure is recommended following IPL treatment. Risks Of Intense-Pulsed-Light Skin Rejuvenation One possible contraindication for IPL treatment is taking medication that increases photosensitivity. A patient using a topical or oral medicine that increases sensitivity to light may not be a candidate for IPL treatment. And, although IPL skin rejuvenation is considered safe, there are some risks associated with its use. Although rare, IPL skin rejuvenation can cause skin discoloration, blisters, scars and burns.

  Link: IPL PHOTOFACIAL

• LASER SKIN RESURFACING

  Modern technology provides a variety of successful laser resurfacing treatments for improving the condition of the skin. Laser skin treatments employ focused beams of light energy to counteract the effects on the skin of acne, aging, sun damage, hyperpigmentation, scars, or poor nutrition. Resurfacing laser treatments are safe and efficient, requiring little downtime to provide effective results. Much less invasive than dermabrasion and chemical peels, laser treatments remove damaged skin and rejuvenate the patient's appearance. Most of the time, such treatments are sought for the face, but may also be performed on other parts of the body. Reasons For Laser Resurfacing Patients seek laser resurfacing for a variety of reasons, all related to discontent with their appearance. Laser resurfacing may be performed for any of the following reasons: To decrease or eliminate wrinkles or stretchmarks To diminish the appearance of scars To rejuvenate non-responsive skin after a facelift To remove age spots or spider veins To repair sun-damaged skin To improve skin tone due to melasma or other causes To remove warts or birthmarks To decrease the size of enlarged pores To remove tattoos Types Of Laser Resurfacing There are two basic types of laser resurfacing treatments: ablative and non-ablative. Ablative Laser Resurfacing Ablative laser treatments, which penetrate more deeply, actually cause a wound, since they remove a layer of skin. Since ablative resurfacing actually vaporizes a layer of the skin, it provides more dramatic results and requires fewer sessions, but also requires a longer period of healing. Non-Ablative Resurfacing Non-ablative treatments do not burn away skin tissue, but use laser energy to stimulate collagen growth and tighten underlying skin. Non-ablative resurfacing is gentler than ablative and requires less downtime, but may necessitate more treatment sessions and may yield less dramatic results. In general, non-ablative laser treatments are used when the repair needed is less extensive. Also, non-ablative treatments are recommended for people of color for whom ablative resurfacing may be more likely to cause unsightly changes in pigmentation. A form of ablative resurfacing known as fractional ablative laser is now increasingly in use. This procedure targets more specific regions so that laser microbeams pinpoint and peel away smaller areas of skin. During fractional laser surfacing, no visible wounds are caused, so, although results are more noticeable, less downtime is necessary than after conventional ablative treatments. For some individuals, fractional ablative laser resurfacing represents the best of both worlds. The Laser Resurfacing Procedure Laser treatments for skin conditions are typically performed in the doctor's office with topical anesthesia. Procedures typically take between 30 and 90 minutes to perform, depending on the size and location of the treated area. While some individuals will notice significant results after just one treatment, particularly with ablative procedures, many patients will require multiple sessions in order to achieve the desired results. It is also possible that additional touch-up treatments will be needed at a future date. Risks Of Laser Resurfacing Although laser skin treatment is considered safe for most patients and is typically performed with no long-term complications, there are certain risks associated with any type of medical procedure. While considered rare, risks may include: Infection Scarring Redness Pigmentation changes Acne Milia, tiny white bumps on the skin Recovery From Laser Resurfacing Recovery from laser resurfacing procedures varies according to the particular procedure undergone and the individual patient's skin type. In all cases, however, patients who have undergone these treatments should avoid sun exposure wherever possible. Recovery From Non-Ablative Laser Resurfacing After treatment, patients may experience redness and peeling at the treated site as the skin heals. The duration of these side effects varies, but is commonly several days. Ice packs may ease discomfort and improve appearance. Normal activities can be resumed during healing, and makeup may be applied to camouflage any unwanted, evidence of treatment. Recovery From Ablative Laser Resurfacing After ablative laser resurfacing, the treated skin will temporarily be raw, swollen and itchy and the yellowish liquid that oozes from treated areas may form crusts. After treatment, a thick ointment, such as petroleum jelly, and a watertight dressing will be applied to the affected area. If treatment has been performed on the face, the patient may be instructed to keep the head elevated during the night. Ice packs and over-the-counter pain relievers may be recommended for symptom relief. To help avoid scarring, patients are instructed not to pick at crusts or pieces of skin. Visible healing may take a week or two.

  Link: LASER SKIN RESURFACING

• MEDICAL GRADE SKINCARE

  Medical grade skincare (skincare dispensed from a physician’s office) is backed by scientific research, and is key to achieving your skin goals, and help you to maintain the wonderful results from our in-office procedures. We work with you to build a customized routine that encompasses prevention of long-term skin damage from environmental and UV stressors, as well as correction of current concerns from pigmentation, to dullness and fine lines.

  Link: MEDICAL GRADE SKINCARE

• MICRONEEDLING

  Microneedling, or collagen induction therapy, is a minimally invasive in-office procedure using very fine needles to enhance collagen and elastin production in the skin. Microneedling can be used to treat fine lines and wrinkles, pigmentation, and acne scars.

  Link: MICRONEEDLING

• SMALL PARTICLE HYALURONIC ACID (SKIN BOOSTERS)

  Small particle hyaluronic acid can be injected diffusely under the skin of the face, neck or hands to improve skin smoothness, elasticity and radiance. Different from soft tissue fillers, the hyaluronic acid is not used in this setting to add volume, but rather to improve skin tone and texture.

  Link: SMALL PARTICLE HYALURONIC ACID (SKIN BOOSTERS)

• V BEAM VASCULAR LASER

  The V-Beam laser is the gold standard for treatment of facial redness and prominent facial veins. A series of sessions minimizes redness resulting from rosacea or broken blood vessels, restoring a clearer appearance to the skin.

  Link: V BEAM VASCULAR LASER

• PRP

  PRP Injections For many years, the medical community has been acutely aware of the body’s natural regenerative qualities. Physicians across all fields, including orthopedics, dentistry, and sports medicine, have implemented protocols that work synergistically with the body. The use of platelet-rich plasma (PRP) is common for promoting joint recovery and managing degenerative disease. It was only a matter of time before science discovered the value that PRP held for the body’s largest organ: the skin. We are pleased to offer PRP treatments to help our patients address their cosmetic concerns. What Is PRP? PRP, or platelet-rich plasma, is an organic substance that has long been advocated for its ability to facilitate tissue regeneration and wound healing. The substance exists in every person’s blood, which makes it safe and convenient. PRP is obtained through a simple blood draw and centrifuge (spinning) process. Centrifugation of the blood separates nutrient-rich platelets from red blood cells and other product. Platelets are valuable because they contain a large number of growth factors. These include epithelial and vascular epithelial growth factors as well as fibroblast and connective tissue growth factors. Each type of growth promotes vital processes such as inflammatory response, blood vessel regeneration, tissue remodeling, and cell proliferation. What Are The Benefits Of Platelet-Rich Plasma Injections? The growth factors contained in platelet-rich plasma are involved in almost every regenerative process in the body. When PRP is injected just beneath the skin, it stimulates collagen proliferation through which a number of benefits occur. PRP injections add volume to areas of the face that have begun to droop or atrophy. The cheeks can be rounded out and under eye hollows that cause dark circles and bags can be softened. Due to ongoing collagen remodeling, PRP injections also promote softer, smoother, tighter skin over time. Injections of platelet-rich plasma are also beneficial because they are safe for all skin types and tones. The organic nature of treatment, using your own blood product, significantly reduces the potential for side effects such as allergic response. How Does PRP Work For Aesthetic Rejuvenation? Platelet-rich plasma is used in two ways to improve the appearance and overall vitality of the skin. The product may be injected beneath wrinkles, hollows, and areas of deflation and it may also be applied topically in a gentle microneedling procedure. The way that PRP improves texture, volume, and radiance is by inducing numerous regenerative processes. The various growth factors that exist within blood plasma provide essential proteins, electrolytes, hormones, and other nutrients to the skin. Proteins are integral to the formation of fibrin polymer which lays a strong foundation for firm, youthful tissue. Platelets within the plasma naturally respond to injuries in the body, prompting accelerated tissue regeneration through vascular and cellular regrowth. How Long Do PRP Injections Take? PRP treatment with injections takes only slightly longer than an average injectable treatment. We begin with a standard blood draw. If desired, a topical numbing cream can be applied to the treatment area while blood is processed in the centrifuge. This takes just a few minutes. The provider carefully observes the face and may mark areas where injections are recommended. The entire process is typically complete within 15 to 20 minutes. Microneedling with PRP is also brief, taking approximately 30 minutes from start to finish. What Happens After The PRP Procedure? Patients can resume normal activity immediately following their PRP procedure. Slight redness and swelling should be expected. Some patients notice minor bruising. These side effects typically disappear within the first day after treatment. How Long Will It Take To See Results? Patients who undergo microneedling with PRP may notice an immediate boost in the radiance and softness of their skin. PRP injections work beneath the surface to restructure the collagen matrix in superficial tissue, so results from injections alone become more noticeable after a few weeks. As healing mechanisms increase, patients notice improvements such as: Smoother texture due to improved collagen formation. More radiance due to new blood vessel formation. Fresher, younger-looking skin due to the influx of vital nutrients. What Are The Advantages Of PRP Vs. Other Injectables? Studies have indicated that patients treated with platelet-rich plasma facials and facelifts find that their results continue to improve over time. Several months after treatment, the effects of cellular regeneration may be even more noticeable than they are right after microneedling or injections. This is because plasma stimulates cellular activity in which collagen and elastin are remodeled.

  Link: PRP

• MICRODERMABRASION

  Microdermabrasion is a minimally invasive skin-exfoliation procedure designed to treat sun damage, scars, wrinkles and hyperpigmentation. In addition to its cosmetic benefits, microdermabrasion helps to enhance circulation and lymph flow. Results are immediately visible, and there is no downtime for the patient, who can immediately resume regular activities. Performed in-office, microdermabrasion does not require anesthesia, and can be combined with other procedures such as chemical peels or laser treatment. Microdermabrasion is a much less invasive procedure than dermabrasion, which is used to treat more serious skin problems. Dermabrasion, in which several layers of skin are removed, is considered a surgical treatment. The Microdermabrasion Procedure During the microdermabrasion procedure, which is usually performed by an aesthetician, a handheld device is used to transmit tiny crystals of aluminum oxide across the targeted treatment area. The crystals and dead skin are then suctioned away with a vacuum tool, revealing fresh underlying skin. A treatment session can last from five to 60 minutes. The results of a single microdermabrasion treatment are temporary. For continued improvement, treatment should be repeated every 2 to 4 weeks. Risks Of Microdermabrasion Microdermabrasion is considered safe for all skin types, and is appropriate for Asian and dark-skinned patients who may be at risk for skin discoloration with other types of treatment. There are no serious risks associated with microdermabrasion, although some patients experience mild redness and irritation, and patients older than 70 may have a slightly escalated risk of bruising and skin abrasions. Avoiding sun exposure after microdermabrasion is important because it may have removed some of the skin's natural protection. In patients who have a history of cold sores, undergoing microdermabrasion may reactivate the virus that causes them. In those cases, avoiding treatment around the lip area and/or taking preventative antiviral medication prior to treatment may be recommended. Microdermabrasion FAQs What Is Microdermabrasion? Microdermabrasion is a minimally invasive exfoliation treatment for skin. During treatment, a gentle stream of aluminum oxide crystals exfoliates the outer layer of skin, after which the dead skin cells and crystal particles are vacuumed away to reveal healthy, fresh skin. Microdermabrasion is less invasive and has a faster recovery time than many other skin resurfacing treatments. What Does Microdermabrasion Treat? Microdermabrasion is used to treat a variety of mild-to-moderate skin problems, including acne, scarring, sun damage, age spots and fine wrinkles. Because it only affects the outermost layer of skin (epidermis), it is not effective for repairing deep tissue damage, or removing congenital marks, tattoos, moles and scars. What Are The Benefits Of Microdermabrasion? Microdermabrasion safely and effectively, with no pain and no downtime, improves the color, tone and texture of skin. Microdermabrasion is considered safe for all skin types, and is especially effective for Asian and dark-skinned patients who may be at risk for skin discoloration with other types of treatment. The vacuum used during dermabrasion enhances circulation and lymph flow, rejuvenating the skin internally as well as externally. Is It Necessary To Wear Sunscreen After Microdermabrasion Treatment? After microdermabrasion is performed, the newly exposed layer of skin is vulnerable to sun damage, so wearing sunscreen is necessary. Avoiding the sun the first few days after treatment is recommended. How Long Do Microdermabrasion's Results Last? Microdermabrasion's results are temporary. To sustain results and/or for continued improvement, microdermabrasion should be repeated at 2- to 4-week intervals. What Are The Risks Of Microdermabrasion? There are no serious risks associated with microdermabrasion. Possible minor side effects of microdermabrasion include skin tightness, redness, minor bruising, fine broken blood vessels, post-inflammatory hyperpigmentation, and cold sore reactivation around the lips. Patients older than 70 may have a slightly escalated risk of bruising and skin abrasions.

  Link: MICRODERMABRASION