Category Archives: Cosmetic Surgery

When to restart Tretinoin after an Obagi Blue Peel Radiance Peel

I got this question today, and it’s a question we address constantly.  I thought I’d write about restarting facial topical Tretinoin after a Blue Peel Radiance (Obagi) Peel treatment on the face.

Obagi Blue Peel Radiance in Modesto, CA

When should I re-start Tretinoin again after I receive a Blue Peel Radiance Peel (Obagi)?

The quick answer is about 6 days to restart your tretinoin, also known as Retin-A (among other names).  The range for most patients would be 4-8 days.  Some can restart sooner if there wasn’t too much irritation from the Obagi Blue Peel Radiance.

The problem of starting Tretioin too soon after a Blue Peel Radiance is that your skin may become too irritated and uncomfortable.

The same goes for restarting all the other Obagi Nu-Derm skin care products which may have been stopped – such as Exfoderm, Exfoderm Forte.

Everyone’s skin is a little different and every esthetician, doctor, dermatologist, surgeon, nurse has a different plan.  My guideline of about 6 days works for us at Surgical Artistry, Modesto.  But please consult your own practitioner for their own preferences.  Our plastic surgery office is directed by Dr. Tammy Wu, Plastic Surgeon and we are located in Modesto, California.  Different locations and different climates on the skin affect these recommendations on returning back to tretinoin use.

Other important aftercare instructions for Obagi Blue Peel Radiance Chemical Peel:

Download the Blue Peel RADIANCE After-care Card here or with the below link.

  • http://obagi.com/sites/default/files/bluepeel_ttearpad.pdf

The pdf file above will talk about the importance of applying Sunscreen.

When to consider another Blue Peel Radiance Chemical Peel.

One can consider another Blue Peel Radiance chemical peel about 1 month later.  Theoretically, one can consider a repeat Blue Peel Radiance as close as 2 weeks apart.  The purpose of “stacking” the peels closer together is to continue to get better results.  After about a series of 5 peels, the improvement is at it’s maximum, and then the goal is maintenance which may be achieved with continued peels every 2-3 months.

A Recent Botox and Dermal Filler Review for Calvin Lee, MD in Modesto, CA

Botox and Dermal Filler review for Calvin Lee, MD Modesto, CA

Botox and Dermal Filler review for Calvin Lee, MD Modesto, CA. November 2013.

The review can be found here:  https://plus.google.com/102548094439476506081/about?gl=US&hl=en-US

I have saved other (older) plastic surgery and botox reviews here.

Thank you very much for the Botox and Juvederm and Boletero review. It’s very much appreciated. And I will continue to do my best to improve and live up to those high standards written in these very kind reviews.

 

www.SurgeryToday.com (209) 551-1888

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(209) 551-1888

 

 

My uses for Hypertonic Saline

Normal Saline was invented in 1896 by Mr. Hartog Hamburger in Holland. Yes, this was at one point called Hamburger’s solution. Normal saline is a close approximation to the osmolarity of blood – thus there are tons of uses for normal saline. So how about HYPERTONIC Saline? What are the uses of something that has a higher osmolarity of blood? There are multiple uses but in my career it has been used for reducing brain swelling in trauma patients (more specifically to lower intracranial pressure, where maintenance of cerebral perfusion is key as it relies on blood pressure being high enough above intracranial pressure.)

The other use of HYPERTONIC Saline is in the COSMETIC treatment of spider veins. Now it’s less popular for this indication because POLIDOCANOL has been shown to be a superior product for spider vein treatment (and more expensive), but safety and superiority trumps cost for the most part. We use Polidocanol at Surgical Artistry, in Modesto, CA.

Belotero Balance a new Dermal Filler from the makers of Radiesse

BELOTERO

Belotero Balance vs. Juvederm – initial thoughts in Modesto, CA

Today I used two syringes of Belotero Balance and two syringes of Juvederm in today’s line of work.  I’m happy to report that Belotero didn’t disappoint.  I’ve done many tear troughs before with Juvederm and I’ve always injected deep.  For Belotero, I injected more superficially.

For both syringes which I’ve used, I mixed in a small amount of Lidocaine with Epinephrine.

Belotero is a dermal filler which was recently approved by the FDA in December of 2012.  Belotero FDA approval.

The Belotero Balance Syringe

belotero-syringe

This is much smaller and much more ergonoic than their Radiesse syringe also made by Merz.

There was no cracking or splitting of the syringe which I’ve sometimes seen when I attach the Juvederm to my 3 way valve.  I could probably get a better connector; however, the three way valve is something that is handy in my office because I use it  for vein sclerotherapy in it’s foamed version.

The syringe itself is smaller than the the Juvederm syringe; thus it made it somewhat easier to inject initially where the thumb doesn’t have to stretch out as far.  It’s a small advantage for those with small hands – such as me.  I think this was done on purpose – to make the syringe shorter.

There were, however, some parts of the syringe that snap off – perhaps this is on purpose.  The luer lock itself came off when I first connected it to the 3 way valve.  The flanges for the syringe itself also slides off, and when playing with the syringe after injecting the product, the rubber tip of the plunger can also become dislodged.   Regardless, these are very minor issues – which mostly arise because I like to fiddle with the syringe itself.

Initial Conclusions on Belotero in my Modesto practice

On injection, it feels smooth, and can be easily molded after injection into the skin.  I used one syringe on tear trough and the other syringe on the accordion type lines around the side of the skin.  I used a superficial approach to these lines – in attempt to use less product.  It seems to work well.

It is on the opposite spectrum of their other product – Radiesse – which is a harder substance.  Belotero is very soft and pliable but lacks the intense hardness and lift capacity of Radiesse.

I believe that Belotero has a place in the palette of “paintbrushes” we use in our cosmetic injection craft.  But I think that more than one syringe is necessary to fill out fine line wrinkles in faces.

Disclaimer:  Much of what is discussed above is considered off-label FDA usage of Belotero and Juvederm Dermal Fillers.  More info about my Belotero Dermal Filler practice.  Belotero has been mispelled – sometimes as Boletero, Bolotero, Belotora, Belatoro.  “Belotero” is the correct spelling.  An example of a dermal filler consent form, see an example of the Radiesse consent form.

www.SurgeryToday.com (209) 551-1888

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(209) 551-1888

Surgical Artistry FaceBook – Modesto Plastic Surgery

I tend to get wordy – scroll down to the bottom for the summary of the three worthy FaceBook pages related to Surgical Artistry in Modesto, CA.

Crackled-Facebook-Logo

How do I find the Surgical Artistry page on FaceBook?

This is confusing because somehow FaceBook has a page created for Surgical Artistry – but regardless of how I try to “edit” that page – it doesn’t take my “suggestion” for redirecting to a page we created – which we consider the “official” Surgical Artistry FaceBook Page.

The Official Surgical Artistry FaceBook Page

www.FaceBook.com/ModestoPlasticSurgery – I figured that Modesto Plastic Surgery described best what we did.  Looking at our services – there is more to Surgical Artistry than just Plastic Surgery.

Birth of a second Official Surgical Artistry FaceBook Page

However after a while, some of my patients thought I (Calvin Lee, MD) should have a page of my own relating to Botox, Juvederm, and other Dermal Fillers.  So we created:  www.FaceBook.com/BotoxModesto.  On this page we talk about things like cannulas for cosmetic injections, dermal fillers for lip augmentation, and perhaps even cosmetic acupuncture.  this page is more related to the stuff I do, but with a slant on cosmetic injections and dermal fillers.

Wait, there is yet another FaceBook page

Worth mentioning is my “personal” FB page – everyone is welcome to find me there.

The URL is www.FaceBook.com/Modesto – I like Modesto so much that yes, it has become my FaceBook vanity URL.

Summary of the three FaceBook pages:

  1. Surgical Artistry Modesto Plastic Surgery FaceBook – slant on plastic surgery
  2. Surgical Artistry Modesto Botox FaceBook – slant on Botox
  3. Calvin Lee Personal FaceBook – everything Modesto
www.SurgeryToday.com (209) 551-1888

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(209) 551-1888