I am excited to announce Xeomin, a relatively new neurotoxin on the market which was approved for cosmetic use last month (July, 2011).  With this introduction, I would like to present some helpful facts about this exciting new product:

• The principle difference between Xeomin and Botox or Dysport is it is the only neurotoxin that contains no additives. This may mean there is a lower chance that the body will develop antibodies in response to the injectable. Theoretically, such antibodies could prevent a neurotoxin from producing the desired result.
• Xeomin, unlike Botox and Dysport, is the only botulinum toxin that does not require refrigeration prior to reconstitution.  This feature significantly simplifies the distribution and storage of the product, thus further insuring the integrity of the substance on injection.
• Xeomin is similar to Botox in that it is a neurotoxin that works by blocking the signals from nerve to muscle, thus paralyzing the muscles that create wrinkles.
• Like Botox, the full effect of the product is seen after about one week and results should last about three months.
• More than 84,000 people use Xeomin worldwide, and the United States is the 20^th country to approve it for cosmetic use.

In medicine, and particularly in dermatology, it can be frustrating to see patients who fall victim to “old wives tales” or marketing myths when it comes to matters of health and appearance. Many of these patients are subsequently disappointed when they come to my office and I debunk these falsities. Case in point: cellulite.

First things first: a healthy weight, nutritious diet, and adequate hydration are great for everyone and benefit many conditions. However, the very nature of cellulite makes it highly resistant to most treatments. Why? Let’s take a look.

Cellulite is non-discriminatory. It affects all postpubertal ages, sizes, weights, and races. The tell-tale skin dimpling is caused by herniation (bulging out) of fat between fibrous connective tissue. Causes include hormonal, circulatory, genetic, inflammatory, and structural factors.

Desperate for a way around this annoying condition? You’re not alone. In fact, studies show cellulite appears in up to 80-90% of females, and even occurs in males. So now for the truth. First, while liposuction is great for fat deposits, it isn’t a solution for cellulite, and can even exacerbate the problem. Creams? Forget it. A cream cannot possibly alter herniating adipose tissue or fibrous bands. The idea itself is preposterous. And oral supplements? Not a single reputable study has ever proven them even remotely effective.

So now for what can work. Unfortunately, there are simply no long-term solutions. And like I so often tell my patients, if someone tells you they can offer you a long-term solution: run. They’re either lying or grossly misinformed. Fortunately, New York Cosmetic Laser Skin Surgery does offer an effective option: Velashape.

VelaShape combines radiofrequency waves, infrared light energy, plus vacuum and mechanical massage. You can learn more on the Velashape section of my website, but the key points are as follows:

• Several treatments are needed. Ideally, 3-6 sessions produces the best results.
• The procedure is simple and has zero downtime. It feels like a one-hour massage!
• Results are temporary and typically around 3 months.

That being said, the perfect time to get a head start on combating cellulite for the summer is now. If you’d like to schedule a VelaShape consultation, call our offices at 516-512-7616 or 212-285-1110.

May is skin cancer month, which means we will depart from our exciting new cosmetic introductions to discuss one of the most important topics in dermatology. Over 3.5 million skin cancers are diagnosed each year, and though other cancers may get more media attention, melanoma is the most common cancer in persons aged 25-29. Not only that, but while the incidence of the seven other highest skin cancers is decreasing, melanoma continues to rise.

I am very aware that people love the sun. I myself could lie on a beach for days on end. Whether you enjoy outdoor activities or like having tan skin, ignoring the dangers of sun exposure can be extremely harmful, and even deadly. Though basal cell and squamous cell carcinomas are rarely deadly, they can cause pain, bleeding, and disfigurement. Plus, ask any patients who have had to come to me for half a day of Moh’s micrographic skin cancer surgery, and they’ll probably tell you they would have preferred to spend the time doing something else (regardless of how pleasant we try to make the process!) Luckily, I specialize in Moh’s, and if you’re in need of BCC or SCC removal, it is the best way to remove the cancer with 99.9% accuracy and maximum healthy tissue preservation.

I think most people can agree that tanning beds are officially off limits to anyone prone to skin cancer. “But Dr. Rokhsar! I want to just get a base tan at a salon so I don’t burn on vacation!” Unfortunately, the truth is that a base tan offers protection of about SPF 4, and any change in skin color comes as a result of UV exposure. Furthermore, the International Agency for Research on Cancer, an affiliate of the World Health Organization classifies tanning beds as a Class I carcinogen. What else joins tanning beds in this category? Plutonium and cigarettes…to name a few.

Now for another myth: “I don’t need to worry about skin cancer, I have darker skin.” While it is true that African-Americans, Hispanics, and Asians have fewer incidents of melanoma than Cacuasians, they also have a greater tendency to present with advanced and often times fatal disease.

So, prevention. First things first: sunblock. I always recommend a high SPF and a product that includes zinc or titanium. Most importantly, however, the sunscreen needs to be reapplied every two hours, especially when sweating or swimming. Wide brimmed hats, sunglasses, and clothing are also helpful, especially in areas (or at times such as 10-4) when sun is at its peak.

If a skin cancer does develop, early recognition is key. Melanoma analysis is easy to remember: ABCD.

Basal and squamous cell cancers can be a bit more challenging, but by paying attention to your skin regularly, you’ll easily detect changes, even subtle ones. These skin cancers often appear from a wound that doesn’t seem to heal, or a patch of skin that oozes, crusts, scales, itches, or stays red. Be sure to pay special attention to areas of frequent sun exposure, like hands, face, ears, scalp, and back.

Stretch marks: the subject of untold studies, marketing, and complaints. Whether it is due to rapid muscle or weight gain, pulling on skin, pregnancy, or rapid puberty, these stubborn striae can be frustrating for anyone. Their appearance can vary from purple to bright white, and they usually occur in areas where fat is stored, such as breasts, thighs, buttocks, hips, and arms.

Unfortunately, desperate sufferers are easy prey for companies advertising creams, pills, and even devices to combat their undesirable appearance. Stretch marks, however, are caused by a tearing of the dermis. This means that very few so-called “treatments” can even access the area, let alone repair it.

It is often touted that keeping an area extremely moist during a time of anticipated stretch mark formation can reduce their severity and quantity. Though some studies have supported this notion, they are often poorly run and not statistically significant. More than hydration, hormones and genetics play a large role in stretch marks.

So…is there a solution? I’m happy to report there is: lasers. In fact, a 2007 trial showed a 75% improvement in striae in just 5-6 treatments. In my practice, I use the V-Beam Profecta redness laser to improve the color of red or purple stretch marks, and the Fraxel re:store to resurface the skin. The laser creates miniscule damage to the underlying skin, stimulating new collagen formation and improving the appearance and texture of stretch marks.

If you’re interested in discussing a stretch mark solution that fits your needs (just in time for summer), feel free to schedule a consultation with us by calling 212-285-1110 or 516-512-7616.

Spring is here…whether New York weather always agrees with us or not. And as the temperatures slowly start to rise, exciting changes here at Cosmetic Laser Skin Surgery are coming as well. As I spoke about in my last blog, Zeltiq is an incredible new non-invasive fat-removal technique…just in time for summer! But we have another new arrival as well: Ulthera.

One of the key ways to increase youthful radiance is to open up the eyes. Eyes that look larger and refreshed can take off many years. Using Ulthera, we can tighten droopy, excess eyelid skin and raise the brow. Ultherapy can also also be used for sagging skin beneath the chin. Pulling this area closer to the face can provide a longer-looking neck and a beautiful jawline. Accomplishing these transformations in an hour with no recovery…what more could you ask for?

While I offer surgical procedures for dramatic changes, I’m so passionate about non-surgical alternatives because they are quick, involve minimal downtime, and produce results that come from within. When your own body is responsible for the tightening, resculpturing, and tissue formation, the outcomes are always natural-looking. This eases the concern that many of my patients express for obtaining change without harsh, instantaneous “you’ve had something done” appearances.

Ulthera is another example of how rigorously tested and proven scientific concepts can be put to use in the aesthetic arena to great success. While I won’t get into the specifics here (I’ll leave that to the information page on my site), it’s important to note that ultrasound technology is incredibly safe…even more so with Ulthera’s “DeepSEE” technology which allows me to visualize target areas for precise treatment.

Summer is on its way and with it a chance for you to debut skin that enhances your natural beauty. If you are interested in Ultherapy, you can read more about it on our website, or call at 212-285-1110 or 516-512-7616.

When it comes to losing unwanted fat, it doesn’t get much easier than Zeltiq. Never before has there been a method for non-invasive, safe, quick adipose removal, which is why I am so excited to offer it to the patients in my practice.

I haven’t met many people who don’t have at least one “problem area”…that spot on the body they hate to pinch and just can’t seem to get rid of. Maybe it is a love handle, the upper or lower abdomen, the chest, the thighs, or even the oddly named “banana roll,” a fat deposit just under the buttocks. Regardless of the area, even fit patients in a healthy weight range can have places that make them uncomfortable. Some of my patients are highly athletic, but to lose the fat they would like to would result in a gaunt facial appearance. Regardless of the reasons, Zeltiq is perfect for minor sculpting and major satisfaction.

I myself have undergone the procedure and am convinced that it yields quantifiable results. It was an odd sensation at first, but I quickly relaxed and settled in for some rare but much-appreciated relaxation. Our Zeltiq suite is equipped with an iPod dock, radio, and large flat-screen TV offering NetFlix, On-Demand shows and movies, and hundreds of digital channels. It is often humorous to see just how much busy New Yorkers enjoy a mid-day nap or some television while undergoing treatment! Even for the most industrious of patients, the experience is a chance for some quiet, uninterrupted work or reading time. All these options while losing up to 20% circumference? That is the ultimate in multi-tasking!

I’m so excited about Zeltiq that I am currently offering complimentary consultations to anyone interested. While it isn’t a substitute for liposuction, it is an innovative alternative that uses the fascinating concept of cripolipolysis. If you’d like to learn more about the specifics, check out my page at http://www.cosmeticlaserskinsurgery.com/Zeltiq.html or schedule a consultation with me by calling 212-285-1110.

Testing……