Dr. Janice Liao welcomes you to the Dermatology and Hair Transplant Clinic where she offers the following non insured cosmetic services:


Microdermabrasion
Botulinum Toxin
Injectable Fillers
Leg and Face Veins
Treatment for Pigment Discolouration
Fractional Laser
Skincare

We offer regular medical dermatological services and for those services the patients must be referred.
Non-insured services are cosmetic procedures and the consultations do not require any referral.
All consultations are by appointment only.




What is Microdermabrasion?

Microdermabrasion is a mini-procedure used to rejuvenate the skin, lessen the signs of scarring, and the effects of Acne. The procedure is a state-of-the-art precision, non-invasive, exfoliation and skin rejuvenation system of the epidermis layer of the skin. Our microdermabrasion skin care equipmemt uses a hand piece to gently vacuum crystals onto the surface of the skin and resurface the superficial layers of the skin. As the crystals contact the skin, they remove old, dead, and flaking skin cells and exfoliates and polishes the skin beneath. Microdermabrasion helps to rejuvenate skin by removing the dull, lifeless and sun-damaged epidermis. It also helps to stimulate the production of new skin cells and collagen and helps to maintain the elastin, resulting in a firmer, smoother, more youthful looking skin over time.

Is it Painful?

Microdermabrasion causes minimal discomfort unless it is done for scars or striae. Local anaesthetic may be used. e.g. Maxilene applied at least 30 minutes prior to the procedure.

What Type of Skin Problems can be Improved with Microdermabrasion?

1. Blotchy pigment changes caused by sun damage and aging. Microdermabrasion can be used on most areas.
2. Pigmentary (melasma) changes as a result of pregnancy or hormones. The patient must also use   bleaching creams and sun blocks after treatment.
3. Facial wrinkles are caused by time and sunlight. Microdermabrasion may be used for the neck too. It works great for the texture, but not for the sagging or lax skin.
4. Oily and acne prone skin conditions.
5. Striae or stretch marks but only when the lesions are new. Also, although it makes an improvement, it does not remove the striae.
6. Superficial tattoo, e.g., eyebrows that have been tattooed on and the colour have become unacceptable.
7. Scars like Chicken Pox and acne can be removed.
8. Aging spots on the face, hands, or other areas of the body.
9. Blackheads, enlarged pores, and roughly textured skin.

    How Many Treatments are Necessary?
    Microdermabrasion is a gradual process and requires multiple treatments. Superficial conditions may require 4 to 6 treatments. Deeper problems will require more treatments. There is no limit to the number of treatments that can be performed if necessary. It is important that a one-week recovery time be allowed for healing between microdermabrasion sessions.

    What are the Possible Side-Effects of Microdermabrasion?
    Minimal temporary redness or flushing may be present after Microdermabrasion. Your face will look polished with some glowing areas. If treatment is for scars, striae, or dark pigment, the areas may have some pinpoint crusting and scabbing. To minimize downtime, we have to use multiple peels to get rid of the unwanted deeper problems. These areas should be cleansed and an antibiotic cream applied. Make-up may be used to cover this area. Healing is fast because the wounding is very superficial. Sunblocks must be used.

    Can Microdermabrasion be Used on All Skin Types?
    Yes, this is the great advantage of microdermabrasion, as olive skin or pigmented skin when injured by chemical peels or lasers, shows pigmentary changes. However, microdermabrasion is very gentle and involves removing the superficial layers of skin. Very few pigment cells are affected. Chemical peels may have varying penetration. Lasers produce heat and cryotherapy produces thermal drainage that affects the pigment cells.

    What Areas of the Body may be Treated?
    The face is the area most commonly treated. Areas exposed to the sun such as hands, forearms, and neck are the areas most commonly treated. Scars on the back may also be treated..
    How Do I Prepare for Microdermabrasion?
    To be treated, the skin must be clean, dry and free of make-up. The skin should also be free of rashes, sunburn or irritations. Any underlying diseases, allergies and problems, should be treated before microdermabrasion treatments.

    How Often Should Microdermabrasion be Performed?
    2 to 6 weeks intervals are the most common schedule.
    Depending on the skin conditions, the intervals may be modified.

    How Long Does it Take to Perform Microdermabrasion?
    The procedure takes approximately 30-45 minutes. Microdermabrasion is a gradual process and requires multiple treatments. Superficial conditions may require 4 to 6 treatments. Deeper problems will require more treatments. There is no limit to the number of treatments that can be performed if necessary. It is important that a one-week recovery time be allowed between healing and microdermabrasion sessions.

    How Do I get Started?
    Consultations are required before microdermabrasions are performed. You should schedule a series of treatments with one-week recovery time between each treatment. Deeper treatments require two weeks. Microdermabrasion appointments require that we schedule time, equipment, and personnel to perform the procedure. There is a $25.00 charge for the consultation visit, which will be deducted from the total cost if future microdermabrasion sessions are booked. There is a $50.00 charge for missed appointments, or appointments not cancelled with 48 hours notice. If there is an emergency or illness, please have a doctor's note. If you are late, we may have to reschedule.

    Costs
    The cost of microdermabrasion is $150.00 + G.S.T. for each treatment.
    The recommended number of treatments is 5, and the total cost will be $750.00 + G.S.T. for 5 treatments.
    When total cost is paid in advance there is 1 free treatment for a total of 6. This may be paid by Visa, American Express, cash, or certified cheque.

    Patient Consent is Required.
    A patient consent form must be completed before proceeding. The consent form is available at our office.

    MICRODERMABRASION POST-OPERATIVE INSTRUCTIONS

    • The skin should feel smooth and glowing.
    • If skin is stinging slightly, you may rinse with cold water.
    • Swelling is very rare and may be treated with ice bags.
    • Sunblock must be used all the time. It is preferable to use an inert sunblock and not a chemical sunblock. Titanium Dioxide and Zinc Oxide are inert ingredients and can be found in Neutrogena SPF 30 for sensitive skin, Marcelle SPF 25 for sensitive skin, Clinique SPF 25 Super City Block and Vichy SPF 60.
    • If there are any areas of pinpoint bleeding, please apply antibiotic ointment e.g., Bactroban, Fusidin, or Polysporin many times daily to keep the area moist.
    • Make-up may be used.
    • Start using vitamin A acid cream or alpha hydroxyl acid cream three days post-peel.
    • NEVER pick at scabs, loose skin, or crusts on your skin. Let the scabs fall off when ready. Otherwise, the picked or injured areas will scar.
    • If there is pain, swelling or an increase in heat in any one area suddenly, contact our office immediately. This is very rare, even if wide areas of the skin are treated.
    • If you are on anti-viral therapy, please continue until the course is finished





    Botox is botulism –A exotoxin used in a very dilute versions to produce paralysis in muscles that cause wrinkles. Furrows at the forehead, between the eyebrows, and crows feet are due to muscle action at those areas. Inactivate the muscles the furrows will disappear.

    An injection of botox imitates patients who have had strokes and who are noted to have no deep wrinkles on the affected side. The effects of botulism A exotoxin may last 3-4 months. The muscle recovers and you may notice the grooves again. That is the time when you may need more. As the muscle weakens with repeated botulinum A toxin, less dosage is required to inactivate the muscle. After therapeutic use, this affected muscle begins to weaken in 2-14 days. The patient should stay upright for 4 hours post-operatively.

    Do not massage the area. Do not use ice or heat. You may apply make-up. Please keep moving the muscles that were injected by squinting or lifting the eyebrows. This helps the muscle to absorb the toxin.

    Botox was approved by the US Food and Drug Administration and the Canada Health Protection Branch in 1989 for muscle paralysis in correction of eye disorders. This substance was later used for frown lines.

    Botox comes in vials containing 100 units. It is shipped and stored frozen. It is reconstituted with sterile saline. The amount of fluid used to dilute the dry Botox depends on the doctor using it. The amount of Botox required to paralyze a muscle is dependent on the units of Botox and not the volume. Some doctors prefer a higher dilution for larger muscles, and a lower dilution for smaller muscles, but in the end it is the units that are used that matters.


    SIDE EFFECTS
    • Pain of the needle
    • May have local swelling or bruising
    • Transient headache
    • Mild Nausea
    • May have mild eyelid swelling and numbness
    • The most significant complication is ptosis. This is droopy upper eyelids. This is temporary and might last 2-4 weeks. This is due to weakening of the muscles that elevate the upper eyelids so you may have a heavier feeling eyelid.

    Botox is not used much for the lower half of the face at present, as drooping of the cheek muscles, especially asymmetry, is much harder to control.

    OTHER USES FOR BOTOX
    Hyperhidrosis –Excessive sweating may be treated with BOTOX. Sweating is controlled by the autonomic nervous system and Botox blocks the neuro-transmission. Botox may be injected into the palms or axilla for excessive sweating.
    Some Insurance Plans that cover prescription medications, may cover the Botox and a prescription will be given for patients to purchase it and Dr. Liao will inject the Botox.
    The side effects are pain, weakness of muscles, especially in the palms, e.g., poor grip and bruising.

    Patient Consent is Required.
    A patient consent form must be completed before proceeding. The consent form is available at our office.



    LUX G
    For: Benign Pigmented Lesions, Facial Vascular Lesions, Improving Skin Texture and Tone

    The Lux G uses intense pulsed light energy to treat pigmented and vascular lesions and improve your skins texture and tone, promoting skin rejuvenation. Examples of pigmented lesions are liver spots and melasma. Examples of vascular lesions are rosacea and spider veins.

    After your initial preparation we move a hand piece over the treatment area, which emits the light. Most people feel a gentle snapping sensation, which causes little or no discomfort.

    Pre-treatment Instructions
    Only people with skin types I-IV can use the Lux G.
    Avoid tanning, including self-tanning lotions or sun exposure, for 4-6 weeks prior to treatment. A sun block with minimum SPF of 25 containing titanium dioxide e.g. Neutrogena SPF 30 for sensitive skin, Marcella SPF 25 for sensitive skin or Clinique SPF 25 Super City Block should be used on any area of sun-exposed skin, which you plan to treat.
    People who have a history of cold sores in the area to be treated need to receive a prescription prior to treatment.

    Post-treatment Instructions
    Benign Pigmented Lesions

    Pigmented lesions usually darken slightly after treatment and then fade away after about 2 weeks
    Most people experience a mild sunburn-like sensation shortly after treatment, which usually lasts 2-24 hours. In some cases prolonged redness and blistering may occur.

    The lesion may initially look raised and darker and may have a reddened perimeter. You may apply cool compresses to the treatment area for 5-10 minutes every hour for the next 4 hours if needed to reduce discomfort and heat sensation.

    The treated area can be gently cleansed and an antibiotic ointment (e.g. Bactroban) may be applied if needed. Apply a thin coat of antibiotic ointment to any areas of crusting 2-3 time a day if needed.

    The lesion will gradually turn darker over the next 24-48 hours and may progress to scabs/crusting and will start to flake off in 2-3 days. Do not pick, scratch, or remove scabs, loose skin or flakes. This will help prevent unwanted side effects (scarring).

    The lesion is usually healed in 7-10 days. It will continue to fade over the next 2-4 weeks.
    Bathe or shower as usual. Treated areas may be temperature sensitive. Avoid use of scented lotions or soaps, exfoliant creams or loofa sponges in treated areas during the healing phase. Until redness has completely resolved avoid all of the following:


    * Applying cosmetics on or near treated area
    * Swimming
    * Hot tubs and Jacuzzis
    * Activities that cause excessive perspiration


    Always avoid sun exposure to treated areas. Apply a sunblock with SPF 25 or greater daily to sun-exposed treated areas between treatments and for 4-6 weeks after last treatment.

    Facial Vascular Lesions
    Vessels generally undergo blanching and surrounding area may redden. The vessels then gradually fade in about 10-14 days.

    Most people experience a mild sunburn like sensation shortly after treatment, which usually lasts 2-24 hours. In some cases prolonged redness and blistering may occur. You may apply cool compresses to the treatment area for 5-10 minutes every hour for the next 4 hours if needed to reduce discomfort and heat sensation.

    The treated area can be gently cleansed with a mild soap (e.g. Dove or Cetaphil) and an antibiotic ointment (e.g. Bactroban) may be applied if needed. Apply a thin coat of antibiotic ointment 2-3 times a day if there are raw areas.

    The vessels generally undergo immediate blanching and may turn brown. The vessels then gradually fade/resolve after about 10-14 days. The area becomes normal looking as the vessels fade/diminish. Do not pick, scratch or remove scabs, loose skin or flakes that develop. This will prevent unwanted side effects (scarring).

    Bathe or shower as usual. Treated areas may be temperature sensitive. Avoid use of scented lotions or soaps, exfoliant creams or loofa sponges in treated areas during the healing phase. Until redness has completely resolved avoid all of the following:


    * Applying cosmetics on or near treated area
    * Swimming
    * Hot tubs and Jacuzzis
    * Activities that cause excessive perspiration


    Always avoid sun exposure to treated area. Apply a sunblock with SPF 25 or greater daily to sun-exposed treated areas between treatments and for 4-6 weeks after last treatment (e.g. Neutrogena SPF 30 for sensitive skin).

    Improve Skin Texture and Tone
    The Lux G is a specialized handpiece that produces intense light therefore it can be heat up the collagen under the skin to promote new formation. The green spectrum is also absorbed by brown and red pigment.

    Most people experience a mild sun-burn like sensation shortly after treatment, which usually lasts 2-24 hours. In some cases prolonged redness and blistering may occur. You may apply cool compresses to the treated area for 5-10 minutes every hour for the next 4 hours if needed to reduce discomfort and heat sensation. The treated area can be gently cleansed and an antibiotic ointment (e.g. Bactroban) may be applied if needed. Apply a thin coat of antibiotic ointment 2-3 times daily if needed (e.g. blistering).

    Bathe or shower as usual. Treated areas may be temperature sensitive. Avoid use of scented lotions or soaps, exfoliant creams or loofa sponges in treated areas during the healing phase. Until redness has completely resolved avoid all of the following:


    * Applying cosmetics on or near treated area
    * Swimming
    * Hot tubs and Jacuzzis
    * Activities that cause excessive perspiration


    Always avoid sun exposure to treated area. Apply a sunblock with SPF 25 or greater daily to sun-exposed treated areas between treatments and for 4-6 weeks after last treatment (e.g. Neutrogena SPF 30 for sensitive skin).

    Complications/Unwanted side effects
    Blisters may occur. These are generally intra-epidermal and will usually heal without scarring. Call the office for follow-up appointments. If they occur, cleanse gently and apply antibiotic ointment until they have completely healed.

    Pigmentary changes: Hyperpigmentation or Hypopigmentation may occur. It may not be visible for 2-4 days after treatment. Most color changes will resolve within 3-12 months.

    Prolonged redness and swelling: May occur following treatment and usually resolves in a couple of days.

    3-Step Rejuvenation
    Rejuvenation is a combination of 3 steps. Sometimes called the 'New York Rejuvenation 3 Step' and consists of:
    1. Micordermabrasion
    2. Non-ablative laser
    3. Medication for skin to stimulate collagen or combinations to remove discoloration

    1. Microdermabrasion
    This is a very popular procedure whereby crystals are blown and blasted to the skin so that some of the epidermis (top layer) is removed. This is great for mild discoloration like liver spots (Lentigo) and roughness due to sundamage. It smoothes the skin and gives it a great glow so it looks more youthful. Removal of the dead cells and rough areas will enable better absorption of the cosmeticeuticals, i.e. substances that can enhance the skins appearance and may repair sundamage, e.g., retinioc acid.

    2. Creams or Topicals

    Creams with retinoic acid, kinerase, Alfa-hydroxy acids, beta hydroxy acids, L-ascorbic acids, Vitamin E & K, Lipoic acids and soy lecithin are all promoted. Some work on the epidermis to make the skin smooth with no loss of pigmentation. Some may promote collagen formation at the dermal level to reduce wrinkling. Microdermabrasion may reduce the skin barrier to these medications, so that the penetration is much more. Selection of the ingredients depends on what the patient’s skin condition requires. Dr. Liao and Dr. Rao will match what is required.

    3. Non-ablative Laser treatment

    This is aimed at the dermal (deeper skin) layer where collagen resides. The targeted sites are the wrinkled areas. We have noted with chemical peels, laser ablation, etc. That after wounding the skin tightens because of the new collagen formation. However, the down time take anywhere between 3-15 days.

    It has been noted that intensive light therapy for facial veins removes wrinkles, large pores, and smoothes the skin. Some lasers have been developed to warm up the water on the dermal layers so as to activate new collagen formation. There is no down time for this situation. At most, some redness for a few hours. The new collagen formation is a slow process and it takes many treatments to achieve a noticeable result.

    Combination of the three above techniques is supposed to enhance the rejuvenation process and the recommendation is microdermabraison followed 2 nights later by the topical therapy and then 2 weeks later by non-ablative laser, then 2 weeks later microdermabrasion again.

    Suggestion is 4 microdermabrasion with 3 non-ablative laser treatments. The worse looking skin or wrinkles will respond the most. Subtle differences are difficult to pick up but before and after pictures will be done and patients can compare and see the difference.

    The price for the microdermabrasion and the Lux G is $1780.00 for the face, $2780.00 for face and neck payable at the start of the procedure.


    What is the Palomar Lux 1540 Fractional Laser?

    Palomar has developed and patented Fractional Photothermolysis first, ahead of other companies, to create a revolutionary treatment: in non-ablative soft tissue coagulation and skin resurfacing with high efficiency. This system has two easy-change hand pieces for different treatment approaches. It has also proven to be the gold standard for the treatment of many skin conditions.

    Palomar Medilux 1540 Fractional Laser (left)
    IPL System Hand piece (right)

    How does the Fractional laser work?

    The Lux 1540 delivers light in an array of high precision microbeams that penetrate into the dermis, the deepest layer of your skin. The dermis is responsible for the production of collagen and elastin, which gives our skin its youthful look. Unfortunately, as we age, collagen and elastin breaks down. The result is usually a look we are not pleased with. The 1540 helps to rebuild and stimulate the production of collagen and elastin, giving your skin back that youthful look again since fine lines, wrinkles, and sagging skin virtually disappear. The Lux 1540 offers greater energy per microbeam, and greater depth of penetration (up to 1mm), than any competing device. This stimulates quick healing within the surrounding deep tissue for the most effective deep corrections.

    (At left: An example cross-section of treated area shows penetration of microbeams into deeper layers of skin.)

    The Fractional laser delivers its microbeams in one short pulse at a time, with active contact cooling. It’s built-in cooling minimizes discomfort and enables practical use of high energies. Topical anesthetic may be applied for those who are more sensitive to discomfort.


    What skin problems is the Fractional laser used to treat?

    • Fine lines and wrinkles
    • Sagging skin
    • Sun-induced pigmentation
    • Melasma
    • Acne scarring

    Our new FDA-approved HYPERLINK "http://www.youthfullook.com/Flaser.htm" Fractional Laser produces gently penetrating microbeams that encourage collagen repair under the skin. Sun-damaged, wrinkled skin is repaired from under the surface while the skin’s outer layer is resurfaced.

    What skin types will the Fractional laser treat?
    The Fractional laser will treat all skin types.

    How long are the treatments and how many will I require?
    Dependant on the area being treated, it can vary anywhere from 30 to 90 minutes per session. (i.e. full face takes about 90 minutes) In most cases 3 to 4 sessions may be required, spaced 2 to 3 weeks apart. Also, it may take up to 6 months for maximum results to be seen.

    Is there any downtime involved with these treatments?
    There may be some redness and swelling for a few days following treatment. The practice of medicine is not an exact science, and reaction may vary with each individual.

    How much will these treatments cost?
    Prices will vary, depending on the area to be treated. Packages are also available. Ask any one of our helpful staff. Set up an appointment for your free consultation today.

    ** PLEASE NOTE: Any patients, who are prone to or have had cold sores, must be on cold sore preventive therapy medication in order to have this laser treatment performed.


    Customized Skincare

    Due to the patient popularity, Dr. Liao is only offering the Anti-Aging Night cream by PRESCRIBEDsolutions®. This is available only from select physicians – it is not available online or in retail.

    Correction Fluid TM Anti-Aging Night Cream

    Purpose:
    To provide nourishment and repair to aging skin.

    This is a rich cream for mature skin that is challenged by environmental damage and the aging process. It is loaded with a powerful blend of vitamins, hydrators and anti-aging ingredients. This formula helps to reduce the colour of age spots, improve the skin’s tone and texture, reduce pore size, as well as accelerate the healing process of dry, dehydrated and under nourished skin.

    For Best Results:
    After evening cleansing, apply a thumbnail amount over face and neck. Avoid contact with the eyes.

    The Benefits:

    • removes dead skin cells
    • re-hydrates and rejuvenates the skin
    • protects against environmental and photo damage
    • promotes clearer, brighter skin


    Dr. Liao recommends practicing sun safety by using a physical sunblock daily.  Physical Sunblocks protect your skin from the sun by deflecting or blocking the sun's rays and contain Zinc oxide or Titanium oxide as their key ingredients.  Chemical Sunblocks work by absorbing the sun's rays and can be more irritating for sensitive skin. 

    Dr. Liao carries:

    La Roche-Posay SPF 60 Anthelios XL Sunblock – 100ml”

    La Roche-Posay SPF 60 Anthelios Ultra-fluid lotion for daily use on the face – 50ml

    **Skincare purchases may only be made by our patients.  Please call the office to check for product availability.**

     
     
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    Dermatology & Hair Transplant Centre 11516 Jasper Avenue Edmonton AB T5K 0M8
    Phone: (780) 482-1548 • Email: dr.j.liao@gmail.com