Been "Thermaged" Lately? Thermage and Thermage PLUS in Orange County, CA

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Tweaking the Thermage delivery techniques has already proven to offer substantial improvements. Adding customized "PLUS" treatments creates an effective program for de-aging. Patients get a personalized recipe for both short term and permanent effects.

If you were to hear the first line Thermage patients tell the story, the treatment was akin to torture. The “old” Thermage came with some incredibly intense moments. Patients and doctors took matters into their own hands, fashioning a new way to use the system with lots less pain and lots more results. The “new” Thermage is a keeper.

Total Dermatology medical director Nissan Pilest in Irvine, Ca., uses the new protocol and says his Thermage machine is much busier these days. “I used to tell my patients that they were going to have to suffer to gain results. To be honest, it was initially not a wildly popular procedure. Who wanted to feel like they’d been in a boxing ring for an hour? And I wasn’t going to lie and say it was a no-pain treatment…because it DID hurt! Not anymore…though. It’s a relief for me, and my patients can enjoy the benefits of tighter skin without having to suffer.”

Thermage has a reputation of “lag time” results. Why do you have to wait to see the changes?

“Thermage does have some instant “preview” results, that while minimal, give the patient a starting point,” says Dr. Pilest.” Since the collagen remodeling (the term for collagen building and tightening) that occurs with Thermage takes place over a period of about 6 months, the firming and contouring increase gradually instead of all at once. One day you look in the mirror and say ‘Hey…I’m looking pretty good!’ That’s when you appreciate what Thermage can do. It’s subtle. It’s not a facelift, so someone with heavy wrinkles and super-sagging skin can’t expect a miracle. I don’t say it’s a non-surgical face lift, because it’s not. Unfortunately, some of the media hype offers promises that medical science can’t deliver. I’m very straightforward with my patients. They may choose to forego a procedure once I explain the limitations, but I’d rather that happen than have an unhappy patient who expected something that I knew wasn’t possible.”

Dr. Pilest combines treatments in what he calls Thermage PLUS, a synergistic combination of Thermage and individually selected procedures that affect the upper layers of the skin or the underlying muscles. Botox is used to smooth the forehead wrinkles, giving the new collagen that forms after Thermage an unwrinkled canvas to build upon. Restylane, Hylaform, Cosmoderm and Captique give instant fill-up to wrinkles that disperses over the same time frame of the new Thermage-induced collagen production. It’s a “no wait to see” system. “The total effect is not possible with one single treatment so implementing these extras makes a huge difference, and the effect is immediate,” Dr. Pilest says. “ The newest PLUS treatment, and the one that is especially exciting because of the permanent effects, is Fraxel. Thermage deep-tightens. That’s the core anti-aging procedure. Fraxel comes after and resurfaces the top layers to smooth the skin of fine wrinkles, brown spots, and roughness in a gentle way. Fraxel is a phenomenal laser and is becoming a top-requested treatment in our office, with or without Thermage.

“With the combined effects of the new lasers and fillers and Thermage and Botox, staying out of the operating room is a lot easier and certainly far less painful. Dermatology has dramatically changed the methods of improving skin, both on a surface and deep structural level."

Dr Pilest cautions patients: "Don't take your Mercedes to the bike shop!

"Using these new techniques and lasers requires a special knowledge of the skin that only Dermatologists have. Almost any kind of doctor can buy a laser machine, but not just any doctor understands the mechanics of skin function and response. Every patient's skin is different and if you don't know exactly what you're doing, and why, the end result can be pretty daunting. Improper use of a laser can cause permanent disfigurement. Don't take your Mercedes to the bike repair matter how great they are at repairing bicycles.

"Many plastic surgeons and ob-gyns and even dentists are starting to offer technically complicated skin treatments as a “side service” and frankly, that concerns me. Dermatologists know skin and they know it best. I don't offer facelifts because I’m not a plastic surgeon. By the same token, I’d rather have my dentist work on my teeth and leave my skin alone. I certainly wouldn’t attempt to do either of their jobs because there’s no way I can do them as well...just as there is no way they can do mine as well as I do. That’s just the way it is. The American Medical Association designates specialties and requires different training and continuing education for each one. Mine is Dermatology - period.”

Dr. Pilest has been practicing corrective and cosmetic dermatology for over 26 years. He is board-certified, an associate professor at the University of California Irvine Department of Dermatology and is the recipient of the coveted Orange County Best Physicians selection. His practice, Total Dermatology, is noted as one of Southern California’s most comprehensive laser centers. Contact phone is 949 727 3800. Website is Dr Pilest believes patient education is vital and offers a free monthly emailed newsletter and public education seminars.

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Nissan Pilest
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