Face Services

The brow lift has overcome the stereotypes of the past and is now a safe and effective rejuvenation procedure. In years past, the term “brow-lift” summoned up visions of a long incision in the hairline from ear to ear, and a permanently startled look. Now, across-the-head incisions are performed only in the most extreme cases. Even in those situations, there is every effort to create a natural-looking result.

 

The advent of fiber-optics and micro-cameras has all but eliminated the long incision, replacing it with tiny, half-inch incisions totally hidden in the hairline. The brow can be accurately repositioned and secured with dissolving “fixers” (sutures), and an upper/mid-facelift can be included in the procedure, with no visible incisions.

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This is a simple, natural, and extremely effective lift that rejuvenates the brow and upper face, including the cheekbone area. It is very useful for younger patients whose upper face is sagging prematurely. Healing time is very short — about four to five days — and the operation usually takes about forty-five minutes. It is done on an outpatient basis, with twilight sedation and local anesthesia.

The brow lift includes weakening of the frown line muscles between the brows and eliminates the need for future Botox treatments.

 

COMBINED WITH EYELID CORRECTION 
The brow lift can be combined with upper-eyelid surgery, using the same incisions. This means there will be only two tiny incisions, hidden in the hair, and even more rapid healing.

 

POST-SURGERY 

All the sutures dissolve, and the hair can be washed and combed, three days after the surgery. Depending on your occupation, you can return to work in as few as five days.

Treatments That May Help
The following treatment links will take you to Ajune
for more information: 

Eyebrow Waxing and TweezingAnti-Aging Eye Zone TreatmentCollagen TreatmentMiracle Waves LEDProfect Laser TherapyLymphatic Drainage Treatment

For before and after images, please contact Dr. Romita at 212-772-3220.

Very few corrective aesthetic procedures impact the appearance of the entire face the way eyelid rejuvenation does. The eyelid skin may show early signs of aging by the late thirties, creating a tired appearance that will make the whole face look older.

 

When the appearance of bags in the lower lid becomes apparent, the overlying skin may not at first appear to wrinkle excessively. But if it is left untreated for several years, the skin will lose its elasticity. Few procedures can remove the tired, aged look from a young face the way corrective eye rejuvenation can.

 

Eyelid surgery is more effective than ever and, if addressed early enough, is not extensive. In fact, bags in the lower lids can be permanently corrected without a skin incision. With tight young skin, the lower lid shrinks and flattens, and the skin re-drapes naturally. Healing time is very short, about three to four days. If the skin has stretched, an inconspicuous incision under the eyelashes will be necessary, but the scar will fade in about four weeks, more extensive surgery becomes necessary as the condition of the skin deteriorates.

 

The upper eyelid operation also raises the brow and corrects frown lines. This can rejuvenate the face from the cheekbone to the hairline. If caught in time, correction of the upper and lower eyelids will impact one’s appearance almost as much as an entire face lift, but with a very short recovery time.

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PRE-SURGERY
A thorough history and exam must be done by the surgeon to address all conditions concerning visual acuity, tear production, and eyelid tone. Should any questions arise, a qualified ophthalmologist should perform a pre-operative exam to clear the patient for surgery. This exam should be routine for all patients, even without symptoms, if they are over fifty-five or have any family history of hyperthyroidism or glaucoma. Good tear production is a must for any extensive eyelid surgery to heal properly. If your eyes are always dry, you may not be able to enjoy the benefits of aesthetic eyelid surgery. When in doubt, consult your ophthalmologist.

 

POST-SURGERY
This is an outpatient procedure, done under local anesthesia with sedation. Most patients return home the same evening and can return to an active work and social life in less than a week.

 

AJUNE TREATMENTS FOR PRE- AND POST-OPERATIVE CARE
Before any eye enhancement surgery, a lymphatic drainage facial is highly recomended at least once, a few days before your surgery. This treatment prepares the skin and eye area by making tissues as healthy as possible, which improves recovery time. Included in this treatment is a deep cleansing facial for your face and neck. After your eye-enhancement procedure, lymphatic drainage (with or without a facial) can usually be resumed one to two weeks post-operativly. However, your doctor will determine the time and frequency of the treatment. Lymphatic drainage dramatically shortens the healing process by reducing swelling and inflamation, as well as supporting the immune system.

 

For keeping the eye area strong, lifted, and hydrated, we recommend an eye treatment that instantly relieves swelling and puffiness, and incorporates microlifting. Microlifting exercises the muscles around the eyes to stay strong, and tight. This treatment is most effective when done two or three times a month.

 

Photomodulation is one of the latest technologies to reduce the hallmarks of photoaging, such as fine lines and a blotchy complexion. GentleWaves LED takes less than a minute, and because it doesn’t use heat but Light Emitting Diodes, it’s painless, with no side effects. Several treatments are needed, eight in total, which can be done once or twice a week. This non-invasive treatment is a perfect post-operative complement to any facial surgery, to increase collagen production and reduce inflamation. It is appropriate for all skin types.

 

Treatments that may help: 
Anti-Aging Eye Zone TreatmentMiracle Waves LEDProfect Laser Therapy,Lymphatic Drainage Treatment

 

Products that may help:
Neocutis, Lumiere Eye Treatment

 

For before and after images please contact Dr. Romita at 212.772.3220.



WHAT IS BLEPHAROPLASTY?

The facelift procedure has undergone many significant improvements in the past two decades. Many of these have involved making the operation safer and more effective at creating a natural look, while reducing recovery time. These advances include improved material technology and far more sophisticated surgical techniques.

 

The advantages to the patient are many, as these procedures can now be done in an outpatient setting, with a one-night stay in a hotel or similar facility. The incisions are shorter, leaving less bruising and swelling. The risks, such as visible scars, nerve weakness, and post-operative bleeding, have been all but eliminated.

 

Probably the most significant outcome of these improvements is that the face can be rejuvenated earlier, with a longer-lasting, natural result. Patients can return to a comfortable lifestyle in about ten days, although it will take several months longer for the final result to appear.

 

Patients no longer have to tolerate a sagging neck or jowls. The results of early intervention are far more believable than when aging becomes more pronounced. One can look younger earlier and longer — safely and more simply than ever before.

 

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PRE-SURGERY
The patient must be in good health and a non- or minimal smoker. In less extreme cases, however, the current short-scar facelifts can be performed safely in smokers who are otherwise in good health. Patients who are hypertensive, or who have a prolonged clotting time, must be treated by their primary care physician and regulate these conditions by medication. Obvious medical problems, such as heart, lung, or kidney disease, also preclude any aesthetic surgery procedure.

 

Obese patients must lose weight before undergoing surgery and inflammatory or infectious skin conditions must be brought under control to ensure good healing.

 

POST-SURGERY
One can expect ten days to two weeks of recovery before life returns to normal. Daily activities and athletics may be resumed after a month or six weeks.

 

AJUNE TREATMENTS FOR PRE- AND POST-OPERATIVE CARE
Before any facial enhancement surgery, a lymphatic drainage facial is highly recommended, several days before surgery. This pre-operative treatment prepares the skin by making tissues optimally healthy, which improves recovery time. Also recommended is a deep cleansing facial for your face and neck. After your facelift, lymphatic drainage (with or without a facial) can usually be done as soon as one to two weeks post-operatively. Your doctor will determine the exact time and frequency of the treatment. Lymphatic drainage will dramatically shorten the healing process by reducing swelling and inflamation, as well as strengthening the immune system.

 

 

An excellent way to support the skin a few weeks after surgery is a hydrating facial. This treatment will combat the dryness, chafing and dehydration common after surgery. The facial gently exfoliates and bathes your skin in essential serums and creams containing ceramides. Lipids and hydrating nectars are applied to maintain moisture and increase cell cohesion. Then two masks of nutrient-rich sea algaes and soft clay aid in clearing and smoothing the skin. Texture, tone, and clarity are all enhanced, resulting in luminous skin.

 

 

Another effective post-operative treatment is Photomodulation, one of the latest technologies to stimulate collagen and reduce the hallmarks of photoaging, such as fine lines and a blotchy complexion. GentleWaves LED, which takes less than a minute, is painless because it doesn’t use heat. Instead it uses Light Emitting Diodes and has no side-effects. Several treatments are needed, up to eight in total, done once or twice a week.

 

 

Treatments That May Help
The following treatment links will take you to Ajune
for more information: 

Pre-facelift: Alpha Beta Extreme Clean, 
Post-facelift: Collagen Treatment
Other: Miracle Waves LEDUltimate Ajune GlowTotal Bio-EnergizerVitalize PeelGlycolic PeelsMicrodermabrasionDermasterProfect Laser Therapy,Anti-Aging Eye TreatmentLymphatic Drainage Facial

 

 

Products That May Help: 
Neocutis Biocreme and Neocutis Hyalis

 

 

For before and after images please contact Dr. Romita at 212.772.3220.

As we age, our faces begin to show the effects of gravity, sun exposure, and years of movement, including smiling and squinting. Injectable fillers can help fill in lines and creases, temporarily restoring a smoother, more youthful-looking appearance. In 2003, 2.8 million people underwent Botox injections. This popular denervating agent prevents certain muscles in the face from contracting, thereby impeding the ability to make expressions that generate wrinkles. In addition to Botox, fillers such as Hylaform, Restylane, and even your own fat are viable options.

 

When injected beneath the skin, fillers can plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as alaser treatment, or a recontouring procedure, such as a facelift.

 

Can you combine injectables? 
Combining Botox with Restylane is very popular in the frown-line area between the eyes. Data tends to support its use when the lines are well established over a long period of time and the skin remains indented, even when the muscles aren’t moving. These lines are called static wrinkles and are ideal for fillers such as Restylane. This combination in the right patient can last up to seven months, as opposed to three or four for Botox alone. If, as is usually the case in younger patients, frown lines appear only when the muscles are active (dynamic wrinkles), then Botox alone is sufficient.

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Course of treatment and pricing should be determined by you and your plastic surgeon or dermatologist. Here are some injectable options to discuss with your doctor:

 

 

Injectable option:
Helps to:
Results:
Sculptra
Polyulactic Acid
Stimulates new collagen growth; fills out sunken areas of the face up to two years
Restylane,
Hylaform

Hyaluronic Acid
Add volume to forehead wrinkles, smile lines, and lips four months to one year
Botox
Botullmun Toxin
Temporarily relaxes the muscle including forehead, frown lines,
crow's feet, and vertical neck lines
up to six months
Juvéderm
HD Filler
Adds volume to Nasolabial folds,
frown lines, crow's feet, and lips
up to one year
Fat Injections
Fat Injections
Adds fat to Nasolabial folds,
crow's feet, lips, frown lines, and
facial recontouring
highly variable, months to years
Evolence
Human-Based
Collagen
Adds volume to the Nasolabial folds up to one year
Radiesse
Calcium Hydroxy
FIlls out sunken areas of the face and hands permanent with multiple treatments

 

 

AJUNE TREATMENTS FOR PRE- AND POST-OPERATIVE CARE
Whether you are relaxing with Botox or plumping with a filler, these injectables will have a longer-lasting effect when combined with Collagen Stimulating Therapy. Our most popular treatment is Photomodulation, one of the latest technologies to stimulate collagen and reduce the hallmarks of photoaging, such as fine lines and a blotchy complexion.

 

We offer Gentle Waves LED, which takes less than a minute, and because it doesn’t use heat (but rather Light Emitting Diodes), it’s painless with no side effects. Several treatments are needed, eight in total, which can be done once or twice a week. This non-invasive treatment is a perfect complement to any injectable, so you can go longer in between treatments.

 

Treatments That May Help
The following treatment links will take you to Ajune
for more information: 

Profect LaserLED

 

Products That May Help: 
Comfort Zone Instant Tensor, TNS Recovery Complex, Neocutis Restorative Cream

 

 

For before and after images please contact Dr. Romita at 212.772.3220.

Hyperpigmentation is a darkening of the skin compared to its normal color. The origin of color change is highly varied. The causes can range from the benign e.g. a freckle – a reaction to medication (e.g. minocycline) to a systemic disease such as Addison’s, to a potentially life threatening condition like Melanoma. In general, hyperpigmentation of unknown origin should be evaluated by a dermatologist before any treatment is undertaken.

 

Cosmetic cases of hyperpigmentation, such as a dark mark left by a pimple, brown patches occurring during pregnancy, oral contraceptive use, or liver/age spots from sun exposure, can be improved by a variety of treatments. These include topical bleaching agents, chemical peels and laser/light treatments.

 

 

Where to begin depends on the specific condition, its extent and/or severity, and the desired level of aggressiveness.

 

 

In general, application of a topical medicine (e.g., cream/lotion) is a simple way to start. Some products require a prescription and others are over-the-counter. For patients whose condition does not adequately respond to topicals alone, a combination of peels, microdermabrasion, and laser/intense pulsed light may be used. In most cases of hyperpigmentation, the sun is a causative or exacerbating factor, and thus strict sun protection is an absolute must.

 

 

 

For before and after images please contact Dr. Romita at 212.772.3220.

 

Lasers — intense, narrow beams of light — have many uses in the care and treatment of skin, from repairing sun damage to reducing wrinkles to increasing collagen.

 

Fractional Laser
Fractional carbon dioxide laser skin resurfacing and tightening , the best return on investment in skin care.

 

The early versions of the carbon dioxide laser gave incredible results but the healing times were long, there was prolonged after care and the skin could suffer the effects of permanent lightening change.

 

The skin got restored and the wrinkles were gone however, the big kick was the amount of tightening the skin underwent through shrinkage almost like a mini face lift without the surgery.

 

Get the benefits of the resultant skin tightening with minimal healing, less discomfort, only local cream anesthesia, and no loss of natural color, and still get rid of wrinkles and brown spots.

 

Technology has now allowed us to keep the positives and eliminate the negatives, of carbon dioxide lasering. There is no other skin care system that compares when sun and elements have taken their toll. When milder peels no longer have effect it’s time to inquire about fractional laser therapy.

 

The answer lies in being able to fractionate or disperse the laser energy, so the deep layers of the skin can be stimulated to tighten and generate new young collagen while keeping intact a significant portion of the outer skin layer so healing is accomplished quickly from the skin surface.

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The small vaporized dots peel off in 4 days and make up can be applied, the majority of the redness is gone in one week. People can resume normal activity in 7 days, while the deep skin layers continue to produce new collagen for three to four months!

 

This laser can be used effectively on delicate neck skin and chest skin as well as hands, it removes wrinkles, brown spots and gives back a youth full skin texture with new collagen.

 

The Fractional laser know as the Active FX Encore is the most flexible safest and most comfortable way to a new younger face. It has many of the benefits of a face lift without the surgery and risks. It’s effective at a wide spectrum of age groups from late 30′s to 80′s whenever the sun has damaged skin excessively.

 

Call the office and see if you are a candidate. There is no recovery so the patient can leave the office without assistance 20 minutes after the procedure.

 


Carbon Dioxide (CO2) Laser
The carbon dioxide (CO2) laser has been the premier skin resurfacing tool for the past decade. Its primary advantage over peeling and other laser techniques is that it tightens the skin naturally, while stimulating much collagen production. The results approximate that of a mini-facelift, without incisions.

 

The rejuvenating effects of the CO2 laser are aesthetically pleasing and will last for many years. In the hands of a skilled practitioner, the technique is very safe. The procedure is done under a local anesthetic, with sedation by an anesthesiologist, and takes less than an hour to complete. New methods of post-laser care have significantly shortened the period of redness following a CO2 laser treatment. With make-up, it is possible to return to work in about a week.

 

For correcting mild wrinkles, the patient has several options and should carefully consider the risks and benefits of each. But when the wrinkling is more advanced and the skin begins to lose elasticity, then the CO2 laser, with its longer healing time, is a far better choice. Rejuvenation of the skin surface is dramatic and new collagen is abundant.

 

PRE-SURGERY
The patient must have a proper cleansing routine appropriate for their skin. All steroid use must stop. Retin-A use should stop two weeks before treatment, and Accutane use should stop six months before treatment. The patient should avoid exposure to the sun. CO2 laser treatment is best done without a suntan.

 

POST-SURGERY
The patient must take meticulous care of dressings. Redness may persist for longer periods, but can be camouflaged with proper makeup. The patient should stay out of the sun for five to seven days after treatment.

 


Profect Laser
Fast and painless, the Profect laser is the first selective non-ablative laser approved by the FDA for wrinkle reduction and acne treatment. “Non-ablative” means that unlike most lasers, the Profect triggers a healing response in the skin without damaging the superficial layer. In addition to wrinkles and acne, the Profect laser targets fine lines, rosacea, facial capillaries, and acne scarring. When combined with microdermabrasion and Levulonic acid, the Profect laser is highly effective at correcting even the most bothersome skin conditions. The best results are achieved with a series of three treatments–three at minimum.

 

PRE-TREATMENT
Depending on the condition of the skin, most people are advised to prep the skin with either a tretinoin or alpha hydroxy solution. It is important to avoid sun exposure before a Profect laser treatment.

 

POST-TREATMENT
The Profect laser makes the skin photosensitive, so it is of utmost importance to avoid direct exposure to sunlight for at least seventy-two hours post-treatment. Side effects, although rare, may include dryness, redness, and hypersensitivity to topical products that are normally well tolerated. Any side effect generally lasts no more than two to five days and can be relieved with topical cortisone cream.

 

Combination Therapy
After surgical skin resurfacing, the new complexion can be maintained with glycolic peels and Dermaster treatments, done as needed. Topical application of Neocutis and TNS Recovery Complex will aid in the skin’s healing and prolong the effects of the laser treatments.

 

Photomodulation is one of the latest non-invasive technologies using pulsed light to reduce the hallmarks of photoaging, including fine lines and blotchy complexion, and promote collagen growth. Because GentleWaves LED doesn’t use heat but rather non-laser Light Emiting Diodes, it is painless with no side effects. Each treatment takes less than a minute. For maximum effect, eight treatments, done once or twice a week, are required. LED is a perfect complement to any facial surgery and works for all skin types.

 


Treatments That May Help
The following treatment links will take you to Ajune
for more information:
 
Post-Treatment – Collagen Treatment 
Other: Miracle Waves LEDUltimate Ajune GlowVitalize PeelGlycolic Peels,MicrodermabrasionDermasterProfect Laser Therapy

 

Products That May Help: 
TNS Recovery Complex, Skinceuticals Physical Defense, Neocutis

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 

Some of us are lucky enough to be born with full, alluring lips. Others may have to camouflage a deficiency in that area. Everyone’s lips atrophy (shrink) with age, leaving fine lines – often called “smokers’ lines” – that have a habit of attracting lipstick in a most unappealing manner – even in non-smokers. There is no doubt that full lips are youthful and attractive, and can do more to increase one’s aesthetic appeal than most other enhancements. The question is, how can we plump up thin, or thinning, lips?

 

Fuller lips are a goal for many people, especially women approaching middle age, when loss of fat in the lips becomes more noticeable. And at any age, people whose lips are naturally thin may want a more sensuous mouth. Attempts to permanently enhance the upper and lower lip have met with varying degrees of success. Here are some of the methods currently in use:

 

Permanent Augmentation
Procedures that aspire to be permanent fall into three categories: injectables, implants, and surgery:

 

Injectables
The best permanent injectable is medical-grade silicone. It is safe, but must be injected by a true expert. Once it is in the lips, it is not easily removed. For best results, the augmentation will be built up slowly, with great care. Too much silicone makes the lips look fake and feel like rubber.

 

Implants
Implants are another route. Some, like Softform, are made of medical-grade Gore-Tex, a synthetic material also used in sutures. Implants require incisions to insert, causing swelling that may persist for some time. There can be a host of complications with implants, not the least of which is infection. Some side effects can permanently deform the lips. Implants made of human tissue are subject to the same problems as synthetic. Consider this route very carefully.

 

Surgical Augmentation
Surgical lip augmentation involves making an incision under the nose to lift the upper lip. Done expertly, the incision is inconspicuous and the results are pleasing, especially when the procedure is combined with a facelift. The downside is that if the scar does not heal well, it is almost impossible to hide.

 


 

Fat Injections
Fat injections are often touted as a permanent method of lip augmentation, but there is little evidence to support this claim. Even in expert hands, the results are highly variable. The problem is that fat often dissipates. This is an expensive method, with a long healing time. The good news is that if it succeeds, the effect is very natural. And if the fat dissipates, the lips are unharmed, unlike what happens with some other methods.

 


 

Temporary Fillers
Most of the attention now is on temporary fillers, which offer a safe, effective means of lip enhancement. The goal is to find fillers that are long lasting and, therefore, cost effective. Temporary lip augmentation must be repeated periodically, so if expense is an issue, be sure to do the math before choosing one of these treatments.

 

Juvéderm is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration under the skin to instantly restore your skin’s volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).

 

Restylane and Hylaform are varieties of hyaluronic acid, the same complex sugar found naturally in cartilage. The results look very natural and can last as long as seven to eight months, making these fillers very cost effective. There are few complications with hyaluronic acids, which are well tolerated by the body. In most hands, these are the best of the non-silicone lip enhancers.

 


 

Treatments That May Help
The following treatment links will take you to Ajune
for more information:
 
Collagen TreatmentMiracle Waves LEDProfect Laser Therapy,MicrodermabrasionDermaster

 

Products That May Help: SkinCeuticals Lip Repair, Comfort Zone Lip Treatment

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 

Nasal refinement has become the second most popular operation in plastic surgery after liposuction. The results are more natural than ever, thanks to vast improvements in surgical technique and advances in anesthesia over the past twenty years.

 

Nasal surgery is best postponed until after the teenage growth spurt is complete, at about age sixteen for boys and, for girls, two to three years after puberty. Until then, the nose may continue to grow, compromising the results of any correction. Any breathing problems should be discussed in the initial consultation with the surgeon, in order to determine whether work on the nasal septum or other internal structures should be performed at the same time as the refinement procedure.

 

Rhinoplasty can now be done in the doctor’s office, on an outpatient basis. New developments in anesthesia, including “twilight sedation,” mean that the patient will feel and hear nothing during the procedure and remember nothing of it later on.

 

PRE-SURGERY 
Before an aesthetic correction of the nose is contemplated, all breathing problems should be evaluated. Ideally, an ENT specialist will do a complete exam of the deep septum. The evaluation may include CAT scans of the nasal septum and nasal sinuses to assess chronic allergies, sinusitis, nosebleeds, and other conditions. If surgery will be covered by health insurance, these studies will be mandatory.

 

 

Computer imaging is a very useful tool in the initial consultation. The patient will be much better informed about what is possible, and much more realistic about her goals and expectations for the surgery. Always ask to see pictures of post-operative results.

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POST-SURGERY 
After the operation, the nose usually will be splinted with a plaster cast for five days and may be packed for several days, if internal work is done. Black eyes, a result of bruising, usually last about the same amount of time. The patient can return to an active lifestyle in about a week, but the nose must be protected from the sun for about eight weeks post-operatively. After that, full participation in athletic activities is permitted. Final results of the rhinoplasty should be evident in six months to a year.

 

Treatments That May Help
The following treatment links will take you to Ajune
for more information: 

Alpha Beta FacialLymphatic Drainage

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 

Your face does not stop at the jawbone. The neck lift is a regional operation, encompassing the area from the jowls – the flesh part below the jaw – to the collarbone. Most often a neck lift is done as part of a facelift procedure.

 

Skin in the neck usually begins to droop in the late thirties or early forties. There are, however, younger people with good upper- and mid-face tone who have sagging necks. The most common reason is excess fat in the upper neck (a “double chin”), which can be hereditary even in thin people. Weight loss, too, may result in excess flesh, or “turkey wattles,” hanging below the chin, or the emergence of muscle bands in the subcutaneous layer. (Muscle bands appear as cords extending vertically from the chin to the base of the neck, on either side of the midline). Each of these problems must be handled differently.

 

In a young patient with excess fat and good skin tone, liposuction — alone or combined with a small chin implant — can work miracles. The procedure is done under local anesthesia, healing is fast, and the results start showing within about a week. This surgery is often done at the same time as rhinoplasty (nasal refinement).

 

To correct loose, sagging skin, the surgeon makes a small incision behind the ear — and sometimes a short incision tucked into the chin crease — to remove the extra skin and tighten the lateral neck muscles. This creates a more defined jawline and eliminates the neck bands. Microcannula liposuction — suctioning the fat through microscopically fine tubes — can be used to remove excess neck fat and contour the jowl area. If the chin is weak, a small implant can be inserted through the same short incision under the chin that is used for the lift.

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The results of cervicoplasty can be dramatic. This is an outpatient procedure, with sedation, that takes a little over an hour to perform. Usually one can resume normal activities a week or sooner after surgery. A chin support is generally used during the recovery period.

 

For a lunch hour fix, the neck bands can be softened temporarily with Botox injections to relax the muscles. This is a three-to-four-month fix that will safely buy time before more permanent work is considered.

 

PRE-SURGERY 
If the patient is overweight, some weight loss may be recommended before a neck lift. A lymphatic drainage facial done a few days before the surgery will make the skin as healthy as possible and reduce recovery time.

 

POST-SURGERY 
The patient may need a neck support for five or six days. Lymphatic drainage, with or without a facial, can usually be done one to two weeks post-operatively. (Your doctor will determine the timing and frequency of the treatment.) Lymphatic drainage can dramatically shorten the healing process by reducing swelling and inflammation, and supporting the immune system.

 

AJUNE TREATMENTS FOR PRE- AND POST-OPERATIVE CARE 
Before any neck enhancement surgery, our lymphatic drainage facial is highly recomended at least once a few days before your surgery. This pre-operative treatment prepares the skin by making tissues as healthy as possible before the surgery, which improves recovery time. Also included is a deep cleasning facial for your face and neck. After your neck enhancement procedure, lymphatic drainage (with or without a facial) can usually be done as soon as one to two weeks post-operative, however, your doctor will determine the time and frequency of the treatment. Lymphatic drainage will dramatically shorten the healing process by reducing swelling and inflamation, as well as supporting the immune system.

 

Treatments That May Help
The following treatment links will take you to Ajune
for more information:
 
Miracle Waves LEDCollagen Treatment

 

Products That May Help:
Neocutis Biocreme, and Nia 24 SPF 30

 

For more information, please contact Dr. Romita at 212-772-3220.

 

Exfoliation
Exfoliation removes or sheds the thin layers of the skin. Exfoliation occurs naturally as new skin cells are produced and old cells fall off. This can be enhanced by many methods, including chemical peels, microdermabrasion, and topical creams. Increasing exfoliation tends to decrease the thickness of the dead skin layer and induce faster production of new cells. The result of this can be: improved skin brightness, texture, tone, and firmess, as well as decreased wrinkling and dyspigmentation. Some skin conditions such as acnerosacea, and freckling can be improved by regular exfoliation.

 

The amount or method of exfoliation depends on an individual’s skin type and the specific problem being addressed. Consultation with a plastic surgeon is a good way to develop a program of rejuvenation that includes regular exfoliation.

 


 

Peels
Medical chemical peels offer some of the fastest methods in the quest for a flawless face. A true “lunch hour” procedure, peels can be done quickly with little to no after-effects. Thus, glowing with the look of younger and healthier skin. Chemical peels provide the strongest exfoliating options, but any treatment plan should start with your doctor evaluating your skin’s needs.

 

How can peels help?
Chemical peels can help aid in the treatment of acne, soften wrinkles, smooth out fine lines, reduce the appearance of scars, and bring out a rosy glow. Peels can be administered to the face, neck, décolletage, and even hands.

 

There are a variety of peels and processes that can quickly bring your beauty to the surface.

 


 

Glycolic Peel
The most common of the chemical peels used in aesthetics is glycolic acid, an alpha hydroxy acid derived from sugar cane. Glycolic acid is effective at “ungluing” the cells of the stratum corneum, the top layer of the epidermis.Superficial chemical peels like glycolics have a proven track record for improving skin conditions such as acne, hyperpigmentation, fine lines, and wrinkles.

 

PRE-TREATMENT
The client should refrain from facial hair removal for one week prior to a glycolic peel and preferably pretreat the skin with Tretinoin, to facilitate absorbtion of the glycolic acid when it is applied.

 

POST-TREATMENT
Clients should apply an SPF of at least 15 containing both UVA- and UVB-blocking ingredients, while avoiding direct exposure to sunlight one week post-peel. Side effects of glycolic peels include erythema (redness of the skin), flaking, and a hypersensitivity to aggressive skin care products: these products should be avoided several days post-peeling. Greater absorption levels post-peel make it a good time to infuse the skin with peptides, human growth factors, and anti-oxidants.

 

COMBINATION THERAPY
Glycolic peels can be done in combination with LEDs, hydrating facials, and collagen masks.

 


 

Vitalize Peel


Using a combination of lactic, salicylic and retinoic acids the vitalize peel is an ideal combination chemical peel used for treating acne, hyperpigmentation, scarring, and sun damage. One of the advantages to this type of peel is that dramatic results are seen after each treatment. Clients can expect to see a lightening of superficial hyperpigmentation and a reduction of inflammatory acne lesions, blackheads, and clogged pores.

 

PRE-TREATMENT
Avoidance of facial hair removal is advised, at least one week before peel.

 

POST-TREATMENT
Because of possible shedding of the skin post-peel, clients are advised to avoid facial waxing and direct exposure to sunlight.

 


 

Photodynamic Therapy
Photodynamic therapy (PDT) is a special treatment performed with a topical photo sensitizer called Levulan, or aminolevulinic acid (ALA), followed by the application of intense pulsed light (IPL). ALA is a natural substance found throughout the body that is a precursor for hemoglobin synthesis. When localized in the target tissue, ALA is converted to produce oxygen intermediates that destroy target tissue cells.

 

Simply stated, ALA-PDT removes sun-damaged pre-cancerous skin cells while improving fine lines and blotchy pigment. This treatment also has the unique ability to minimize pores and reduce oil glands, effectively treating stubborn acne vulgaris and acne rosacea while improving the appearance of some acne scars.PDT photo-rejuvenation is also known as Power PhotoFacial or Super PhotoFacial because the results are similar to those of three to five PhotoFacial/IPL treatments.

 

How much improvement can I expect?
Patients with severely sun-damaged skin manifested by actinic keratosis and texture and tone changes, that include mottled pigmentation and skin laxity may see excellent results with PDT. You may also see improvement of large pores and pitted acne scars. Active acne can be dramatically reduced.

 

How many treatments are necessary?
Achieving maximum improvement is greatly dependent on the protocol you and the doctor select. With a more aggressive protocol, just one or two treatments are usually required. If you select a less aggressive protocol, it may require two to five treatments. Treatments are spaced two to five weeks apart. Additional treatments may be done at periodic intervals in the future to maintain the rejuvenated appearance of the skin.

 

It is important to avoid sun exposure for the first two days following PDT and to avoid prolonged sun exposure thereafter. You should not use a tanning booth at any time before or during PDT treatments. Doing so will greatly increase your risk of a negative side effect.

 


 

Treatments That May Help
The following treatment links will take you to Ajune
for more information:
 
Ultimate Ajune GlowTotal Bio-EnergizerVitalize PeelGlycolic PeelAlpha Beta Facial, Melasma Peel, Jessners Peel

 

Products That May Help: 
Neocutis, Nia24 SPF 30, Nia24 Physical Cleansing Scrub

 

 

For more information, please contact Dr. Romita at 212-772-3220

 

What Is Rosacea? 
Rosacea is a chronic (long-term) disease that affects the skin and sometimes the eyes. The disorder is characterized by redness, pimples, and, in advanced stages, thickened skin. Rosacea usually affects the face; other parts of the upper body are only rarely involved.

 

Rosacea to some degree is very prevalent especially in fair skinned individuals, and its intensity can vary with flair ups accompanied by pimples and cysts. Not all dermatologists agree in the exact reason why some people are affected more significantly than others but all sufferers agree that the condition when triggered can be very difficult to hide and uncomfortable.

 

The good news is there is a successful protocol which addresses both prevention and treatment from mild to severe.

 

What can you do to treat the outbreaks when they occur? There is a general consensus of opinion that Intense Pulsed Light treatments IPL are very effective and safe for relieving the redness and destroying the bacteria carrying skin parasites which cause the inflammatory response. The IPL is combined with topical cleansers, sustained release antibiotics and occasionally retinoids. This is a very effective means of bringing back normal skin color and tone.

 

There is a cost effective way to treat Roseacea with minimal discomfort or lifestyle compromise.

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 

The Types of Scars
There are many types of scars, including keloidal, hypertrophic, and atrophic. Keloidal scars are tumor-like formations that overgrow the site of original injury. These may occur in anyone, but are found more frequently in darker-skinned individuals. Hypertrophic scars are thickened scars that remain within the boundaries of the original injury. Atrophic scars form a depression at the site of injury.

 

All of these scars may differ in their color, cosmetic, and functional considerations as well as treatment.

Lasers, excisional surgery, dermabrasion, chemical peels, steroid injections, filling materials, and topical medicines all have a place in scar management. The best results come from a careful evaluation of the scars by a physician with experience in all modalities of scar treatment.

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 

Research shows that there are two types of aging, one caused by the genes we inherit and one caused by environmental factors such as exposure to the sun. We know that without protection from the sun’s rays, just a few minutes of exposure each day over the years can cause noticeable changes to the skin. Freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles that disappear when stretched, loose skin, a blotchy complexion, actinic keratoses (thick, wart-like, rough, reddish patches of skin), and skin cancer can all be traced to sun exposure.

 

What Are Sun Spots?
One consequence of exposure to UVR (ultraviolet radiation) is the development of solar lentigines. These are round, flat, brown spots that occur mostly on sun-exposed skin (e.g., face, tops of hands, and upper chest). They are commonly known as “sun spots,” “age spots,” or “liver spots.” They can occur in children and become more prevalent in adults, especially fair-skinned individuals.

 

Although not dangerous (any new or changing spot should be evaluated by a dermatologist), they often contribute to an aged look, and their removal gives a much more youthful appearance to the skin.

 

There are many ways to remove lentigines, but the most effective are laser orIPL (Intense Pulsed Light) treatments. IPL has the added benefit of treating broken blood vessels and fine lines at the same time. This usually involves one to three treatment sessions to a given area over the course of six to eight weeks. There may be mild discomfort associated with this treatment and side effects including mild redness, swelling, temporary darkening of the spots, and scabbing. Most people find they can return to work or social situations with minimal to no downtime.

 

Prevention of new spots and reoccurrence of treated ones involves minimizing UVR exposure and judicious use of sunscreen with a sun-protection factor of (SPF) of 30. Topical preparations are usually beneficial in maintaining the skin improved by laser/IPL.

 

Photoprotection
Two types of ultraviolet radiation from the sun reach the earth’s surface: UVB and UVA. UVB produces redness more easily, while UVA produces tanning more easily. Both are associated with long-term damage and aging to the skin, as well as skin cancer. Significant UVA exposure occurs even in the shade.

 

Clothing is photoprotective but varies widely depending on the fabric, thickness, and color, among other things. In general, tightly woven and thicker fabrics are better protection. For example, wool and polyester provide more protection than cotton, linen, and rayon. Darker colored and looser fitting clothes also usually offer more protection.

 

Hats are important, but they need to have a wide brim. Some narrow-brimmed hats, such as baseball caps, provide only slight protection for the nose and little to no protection for the chin and neck.

 

UV radiation damages ocular tissue and can cause cataracts and eye cancer over the long term. It is important to wear sunglasses that absorb 99 percent to 100 percent of both UVB and UVA. Just because they are expensive or polarizing does not guarantee adequate UVA protection.

 

Normal, clear window glass blocks UVB but not UVA. Tinted glass can block a significant portion of UVA; in most cars, the windshield provides more protection than the side windows.

 

Broad-spectrum (protection from UVB and UVA) sunscreen with an SPF of 30 or greater is an important means of reducing photoaging and skin cancer. Even then, the efficacy may be severely diminished by inadequate application and infrequent reapplication. As a general guideline, apply suncreen 15 to 20 minutes before initial sun exposure, then every two to three hours and after swimming and heavy sweating.

 

Sunless tanning creams and sprays only provide an SPF of 2.

 

The same warnings about UV exposure apply to children, but the job of providing and emphasizing protection often falls on adults. One survey of 25,000 schoolchildren showed that only 20 percent used regular sun protection. Children six months and older should use sunscreens regularly as part of an overall sun protection regimen. Children under six months should be protected from sun exposure through clothing, shade, and sunscreen application only to exposed skin.

 

Fractional Laser
Fractional carbon dioxide laser skin resurfacing and tightening , the best return on investment in skin care.

 

The early versions of the carbon dioxide laser gave incredible results but the healing times were long, there was prolonged after care and the skin could suffer the effects of permanent lightening change.

 

The skin got restored and the wrinkles were gone however, the big kick was the amount of tightening the skin underwent through shrinkage almost like a mini face lift without the surgery.

 

Get the benefits of the resultant skin tightening with minimal healing, less discomfort, only local cream anesthesia, and no loss of natural color, and still get rid of wrinkles and brown spots.

 

Technology has now allowed us to keep the positives and eliminate the negatives, of carbon dioxide lasering. There is no other skin care system that compares when sun and elements have taken their toll. When milder peels no longer have effect it’s time to inquire about fractional laser therapy.

 

The answer lies in being able to fractionate or disperse the laser energy, so the deep layers of the skin can be stimulated to tighten and generate new young collagen while keeping intact a significant portion of the outer skin layer so healing is accomplished quickly from the skin surface.

 

The small vaporized dots peel off in 4 days and make up can be applied, the majority of the redness is gone in one week. People can resume normal activity in 7 days, while the deep skin layers continue to produce new collagen for three to four months!

 

This laser can be used effectively on delicate neck skin and chest skin as well as hands, it removes wrinkles, brown spots and gives back a youth full skin texture with new collagen.

 

The Fractional laser know as the Active FX Encore is the most flexible safest and most comfortable way to a new younger face. It has many of the benefits of a face lift without the surgery and risks. It’s effective at a wide spectrum of age groups from late 30′s to 80′s whenever the sun has damaged skin excessively.

 

Call the office and see if you are a candidate. There is no recovery so the patient can leave the office without assistance 20 minutes after the procedure.

 

Treatments that May Help
The following treatment links will take you to Ajune
for more information: 

Post-treatment: Collagen Treatment
Miracle Waves LEDUltimate Ajune GlowTotal Bio-EnergizerVitalize Peel,Glycolic PeelMicrodermabrasionProfect Laser TherapyProfect Laser,Lymphatic Drainage FacialAnti Aging Eye TreatemntMen’s Grooming Facial,Hydrating TreatmentSkin Ceuticals Vitamin C TreatmentAjune Body Facial,Shea Butter Body EmulsionAirbrush TanningMicrodermabrasion for Hands and Feet

 

Products that May Help: 
Prevage, TNS Recovery Complex, Neocutis, Skinceuticals Vit C

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 
SILHOUETTE INSTALIFT


While multiple different treatments are available to address wrinkles, age spots and skin volume loss, there has been no minimally invasive way to lift the deeper layers of facial skin (one of the major contributors to an aged and tired appearance)…until now. When visiting Dr Mauro C Romita, patients now have the option to undergo a new procedure called Silhouette InstaLift. Nonsurgical and virtually painless, Silhouette InstaLift received FDA-clearance in April 2015. It is a simple in-office procedure to re-contour your face by lifting the deeper layers of your skin for a more youthful appearance. Washington Institute of Dermatologic Laser Surgery is the only practice in the Washington, DC area to offer this exciting new minimally-invasive technique to lift sagging facial skin.

What is Silhouette InstaLift?

Silhouette InstaLift is a simple procedure to re-contour your face, lifting the deeper layers of your skin for a more youthful appearance.

How Silhouette InstaLift works?

During a short in-office procedure, our board-certified cosmetic dermatologists will insert the patented

Silhouette InstaLift sutures to lift the deeper layers of the skin in your mid-face or cheek area. During the

procedure, sutures with bidirectional cones will reposition and elevate the skin on the face.

Silhouette InstaLift™ sutures are made in the U.S. from poly-L- lactic/glycolide acid (PLGA), a commonly

used biomedical co-polymer that is well tolerated by the body. The fully absorbable sutures lift and

reposition subdermal tissue while the bi-directional cones hold the sutures and facial skin in an elevated

position. Over time, the implanted PLGA sutures and cones also stimulate collagen production to help

increase and restore volume to the mid-face for natural-looking, long lasting results.

Who is a good candidate for Silhouette InstaLift?

Silhouette InstaLift is the ideal minimally-invasive solution for many men and women who are interested in refreshing their appearance without major surgery. It offers a new and unique technology to lift sagging facial skin and can be used in conjunction with lasers and injectables to provide further cosmetic enhancement.

What does Silhouette InstaLift treat?

Sagging skin is one of the major contributors to an aged and tired appearance. Silhouette InstaLift treats sagging skin by lifting the deeper layers of your skin for a more youthful appearance. The procedure lifts and helps increase volume and restore contours to the mid-face, cheeks, jawline and neck.

How long does Silhouette InstaLift last?

Silhouette InstaLift provides noticeable clinical enhancement for 18-24 months. The unique Silhouette InstaLift sutures are naturally absorbed by your body over time while stimulating the production of collagen.

What to expect during Silhouette InstaLift Treatment?

The treatment does not require general anesthesia and typically takes less than an hour. During the in-office procedure, our specially-trained physicians will begin by marking the areas of desired lift on the patient. A thin needle is inserted into the skin and the suture with cones is guided through the subcutaneous tissue with extraction at two exit points. The sutures have bidirectional absorbable cones that hold them in place.

 How is Silhouette InstaLift different from Thread Lifts?

Silhouette InstaLift is an entirely new technology and procedure. Rather than temporarily moving the surface of the skin with hooks and barbs, InstaLift™ repositions the underlying layers of the skin with patented bi-directional cones. Another important advance is that InstaLift sutures are fully absorbable and are not permanent. As the InstaLift™ sutures and cones are resorbed, they stimulate collagen renewal which helps increase and restore volume to the mid-face for natural-looking, long lasting results.

How soon will I see results of Silhouette InstaLift?

You will see immediate lifting after the procedure and gradual improvement of skin volume and contour over several months.

What is recovery like for Silhouette InstaLift?

Recovery time is minimal. Typically, a long weekend (2-3 days) is all that is necessary. Makeup can be applied within 2 days of the procedure as needed.

True “lunch hour” wrinkle correction must meet specific criteria. It must be effective, either permanently or for a truly significant period of time. Treatment takes less than one hour. Finally, it must be entirely non-invasive. There must be no pain, redness, swelling, or post-treatment care, so the patient can immediately return to his or her daily routine.

 

Wrinkles can form where the skin is exposed to excessive solar radiation and in areas where excessive use of the facial muscles causes the skin to pleat, such as between and around the eyes, and at the corners of the mouth. Fine wrinkles due to sun damage are usually evenly distributed. The deeper lines occurring in specific areas are normally due to muscle activity. The effect of this wrinkling is a prematurely aged appearance. When treated promptly, many of these problems can be effectively corrected in a non-surgical, yet long lasting way. An effective treatment program must address each of these problems.

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Fractional Laser
Fractional carbon dioxide laser skin resurfacing and tightening , the best return on investment in skin care.

 

The early versions of the carbon dioxide laser gave incredible results but the healing times were long, there was prolonged after care and the skin could suffer the effects of permanent lightening change.

 

The skin got restored and the wrinkles were gone however, the big kick was the amount of tightening the skin underwent through shrinkage almost like a mini face lift without the surgery.

 

Get the benefits of the resultant skin tightening with minimal healing, less discomfort, only local cream anesthesia, and no loss of natural color, and still get rid of wrinkles and brown spots.

 

Technology has now allowed us to keep the positives and eliminate the negatives, of carbon dioxide lasering. There is no other skin care system that compares when sun and elements have taken their toll. When milder peels no longer have effect it’s time to inquire about fractional laser therapy.

 

The answer lies in being able to fractionate or disperse the laser energy, so the deep layers of the skin can be stimulated to tighten and generate new young collagen while keeping intact a significant portion of the outer skin layer so healing is accomplished quickly from the skin surface.

 

The small vaporized dots peel off in 4 days and make up can be applied, the majority of the redness is gone in one week. People can resume normal activity in 7 days, while the deep skin layers continue to produce new collagen for three to four months!

 

This laser can be used effectively on delicate neck skin and chest skin as well as hands, it removes wrinkles, brown spots and gives back a youth full skin texture with new collagen.

 

The Fractional laser know as the Active FX Encore is the most flexible safest and most comfortable way to a new younger face. It has many of the benefits of a face lift without the surgery and risks. It’s effective at a wide spectrum of age groups from late 30′s to 80′s whenever the sun has damaged skin excessively.

 

Call the office and see if you are a candidate. There is no recovery so the patient can leave the office without assistance 20 minutes after the procedure.

 


Retin-A
The majority of patients find that preparing the skin with Retin-A is extremely helpful in allowing the skin to repair itself from below the surface. It encourages the production of healthy, young collagen for pristine skin. A”lunch hour” program of wrinkle reduction can then address each of the skin surface problems without side effects. The first step is air-brushing away fine lines and sun-spots using powdered salt in a series of microdermabrasion treatments. These are painless and effective, and require no after-care so you can return to your normal routine right away. Six treatments spaced about two weeks apart will dramatically eradicate sun damage.

 


Botox
Injections of Botox promote the reduction of pleating frown lines. Botox relaxes hyperactive muscles, eliminating the contractions that are a leading cause of deep wrinkles between and around the eyes, and raising drooping brows.

 

These treatments, used in conjunction with a consistent routine of skin care and nutrition, can dramatically reduce the effects of sun and aging without surgery or healing time.

 


Treatments That May Help
The following treatment links will take you to Ajune
for more information: 

Profect LaserPDT, Jessners Peel

 

Products That May Help
Neocutis Biocreme, Neocutis Hyalis, Nia24 SPF 30

 

 

For more information, please contact Dr. Romita at 212-772-3220.

 

Non-Surgical Facial Tightening