Coral Gables Dermatology & Aesthetics

Skin Care Clinic

BOTOX® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. In addition to its cosmetic applications, it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back and jaw pain, and migraines.Applications for BOTOX CosmeticAlthough originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, BOTOX Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of BOTOX Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines. BOTOX Cosmetic is used to treat the following:Forehead furrowsFrown linesCrow's feetSkin bands on the neckAccording to Allergan, BOTOX Cosmetic has been "extensively researched, with approximately 2500 studies."BOTOX Cosmetic Procedure and ResultsUsing a very fine needle, BOTOX Cosmetic is injected directly into facial muscles that are causing furrows and lines. Receiving the injections requires no anesthetic, but some doctors choose to numb the area to be injected with ice packs or a topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to four months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals.Side Effects of BOTOX CosmeticInjection-site side effects of BOTOX Cosmetic are usually mild and temporary, and include the following:PainInfectionInflammationTendernessSwellingRednessBleedingBruisingNormal activities may be resumed immediately after receiving injections.Additional ResourcesMedlinePlusNational Institutes of HealthCenters for Disease Control and PreventionEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentU.S. Department of Health & Human ServicesU.S. National Library of MedicineWebMD

Body Contouring - CoolSculptingCoolSculpting® treatment is a breakthrough, non-invasive procedure that uses patented cooling technology to eliminate fat without surgery. This clinically proven technique is designed to selectively reduce the fat in problem areas that has proven resistant to reduction through diet and exercise. CoolSculpting gently cools targeted cells in the body to induce a natural, controlled elimination of these unwanted fat cells.Based on the scientific principle that fat cells are more sensitive to cold than the overlying skin and surrounding tissues, CoolSculpting reduces the temperature of fat cells in the treated area. This is intended to promote fat cell elimination through a natural biological process known as apoptosis, without causing scar tissue or damage to the skin, nerves or surrounding tissues.The CoolSculpting ProcedureWhen treatment begins, the doctor will position the CoolSculpting device on the area and it will draw the bulge up between two cooling panels. The sensation is a firm pull and pressure-enough of a pull to ensure the selected tissue will be cooled efficiently. During the first few minutes of the cooling, you will feel pressure and intense cold. This soon dissipates and patients experience no pain. Many people read, work on a laptop or take a nap during their treatment. Treatment is usually complete in about one hour.Results of CoolSculpting TreatmentPatients generally start to see results as soon as three weeks following treatment, with the most dramatic results occurring over a period of two to four months. The body will still flush out fat cells and continues doing so for up to six months after treatment.CoolSculpting is not intended as a weight-reduction program for obese individuals. The best candidates for the CoolSculpting procedure are people near their ideal body weight who eat well and exercise regularly yet have pockets of fat that are unresponsive. It is appropriate for those who are seeking spot reduction for specific areas of fat but are not interested in a surgical procedure.Recovery of CoolSculpting TreatmentThe procedure is completely non-surgical, so most people can resume their regular activities immediately. Patients frequently return to work after the session is finished.

Prescription Dysport® injectable is a U.S. Food and Drug Administration-approved treatment for temporarily lessening or eliminating moderate-to-severe frown lines between the eyebrows. Like BOTOX® Cosmetic, Dysport injectable is placed directly into the muscle underneath a furrow, weakening the muscle to the point where it cannot contract.Dysport, also known as Reloxin, is made from a neurotoxin produced by the bacterium Clostridium botulinum; it is the same neurotoxin used in BOTOX Cosmetic.Applications for Dysport InjectableMedically, Dysport injectable is used to treat excessive underarm sweating; symptoms of cervical dystonia, which include neck pain and abnormal head position; and muscle spasms. Cosmetically, Dysport injections are used to treat the following:Forehead furrowsFrown linesCrow's feetSkin bands on the neckDysport Injectable Procedure and ResultsUsing a very fine needle, Dysport injectable is placed directly into facial muscles that are causing furrows and lines. No anesthetic is required, but some doctors choose to numb the area to be injected with ice packs or a topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to 4 months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals.Candidates for Dysport InjectableAccording to the manufacturer's website, candidates for Dysport injectable are "adults less than 65 years of age" who want "temporary improvement in the look of moderate-to-severe frown lines between the eyebrows (glabellar lines)." It may not be suitable for those with the following:Allergies to Dysport injectable or its ingredientsAn allergy to cow's milk proteinSurgical facial changesVery weak muscles in the treatment areaA face that looks very different on each sideInflammation or infection in the area to be injectedDroopy eyelids or sagging eyelid foldsDeep facial scarsThick, oily skinWrinkles that cannot be smoothed when spread apartAnyone who is pregnant or breastfeeding, or has a neuromuscular disease, should not receive Dysport injectable.Differences Between Dysport Injectable and BOTOX CosmeticAlthough made from the same bacterium, there is anecdotal evidence that Dysport injectable may last longer, spread farther and take effect more quickly than BOTOX Cosmetic.Side Effects of Dysport InjectableSide effects of Dysport injectable are usually mild and temporary, and normal activities may be resumed immediately after receiving injections. Injection-site side effects include the following:PainInfectionInflammationTendernessSwellingRednessBleedingBruisingEyelids can droop when Dysport injections are made in the glabellar region; they usually return to normal within 3 weeks. Side effects of Dysport injectable are the same as those of BOTOX Cosmetic.

VOLUMAComing SoonRADIESSE® Volumizing FillerRADIESSE® volumizing filler is a synthetic injectable filler that has been U.S. Food and Drug Administration (FDA)-approved for reducing moderate-to-severe wrinkles, folds and creases around the nose and mouth by augmenting the skin's natural collagen supply. It is a safe, effective and long-lasting alternative to injectable collagen and other dermal fillers for smoothing wrinkles and adding facial volume and contour.RADIESSE filler is composed of microspheres in a water-based gel; the microspheres are made of a substance called calcium hydroxylapatite, which stimulates the production of collagen. When injected into lines and wrinkles, the additional collagen that is produced smooths out the lines and wrinkles, and adds volume to the skin.RADIESSE Volumizing Filler ApplicationsRADIESSE volumizing filler can be used on various areas of the face and body. In addition to correcting scars that leave depressions, it is effective in improving the look of the following:Nasolabial folds (run from corners of nose to corners of mouth)Marionette lines (run downward from corners of mouth)Downturned corners of the mouthJowl pre-saggingChin wrinklesRADIESSE filler has also been approved by the FDA to restore and correct the signs of lipoatrophy (loss of fat beneath the skin) in patients with the human immunodeficiency virus (HIV).RADIESSE Volumizing Filler ProcedureBefore a patient is given RADIESSE filler, the treatment area is cleaned. RADIESSE injections are then made with a fine needle, and typically take only 15 minutes to perform. There is little-to-no downtime; many patients return to their normal activities right away. RADIESSE volumizing filler is also FDA-approved for mixing with the anesthetic lidocaine, which makes the injections less painful. Typically, only 1 or 2 treatments are needed to achieve the full benefits of RADIESSE volumizing filler.RADIESSE Volumizing Filler ResultsResults are visible immediately after injection, and sometimes last up to a year. Because results are temporary, treatments must be repeated to sustain them. Touch-up treatments may prolong the effects of RADIESSE filler.RADIESSE Volumizing Filler Side EffectsSide effects of RADIESSE filler are usually not serious, and go away on their own. They occur at the injection site, and include the following:Mild irritationSwellingItchingRednessBruisingTendernessAllergy testing is not necessary before treatment because the calcium hydroxylapatite microspheres in RADIESSE filler are similar to minerals that occur naturally in the body.JUVÉDERM® XC Injectable GelJUVÉDERM® XC injectable gel is a U.S. Food and Drug Administration-approved dermal filler that, according to its manufacturer, Allergan, Inc., is designed to "temporarily treat moderate to severe facial wrinkles and folds such as nasolabial folds" in people older than 21. Unlike the original JUVÉDERM injectable gel, JUVÉDERM XC is infused with lidocaine to make its injection more comfortable.JUVÉDERM XC is a smooth-consistency gel that restores volume to the skin, and smooths away moderate-to-severe facial wrinkles and folds. It is made of hyaluronic acid (HA), a sugar that occurs naturally in the body. In terms of the skin, HA's role is to deliver nutrients and hydration, and act as a cushioning agent. Young, healthy skin contains a lot of HA, but factors that include aging and sun exposure reduce the amount, causing skin to lose structure and volume. JUVÉDERM XC is most effective in improving the appearance of nasolabial folds, the lines that run from the bottom of the nose to the corner of the mouth on both sides of the face.JUVÉDERM XC Injectable Gel ProcedureJUVÉDERM XC injections take about 15 minutes to administer in a doctor's office. A fine needle is used for the injection, which is given under the skin in the targeted area to add volume or fill in wrinkles and folds. Because JUVÉDERM XC contains lidocaine to improve comfort, an anesthetic may not be needed. However, a doctor may still elect to use a topical anesthetic on the area to be treated before giving the injection. Afterword, the doctor may gently massage the treated area(s).Once treatment is completed, patients can return, with virtually no downtime, to their regular activities. For the first 24 hours after treatment, to reduce the risk of complications, patients should avoid strenuous exercise, excessive sun or heat exposure, and alcohol consumption.

Intense-Pulsed-Light (IPL) skin rejuvenation uses high-energy pulses of light to improve the skin's appearance. Also referred to as IPL photorejuvenation, photofacial therapy and pulsed-light therapy, IPL skin rejuvenation is a nonabrasive and noninvasive treatment option for removing red and brown pigment from the skin. IPL is used to treat age spots, birthmarks, freckles caused by the sun, symptoms of rosacea, spider veins, and scarring from acne; it is also an effective tool for hair removal. IPL penetrates below the surface of the skin, leaving the top layer of skin intact, which means that there is no post-treatment recovery period. The light is absorbed by the pigment in sunspots and the blood in the visible vessels, and converted to heat. The heat dissolves the cells that create the pigment and shrinks the vessels.The Intense-Pulsed-Light Skin Rejuvenation ProcedurePrior to IPL treatment, a topical anesthetic gel is applied to the skin to reduce discomfort. The IPL machine is placed on the settings that best suit the patient's skin; among the factors considered are the condition being treated and, because IPL is absorbed differently by different skin colors, the amount of pigment in the skin. Protective coverings are placed over the patient's eyes, and the IPL handpiece is gently pressed to the skin as pulses of light are emitted. The light is absorbed by the skin's red or brown pigment and converted to heat, which dissolves the pigmented cells. After treatment, the topical anesthetic is removed with a warm cloth, and a moisturizer with sunscreen is usually applied. If there is any swelling, a cold pack is applied for 5 to 10 minutes.Three to six treatment sessions are usually required; sessions typically last from 30 to 90 minutes each, and are spaced approximately 3 weeks apart. Gradual improvement may be seen after each treatment, but optimal results appear only after several months.Recovery from Intense-Pulsed-Light Skin RejuvenationThere is no recuperation time following IPL treatment. A patient can return to work or resume normal activities on the same day. Although skin may be slightly reddened after the treatment, redness typically disappears within a day or two. As it heals in the days following treatment, skin often begins to flake. Over time, however, a gradual, natural-looking improvement in the skin becomes noticeable. Applying sunscreen regularly and avoiding sun exposure is recommended following IPL treatment.Risks of Intense-Pulsed-Light Skin RejuvenationOne possible contraindication for IPL treatment is taking medication that increases photosensitivity. A patient using a topical or oral medicine that increases sensitivity to light may not be a candidate for IPL treatment. And, although IPL skin rejuvenation is considered safe, there are some risks associated with its use. Although rare, IPL skin rejuvenation can cause skin discoloration, blisters, scars and burns.

Dr. Alonso and his staff treat a wide variety of conditions affecting the skin, nails, hair, and veins, including:WartsAcnePsoriasisRosaceaEczemaDermatitisPigment DisordersVitiligoMelasmaSkin CancerBasal Cell CarcinomaMelanomaSquamous Cell Carcinoma