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Cynthia Golomb, MD | Dermatology Boutique

Dr. Cynthia Ann Golomb

The tragedy of misinformation

· In the News · Comments Off on The tragedy of misinformation

Allure magazine wrote a good article about all the misinformation out there about dermal fillers and the COVID-19 vaccine.

I think it is a tragedy that many filler patients refused to get vaccinated because of the misleading reports in the news media.  Some reporting caused panic, confusion and concerns that were out of proportion to the actual, rare events that resolved quickly.

Yes, there have been a few, rare reactions to the COVID vaccine in filler patients, but these types of reactions are not new, nor are they unique to the COVID vaccine.

Click to read the Jan. 20, 2021 article:  “Why You Should Still Get the COVID-19 Vaccine Even If You Have (or Plan to Get) Dermal Fillers.”

 

Festoon Update

· Lasers · Comments Off on Festoon Update

Earlier I posted a video of the CO2 CoolPeel laser treatment to reduce the festoons under my eyes.  Now with these photos, you see what I looked like pre and post-procedure.

Festoons appear below the “eye bags” as a mound or bump around the cheekbones.  Or, a festoon could be sagging skin or folds of skin above the cheek.

I was red immediately after the laser treatment, but the CoolPeel has less downtime and less redness than older technology CO2 lasers.  The CoolPeel’s new technology delivers energy more precisely, without a lot of thermal damage to the skin, so recovery is faster.

The laser can be set to mild, moderate or aggressive and the downtime increases with the intensity of the treatment.

The treatment I had was moderate and addresses fine lines, superficial wrinkles, dark circles and festoons.  The cost for this treatment under the eyes is $850.  The downtime is 3 to 5 days.  You can begin wearing makeup in 2 to 3 days.

Laser resurfacing with a CO2 laser encourages the skin’s natural healing process and revitalizes the area by creating better support in the skin.  It also tightens the skin by “shrinking” tissue.

My CoolPeel CO2 laser can be customized to your unique needs — it is powerful, fast and gives fabulous results.  After your treatment, your skin will look smoother, tighter, fresher and more youthful.

CoolPeel CO2 Laser Reduces Festoons

· Lasers · Comments Off on CoolPeel CO2 Laser Reduces Festoons

Do you have festoons?  I do.  They are below the “eye bags,” a swollen area appearing as a mound or bump around the cheekbones.  Or, a festoon could be sagging skin or folds of skin above the cheek.  Festoons can be genetic and often get worse with aging, sun exposure, or smoking.

The puffiness under the eyes gets worse with age because the structural support of the skin is deteriorating and the muscles under the eyes weaken.  Lower eyelid surgery can sometimes improve the appearance, but it also can make the festoon look more prominent.

Laser resurfacing with a CO2 laser can encourage the skin’s natural healing process and revitalize the area by creating better support in the skin.

Click photo to view CoolPeel video

The laser you see in the video is the next generation of CO2 that has less downtime and less redness.  It has power and delivery that is unmatched in any other fractional carbon dioxide laser.  The CoolPeel CO2 uses carbon dioxide technology to deliver energy precisely, without a lot of thermal damage to the skin, thus a faster recovery.  It can be used for fine lines and to improve skin texture and pigment.  It also tightens the skin by “shrinking” tissue.

The laser can be set to mild, moderate or aggressive and the downtime increases with the intensity of the treatment.  The treatment in the video was moderate and will address fine lines, superficial wrinkles, dark circles and festoons.  The cost for this treatment under the eyes is $850 and full face is $1000.  The downtime is 3 to 5 days.

A mild treatment of the full face and neck to improve pigment, sun damage and texture is $850.  The downtime for a mild treatment is about 2 days.

An aggressive CoolPeel carbon dioxide laser ablation to treat skin laxity, acne scars, deep lines and wrinkles is $2000.  The downtime is 5 days.

My CoolPeel CO2 laser can be customized to your unique needs — it is powerful fast and gives fabulous results.  After your treatment, your skin will look smoother, tighter, fresher and more youthful.

Dermal Fillers and the COVID-19 Vaccine

· In the News · Comments Off on Dermal Fillers and the COVID-19 Vaccine

In case you have not heard, during the Moderna vaccine trial, three participants who had facial filler injections experienced facial swelling after receiving the COVID-19 vaccine.

One of the three previously had a similar reaction to an influenza vaccine.  In all three cases, the swelling decreased with antihistamines or steroids.

As a result, the FDA has said “it is possible the localized swelling in these cases is due to an inflammatory reaction from interaction between the immune response after vaccination and the dermal filler.”

One of my professional organizations, the American Academy of Dermatology, has a registry of cases of dermatologic side effects of COVID-19 and the vaccines and is closely monitoring reports.

At this point this reaction appears to be rare, but I will keep you up-to-date if we learn more.

I will be vaccinated for COVID this week and I am not concerned, even though I have recently had filler.  I strongly believe the vaccine is very important.

If you have any concerns about being vaccinated because you have had filler, take an antihistamine the day before and the day of your COVID vaccine.  I recommend Zyrtec.

 

The face mask you wear matters

· In the News · Comments Off on The face mask you wear matters

 

  • Scientific simulations have demonstrated that if 80% of the population wore face masks, the pandemic spread would slow to a point even better than a lockdown.
  • Masks with one-way exhalation valves can expel droplets of the coronavirus. They’ve been banned by hospitals, airlines and major U.S. cities.  If you wear a mask with a valve to my office, we’ll ask you to change into a mask that we provide.
  • While a one-layer cloth face mask reduces droplets, two layers are better.
  • The more form fitting your face mask, the better. Your face mask should cover your mouth and nose with no gaps at the sides.
  • The jury is out on neck gaiters. One reason is that they are one layer, another is the polyester fabric most are made of.  One study found they reduced large droplets into smaller ones and expelled those droplets.
  • Bandanas have also been found to be not particularly effective as a face mask.
  • A recent study in Japan found that a plastic face shield without a mask does not stop the spread of the coronavirus. A face shield or goggles will protect the mucous membranes of your eyes.  A face shield should always be used in conjunction with a mask.
  • Masks are not recommended for children under 2 years of age due to the risk of suffocation.

Mohs Provides Higher Cure Rate for Skin Cancer

· Skin Cancer · Comments Off on Mohs Provides Higher Cure Rate for Skin Cancer

Immediately after Mohs surgery.

I performed Mohs surgery and then did a skin graft on this patient.  She had basal cell cancer on her ear.

Mohs surgery is a precise technique to remove skin cancers layer by layer resulting in a higher cure rate than standard excision or radiation therapy.

For example, basal cell carcinomas have a 97 to 99% cure rate.

Mohs also allows me to limit the size of removal and conserve normal skin to minimize scarring.  After removal, I treat the wound in a manner to promote good healing and preserve cosmetic results.

The Mohs procedure can be as short as one hour as in the case of this patient, or it can take several hours depending on the number of layers and type of repair, like a skin graft.  This patient’s skin graft took an additional hour.

This photo was taken 11 days after her Mohs surgery and skin graft.

I became very interested in Mohs during my residency and training at the University of Miami, and then later during my dermatopathology fellowship at Roger Williams Hospital at Boston University.  A dermatopathologist diagnoses skin disorders under a microscope.

Removing a tumor and examining the tissue immediately after removal was a natural for me because of my sub-specialty as a dermatopathologist.

Designed by Frederic E. Mohs, M.D., the surgery excises not only the visible tumor but also any “roots” that may have extended beneath the surface of the skin.

This procedure is most commonly used for the treatment of basal and squamous cell carcinomas, the two most common types of skin cancer, although it can also be used to treat melanoma and other types of cancer.

Mohs surgery is often recommended for recurring cancer because its results are so thorough.

My patient 3 1/2 months after Mohs and her skin graft. Her face mask is pulling the top of her ear forward in this photo.

It is ideal for treating cancer in cosmetically and functionally prominent areas such as the nose, eyelids, lips, hairline, ears, hands and feet.

Compared to other skin cancer treatments, Mohs surgery has a very high success rate. As I mentioned, basal cell carcinomas have a 97 to 99% cure rate, while squamous cell carcinomas are cured 94% of the time.

Natural Does Not Necessarily Mean Safe

· In the News · Comments Off on Natural Does Not Necessarily Mean Safe

I’m a believer in science and clinical trials when deciding on what to recommend to patients for skincare and of course, pharmaceutical treatments.

But right now there’s a lot of money and social media influence spent on convincing you that some ingredients in skincare products are harmful.

What’s interesting is that the alternatives pushed by the clean beauty movement often result in skin irritation, infections or allergic reactions.

As you’ll see from this editorial in JAMA Dermatology, many useful and safe ingredients have been “demonized” without any scientific evidence.

Beware of marketing terms like “natural” and “clean” and look for clinical trials that demonstrate the results of the product and show the vast majority of testers did not have adverse reactions.

You can read the editorial from JAMA Dermatology here.

Kysse is new for lips

· Fillers · Comments Off on Kysse is new for lips

I injected my patient with the new Restylane Kysse and she looks amazing!  I only used ½ of a syringe, because she did not want “big lips.”

That’s the beauty of this new product.  I can use less product and still achieve a nice improvement in volume and texture.

Because it is soft and flexible I can shape the lip to the patient’s desire:  a French lip, heart shape or geisha lip, or other options for any age group.

The best news is that this filler lasts longer!  From nine months to possibly up to a year.

Using less filler that lasts longer translates to a value for my patients.

 

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Returning to Full-Service Appointments

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I am happy to let you know that I have returned to full-service appointments.  That includes cosmetic procedures and full-body skin checks.  But things will be a bit different.  See below.  I look forward to seeing you soon!

Reveal Younger-Looking Skin!

· Lasers · Comments Off on Reveal Younger-Looking Skin!

Many of you know our friendly nurse, Franny.  She recently had a CO2 CoolPeel treatment that significantly reduced the wrinkles on her face and neck.

The CoolPeel laser helps with stubborn crows feet, lipstick lines, smile lines and pore size.  Most notably, CO2 improves wrinkles that cannot be corrected with fillers.

Franny was also one of the first to receive an Infini treatment, which does a great job of tightening skin.  Genius is the next generation of Infini.  Genius is an improved microneedling treatment with radio frequency.  It addresses sagging, crepey skin, turkey neck, jowls and large pores.  We upgraded to the Genius device last year.

If you have wrinkles along with loose, lax skin, this duo of treatments might do the trick.  Franny has had one CoolPeel and had 2 Infini treatments a couple of years ago.

When you’re in the office, feel free to ask Franny about her treatments and see her results in person!

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