For the past 25 years or so, intravenous (IV) infusion therapy options have become wildly popular. IV therapies are used for everything from anti-aging to hangovers to jet lag. IV therapies have gone mainstream, as noted with Hollywood celebrities like Rihanna, Madonna, and many more. So is this a real thing?  Does medical evidence support this trend?  Most importantly, is this safe? 

As we all know, everything is changing during this pandemic.  As COVID has taken away our sense of safety, we take stock of our everyday health. Just how immune are we?  Thing is, most of us tend to take our health for granted until suddenly it has been compromised. When we’re down for the count, however, it’s not the most ideal time to take action.  My hope is that most people will see COVID as a kind of wake-up call — a universal message telling us that staying healthy is a must.  In fact, staying as healthy as possible is the only current weapon we have to fight the COVID illness.  

Staying healthy and aging well has never been easier.  Certainly Madonna was an early adopter of healthy aging and self care.  Her image today is a result of the self-care commitments in her younger years.  For the younger generations, self-care is an essential part of their lives, botoxing at the sign of the smallest eye wrinkle.  The key is to know which treatments appropriately fit into your expectations, goals and lifestyle.

How many of us are actually aware of which vitamins our bodies lack?  We tend to eat the wrong foods and unknowingly create a  vitamin deficiency for our bodies.  Modern living and commercial farming practices make intake of adequate vitamins a challenge for the everyday person. This has been recognized by the National Institute of Health and the World Health Organization, among other health organizations, for decades.  When you Google “vitamin deficiencies,” you’ll browse the numerous pages of medical articles that discuss this. Even more interesting?  Google “vitamin D blindness in the UK” and discover how otherwise healthy teenagers are losing eyesight due to lack of vitamin D.  Vitamin deficiencies are a real problem. 

The benefits of iv infusions include boosting energy, supporting the immune system, glowing skin, boosting the metabolism and recovery from fatigue. Unlike pills,  IV infusions bypass the gut and are 100% absorbed.  So if taking vitamin supplements by mouth is not for you, IV infusions are a great option. We have started offering infusion therapy to our clients who do not like taking vitamin supplements every day.  Several of the clients have voiced that getting an infusion is instant gratification, helping them feel both rejuvenated and energized.   

So the next time you are at a physician’s appointment, ask to have lab work for B6, B12, and Vitamin D.  Don’t leave your health up to chance.  Take the opportunity to thrive, as opposed to survive, the hectic schedules we all have.  For now, time is on our side.  It’s a good opportunity to make changes and priorities for your health. And if you’d like more information about the IV drips we offer, please get in touch! 

~ Dr. Andrea Tse

What’s your reason for seeking help from a med spa doctor like myself? Whether it’s preserving or improving already good skin, treating you for laugh lines or lines around your mouth, adding dermal fillers or freezing a muscle that causes a deep furrow to persist, I am here for all of it. But what about middle-aged to older women who come to me with concerns about the toll gravity has taken on their faces? You may ask what I can do about wrinkles that go deep or skin that hangs loose.

My first line of questioning is always about what my patients hope to achieve. Is it in their eventual plans to have a face lift when they are older? Some say yes, but they still want to make their skin as youthful as possible in the meantime.  Others say no — they prefer not to go “under the knife” because they fear the outcome will make them look like someone else. Both are understandable beliefs and options.

Thing is, you are probably staring every day at people who have had cosmetic surgery and you would never know it. One of my clients’ eyelids have been naturally slightly hooded all her life, but now that she is in her 60s, those lids have gotten heavier, blocking some of her peripheral vision. So soon she will be getting some diagnostics done to determine if she is a candidate for an insurance-paid blepharoplasty (an eye lift). And she has no fear about having it done, since she is researching surgeons who routinely do it, studying their results. Her goal is to find a surgeon that will merely remove some of her eyelid skin but not raise the brows, making her look rested.

For those patients whose wrinkles are particularly bothersome but prefer not to have surgery, I offer a combination of treatments to soften their lines and firm up their skin. What works with some skin does not work for others, so it’s a fact-finding mission at first for both myself and my patient.  Some may respond to skin care and physician grade peels and others may be better off with laser treatments. In either case, the results are rewarding, because in the end it’s about looking the best you can look for your age, whatever that age may be. 

Botox? For those who have had appropriately dosed injections, it can work miracles within a few days. For those considering it, however, there is a modicum of fear.   I think we’ve all seen examples of overdone Botox and/or med spa procedures not being applied properly. These are the patients I must take by the hand and explain how measured I am about using/doing them.

Since Botox injectables were first approved by the FDA in 2002, they have become a household word for relaxing wrinkles; a brand name virtually interchangeable with the category itself. Here in the U.S., the most common cosmetic procedure is a form of botulinum toxin type A which, injected in small doses into the underlying muscles of the face, paralyzes the muscular function responsible for wrinkles to create smooth, furrow-free skin.

While there are newer competitors on the market, Allergan’s Botox remains the gold standard —  safe, effective, and proven. One of those competitors is Jeuveau,  green-lighted by the FDA. It’s the first new neurotoxin approved for aesthetic usage in nearly a decade. Despite being structurally identical to the others, Jeuveau can be sold at a slightly lower price point and is poised to give its competitors a run for their money.  Jeuveau  provides a soft relaxation effect to the muscles.  This smooths wrinkles while allowing more natural movements during facial expressions — a great choice for my clients who wish to keep their beauty treatments a secret.

Allergan Botox is FDA approved for your “11” (glabellar) lines — those vertical lines between your eyebrows. It’s also great for forehead lines, muscle spasticity, and migraine headaches.  Jeuveau is FDA approved for 11 lines lines only.    Both brands are used “off-label” (non FDA approved), however.  Common off-label uses for Botox include neck lines, lip lines, teeth grinding, and more.  Off-label uses are when Allergan becomes my go-to Botox brand.  With more than 100 million vials sold, the safety profile and efficacy is unrivaled by any other Botox brand.  Allergan diffusion is more reliable and predictable, making it ideal for small muscles.  Many patients believe Allergan Botox is longer lasting as well.  This varies from person to person, so the goal of each client’s treatment needs to be determined.

Botox and Jeuveau are produced by different facilities but are derived from different strains of the same toxin. The risks and potential side effects listed by the companies are also identical. I use both regularly, sometimes at the same time on the same patient.  But I won’t use either until we discuss what works for you. So let’s talk — and happy holidays!

~ Dr. Andrea Tse

Throughout our lives our skin takes a beating. Whether skin discoloration occurred from too much exposure to the sun, remnants of teenage acne scarring, unbalanced hormones or just not taking care of it, skin discoloration or pigmentation is an issue most individuals will encounter during their lifetime. 

Cosmetic companies have our numbers. They make a fortune selling products to even out skin tone. And because we prefer not to have people focus on our blotchy faces, we buy their products eagerly. What much of the public doesn’t know, however, is that skin discoloration does not have to occur.  Prevention starting at the earliest age possible is the key to keeping young, glowing skin. 

Skin pigmentation simply means skin color in all its glory. That can mean patches of dark skin where even skin tone used to appear, most of which comes from the body producing melanin, which is the substance inherent in our skin at birth.  Melanin production can also occur when the skin cells respond to an inflammatory process to protect the DNA of your skin.  A perfect example is sun exposure.  In fact, sun exposure is the leading cause of abnormal skin pigmentation.  When melanin is produced as a form of skin protection, the pigment can be spotty or appear in patches. The result? Abnormal skin color and texture. Did you know that a suntan is actually a form of skin damage and there IS NO SUCH THING as a “healthy tan?” Those who were born in the era where they encouraged the sun with a bottle of baby oil laced with iodine will be the first to admit that they were ignorant as to the damage they were inflicting. And that a deep tan each year, while considered attractive at the time, served as a ticking time bomb as they aged.

So let’s get back to basics. Why is the skin of a toddler so perfect? With no wrinkles and no sun exposure, the skin has a glow and brightness as a result of perfect, even skin pigmentation.  No melanin has yet been triggered and in our youth our skin is rapidly producing new skin cells to replace the few that were damaged.  Fast forward to the teenage years and skin is starting to become uneven, no doubt by significant sun exposure and biological hormones as well. 

Now we are in our midlife. Decades of sun exposure, hormonal influences from pregnancy and/ or menopause, and/ or pharmaceutical medications like antibiotics have taken their toll.  By our 40s our skin cell turnover has declined, decreasing more with each passing year.  Age spots begin to appear because our skin can no longer combat the years of accumulated skin insults. Ever notice how you can see a difference in the age spots and even wrinkles on the left side of your face compared to the right side? It’s probably because the sun hit you on that side while driving your car.

What can be done now?

• First and foremost, sunblock every day.  And I don’t mean relying on the spf factor in your foundation or moisturizer, I mean a real stand-alone sunblock of 30 spf or higher. 
• Secondly, the products you use can be considered your skin’s diet.  Rejuvenating serums can be used to ensure the skin has all the materials necessary for healthy skin production and slow the aging process.  Products with vitamin C and E also help to combat skin cell inflammation and significantly reduce the formation of abnormal skin pigment. Remember that the skin is the largest organ in your body and maintenance is a crucial factor.
• Lastly, encourage skin cell turnover.  There are many ways to do this depending on your budget and skin types.  Peels, hydrafacials, photofacials, and lasers can help increase cell turnover and treat abnormal skin pigmentation to turn back the clock for that healthy skin glow.

If you are fortunate enough to have been spared skin discoloration on your face, start a skin health care plan now.  Skin care products and a targeted method of encouraging skin cell turnover will provide beautiful skin well into your senior years.  Do not wait to care for your skin until abnormal pigmentation occurs.  This is a signal that significant skin damage is present.  Prevention is better than a cure when it comes to having beautiful skin and defying your age.

Call me for a skin consultation to discuss putting a slowdown on the aging clock and to even out your skin tone. It’s about repair and protection. I really do care. Focusing on your skin is my biggest priority.

~Dr. Andrea Tse

It’s a given. Watching your diet and exercising promotes good health, especially as you age. So how is beauty care so radically different? We work hard to take care of our insides as well as our bodies, but is paying attention to your looks such a narcissistic endeavor?

Med spa doctors and plastic surgeons get women and men of many ages through their doors. Some are trying to fix something that has bothered them, some are worried about how age is treating them, and others are just on a tear to look as gorgeous as they can be. And we enjoy addressing all of it. Some patients will not breathe a word about having come to us, as if spending money on themselves is the ultimate in self-centeredness. Many practitioners like me will admit that it’s rare their patients will even permit them to use before-and-after photos of them with their eyes blocked out and their identities hidden to show others how their treatments work. In other words, beauty care tends to be a deep, dark secret except, perhaps, between BFFs. 

While I understand this need to keep beauty care private, I also don’t see the need for shame. If you remodeled parts of your house or got your car repainted it would be no big deal. How are your looks any less something you own and keep up? In reality it just makes you feel better about yourself, so how on earth is this a bad thing? In her “(R)aging with Grace” article, Beauty Care: Feeling Good About Your Looks Past Age 60 writer Dena Kouremetis gets into the meat of it. “I often hear resignation from my age 60+ peers about keeping up with beauty care, but when I think about the alternative, it just sounds unacceptable in my world of one,” says Kouremetis. “So I began looking for the advantages to beauty care past age 60 and found that it’s not uncommon to be shamed by others about wearing makeup and/or appreciating it. She quotes a psychologist who argues that activities that allow us to take care of our personal beauty needs should not be viewed as “guilty pleasures.”

We have been carefully taught to suppress our interest in our looks, especially as we age, as if aging is a lost cause. In fact as many (women, in particular) age, they stop wearing makeup or doing skin care, accepting whatever nature hands them. And that’s fine. It’s a free country. But to put down others because they enjoy trying to look fresher and younger? That’s just not right. There are no absolutes where self-esteem is at stake. When you feel great about how you look, you have a better outlook on just about everything.

Morgan Shanahan’s Babble article I Got Botox and Didn’t Tell my Husband tells the story of a woman’s guilty pleasure. While she wanted to get rid of a wild eyebrow that had bothered her all her life, she failed to tell husband, Scott, that she was going to get Botoxed. “Three days later I woke up to discover I had no movement in my forehead whatsoever. It looked pretty good, but HO-LY was it a weird experience. My first reaction was to run in to Scott and make him poke my forehead and watch me try to raise my crazy eyebrow. But I couldn’t. Because I’d lied by omission and I was in it to win it now.” She goes on to say that about 6 months later she admitted it to him at a party.  “The thing is, my husband does think I’m beautiful no matter what. He also never noticed that I had frozen a quarter of my face. But now that he does know, our trust has been damaged. He can’t believe I would have gone and done something like that without telling him, and honestly … neither can I.”  While Shanahan loves what the injections did for her, the penchant to keep it a secret took a toll in this case.

While self-care is now a popular topic, many women find it necessary to justify spending money on beauty. One of my clients told me that each beauty product or procedure she spent money on began to feel like a small victory after years of feeling guilty about it.  She also told me that this was quickly followed by remorse and then another round of justification. When she discovered what she purchased actually worked, however, there was euphoria. This is a cycle that repeats itself, but there is no reason she should continue to suffer from it.  We have one time to go around, and there is no reason to think that an investment in your looks is not a prudent one.

Kouremetis said it best: “Having dominion over my looks means have a sense of control over something.  The concentration with which I apply eyeliner is unmatched and when I’m done with my going-out preparation I feel more confident to face the world.”

“Nature gives you the face you have at 20.  It’s up to you to merit the face you have at 50.” 

Coco Chanel was ahead of her time when she uttered this, and never was it truer than today, when combinations of treatments and good skin care make youthful-looking skin last longer than ever. There is no better time in history to have birthdays than now, with anti-aging treatments capable of producing more extraordinary results than we ever thought possible. 

With all these anti-aging options available to you, where do you start?  Do you choose botox, filler, or skin treatments?  As a medical professional who has studied these treatments and their results in earnest, the answer is all of these choices.  While each category fills a different need, all work in harmony to minimize wrinkles, add volume in the cheeks and lips, and give you glowing skin.

Botox rules. It is the number one anti-aging aesthetic choice, providing a safe, reliable result when used properly. (We will explain “properly” in a moment.) No other product delivers such immediate results for wrinkle improvement than botox.  The optimal places for anti-wrinkle treatments with botox are crows’ feet (wrinkles around the eyes), “eleven” lines (wrinkles between the brows), and fine forehead lines.  While treatments for these areas are easily treated, forehead treatments can be a bit trickier. It’s important that your practitioner correctly balance both the anti-wrinkle result as well as the brow position or you may find your botox treatments causing unintended results.  Aggressive treatments with botox in the forehead can result in brow lowering, abnormal elevation of the brow, or uneven brows.  None of these results add to your anti-aging efforts and may even have the opposite effect — making you look “overdone.” Bottom line?  Botox in the forehead is best done conservatively.  Understanding the goals and limitations of botox is the first step in achieving an optimal result.   

Fillers came along as an alternative to botox, but are equally important — another product that can achieve that immediate anti-aging result.  Filler is a great option to add volume to the areas of the face that have decreased over time.  Using it in the cheeks and lip areas can create amazing results, creating the youthful look of a full face.  Nasolabial folds (upper mouth fold) and marionette lines (lower mouth wrinkles) can be filled as well, but should be considered only after the cheeks and lips have been appropriately evaluated.  Filling the nasolabial folds and marionette lines will raise folds and can create a somewhat unnatural upward smile (we’re sure the “Joker” Jack Nicholson look is not what you have in mind).  If budget is not a concern, I recommend filling all these areas, with cheeks and lips being addressed first.  Full cheeks and lips offer a youthful and sultry look. If you’re worried about lip injections, don’t. When performed properly (there is that word again) as an anti-aging technique, lip injections simply remove wrinkles and create natural looking fullness.

Somehow I think that if photofacials and lasers were available when Coco Chanel was in her 30s or 40s she would have looked even more amazing.  These are the anti-aging game changer.  Glowing skin with improvement in collagen and elastin has never been easier, safer, and taken less downtime.  The younger you start the treatments, the better your skin looks as you age, as if it resides in some form of  (happily) arrested development.  Photofacials and laser treatments promote the building of collagen and elastin which decrease wrinkles in the skin.  In addition, the devices I use promote a smoother skin texture and evens out pigmentation.  Our office uses the Sciton photofacial and laser device.  This brand is often referred to as the “luxury line” of laser machines.  Sciton’s motto of “because results matter” means what it says.  Not all devices are equal. Choose carefully and wisely to avoid a poor outcome or complication.  Scarring and burns can occur if a photofacial/laser is used poorly or aggressively. My advice is to choose Sciton or simply research the device you plan to have used on you before making a final decision.

Consider botox, filler, photofacials and lasers in combination to maximize your anti-aging regimen.  The goal is to use all these products in reasonable measure to achieve the kind of  outcome that will have you smiling and everyone else asking why you look so good!

~Dr. Andrea Tse