• BOTOX® Cosmetic
• Restylane®
• Sculptra®
• Radiesse®
• Other Dermal Fillers
• Microstructural Fat Grafting
• The "Fraxel®" Laser
• Safety
• Return Visits

Dr. Pearl offers several new and exciting injectable treatments for Palo Alto, Mountain View, Los Altos, San Jose, and Bay Area residents, including Restylane®, Perlane®, Radiesse®, Juvederm™ and Juvederm™ Ultra Pulse. These fillers are designed to treat lines and deep wrinkles around the eyes, forehead, mouth, lips, and contour the cheeks and hollow areas beneath the eyes.

Dr. Pearl continues to incorporate emerging non-surgical facial rejuvenation procedures into his Mountain View practice. For news and information about the latest FDA approved cosmetic dermal fillers, contact Pearl Plastic Surgery Center today.

See BOTOX® Cosmetic

Restylane® is approved for the treatment of fine lines around the mouth and lips, smile lines, marionette lines and frown lines. Restylane® can also be used to fill out depressed areas beneath the lower eyelids. Restylane® is one of several new injectables made of hyaluronic acid, a natural substance that is produced by the body and naturally absorbed over time. Cosmetic surgery patients in Mountain View can expect Restylane® injections to last for approximately 4-8 months, after which time periodic sessions will be required to maintain the effects of the treatment. Restylane® treatments can cause significantly more discomfort than BOTOX® injections. Dr. Pearl has found that local anesthesia placed in the treatment areas prior to placing Restylane® has dramatically improved patient comfort during the procedure. Dr. Pearl recommends that patients ice the treated area after the injections, and allow 1-3 days for bruising, redness and discomfort to subside.

Sculptra® is one of the most promising and long-lasting new injectable fillers being introduced to the market. Sculptra® works by filling in deep lines and wrinkles around the face, as well as sunken or depressed areas beneath the eyes and in the cheeks. Sculptra® is composed of a synthetic lactic acid material that can potentially last for up to 18 months. Sculptra® was originally approved in Europe for the correction of skin depression, and Dr. Pearl is now exploring its application at his Mountain View cosmetic surgery practice near Palo Alto.

After a Sculptra® procedure, there is a slight risk of post treatment nodules (bumps) developing in the areas treated. Bruising, swelling and redness from the injections usually lasts 3-5 days, and occasionally up to 10 days.

Sculptra® is primarily used for smile line depressions. It should be noted that at this time, treatment of the smile lines is considered an "off label" use.

For up to date information about Sculptra®, contact our cosmetic surgery practice, serving Palo Alto, Mountain View, Sunnyvale, Los Altos and the Bay Area.

Radiesse® is a fantastic new FDA-approved filler that is primarily composed of hydroxyapatite suspended in a water based gel. It feels thicker and more dense than hyaluronic acid fillers (Restylane® and Juvederm™) and is placed in a slightly deeper plane of tissue. It is an excellent way to fill deep smile lines, furrows and the marionette lines that extend below the corners of the mouth. It can also be used effectively in the cheek area and jawline to restore volume. I do not recommend Radiesse® for the lips at this time. Usually, a local anesthetic is placed in the area prior to treatment. As with Restylane® and Juvederm™ treatments, some swelling, bruising and discomfort is to be expected.

An initial complete treatment frequently consists of a touch-up dose administered three to six months after the first Radiesse® is given. It is not uncommon to see significant improvement for 10 months or longer after the initial treatment is finished. My patients and I have been extremely impressed with the outstanding results from this exciting new filler.

ArteFill® is a newer version of Artecoll® (methylmethacralate microspheres in a gel base). ArteFill® and Artecoll® appear to have the longest lasting results (1-2 years), but have occasionally resulted in nodules (granulomas) that do not appear, sometimes, until many months after the procedure is performed. They can be somewhat difficult to treat. I have decided not to use these products until longer term results and improved safety have been proven to me.

See Microstructural Fat Grafting

We are excited to be one of the first practices in the Mountain View, Los Altos, Cupertino, Los Gatos, Saratoga, Campbell, and San Jose areas to offer the Fraxel® Laser Laser to our patients - (www.reliant-tech.com). This revolutionary innovation allows the areas treated to exhibit better skin texture, more even pigmentation, less wrinkling and fine lines, as well as some tissue tightening. I feel it is the treatment of choice for age spots, especially on the face and hands, as well as melasma and freckling. There is minimal "down" time (1-2 days of mild redness), and the procedure does not require general anesthesia or intravenous sedation, making it an ideal option for Mountain View, Los Altos, Palo Alto, Atherton, and Bay Area residents.

What to Expect

We ask that you arrive at the Pearl Plastic Surgery Center one hour prior to your scheduled treatment. A topical anesthetic will be liberally applied to the planned treatment areas. This will be removed approximately 45 minutes later. A blue vegetable dye will then be applied to the skin, followed by additional local anesthetic ointment. The blue color helps the Fraxel® Laser Laser "recognize" the proposed areas for treatment. The laser will then be used to thoroughly treat all of the planned areas. You will feel some heat during the procedure, which will be minimized by a chilled spray applied to the treated sites. Redness and some stinging follows. Iced compresses and elevation significantly reduces discomfort. Redness usually disappears in several hours, but may last for 1-3 days. Normal activities may usually be resumed in less than 24 hours.

How the Technology Works

The Fraxel® Laser treatment concept is ingenious. For every square inch of treated area, only approximately 30-50% or "fractions" of the tissue is actually exposed to the laser light producing heat and tissue changes to the deeper structures without injuring the skin surface. Most of the area surrounding the lasered tissue is left undisturbed allowing for rapid healing and minimum down time. You should expect to see improvement in the texture, color, and fine lines in the treated areas over a period of 1-3 months. Usually, 4-5 treatments are required to achieve the desired results and clinical improvement may not be apparent until 2-3 treatments have been completed. The treatments may be spaced 1 to 4 weeks apart.

What Areas Can Be Treated

One of the most exciting aspects of this new laser treatment is that almost any area of the body can be treated. Typically, an entire face, neck, and chest can be treated in one session. The hands and entire upper extremity can be treated, as well as the legs, ankles, and feet! Another fabulous advantage of the Fraxel® Laser Laser treatment is that skin of "all colors" may be treated. Asian, Meditteranean, Hispanic, African-American, and Caucasian!

The full potential of the Fraxel® Laser Laser has not yet been fully unleashed. Please contact our Mountain View cosmetic surgery practice to obtain more information about this exciting new treatment. It is expected that we will begin treating patients in the fall of 2005.

Because Sculptra®, Restylane®, and other hyaluronic acid based dermal fillers are not derived from animal or human origin, they minimal risk of allergic reaction or transfer of disease. These fillers are composed of natural substances that are gradually absorbed by the body after 4-8 months. Side effects are minimal, and no pre-testing is required before treatment.

Please do not hesitate to discuss safety issues with Dr. Pearl regarding any aspect of cosmetic plastic surgery.

Treatment with cosmetic dermal fillers will require periodic maintenance for optimum results.

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