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All Posts in Category: Skin

What is a Mommy Makeover? (Am I a Candidate for One?)

“Mommy makeover” is a term used generically for a number of different combined surgical procedures. There is no single mommy makeover surgery, but a general concept of helping regain some of the shape you had before pregnancy. The surgeries may be done in combination, or over more than one setting.

Typically, I am addressing concerns women have with changes they have from pregnancy and breast feeding. However, it can extend to facial changes that women go through due to the stresses of raising kids!

For the breasts, one changes that many women see is deflation, or drooping and flattening of the breasts after pregnancy or when breast feeding stops. This occurs because the enlarged breast ducts start to shrink back down, causing the breasts to get smaller. The constant stretching of the breast skin and breast tissue over the many months of pregnancy and breast feeding eventually leave the tissue very lax (stretch marks are one sign of this).

Most of the time the skin and breast tissue won’t have the same elasticity or “snap back” it used to have. For some women, a breast augmentation (implant enlargement of the breast) is enough to restore the lost volume, shape, and contour of the breast. Sometimes a mastopexy, or breast lift, is needed in addition to the implants. A breast lift can mean any one of a number of different specific surgeries and can involve any one of a number of different incisions and approaches, tailored to you. At a minimum, a breast lift will help relocate the nipple-areola to a more aesthetically pleasing location on the breast mound. Typically, a breast lift will also help round out the entire breast and more the breast tissue back up on the chest.

The belly is another area that goes through a lot of changes too. Stretched, lax skin and additional fat deposits can be a long term issue after pregnancy. Also, many women have diastasis recti – a term for stretched muscle and fascia in the lower abdomen. This is the “bulge” or “pot belly” or “beer belly” of the lower abdomen you may see, even if you are very thin and back to your pre-pregnancy weight. These areas can be helped with a mini-abdominoplasty (mini-tummy tuck) or a regular tummy tuck. These surgeries will address the lax muscle and remove the lower abdominal skin and fat (and stretch marks if they are low on your belly). Liposuction of the flanks / love handles can help contour the waist in addition.

Some women only need liposuction to remove the excess fat of lower abdomen, without removing skin, because their skin has enough elasticity to snap back after removing the extra fat.

Facial lines and wrinkles become more prominent and noticeable after pregnancy, long sleepless nights, and many stressed-out days! Botox and Juvederm filler can help restore some of the look of the face, and reduce those lines and wrinkles.

So! What can I do to help “mommy”? Breast implants and/or lift? Tummy tuck or liposuction? Botox? There are many options depending on which areas concern you the most. Come in to discuss what I can help you with!

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“What’s the Difference Between BOTOX and Filler?”

As well-known and ubiquitous as these products are in the popular press and in my office, there is still a lot of confusion from patients over which injectable to use, when, and where. So here’s a primer!

Botox (and other botulinum toxins like Dysport and Xeomin) works by INHIBITING MUSCLE action.

So, if the wrinkles in between your eye brows (the glabella) or in your forehead or the “crows feet” area are caused by the action of a muscle, then you can decrease the repeated skin creasing by injecting Botox into the muscle. Over about 5-7 days the muscle loses ability to contract, allowing the skin to flatten out and not be so creased. It usually lasts only about 3-5 months before the muscle gets back to full strength and you have to inject it all over again.

However, (and here’s the kicker) the muscle can’t be one that is used for critical facial expressions like smiling or closing your eyes. That’s the reason I avoid injecting Botox around the mouth, cheeks, or into the eyelids – you really need those muscles to work properly to maintain normal facial expressions and functions.

FILLERS (including the hyaluronic acids – Juvederm, Voluma, Restylane, Belotero – and other products like Sculptra and Radiesse) do just that – they FILL! Unlike Botox, the effect is immediately noticeable. They are gels that are injected under the the skin (not into the muscle) to fill in creases, increase volume, and make deeper grooves more shallow. Common places for fillers are in the hollows under the inside part of the lower eyelids (nasojugal grooves), the folds next the nose between the cheeks and lips (nasolabial folds), and the deeper grooves that can form from the corners of the mouth down to the chin (marionette lines).

Fillers can also add volume to the lips and cheeks when used in the right amounts and in the anatomic locations. Just puffing up the lip is easy but looks unnatural. I tend to restore lip symmetry and refine the borders of the lip through very small, precise injections of filler. Very fine lines on the upper lip are difficult to smooth out because of the gel quality of fillers.

So, now that you know the basics, you can come on in to get your injectables! For more information on BOTOX, please visit the skin services section of our website.

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“As if you were on fire within, the moon lives in the lining of your skin.”

One of my favorite poets, Pablo Neruda, penned that line in Ode to a Beautiful Nude.

How appropriate for this post!  How can you feed your skin from within so you have that inner luminosity that no amount of expensive serum, sleep, or sex can create, and that poets write about?

In my experience, clean living and clean eating is the cheapest and most effective way – there’s no magic in it, just a lot of attention to detail (and Pinterest posts and reading the beautiful people’s blogs for recipes) and cooking.  Which means cleaning up too, because your dude just eats it and falls asleep.  Mainly because you didn’t train him right from the very beginning.  But back to clean eating – we all strive for that, and should be doing it ALL THE TIME.  But as usual, I have come up with a way to get around it if you happen to slip up once or twice.  Or five times, or all year.  It happens, because we have lives we have to live.  We need solutions!  That’s why I’m here.  I understand you, AND your needs.

As you know, skin suffers from poor nutrition, lack of proper cleansing (inside and out), dry winter air, alcohol, sleepless nights, working too hard…basically, LIVING is bad for your skin.  I’m going to focus on what you can do for your skin nutritionally that really works.  This list serves as an addition – the “extras” – to a high-quality multivitamin and mineral supplement containing at least 10,000 units of Vitamin A, a good spectrum of B-vitamins, and adequate Zinc.  This is your base.  There are several out there that may fit your lifestyle, be it one-a-day, 6 a day, including digestive enzymes to prevent that vitamin burp, or containing supplemental herbs for women’s health.  Pick a great one!

Number 1 on my list is a good MULTI:


What makes skin beautiful?  The structural proteins of skin (collagen, elastin, and keratin) give it firmness and elasticity.  You want the kind of skin that snaps back like a baby’s cheek.  Collagen is the main structural protein of the connective tissue in the body created by epithelial cells and fibroblasts.  The various collagens and the structures they form all serve the same purpose: to help tissues withstand stretching and GRAVITY.

The surface layers of the skin are supported from below by columns of fibers made up mostly of collagen and elastin. This network of fibers forms the molecular sponge known as connective tissue.  The spaces within this sponge are filled with a composition of water, protein complexes, and hyaluronic acid. This jelly-like complex transports essential nutrients from the bloodstream, via the capillaries in your skin. Hyaluronic acid attracts and holds water, which is what plumps your skin so that wrinkles and lines are less visible.

To make collagen, the fibroblasts need amino acids (building blocks of protein) like proline, glycine, and lysine.  They also need certain co-factors including ascorbic acid, or vitamin C.  The thing about vitamin C is that we burn through it really quickly in the stressful world we live in today, and it’s water-soluble, which means what isn’t used in a few hours is excreted in your urine, NOT stored for later use.  Fortunately, it’s easy to get in food and supplement form, and there’s a timed-release option available.  BINGO.

So, Number 2 on my list is Timed-release Vitamin C:

Next is protein.  Amino acids are found in all sources of protein.  Some are more easily digested and absorbed than others, which increases the bioavailability.  In general, animal proteins have a more complete amino acid profile, and plant proteins need to be combined.  Collagen protein is 20 times higher in glycine and proline than other sources (remember the fibroblasts and their needs) and is very well-absorbed, which makes it ideal for boosting collagen production in the body.  It’s derived from gelatin, which as we all know, makes your hair and nails grow.  Take this stuff, 2 Tbsp a day, and you will be amazed.  I am not kidding!  It’s virtually tasteless.  I mix it in my coffee, tea, soup, smoothies, and sometimes in the interest of just gettin’ it done, in some plain hot water.  Two choices, both excellent.

Number 3 on my list is Collagen Peptides:

Since collagen is a very cross-linked molecule with a lot of bonds to make it strong, you need sulfur to help make it.  A good source of sulfur with several other health benefits is MSM, or methylsulfonylmethane. MSM helps make the skin cells more permeable, and therefore more absorbent and receptive to plumping and hydration. The sulfur provided by MSM produces generous quantities of collagen and keratin, both of which are vital for healthy hair, skin and nails. In fact, MSM is often referred to as the ‘beauty mineral’ owing to its ability to add to enhance the thickness and strength of nails as well as hair in a very short span of time.

Number 4 on my list is MSM:

We’ve all heard that Biotin helps your hair and nails grow.  It’s true, but it also helps your skin glow.  Your body needs Biotin to metabolize carbohydrates, fats, and amino acids, the building blocks of protein, which as you know, is integral for building your infrastructure – keratin, collagen, and elastin.  Biotin deficiency is rare because, in general, intestinal bacteria produce biotin in excess of the body’s daily requirements.  However, we all know that the average person’s microbiome may be compromised.  Supplementing with Biotin is safe as long as you avoid daily doses above 5000 mcg (5 mg).  Some people report acne with too much biotin.
Number 5 is Biotin:
Next are the GOOD FATS.  Fat has made it off the black list and is now considered a beauty nutrient.  Good fats are Omega-3’s, avocado, coconut oil, olive oil, grass-fed organic butter or ghee, fatty fish like sardines and wild-caught salmon, and raw organic nuts and seeds.  Personally, I love getting this through diet alone.  If you don’t feel you can, take a high-quality fish or Krill oil or try Udo’s 3-6-9 Blend for a balanced 2:1:1 approach.
Number 6:  Omega-3 and Good Fats
Avofish  Udo

Hyaluronic Acid is a viscous fluid carbohydrate (not one to avoid!!!) that attracts and holds water.  Roughly 50% of the Hyaluronic Acid (HA) in our body is found in the skin. HA and Collagen are vital to maintaining the skin’s layers and structure. It is the collagen that gives the skin its firmness but it is the HA that nourishes and hydrates the collagen.  HA is well absorbed orally when taken on an empty stomach.  As an aside, it is also excellent for joints.  Take 70-100 mg twice a day with other supplements that are absorbed best without food.

Number 7: Hyaluronic Acid


To wrap it up, if you had to pick one, it would be the Multi.  The second one I would get is the Collagen Peptides.  This is of utmost importance if you’re considering an aesthetic procedure or healing from one.  The rest are icing on the cake!

Yours in safe beauty,


Original Post here:


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Post from FunctionalBeautyMD

Skin Care Ingredient Hype: It DOES Matter!

So, you’ve probably noticed there’s a lot in the media about the beauty industry lately regarding the toxicity of ingredients and lack of regulation. There are certain skin care ingredients you should learn to avoid. Should you pay attention?  YES.  Here’s why:

SkinYour skin is constantly regenerating from the basal layer.  As the cell layers mover closer to the surface and away from their blood supply, they become keratinized, metabolically inactive, and eventually slough off.  The outermost 25-30 layers of skin cells, called the stratum corneum, are dead and provide barrier protection:  they keep water in and chemicals and microorganisms out.  By nature, human skin has low permeability. TO PROTECT US.  But what do we do?

We mess with nature.  Using SCIENCE.

Science has allowed us to enhance the skin’s permeability with additives and chemicals, both natural and man-made, to allow for penetration through these protective layers moving substances deep into the biologically active layers of the skin.  Penetration enhancers (also called sorption promoters or accelerants) work by disrupting the “glue” that holds skin cells tightly together, dissolving the keratin, or otherwise “punching holes” in the layers.  Some examples are polyethylene glycol (PEG), PEG-amine, carboxylic acid, urea, propylene glycol, DMSO, liposomes, nanoparticles…  This is good when the molecule that’s getting through is one we want.  But what happens when harmful molecules that exist in the same product get through with it?  And, why are the harmful ones in there, anyway?  Isn’t someone supposed to monitor that?

moleculeGood molecules, or “actives” nourish and promote the health and youthful appearance of your skin.  These are things like Vitamin C, Vitamin E, ferulic acid, niacinamide, copper peptides, and hyaluronic acid, just to name a few.  We want those to get in and do the job!

Then there are the bad guys – parabens, phthalates, bisphenol-A, ethanolamines...the list is looooong.  They are put in to improve the smell, texture, or performance of a product. Poison Some are proven to cause cancer, genetic mutation, reproductive harm or birth defects.  Others are simply irritating or cause eczema, acne or rosacea.  These molecules hitch a ride on the penetration enhancers along with the good guys and WRECK your good intentions.  Did anyone get the photo?  It’s Poison.

Why are these companies allowed to put potentially harmful or PROVEN harmful ingredients in our products?  Because it’s legal in the US.  The European Union bans over 1300 hazardous ingredients from use in cosmetics.  United States?  11.  Yes, I said eleven, y’all.  Until there is better oversight, we have to protect ourselves, and that means arming yourself with knowledge!

Download the EWG Skin Deep app on your phone and use it when shopping:

Our “stratum corneum” does an amazing job of protecting us. If we are going to mess with that, let’s make sure we are doing so carefully, critically, and thoughtfully.  Here’s some help with the data – and don’t forget to take your reading glasses to the store!!!

More reading:

List of acceptable ingredients generally deemed as safe:

The NEVER List:

Whole Foods’ Never List:


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