KYBELLA™ : A NEW FDA-APPROVED INJECTABLE REDUCES SUBMENTAL FAT PADS (DOUBLE CHINS) FOR A MORE YOUTHFUL APPEARANCE

We are all enthusiastic about the introduction of Kybella at our office. According to a survey by the American Society for Dermatologic Surgery (ASDS), over 66% of patients polled are bothered by submental fullness – second only to crows feet as a major source of discontent about aging faces. So it seems Kybella has arrived just in time. Candidly, there is a lot to like about Kybella. It has solid science behind it, backed by clinical trials involving 2,600 patients worldwide. Impressive results have been well documented photographically. Some before-and-after photos are on this website. Kybella received a 79% patient satisfaction rating at trial. Very good again. As a minimally-invasive, low risk modality, patients can expect fewer and milder side effects compared to surgical procedures.
Patients will also appreciate that it’s done with local anesthetic. Aftercare is easy and it’s lifestyle-friendly (very little downtime if any). Schedule your appointment for Friday and by Monday nobody should be the wiser.

From a doctor’s point of view, Kybella offers a sensible way to treat patients without surgery. I have many patients with submental fat who are quite young and fit but still suffer a double chin and they are clearly not ready for a surgical lift. Another group that I think will become Kybella fans are men. Many of us have double chins but can’t take the time off or can’t bear the fuss associated with surgery.

Another plus for physicians and patients alike? Since Kybella treatments are done in a series, it allows us to inject, observe the progress and adjust subsequent treatment to achieve the best overall appearance on an individual basis. In effect, we can customize or “fine tune” it-a huge advantage over liposuction or surgery.

Overall, Kybella is a procedure that rewards careful patient selection and skilled injection technique. As always, you can count on us to tell you honestly if this is a good choice for you and that we will use our considerable injection skill to your best advantage.

VANQUISH FLEX: New Adjustable Panels Make it The Perfect Device for Slimming and Contouring Thighs and Arms

It’s about time for me to weigh in and share my impressions about our newest addition at the office: Vanquish Flex treatments for fat reduction and sculpting thighs and arms. First off, let me say how lucky I feel, that we have so many lovely patients who take good care of their bodies, are diligent with diet and exercise and sun protection. All that notwithstanding, they are troubled by fatty areas on their thighs and arms that their good habits don’t seem to effect. We feel Vanquish Flex will be extremely for useful for them, offering another tool to help them keep trim, feel better in their clothes and in their own skin.

Vanquish Flex is actually the addition of adjustable treatment panels to our existing upgraded Vanquish system which has been so popular for reducing and contouring torso areas (tummy, love handles, back bulge) As you can see in the photo above, the Flex panels are easily positioned to target the saddle bags and inner thighs, giving legs a more defined shape overall. Great for everyone who lives in shorts, bathing suits and active wear. In addition, we will be treating fatty deposits on upper arms…good news for the sleeveless.

Completely non-invasive, Vanquish avoids the negatives associated with SmartLipo. Providing your fatty areas are not extensive, it will do the job nicely, giving you a noticeable improvement at a terrific savings. It’s FDA-cleared. It’s a 6-week process, with progressive improvements in the ensuing months. It’s very easy to like: no changes to your lifestyle; just dedicate yourself to staying well hydrated so your body can flush the fat away and maintain your results

PELLEFIRM™ : THE NEWEST ENERGY-BASED BODY TREATMENT WORKS ON CELLULITE AND MORE

Cellulite is a devil to treat. It just seems to scoff at exercise and diet and won’t budge an inch. In addition, older procedures and topicals for cellulite can be messy, unpleasant, costly and disappointing. A new device at our office, PelleFirm™ radio frequency is producing admirable results, comfortably, quickly and affordably. Two years ago, we made our first foray into energy-based treatments for facial laxity with a radio frequency device called Pelleve (also by Ellman) and an ultra sound system called Vanquish, which some of you may already be familiar with. We liked the results they produced, our patients concurred and seemed to appreciate that the treatments were easy on their lifestyles, as well. So, this year we are applying our hard-earned expertise with radio frequency to give our patients the bodies they once had, before babies, sun exposure, stress, etc. PelleFirm is an FDA-cleared device with a lot to recommend it. There is really no downside to it. Improvements can be seen after the first appointment and from there, it gets better and better. Touch-ups are easy to do and in most cases, you are out of the office in less than an hour!
If you’re 30 and above, you might be looking at the undersides of your arms with despair. There, weight fluctuations, hormones, muscles and movement causes the delicate, oil-poor skin to stretch continually and what’s left behind is loose, crepe-paper-like skin you’d rather nobody noticed. PelleFirm is terrific for this too. Still another target…areas that have previously undergone liposuction. Here again loose, crepe-paper-like dimpled skin is often an unfortunate “leave behind” from lipo procedures which reduce the fat and therefore, the volume below. PelleFirm is a good solution. We are all very excited about the introduction of PelleFirm at the office this spring and what it will do to beautify and refresh thighs, arms, tummies, butts and bust for our patients. It’s a common sense, low-risk modality we think will fill a rising need and please a great number of people.

Vanquish Is a Fat-Reduction System With Solid Science Behind It!

For adult patients who are within 20 pounds of their ideal weight but want to improve a problem area like a protruding tummy or love handles.

As many of you know, I believe in science and all that it can offer us. So it’s no surprise that when I was considering a fat reduction system, scientific proof was at the top of my list. Vanquish had remarkable before-and-after treatment photos but more importantly, it had proof that fat cells were actually being killed off. The researchers used duplex ultrasound to demonstrate not only a reduction in girth measurement but more importantly a 60% reduction in the thickness of the fat layer…they went from 7.6mm to 2.9mm in four treatments. This means that through a process we call “apoptosis” or programmed cell death, the treated fat cells were eliminated and won’t be coming back. Remember, that new fat cells can grow at any time so you have to watch your diet and exercise, as always. But the iimportant this is that Vanquish can help people be thinner and it can do it safely and affordably without pain or downtime. Needless to say, I’m going to be using it myself because who couldn’t use this.

Putting Vanquish in Perspective for All My Patients. I am excited by the possibilities that
Vanquish offers. It has the largest treatment area in the industry and could be utlimately be used for many areas of the body but for right now, it does a wonderful job on the abdomen. And because it doesn’t require the operator to move, there’s no chance of overlapping or creating a divot or trough. Vanquish requires a little patient commitment (drink plenty of water, before during and after treatment) and I like that too. The hydration will improve your skin and your health overall.

Vanquish Fat Reduction - David M. Duffy, M.D. So. Cal. The newest non-surgical fat reduction system at special introductory pricing. Lose 2-4 inches in a series of 30-minute painless treatments.

Great News for Rosacea Patients! Mirvaso®, a New Fast-Acting, Long-Lasting Topical Gel Can Really Help.

Last month I had a visit from my Galderma representative with a new product introduction so impressive, I decided to make it my blog; The medication is MIRVASO® (BRIMONIDINE) TOPICAL GEL, 0.33%, which is an alpha adrenergic agonist. I see quite a few new products each year but this demonstration was remarkable. Within a few minutes, I could see the redness subsiding.

Mirvaso is the first and only FDA-approved medication developed specifically to address the redness of Rosacea. Rosacea affects some 16 million Americans each year and the most common symptom is facial redness. Clinical studies with Mirvaso indicate that redness began to diminish in as little as 30 minutes and lasted for up to 12 hours. Although, Mirvaso can not offer a cure, it can offer patients an improved appearance that is sustained long enough for a party, special event or big night out…and that’s a step in the right direction. Learn more at www.mirvaso.com.

We immediately started thinking about the possibilities of integrating Mirvaso into our Rosacea treatment regimen, which includes IPL treatments, spaced at the appropriate intervals, oral antibiotics, and anti-inflammatories.

Mirvaso, available only by prescription, is not for anyone under 18. There are some important cautions to be heeded with its use, low blood pressure for one, heart and vascular conditions, etc., but it has a low incidence of side effects which are, for the most part mild and controllable. Youwill need a screening consultation with me to obtain the prescription.

This brings me to another note that I must reiterate….when it comes to Rosacea, we must treat gently. A patient told me the other day that her facialist told her that only big-gun treatments would do her any good. THIS IS LIKE FINGERNAILS ON THE BLACKBOARD TO HEAR. NOTHING COULD BE FARTHER FROM THE TRUTH.
If you suffer from the redness for Rosacea, call us for consultation.

Dermaroller & Platelet Rich Plasma: They are Safe, Progressive and On-Trend!

I think of Dermaroller® Microneedling as a spin-off on FRAXEL laser technology….same principal, non-ablative, a dispersed pattern that stimulates new tissue. It’s gentle and low-risk and pairs well with fillers and Botox. And it is also an overall tightener and plumper, as it causes a revitalization and remodelling of your skin’s natural collagen (collagenesis) and vascularity (angiogenesis). Results in Europe are well-documented. There are studies abroad for Acne scars, stretchmarks and flattening elevated scars, that I find interesting.

Platelet Rich Plasma is anti-aging on the cellular level, using your body’s stem cells and growth factors, so there is no risk of allergy. PRP amplifies collagen production and improves organization, fibrin deposition and blood supply to the treated area. It’s effects are progressive. It works in the deep tissue so I pair it with surface-oriented technologies like peels, fillers, Botox and resurfacing for a wonderful update.

I think it’s important for me to put the value of these 2 new offerings in perspective for my patients. More and more, cosmetic dermatologists like me are showing interest in new directions; we’ve worked for many years with lasers, peels, ablation, fillers and neuro relaxants, all of which are “target oriented” (i.e. we use them to diminish wrinkles, pigments and imperfections that already exist). So naturally, we are excited by therapies that can induce a new wellness and vitality in skin going forward. Dermaroller and PRP are examples of this. They are integrative, synergistic and progressive. What this means to patients is that by adding these new therapies to their usual regimen of fillers, Botox and resurfacing, they are not only subtracting the old surface damage at present, but also adding deep development of better quality tissue to their skin’s future. In a sense, our goal is to teach the skin to rebuild itself better and better. The energy-based treatments we added last year—Ulthera and Pelleve-were moves in this direction. This year, Dermaroller and PRP are more on the same trend!

Energy-Based Therapies: Pelleve and Ulthera


For years, there were 4 main technological categories in restorative dermatology Non-Ablative (lasers, IPL, Fraxel, etc), Peels, Fillers and Neurorelaxants (Botox). Now, we are adding a 5th…Energy-Based Technologies, Pelleve and Ulthera!

Cleared by the FDA for treating facial laxity, they do so much more. They stimulate and firm deep layers (dermis) of the skin without damaging the top layer. It’s remarkable that significant remodelling can take place without surgery and without a hiding period.

We anticipate these new additions will be really helpful for several of our patient groups:
1. Patients in their 40’s to 50’s who have not yet had plastic surgery and want to postpone it,
2. Patients in their 50’s to 60’s who have had plastic surgery years ago and want to extend its results,
3. Patients with loose skin after weight loss or pregnancy,
4. Patients who have routinely used fillers and neurorelaxants and want something more holistic and long lasting.

Choosing the most effective treatment modality for each individual patient is key. For this, of course, we need to see you in person.