ADAS Dermatology

By David T. Harvey, MD, FAAD, FACP

Aging can often take us by suprise and can affect many locations of our skin. Many of my patients in Jacksonville, Ponte Vedra Beach and Palm Coast complain that they don’t like the look and feel of their hands. They complain that doctors can help them with their complexion and skin issues on their face and neck, but friends still notice their hands. Many are self conscious because they experience, easy bruising, skin laxity, discoloration and muscle tendon prominence.

What can I do for this doctor? is the normal question that I am asked. Can you help my hand appearance? Several years ago,  I would not have a good answer but with today’s technology, there are great solutions out there.

At our practice, we like to take a twofold approach to hand rejuvenation. first, we look at degree of 1.  hand atrophy and then assess 2. the hand skin color and laxity.  If skin fullness is an issue, we have some wonderful new fillers today. We love to use Radiesse, a hydroxyappetitie (calcium based) product that has excellent properties for filling natural skin depressions. One to two vials are administered painlessly into the back of thinned out hands. A numbing solution is mixed with the Radiesse, so this makes the procedure very tolerable.

After filler treatments,, we can perform either a Fractional CO2 or IPL (intense pulsed light) treatment to get improve skin discoloration and assit with age spot removal. Fractional CO2 is also a great way to tighten the skin. This a wonderful treatment option with one to two treatments being the norm.

So it time to ante up and show your hands at your next card game or ladies dinner. No longer do you have to worry about giving away your age…instead you will amaze.

By David T. Harvey, MD, FAAD, FACP

Fig 1. Evolence

I wanted to blog about a new state of the art filler that I was recently introduced to and one of the first to use in the Jacksonville, Florida  area… Evolence™. This product is the latest filler to be used by dermatologists and plastic surgeons and has quite a few advantages over others (as I pleasantly found out). First of all,  the material is very, very smooth and easy to place. I was pretty amazed when I treated a patient’s cutaneous upper lip on a smoker I was sure needed a CO2 laser procedure (Fig 2).

The material is derived from porcine (pig based) collagen. It is processed in a very unique way, which eliminates the need for pretesting. The process of ribosylation, evidently reduces some of the secondary post-op swelling that is seen with some of the other products that we commonly use (Restylane™ and Juvederm™).

Anecdotal reports have the material lasting from 15 to 24 months but I am not commenting until I see it for myself. To date, I am very impressed with how the material seems to finds the small lines and virtually erases them. Bruising is minimal. Cost is similar to the other products mentioned and varies from $600 to $800 dollars per vial.

Fig 2a. Before upper lip line treatment

Fig 2b. After treatment

A new filler, Evolence Breeze™, is set to hit the US market next year and this can be used in the lip region.

I will keep you posted of my personal experiences with this material but so far …so good.