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

Eyelid Surgery is a standard therapeutic and cosmetic surgery procedure that is performed in the fields of plastic surgery and dermasurgery. We approach this procedure in a unique fashion…combining the best of cold steel surgery with “state of the art” CO2 laser instrumentation.

Traditionally, eyelid surgery involves the removal of the delicate fat pads by 1. identification of the fat pedicle with gentle skin dissection. 2. lifting of the fat pedicle 3. clamping with a forcep or “kelly” clamp 4. cutting the fat with tenotomy scissors and 5. intense coagulation (heating of the delicate eyelid tissue).

In our practice, with CO2 laser, we are able to eliminate steps 3 through 5. Once the fat is teased out, it can be genly ablated (evaporated) without the need for clamping or excessive heating. Fat which is still noted can be gently sculpted away  and the overlying skin muscle interface (septum) can be contracted without cutting using the CO2 laser in a defocused laser beam pattern.

I believe the technique minimizes the risk of the most serious side effect -retro orbital hematoma (bleeding behind the eye). It also lends itself to a much more precise type of surgery, one where the surgeon is more of an artist and less of a forger and pillager.

Check out the technique by clicking here… ah yes, the eyes ….they are indeed a beautiful sight to behold once again.

Before

  

 

 

 

 

After -7 weeks postop