Wednesday, February 1st and Thursday, February 2nd

Botox® 20% OFF

Just like the “Groundhog Day” movie with Bill Murray, turn back time with a little Botox®.

Regularly $12.50 a unit, just $10 a unit  on those two clinic days only!

Valentine’s Special!

Love your Lashes, Love your Look.

Do Botox® or Juvederm® and purchase a two for one Latisse®!  Latisse® for longer lashes.

Regularly $115 per package, $115 for twowhen purchased at the same time with an Allergan treatment: Botox® or Juvederm® Filler.

Couples Skin Treatment Special!

Bring in your significant other!

Any microdermabrasion, facial, or peel second person half price when your significant other comes in with you.

Brilliant Distincitions®!

Call about Allergan Brilliant Distinctions® discounts for more savings on Botox®.

*No other discounts/offer apply.

*Must be considered an appropriate candidate for all specials.

*Valentine’s and Couples Skin Treatment Speicals good February 1st – 29th.

*Good while supplies and appointment times are available.

With the holidays behind us it’s time to gear up for the New Year – the one time of year when we put pen to paper to outline all our resolutions.  While losing weight and saving money may top your list this year, don’t forget about your skin.  Here are some quick and easy resolutions your skin will love in 2012:

Protect your skin from the sun everyday: Make a commitment to protect your skin from UV damage and wear sunscreen under your makeup or purchase makeup that has at least SPF 15.  UV damage can cause premature wrinkles and sun spots.  By protecting your skin from UV rays you will continue to look more youthful throughout the New Year!  Iowa Plastic Surgery carries the IPS™ Sensitive Sunscreen 30.

Throw away outdated skin products: Make-up that hasn’t been used in a while and other opened, outdated skincare products may be hosting bacteria and can cause breakouts.  Open the medicine cabinet and empty your make-up bag.  If you haven’t touched that skincare product or piece of make-up in months it’s time to say goodbye.  Your skin will thank you later.

Sleep without make-up: Not removing make-up is one of the worst don’ts when it comes to your skincare routine.  Make-up clogs pores and can leave your complexion looking dull.  Wash, tone and moisturize your skin every night before bed this year.

Exfoliate:  This is the step most people skip as part of their skincare routine.  Try exfoliating at least once a week with the Clarisonic® (Iowa Plastic Surgery carries at an excellent price and Bobbi can recommend the one for you) – You will see an immediate difference.  If  you can make it into our office, try a microdermabrasion, a chemical peel or facial.  Peels can take years off our face.

Consult a trained specialized professional before pursuing medical spa services (Botox®, Dermal Fillers): Minimally invasive procedures including Botox® and dermal fillers such as Artefill®, Juvederm®, or Radiesse® continue to grow in popularity.  But not every physician is well trained to perform these procedures.  Make sure you check the physician’s credentials and training, and validate they have extensive experience using the products they have recommended.  Don’t have white coat confusion!  A white coat does not make them a cosmetic expert!

Manage stress: Stress affects your health and over time can cause over-production of oil and inflammation which results in bad skin.  Relieve stress this year by taking a walk, going to a yoga class or other exercise.  You will stay happier, your health will improve and it will be reflected on the outside.  But if outside, don’t forget to protect your skin!

Winter has finally arrived and so is the season of dry, flaky skin.  Bobbi (our medical aesthetician) says you may need to make some adjustments to your skin care regimen.  A more hydrating moisturizer may be needed during the day and/or night to provide that extra care.  The best skin regimen would be a combination of medical mircodermabrasion and/or peels with moisturizing products.  Microdermabrasions and peels will help remove dry, flaky, dead skin cells.

Hydrating is very important for all skin types.  Oily or acne-prone skin also gets dry during the winter.  Keep in mind that if the skin gets dry, the body will try to compensate by producing more oils in the oil glands and that can set up a vicious cycle of dry-oily-acne skin.

*Content supplied by Suneva Medical

Product Spotlight

IPS™ Repair Moisturizer – Restore skin’s natural moisture barrier from within.  Clinically proven to reduce dry, cracked, flaky skin compromised by procedures such as microdermabrasion and superficial chemical peels.

The IPS™ Sensitive Sunscreen 30 -  Ideal for application post procedures such as microdermabrasion, superficial chemical peels that can leave skin dry or sensitive.

Clarisonic® – This device uses sonic frequency to remove oil, dirt and debris from the skin, while gently exfoliating to keep pores clear.  The Clarisonic® also leaves skin feeling smooth and soft and is a great addition for any skin type.

The new Thermage® CPT System represents a leap forward in skin tightening and contouring technology.  Superior results and greater patient comfort are at the core of the new system, which leverages our proprietary Comfort Pulse Technology™ and a vibrating handpiece for more comfortable treatments. 

Improvements:

• Improved efficacy due to more uniform heating and increased volume of tissue reaching therapeutic temperature
• Comfort Pulse Technology™, including a vibrating handpiece, to deliver enhanced patient comfort.

Our new energy delivery algorithm interweaves pulsed radiofrequency delivery with cooling bursts mimicking Transcutaneous Electrical Nerve Stimulation (”TENS”) therapy, to disrupt the brain’s neural response and improve comfort during treatment.

A new vibrating handpiece offers a clinically proven improvement in patient comfort.  In controlled, split-faced clinical studies, comparing treatment of over 40 patients with vibration to treatment without vibration, all patients preferred being treated with vibration.

Our redesigned treatment tips deliver enhanced heat distribution and uniformity, which lead to improved volumetric heating.  A greater volume of tissue is heated to target temperatures and the heating is more evenly distributed across the treatment area.  Data from our clinical study demonstrates that the Thermage® CPT system heats four times more tissue to therapeutic temperatures than current technologies.

Patients will be happier with the results and the treatment experience with the Thermage® CPT system.

100% of study patients preferred treatment with the Thermage® CPT system vs. treatment with prior technologies.  Average patient satisfaction scores 3 months post treatment were 4.2 out of 5 (1=dissatisfied, 5=very satisfied).

**One of our own IPS staff has gone through the treatment and is excited about the improvements, comfort and results.

See the benefits of the Thermage® CPT system in this short video Click Here.

Product Spotlight

IPS Repair Moisturizer.. For Dry Skin and Post Procedure.

Fatty acid, cholesterol and ceramides mimic the skin’s natural lipid barrier and restore moisture from within.  Fragrance, paraben and solvent-free.

Women and men suffering in their 20’s, 30’s, 40’s and even 50’s also suffer from acne breakouts.

The acne cycle is caused by hormones that prompt the oil glands to secrete oil; the pores get clogged with dead skin cells, bacteria cause the area to get inflamed, and then a pimple.  Adult acne can be related to hormonal surges that occur with the menstrual cycle.  Stress may also play a role with changes in cortisol that cause oil gland over secretion and acne.

There are suble differences between adult and teenage skin which may affect how we approach treating acne.  As we get older, our skin gets drier, and we use gentler products.

The first step in clearing acne is to cleanse properly with a product designed for your skin type.  Wash in the morning, at night and after exercise, but avoid washing too much and using harsh scrubs, which can actually make matters worse.  If your skin is really dry and/or sensitive, use a cleanser geared towards sensitive skin.  I like SkinMedica’s® Sensitive Skin Cleanser because it cleans without over drying the skin.  If you’re on the oily side, try a salicylic acid wash, such as SkinMedica’s®  Purifying Foaming Wash, to help gently and effectively exfoliate dead skin cells and unclog pores.

We like to pair these cleansers with the Clarisonic® Skin Care Brush to help deep clean acne prone skin without causing irritation.  This device used sonic frequency to remove oil, dirt and debris from the skin, while gently exfoliating to keep pores clear.  The Clarisonic® also leaves skin feeling smooth and soft and is a great addition for any skin type.

After cleansing, we must address the bacterial component of acne.  Topical benzoyl peroxide (BPO) and either topical or oral antibiotics can help target this part of the acne puzzle.

Retinoids are essential for preventing blemish formation and minimizing breakouts.  SkinMedica’s® Tri-Retinol Complex, which can be tolerated by most skin types and prevents whitehead and blackhead formation without causing redness and peeling, is good for adult acne.

Peels do not get enough attention in acne treatment.  These are terrific for addressing both existing acne and the resultant scarring.  Adult patients have seen rewarding results after a series of chemical peels or a glycolic peel.

Acne can have an effect on self esteem at any age.

Reference SkinMedica® Beauty Talk, Dr. Mona Foad.

Anesthesia, which is used to block painful sensation during surgery, is a major area of concern for many prospective patients.  Before insisting upon one particular anesthesia over another, it’s important for patients to have an understanding of what is normally administered.

Occasionally factors from your medical and health background or past experience associated with anesthetics can influence the decision, but the kind of anesthetic which is used depends upon the nature as well as extent of the operation, the preference of the surgeon and the actual wishes of the patient.  Advances in monitoring equipment and improved anesthesia drugs have largely contributed to improved overall anesthesia safety.  The risk of serious injury from anesthesia is statistically quite low.

Anesthesia Types- The primary function of anesthesia is to prevent pain.  There are four types:

• Local anesthesia is used to prevent pain in the specific area that requires surgery.  During local anesthesia, you are awake and aware of surrounding activities.  This type of anesthesia may be an ointment, spray or injection.
• Sedation is administered intravenously (through a vein) and may be used with other types of anesthesia during surgery.  Sedation includes a combination of medications that help prevent pain and anxiety associated with medical procedures.  There are multiple levels of sedation.  For example, “twilight” sedation is a common term that refers to a mid-level form of sedation.  There are also deeper levels of sedation that produce effects similar to general anesthesia.  generally speaking, during sedation, you are awake but sleepy, and you may not recall or sense that the procedure is being performed.  It is important that you understand the sedation level to be used in your procedure.
• Regional anesthesiais a “block”, such as a spinal block that is administered to the surrounding nerves that may produce pain signals.  regional anesthesia produces effects similar to those of sedation, which may be used in conjunction with regional anesthesia.
• General anesthesia is used for extensive medical procedures.  General anesthesia will put you to sleep.  General anesthesia prevents any pain, and you won’t remember the procedure afterward.  The drugs included in general anesthesia are inhaled or injected into a vein.

There are also some other advantages of different anesthesia.  For example, regional anesthesia, or spinal block when used for a tummy tuck, has less postoperative pain, less nausea, and less chance of hospitalization.  It is usually combined with sedation so for all practical purposes you think you feel you’ve had general anesthesia.

Sedation is less costly, as for healthy patients, it can be administered by a monitoring nurse.  Iowa Plastic Surgery has extensive experience with combining different medications.  Most patients tell us they do not remember anything of the procedure. 

Minor procedures such as mole removal or skin cancer removal we usually do under local anesthesia.

Blepharoplasty or eyelid surgery, some facelifts, repeat breast augmentation, and some liposuction are done under sedation.

Hand surgery or abdominoplasties are sometimes done with a regional block.

Most breast augmentations, breast lifts and larger abdominoplasties are done under general anesthesia.

Most importantly, our surgery center is accredited by the Joint Commission which also accredits hospitals.  Our team of registered nurses are not only well trained, but by performing the same procedures as part of the same team, provide a high level of safety.  Studies have shown familiarity decreases complications.  Iowa Plastic Surgery has a full size operating room with all the monitoring and safety equipment as the hospitals.  Dr. Van Raalte also has privileges at all area hospitals.

Product Spotlight

IPS Repair Toner™

A basic must to your skincare routine.  A staff favorite!

Repair Toner is anti-aging with Green Tea, Vitamin C and E.  May be used as a soap free cleanser to refresh and deliver antioxidants to fragile skin.

Dermal Filler, Injectable Filler, or Facial Filler

Juvederm™ is a non-surgical, injected treatment used commonly for age lines and volume. 

We all want to grow older gracefully.  While some people embrace the natural aging process, others would like their wrinkles to disappear.  The problem is as we age wrinkles and fine lines are inevitable.  To help remove signs of aging and to make one look as youthful as they feel Juvederm can help.

Juvederm™ can also be used for treatment of lines and volume not related to aging.  Common “off-label” uses include adding volume to thin lips, volume to cheeks, treatment of acne pits and scars, and other lines and depression.

Approved by the FDA in June 2006 for nasolabial fold correction, Juvederm™ is a non-surgical, injectable gel used to restore the skin’s volume and provide correction of wrinkles and nasolabial folds.  From the creators of Botox® Cosmetic, Juvederm™ is considered “next generation” injectable; it is a dermal facial filler made of a smooth consistency gel that is composed of cross-linked hyluronic acid.  It is similar to substances naturally made in the human body.

Where Does It Work?

Smile Lines (or “Parenthesis”)

Smile lines or nasolabial folds, run vertically from the bottom of the nose to the corners of the mouth.  This is a popular treatment area that many women seek help.  After one treatment of Juvederm™ – most patients see a real difference with a noticeable softening of the smile lines.

Marionette Lines

Marionette lines are the vertical facial wrinkles and folds that form below the corners of the mouth.  These lines can sometimes give the appearance of sagging and/or down turned expression.  Younger people rarely have these lines and they create a real stigma of aging.  Treatment of these is one of the most dramatic improvements in an office visit.  Patients report they not only look “happier” but feel happier too.

Vertical Lines

Facial wrinkles above and around the lips can appear over time due to ordinary lip muscle movement.  However, environmental factors such as sun exposure, smoking and stress can also contribute to how the area around your lips ages and the formulation of vertical lip lines.  Juvederm™ can soften those with typically just one treatment.

Juvederm™ XC is offered in two formulations: Juvederm XC Ultra (for areas where subtle volume enhancement is required) and Juvederm XC Ultra Plus (for correction of severely deep folds and wrinkles).

Juvederm™ XC (Extra Comfort) contains lidocaine – an effective localized pain reliever.  This formulation provides an injection experience that is gentle and comfortable, so you can feel good during and after treatment.

PRODUCT SPOTLIGHT

IPS CC Repair Serum/Gel

CC Repair Serum (oily skin) and CC Repair Gel (Dry/Sensitive Skin).  They are Vitamin C and E enriched formulas to reduce the appearance of fine lines and wrinkles.  The only Vitamin C compound clinically demonstrated to increase stimulating collagen production.  This compound also provides anti-oxidant activity and provides skin clarifying and brightening actions.  Also contains Green Tea Extract to help reduce skin dryness and irritation.

Are you concerned about uneven dark patches on your skin?

Darker spots on your complexion can be any of a number of skin lesions.  They can be superficial or deep.  They can be lightened by creams, lightened by lasers, or require removal.  They can be removed by either lightly freezing or burning and heal quickly or require excision like a mole.  In rare cases they could be something serious like a skin cancer.  

Hyperpigmentation is a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin. Hyperpigmentation can affect the skin color of people of any race. A more mottled complexion is usually payback for years of sun-drenched vacations.

Age or “liver” spots are a common form of hyperpigmentation. They occur due to sun damage, and are referred to by doctors as solar lentigines. These small, darkened patches are usually found on the hands and face or other areas frequently exposed to the sun in older individuals.

Melasma spots are similar in appearance to age spots but are larger areas of darkened skin that appear most often as a result of hormonal changes. Pregnancy, for example, can trigger overproduction of melanin that causes the “mask of pregnancy” on the face and darkened skin on the abdomen and other areas. Women who take birth control pills may also develop hyperpigmentation because their bodies undergo similar kinds of hormonal changes that occur during pregnancy.

Changes in skin color can result from outside causes. For example, skin diseases such as acne may leave dark spots after the condition clears.  Freckles are small brown spots that can appear anywhere on the body, but are most common on the face and arms. These are seen in young people with light complexioned skin that is prone to sun burns and exposed to the sun.

Freckles, age spots, and other darkened skin patches can become darker or more pronounced when skin is exposed to the sun. This happens because melanin absorbs the energy of the sun’s harmful ultraviolet rays in order to protect the skin. Wearing a sunscreen is a must. The sunscreen must be “broad spectrum” (i.e. it blocks both UVA and UVB).  A single day of excess sun can undo months of treatment.

Optional Treatments for Hyperpigmentation 

Most prescription creams used to lighten the skin contain hydroquinone. This bleaching agent blocks melanin, which are the pigment cells that give our skin color. Bleaches lighten and fade darkened skin patches by slowing the production of melanin so those dark spots gradually fade to match normal skin coloration. In more severe cases prescription creams with tretinoin and a cortisone cream may be used. Topical retinoids (derived from Vitamin A) exfoliate skin and speeds up new skin cell growth, diminishing dark, uneven skin patches along the way.

Chemical peels are also recommended as another step. Lighter peels have little to no flaking but need repetition and more time to lighten. Medium strength peels will lighten more quickly but have more irritation and flaking. Alpha hydroxy acids, such as glycolic acid, are exfoliants and can help remove hyperpigmentation. Beta hydroxy acids, such as salicylic acids, are also exfoliants that can help address hyperpigmentation.

Intense pulsed light (IPL) is good for treating broad areas. IPL treatment improves the appearance of photo aged skin, removes age spots (sun-induced freckles), most benign brown pigments, and redness caused by broken capillaries through a process called photo rejuvenation for face and body. The process is ideal for patients with active lifestyles because the procedure requires no downtime and has a low risk of side effects. IPL treatments are quick, gentle and non-invasive. The gentle, non-ablative treatments use broad spectrum light to treat the face, chest, neck and hands-virtually anywhere that sun damage shows.

There are now effective laser treatments.  A test spot in an inconspicuous place will need to be done as they sometimes make things worse instead of better. These are best for tiny spots and best for darker spots in a lighter completed individual. Think of the IPL treatment as a brush and the laser as a pencil.

In all of these treatments the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc dioxide is preferred over that with only chemical blockers. This is because UV-A, UV-B and visible lights are all capable of stimulating pigment production.

Cosmetic cover-ups can also be used to reduce the appearance of melasma. We carry Jane Iredale® mineral makeup.

Other lesions can appear brown, but since the pigment is deeper in the skin, they have to be treated differently. Seborrheic keratosis is raised, light brown irregular benign lesions. They can be removed by freezing or lightly cauterizing and will heal quickly. Nevi or moles are raised brown lesions that are excised if needed. Rarely, brown spots are premalignant or malignant including lentigo maligna, or melanoma.

IPS skin care products for your pigmentation problems

Gradual brightening skin products:

K Brightening cream Antioxidant skin brightener containing Kojic acid, hydroxyl-acids and Vitamin C. A more gradual brightening cream.

K Brightening pads. A brightening cream for oily skin.

K Dark Circle antioxidant under eye treatment. A gentle under eye brightener.

Weekly Mini Peel once a week exfoliating brightener. Use 1-2 times weekly to lightly exfoliate and brighten the skin.

Higher Intensity skin products:

K Lightening Pads Easy to apply pads contain hydroquinone for melisma and post inflammatory hyperpigmentation in convenient easy to use pads. Enhanced with Vitamin C, Kojic acid, and Salicylic acid.

K Lightening Stick An easy to apply touch stick to treat spots of melisma or other hyperpigmentation with hydroquinone, Vitamin C, Kojic and Salicylic acids.

Retinol Repair Gel 20 and 50 topical retinoids which when added to the lightening treatments will increase dispersion of melanin as well as improve dysplasia and increase collagen.

Retinol 20 pads same as above for oily skin. 

IPS treatments:

IPL – Intense Pulsed Light Treatments

Diolite Laser Treatments

Light peels

Jessners peels

TCA peels

What is a tummy tuck? Also known as abdominoplasty, a tummy tuck removes excess fat and skin. After the changes of pregnancy,  an abdominoplasty can also fix separated muscles creating an abdominal profile that is tighter and firmer.

The ideal candidates for tummy tuck surgery are patients in relatively good physical  shape, stable weight, but have excess skin or fat in the abdominal area that is resistant to diet and exercise.  You should have realistic expectations and not smoke.

Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The common causes of this include pregnancy, significant fluctuations in weight, and heredity.

Expectations

Tummy tuck surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

There are several types of abdominoplasty, mostly depending on how much skin needs to be removed. The length of the scar depends on how much skin is removed. If only the lower abdomen needs improvement a mini tummy tuck can be done. In a mini tummy tuck , the upper abdomen and belly button is unchanged. A full abdominoplasty allows tightening of the entire abdomen and removal of the entire loose skin. If there is loose skin on the sides the incision can go further back and is called an extended abdominoplasty.

After large weight loss, the skin may be tightened all the way around the body, and is called a lower body lift or belt lipectomy. Insurance, in a few cases,  may cover a pannulectomy which is just removal of the overhanging skin without liposuction or tightening of the abdominal wall. Usually the amount of skin is severe, hanging to the knees to be covered by an insurance plan. The majority of abdominoplasties are cosmetic and not covered by insurance.

You should understand the procedure and have realistic expectations. The repair and tightening of the abdominal muscles, along with the removal of the excess skin, may greatly improve body contour and appearance. Tightening of the abdominal wall is what affects the recovery and is similar to having a hernia repair or a C-section in recovery and return to activities.

Many cases can be done as an outpatient going home the same day. Iowa Plastic Surgery uses the On-Q pain pump which drips in numbing medication internally by the tightened muscles to reduce post-operative pain.

Although the results of an abdominoplasty procedure are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight or another pregnancy. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies may be advised to postpone abdominoplasty surgery. Smokers must quit smoking for two months before and after surgery to avoid severe complications to the skin. Other potential complications are all reviewed at the time of consultation.

 Dr. Van Raalte can explain all of the surgical options, discuss related treatments, and help ensure that you are a good candidate for abdominoplasty.

If you  would like further information or schedule a “get acquainted session” that shows an educational video, and before and after pictures, with our office staff at no cost, or if you want to schedule a surgical consultation with Dr. Van Raalte please call at 563-322-8877.

Dr. Van Raalte and the Annual Boy Scout Merit Badge Day 

This was Dr. Van Raalte’s 9th year as the First Aid Merit Badge Clinic Medical Coordinator.  The clinic at Genesis Heart Institute and Genesis Medical Center helped  130 Quad City area Boy Scouts earn their First Aid on  Saturday, February 5th.  The all-day clinic trained and tested the Scouts on how to recognize and treat medical conditions for First Aid. He also organized the Dentistry Merit Badge clinic for another 60 scouts.

New Beginnings…

Resolutions…

We are pleased to announce a NEW Beginning in 2011 with our own specially formulated skin care line…

INTRODUCING…

We researched for a skin care line that incorporated the best in scientific results for skin improvement.  IPS™ will have anti-aging, acne, and skin restorative products that our medical aesthetician, Bobbi, will recommend for your needs.  Cleansers, pigment management systems, eye treatments have been all designed for maximum medical grade results. 

New Advances

Anti-oxidants are very important in the management of skin aging and play an important role in postponing and ameliorating the signs of aging and in reducing photo-damage.

Vitamin C is one of the most beneficial anti-oxidants in anti-aging skincare.  Vitamin C is also a cofactor in collagen synthesis.  One of the latest advances in topical anti-oxidant formulations is an oil-soluble Vitamin C ester developed in Japan, and is one of the key ingredients in the IPS™ skin care line.

Vitamin C and E combinations work synergistically for improvement and specially formulated advances allow water soluble Vitamin C and fat soluble Vitamin E to be administered in the same product.

Peptides are new key ingredients to reduce puffiness and improve fine lines and wrinkles.

Touch Stick

We are especially excited about the pigment touch-stick, a powerful vehicle incorporating Kojic acid, salicylic acid, and Vitamin C in a touch stick applicator to be applied to age spots, pigmented spots, or melasma.

Acne

Salicylic acid is also a powerful agent against acne and is combined with Retinol, another acne fighting agent for two effective methods of treating acne.

As you can see we are very excited to introduce our new line IPS to you.

This is just an introduction before we formally roll out the line in time for Valentine’s Day 2011.