Skin Tightening

BOTOX®, DYSPORT®, and XEOMIN® are three different derivatives of onabotulinumtoxinA made by three different companies and they all work in a similar manner. They are prescription medicines injected into muscles and used for both cosmetic and medical treatments. For cosmetic applications, BOTOX®, DYSPORT®, and XEOMIN® temporarily improve the look of moderate to severe frown lines, crow’s feet, forehead lines, and vertical bands connecting the neck and jaw in adults. Repeated muscle contractions from frowning, squinting, or raising eyebrows cause skin to furrow and fold, gradually resulting in the formation of facial lines. These relaxers work beneath the surface of the skin and temporarily reduce the underlying muscle activity that causes moderate to severe frown lines, crow’s feet, and forehead lines in adults. Treatment requires minimal downtime. You can return to your daily routine immediately after you leave our office. You may notice results within 24 to 48 hours for moderate to severe frown lines. Botox® Cosmetic is manufactured by Allergan Inc, an Abbvie corporation. Treatments with Botox® Cosmetic are supported by the Allē Rewards Program. Dysport® is manufactured by Galderma Inc, a McKesson Specialty corporation. Treatments with Dysport® are supported by the Aspire® Rewards Program. Xeomin® is manufactured by Merz Pharmaceuticals, LLC. Treatments with Xeomin® are supported by the MERZ CONNECT™ Rewards Program.

Hyaluronic acid (HA) is a naturally occurring compound that helps the body retain water and provides a natural lubricant enhancing flexibility and movement to the skin. Injections of HA in various forms to areas of the body can restore a more youthful appearance by reducing the age-related loss of collagen support. HA fillers have been created by connecting individual HA molecules into long polymers using different crosslinking agents. Each polymer form of HA is given a particular name and has various properties of stiffness, support, or flexibility. These different HA fillers can be used to achieve a variety of results depending on the area of the body and desired effect. Juvéderm® Juvéderm® is an HA filler manufactured by Allergan Inc, an Abbvie corporation, as a collection of six unique and long-lasting fillers: Voluma, Volux, Vollure, Volbella, Ultra and Ultra Plus. Each one adds volume and is designed for different needs in specific areas of the face, including the lips, cheeks, chin, smile lines, under eyes, and jawline. Treatments with Juvéderm® products are supported by the Allē Rewards Program. Restylane® Restylane® is an HA filler manufactured by Galderma Inc, a McKesson Specialty corporation, and has various forms sold under the names: Restylane-L, Refyne, Defyne, Lyft, Kysse, and Contour. Each of these HA fillers has specialized properties making each one better for use in various areas of the face. Treatments with Restylane® products are supported by the Aspire® Rewards Program. Bio-stimulating fillers are injectable substances that stimulate production of more collagen when injected into the top layers of the skin. Bio-stimulators are different from hyaluronic acid-based fillers which do not cause the skin to produce collagen and only fill areas of collagen depletion. The advantage of stimulating the production of collagen is that treatment results can last up to two years post injection as opposed to months for hyaluronic acid fillers which may only last for months. Mahinakealo Dermatology offers three types of bio-stimulating fillers. Sculptra® Injection Unlike hyaluronic acid fillers, which fill lines, wrinkles, and folds, Sculptra® is the original FDA-approved poly-L-lactic acid (PLLA-SCA) collagen stimulator that can improve skin glow, tightness, and jawline contour for up to two years, restore natural collagen and improve skin quality for firmer, glowing skin in the entire cheek region. Sculptra® can be used to restore volume to the temple, chin, jawline, cheeks, naso-labial fold, neck, arms and chest, in addition to other areas of the body. Radiesse® Injection Radiesse® builds your unique structural contours by stimulating collagen and elastin production. The results are immediate, natural, and subtle, for a look that perfectly complements your unique beauty. Radiesse® vertically lifts for immediate volume correction, contours and defines the lower face and jawline, stimulates collagen to increase your skin’s thickness and smooth texture, and promotes elastin production to give you noticeable improvements in your skin’s quality and suppleness. Radiesse® can be used to stimulate collagen in the hands and diluted for treatments in the neck, arms and legs. Platelet-Rich Fibrin (PRF) and PRF Gel PRF and PRF Gel are 100% natural bio-stimulating injectables that utilize the body’s natural proteins and growth factors to improve skin tone and texture while treating deep tear troughs, lines and wrinkles, volume loss, and more. PRF combines your body’s own platelet-rich fibrin (PRF) with albumin to create a natural filler that may be safer and more versatile than most injectables because it uses your body’s own blood components. PRF provides an innovative, flexible consistency that allows the gel to adapt to the various treatment areas, including: undereye hollows, sunken cheeks, fine lines and deep wrinkles, enlarged pores, chin and jawline contouring, and lip augmentation. The treatment smooths lines and wrinkles, restores volume, and creates a scaffolding that promotes collagen and elastin generation for smoother, younger-looking skin. PRF can be used anywhere on the face, neck, scalp or chest to induce collagen production without creating a filled appearance. PRF gel fills and stimulates collagen production anywhere on the face.

Microneedling with Evo MicroPen® Mahinakealo Dermatology offers microneedling for acne scars and wrinkling using the Evo MicroPen®, which is a small handheld device with a sterile tip that creates small punctures in the skin to a depth of up to 2.5 mm. This medical grade needling stimulates the wound healing process which includes inflammatory cells secreting cytokines and growth factors as well as stimulation of collagen and elastin production. This treatment is appropriate for Fitzpatrick skin types II to IV to alleviate wrinkling and reduce scar tissues that may have formed from injuries or acne. PRP can be used post procedure to help reduce the recovery time from the procedure. This procedure is commonly referred to as a vampire facial. Radiofrequency (RF) Microneedling Radio frequency microneedling is an ideal treatment for patients with all skin types seeking rejuvenation, or those who want to revitalize their aging skin with minimal downtime. The process involves a series of customizable RF microneedling treatments to provide deep dermal remodeling. Energy is precisely delivered at varying depths to treat common skin concerns such as fine lines, wrinkles, scars, acne scars, striae, pore reduction, and more. The release of radiofrequency energy stimulates the production of collagen at depths of the skin which promotes superior results when compared to microneedling alone. PRP can be added post treatment to reduce the recovery time from the procedure.

TriLift™ represents a non-invasive and non-surgical method for tightening the skin on the face. The procedure involves three different methods for changing the tightness of the facial skin. Glamour Facial Muscles refer to the muscle groups responsible for our toned and defined look. Using Dynamic Muscle Stimulation technology, TriLift™ tones the cheek, jowl line and under-eye areas to enhance the underlying facial structure. The treatment is customizable enabling a specific result for every patient and a naturally lifted look. DMSt - Dynamic Muscle Stimulation technology works by activating different facial muscles with electrical stimulation for a well-defined, toned, and lifted look. TriPollar® RF - Focused RF Thickens and strengthens the dermal layer to treat facial wrinkles, Regenerates collagen and elastin with clinically proven long-lasting results. RFMN - Smooth RF assisted Microneedling increases the natural volume, tightens, and smooths the skin texture while causes 3x more natural production of Hyaluronic Acid

Sofwave™ uses ultrasound energy to stimulate the production of new collagen, resulting in tighter skin with a more youthful appearance. Sofwave™’s Synchronous Ultrasound Parallel Beam Technology is FDA cleared for lifting the eyebrow, submental and neck and reducing fine lines & wrinkles. The advantages of ultrasound-based skin tightening are that the treatment does not puncture the skin, recovery time is minimal, and the patient can resume daily activities, skin care routines and sunscreen immediately after the procedure. The absence of any downtime offers an opportunity to achieve a more youthful appearance without appearing to have had any procedures done. This treatment is for firming and lifting without any resurfacing to the top layers of the skin.

CO2 laser resurfacing can be done with either our Cutera Secret PRO™ or our Alma Hybrid® depending on your skin type. We offer CO2 laser resurfacing for all skin types up to Fitzpatrick V. Our lasers feature high-powered fractional CO2 laser scanner to deliver stable, uniform energy in short pulses. The laser beam momentarily heats the surface of the skin to help regenerate collagen in the upper layer, which results in tightening and wrinkle reduction on the surface of the skin. Fractionated CO2 Lite is a series of gentle, full-face, fractional CO2, micro peel treatments address the superficial layers of photodamaged skin and stimulates collagen production for skin revitalization with minimal downtime. Fractionated CO2 Ultra is an aggressive treatment which uses CO2 laser energy to target, photodamage, uneven texture, scars, crepey skin, and deliver more dramatic results in a single treatment. Mahinakealo Dermatology offers a combined treatment of radio frequency microneedling and a fractionated CO2 laser using the Secret Pro™ by Cutera. CO2 laser treatment induces surface changes to the skin while the RF microneedling promotes collagen production below the surface. Combining these two modalities enables both a short-term tightening of the surface skin and a long-term wrinkling reduction due to the production of new collagen. This treatment represents the best treatment for rejuvenating because of the two-modality approach. Our Alma Hybrid® combines both ablative CO2 and non-ablative laser wavelengths (1570 nm) into a single procedure where both lasers can fire simultaneously, reducing treatment time. Each of the two lasers have adjustable settings which allow for laser rejuvenation and resurfacing of patients with darker skin types comparable to our Secret PRO™ CO2 laser and RF microneedling results, which is primarily for lighter skin types.