Cosmetic dermatology procedures can improve the appearance of the skin by correcting skin flaws such as acne, scars, and wrinkles. Dermatologists can also treat skin conditions that may not necessarily be harmful, but can affect or even disfigure a person’s appearance.
At our office, Dr. Michael Elm or Dr. Kaley Myer will work with you in selecting the appropriate cosmetic dermatology procedures that meet your aesthetic goals.
One of the most popular treatments for lines and wrinkles.
Cosmetic removal of skin lesions such as moles, skin tags, and cysts
Generally cosmetic procedures are not covered by insurances. We accept a variety of payment options including CareCredit.
At the first consultation, your treatment cost will be determined based upon your specific needs. Costs vary significantly between individuals based on various clinical criteria including: the skin region to be treated (such as, face, arm, chest), the size of the treatment area and the treatment technique best suited to meet your needs. A single treatment can range from $200 to $4000 or more depending on the treatment you and your physician choose to pursue.
Your initial visit will involve a consultation and evaluation with your treating physician. During the consultation, you and your physician will discuss together what your goals are and how best to achieve them. Your consultation will last as long as needed to fully address your concerns and lay out various treatment options. This may be as little as five minutes up to 30 minutes. At the conclusion of your first visit with us, you will have an individualized treatment plan and a clear idea about what to expect during the procedure and how much the procedure will cost.
Our cosmetic first consultation costs $100.00. This fee includes the cost of your evaluation and the development of your treatment plan. If you decide to go forward with the treatment plan, the entire fee will be put toward whichever cosmetic procedure you decide to go with.
Botox was introduced to the world in the late 1980s by ophthalmologists, who began using it to treat optic muscle disorders. It was approved by the Food and Drug Administration (FDA) for the treatment of moderate to severe frown lines between the eyebrows (glabellar lines) in 2002, and its popularity has soared ever since. Botox is consistently one of the top five nonsurgical cosmetic procedures performed each year.
In addition to glabellar lines, Botox is used to eradicate crow’s feet, frown lines and furrows in the forehead. Whereas treating crow’s feet with Botox was for many years an off-label use, the toxin got the official FDA nod for treating crow’s feet in late 2013. Botox is also approved to treat a variety of medical conditions, including ocular muscle spasms, problems with eye coordination, severe armpit perspiration, migraine headaches, overactive bladder, urinary incontinence related to nerve damage from conditions such as multiple sclerosis and spine injury. Botox is being studied to determine if it might be useful in treating conditions such as knee and hip osteoarthritis, temporomandibular joint disorder (TMJ) and benign prostatic hyperplasia (BPH).
Botox or Dysport is used to selectively weaken the muscles that cause the creases in the skin. This allows the skin to smooth out over several weeks. Results are visible within one week after treatment and remain for a minimum of three months.
These products should only be injected with sterile instruments in a doctor’s office or a medical spa — not at Botox parties at your local nail salon or neighbor’s living room. Providers specifically trained and experienced with these products include Dermatologists, Plastic Surgeons, and Otorhinolaryngologists (ENT Physicians). You may feel some minimal discomfort from the shot, but today’s needles are so thin and fine that the procedure is often virtually painless. Depending on the extent of treatment, the procedure can take anywhere from a few minutes to 20 minutes.
Selecting the correct injection points is critical to the success of the procedure which is why selection of a provider is so important. Your doctor will likely select numerous injection points for each location to be treated. (These points are located where the muscle contracts — not necessarily at the wrinkle you are hoping to erase.) The product is then injected into the marked points beneath the skin.
You can resume normal activities immediately, but your doctor may advise you to stay out of the sun. It is also critical not to manipulate the skin in the areas that were treated for 24 hours.
The most common side effects of Botox include headache, nausea, flu-like symptoms and redness and pain at the injection site. Infrequently, patients experience muscle weakness or drooping of the upper eyelid muscles. This side effect usually resolves within days. In rare cases, however, upper eyelid drooping may last for months.
The FDA now requires black box labeling on Botox and similar products such as Dysport and Xeomin to warn of rare but potentially life-threatening swallowing and breathing complications if the toxin spreads beyond the injection site. None of these complications have occurred in people using Botox for cosmetic reasons and the FDA states that cosmetic use of Botox appears to be safe.
[Please click here for an update on the current FDA review of Botox after reports of adverse reactions among individuals receiving injections for non-cosmetic reasons.]
There may be alternative treatment options, depending on your condition. For severe wrinkling, surgical procedures may be more appropriate, such as a facelift, forehead lift and eyelid surgery.
Your doctor may recommend additional treatments for you to consider in conjunction with Botox or Dysport. These might include fillers, chemical peels, laser skin resurfacing, microderm-abrasion, , or Ultherapy.
Many types of physicians perform Botox/Dysport injections including dermatologists, plastic surgeons and ENT surgeons. Botox and Dysport injections require a precise knowledge of facial anatomy. Your risk of complications increases when Botox/Dysport injections are performed by unskilled injectors.
The cost for Botox may range from $125 to $400 per treatment area. Multiple areas may be treated at one time, and repeat treatments are needed every three to four months, on average. When it comes to Botox and other injectables, you get what you pay for. Buyer beware: bargain Botox may increase your risk of complications, including poor cosmetic results. If the cost is prohibitive, ask your doctor about payment plans.
Chemical peeling is a technique used to improve the appearance of the skin. In this treatment, a chemical solution is applied to the skin to remove a layer or layers of skin. The new, regenerated skin is usually smoother and less wrinkled than the old skin. Dermatologic surgeons have used various peeling agents for the last 50 years and the best peel for your skin will be determined at your consultation.
Chemical peels are best used to treat early photoaging changes: fine wrinkles, coarse skin texture, sallow skin tone, age spots, and certain other pigmentary abnormalities can respond well. These problems are usually treated with a combination approach of Renova, home use of glycolic acid, and glycolic acid peels performed in the office. The exact combination is individualized for each patient. Chemical peels are also used to help treat skin that has many blackheads and whiteheads. It can help open these up and begin clearing the process more quickly.
Deeper and more severe photoaging changes are better treated with either a deeper peeling agent like trichloracetic acid or more commonly Laser Resurfacing. Areas of sun damaged precancerous keratoses are also sometimes treated with one of these two techniques.
Glycolic acid peels are generally preceded by two or three weeks of Renova and glycolic acid cream applied at home. The area to be peeled is cleansed and degreased and the appropriate concentration of glycolic acid applied and left on the skin for about 2 ½ minutes before the acid is neutralized. A tingling to moderate burning sensation is expected but disappears when the peel is completed. Generally a slight redness appears that lasts hours to a day with a little extra dryness over the same time period. It is almost always possible to return to work the same or certainly the next day. After 24 hours the use of skin medications is resumed. For the rejuvenation procedure, stimulating natural healing processes, a minimum of 4 peels is recommended at two-week intervals followed by maintenance peels at 4-month intervals. Daily sunscreen use is recommended, and specific types will be recommended. For acne, peels are usually performed every 3 to 4 weeks until clearing.
Because glycolic acid peels do not remove the entire epidermis (top layer of skin), there is no wound and thus very few complications. Occasionally focal areas of persistent redness appear that heal with a temporary brown discoloration. Rarely does a blister or scab appear which may leave a brown spot or even less likely a scar. After the peel, 1% hydrocortisone ointment over-the-counter may be used for several days for irritation if needed. Sunscreen should be used daily.
Prior to treatment, it is important to inform us of any past history of keloids (thick abnormal scarring tendency), extensive x-ray therapy of the face, recent Accutane use or recurring cold sores.
Dr. Elm is a graduate of University of Hawaii, John A Burns School of Medicine. He is a member of the American Academy of Dermatology, the American Society for Dermatologic Surgery, and the American Medical Association.
Dr. Elm is board certified by the American Board of Dermatology.
Dr. Elm’s philosophy on cosmetic dermatology is to uncover, revitalize, and restore one’s existing beauty, in order to maintain a natural appearance
Dr. Elm graduated from the University of Hawaii medical school and completed his dermatology residency in San Antonio, Texas. He is a board certified dermatologist.
Dr. Myer graduated from New York University medical school and completed her dermatology residency at the University of Arizona. She is a board certified dermatologist.
We are located at the water edge on the west side of downtown Olympia. Coming from downtown Olympia, take the first right off the second round-about. If you are coming from West Olympia through Harrison Avenue, take the 2nd right off the first round-about. Use Google Map below for turn-by-turn directions.
The entrance to our offices is at the street level on West Bay Dr. Our offices are under the parking lot. You can park in our parking lot or at the street. Walk into the building entrance (has the number 304 on the front) and take the elevator to level 3. Our cosmetic and general dermatology office is on your left as you exit the elevator.
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