How to see a Doctor without seeing a Doctor

 

Virtual Telemedicine is one of the newest and fastest growing fields in medicine. It applies to all specialties in medicine. Start-ups are popping up left and right that offer "Virtual Consults". 

So what is a "Virtual Consult"?

A virtual consult consists of text messages, phone conversation, email messages, pictures, or live video interaction between a healthcare provider and a patient that enables the patient to get a prescription without being seen, or get re-directed to an appropriate health-care facility, specialist, or emergency room. 

This is a great tool for people to use looking for some insight into what is going on with them. There are plenty of new start-ups that allow you to connect to a doctor seamlessly, unfortunately you may or may not know about the doctor and their reputation. When it comes down to it, people like to talk to doctors they know or can relate to. Many practices are offering these services to their patients, they may not all be 24/7 but for the most part have good response times and for non-urgent medical needs can help you out. Typically 75% of the virtual consults I perform can be handled over the phone with follow up needed in some of the cases.

So skip the Doctor's office, if you can, and feel better faster...

Dr B

305.308.5712
www.symmetrymedicine.com
NYC | MIA

Vitamin A The Superhero of Skin Care Vitamin A, better known as Retinol or Retin-A has been the backbone of anti-aging medicine for years. With its implementation the field of anti-aging skincare was founded. Any good skin conditioning regimen incorporates vitamin A into the skin conditioning routine and for good reason.  Vitamin A works by encouraging new and stronger healthy skin to grow. As we age, sun damage and signs of aging build up and our natural mechanism for recovery slows down. Vitamin A will help get your skin improve its tone, texture, radiance, uniformity, fine lines, and thickness.  With more retrospective analysis of skincare regimens  and better technology we have recently been able to evaluate long term trials and newer delivery systems for these medicines. First to understand the general application of Vitamin A, you will have to know the two major groups (yes there are more): Retin-A & Retinol. Retin-A tends to be a much stronger product that has indications for antiaging and skin condition disorders (acne, hyperpigmentation, scaring). It is a great product but comes with some problems. Retin-A has a 3-6 week "reaction phase" in which the skin will need time to adjust to this new product. The skin will become dry and flakey. This can detour a lot of patients from completing use. After 12 -16 weeks your final results will be shown in beautiful radiant skin. Unfortunately, longer studies are showing that without a "skin holiday" (the cessation of using products) Retin-A can cause more harm than good. This is where we turn to Retin-A's little brother, Retinol.  Retinol is a weaker product, but excels greatly in patient compliance. That's right, its easier to use with less "irritating" side-effects. The usual adaption phase of getting used to the product is 1-2 weeks of redness and flaking. Results are similar in long term studies, but Retin-A does work much faster. Another advantage of retinol is that it does not cause any long term side-effects to the skin. The skin will continue to improve and prevent even with long term use.  It is important to know that with any of these products, daily sunscreen application is a MUST. The stability of the product is also important. Not just any product will work well. 0.05-0.1% is the ideal concentration of retinol. It should be in Cream form as gels and lotions cause more irritation. Moisturizer is improtant, but if used during the application of retinol can decrease the retinols efficacy. The product must be kept away from sunlight and at room temperature in order to stay stable. Newer nano-particles and fat designed products enable for better skin penetration. Currently I recommend skinceuticals products as they have the best profile.

Symmetry Medicine Webpage

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Botox: The Latest Trends!

Botox is hotter than ever. Popularity of cosmetic treatments is exploding every year. More and more new treatments keep hitting the market and more patients are seeking out Botox at younger ages and for "off label" treatments. Off label treatments, are treatments that are not the traditionally used method, but an alternate method that patients are getting benefits from. 

What Everyone is Saying:

The general consensus for use of Botox at a younger age is to help prevent lines instead of waiting for them to show up and then correcting them. This has widely been accepted as a valid use with great results.  

One new study that has recently been presented at the American Academy of Dermatology has shown that women that use Botox consistently over a long term period not only perceive themselves as younger, but also feel younger. These woman report more energy, more active lifestyles, and better sex drives. 

Still Coming of Age: Xeomin

Younger patients are turning to Botox's little brother, Xeomin. Xeomin is a Botox alternative and uses a bioidentical form of Botox (Botulinum) results are equivalent in major studies and in 90% of my patients results are equivalent. Xeomin is a great alternative that shows faster results at less cost. Xeomin treatments can be about $100 dollars less on average of a typical Botox treatment. 

Newest Uses
The latest new use is Botox is an old one re-invented. Blocking excessive perspiration (hyperhydrosis). Botox has been used in the past for preventing excessive armpit perspiration which lead to its use to prevent hand or foot sweating. Now with all the time and money being spent on hair salons and dos, woman are having small injections of Botox into the scalp to prevent excessive sweating and preserve their new look. 


Botox is a brand name product produced by Allergan. Xeomin is a botulinum product equivalent to Botox produced by Merz Aesthetics. Both products are FDA approved and safe for use with no known long-term side-effects. Botox has been around since the early 80's. 

Symmetry Medicine is a concierge service that delivers medical grade beauty treatments in the privacy of your own home or apartment. Schedule an appointment today and receive one free skinceuticals sample product and discounted first purchase on any skin care product. 

 

www.symmetrymedicine.com

Beauty Delivered on your time.

Three HUGE tips when getting & buying Botox Treatments

So, you have booked your Botox appointments with lifebooker or Groupon or another social marketing site... Now what? 

No 1. Don't Cheapen Yourself. 

You get what you pay for, lower priced procedures tend to be done by non-physician staff and the treatment is typically subpar or "light". Many clients of mine follow up with me after a "deal" booked online with questions about the treatment and problems with the treatment. It blows my mind sometimes how little clients know what is going on, who is injecting them, how trained that person is. Ask questions! 

No 2. Listen to the Injectors Advice. 

Some clients come from previous injectors looking to change doctors for many different reason. Often, a client will tell you how the other doctor used to do it. This is fine, and I actually like this (especially if you used to get great results by that doctor). Unfortunately, every doctor injects a little differently. Most of the time the information relayed to me is a bit off. Unless you are 100% sure what your previous injector did (how many units is KEY), it is best to take your new injectors advice on how much and where to inject. Your new injector wants you to get a great result, after all return and referral business is their livelihood! 

No 3. Don't do anything silly. 

Yes, you shouldn't use retinA, drink alcohol, take aspirin, and a slue of other "No, Nos" in the week leading up to a procedure. As far as Botox and Filler this is a soft recommendation, it can cause some mild complications but is usually not an issue. What is an issue is patients that have plans after the procedure. Yes you can go out to dinner, grab a coffee with a friend, go to the movies, relax, but please please do not plan to do any time of strenuous exercise or any activity that will have your face down or manipulated. Here is a little list of things people have had planned and had to cancel: Yoga, workouts, soul cycle, massages, acupuncture, steam room, sauna, the list goes on. Just be smart, take a day off. Botox effects can last 3 months but some other procedures can last much longer. Do yourself a favor and take it easy for a day!

Alexander L. Blinski M.D. 

305.308.5812 | ablinskimd@gmail.com

Symmetry Medicine ~ Beauty Delivered

New York, NY

www.symmetrymedicine.com

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Juvederm Voluma: The new kid on the block

If you are reading my blog, that means you know what a dermal filler is.  

A quick recap: Dermal fillers are used to plump up areas or add volume underneath the skin. The dermal fillers I use are typically composed of hyaluronic acid (made synthetically, but is a natural occurring substance in our bodies and dissolves over time). Once any of these fillers are placed they soak up water in the area over the next week or so and expand in size. 

These fillers are typically used to: 

• increase lip size
• decrease facial wrinkles 
• decrease size of lines from the nose to the mouth
• fill in smokers lines
• improve under eye volume loss (leading to the "sunken" look)

The new "Big dog" on the market comes from Allergan, the same company that makes Botox and regular Juvederm. The new product is called Juvederm Voluma. It is a hyaluronic acid filler that is aimed at "re-volumizing" the face. As we age we tend to lose our fat pads in the cheek area resulting in a more hollow faced appearance. Juvederm Voluma is an out patient procedure injection that places this "plumper/volumizer" in the cheek and causes a lifting effect to the entire cheek and face. These results last 1-2 years! The best part, if you are unsatisfied with it, this particular filler can be dissolved!

Results are very subtle and a bit pricey, but 1-2 years!! That is pretty darn good!

More to come on fillers soon, alternative uses and more about Belotero for tear trough defects (undereyes).

Dr. B
www.symmetrymedicine.com

The secrets behind Retin-A and Retinol: The cornerstone of anti aging treatments

All trans retinoic acid, commonly known as Retin-A, is truly the cornerstone of cosmetic medicine and should be included in most, if not all cosmetic treatment regimens. As many of my patients know, a skin conditioning regimen that you can stick to is so very important. With at home skin conditioning, maintenance procedures, and corrective procedures, it is very possible to slow down the aging process or reverse signs of aging by up to 10 years!

Later in the blog series we will discuss what components are in a skin conditioning regimen and why some patients need more than just moisturizer.

Retin-A (a vitamin A derivative) is truly the backbone to the field of anti-aging. The anti-aging revolution was started with this product. Retin-A forces the skin to slowly start making more new collagen. Yes, you read that correctly, new collagen. New collagen equals less fine lines! 

It's important to stick to a few guidelines with Retin-A products:

• Always wear sunscreen (you can burn easier when using Retin-A)
• Be consistent: skin needs time to adjust, your skin will likely be dry, flakey, and irritated for two weeks while the pH of your skin adjust to its new regimen
• Use a good moisturizer, dry skin looks good on nobody
• Apply every evening and take a "holiday" a couple times a year. Just stop using the cream for 2-3 weeks
• If you cant tolerate the strength there are great alternatives: Adapalene and Retinol

I like using skinceuticals skincare products who sell a great Retinol.

Hope this helps everyone know some more about a great product.


Dr. B
www.symmetrymedicine.com

Acne Scars: New inexpensive treatments that work!

Acne is a disease that plagues many people through their teens and some into the late 20's and 30's. Recall those gruesome days in high school? Well, if not, consider yourself lucky. Unfortunately numerous people are left with unsightly acne scars resulting from from the uncontrolled inflammation and damage to the skin resulting in irregular collagen formation.

Typically acne scars come in 3 types: 

• boxcar 
• icepick
• rolling

The type of acne scars that exist will likely depict the response to treatment. Fortunately, most patients have mixed presentation of acne scars and all can be improved or resolved with combination treatments. 

Typical treatment in previous years has consisted of peels, laser/light therapy, and surgical removal. Unfortunately many of these procedures have an increased risk of hyper or hypopigmentation (lightening and darkening of the skin) and can carry a heft price tag. In New York City a full series of acne scar removal with laser therapy may run upwards of $3,000. 

Introducing percutaneous microneedling collagen induction therapy, trademarked as Dermapen and many other competitors. This technology uses high-speed vibrating handheld devices to make micro-injury (controlled injury) to the skin allowing numerous growth factors and collagen synthesis to occur in an organized fashion. 

Over the course of 10 weeks your skin will begin to smoothen out and acne scars will be come less noticeable and some will completely resolve. For acne scaring, I typically recommend patients to have 4-6 treatments, each treatment a month or so apart.

The treatments are painless thanks to topical numbing cream and the vibrations of the device. The device makes tiny microscopic almost pinpoint needle tip penetrations of up to 1,000 times per second! These little mirco-wounds are at a controlled depth by the physician and differ on each spot of your face.

The results are spectacular. The risks, little to none... Can't beat that, and to top it off most sessions start at $200/session with multisession discounts (beats that hefty $3,000 Laser price tag, with equivalent results).

What about downtime? With any procedure, different skin reacts different ways, but in my experience people are ready to go back to work in less than 24 hours. Granted you may peel a little like a sunburn over the next week or so, but nothing as drastic as laser. The technique causes less damage to the surface layer than laser, hence... shorter downtime!

It is very important to follow a post procedure skin care regimen that your doctor can prescribe.

Don't forget this treatment is not just for Acne marks.

It works well for: fine lines, smokers lines, skin tightening, skin complexion, pigmentation issues, skin texture, stretch marks (anywhere on the body), and even scars. 

This device is soon to become a very popular treatment due to its cost, effectiveness, and low risk. Happy skin needling!

Dr. B

www.symmetrymedicine.com