Bruce P.Robinson, MD
We are pleased to introduce ProNox™ in our practice, a patient controlled, inhaled analgesia for in-office use. We want our patients to achieve their cosmetic goals worry-free. Patients say that it has made all the difference in moving forward with many cosmetic procedures.
The use of nitrous oxide in Medical, Cosmetic & Laser Dermatologic procedures is becoming more common. Our goal is to provide each patient with a pain-free experience and to work with their varied anxiety levels. While we have excellent topical numbing options for pain control, nitrous oxide can help calm the patient who is nervous or anxious and also help with pain relief.
What should you know about the procedure before finalizing your decision? We consider these the five most important distinctions.
While a facelift lasts anywhere from 5 to 10 years, a liquid facelift typically lasts up to 4 - 6 months, for the best possible and longest-lasting results. This makes the procedure a good choice for patients who want apparent improvement, but aren’t quite ready for a surgical facelift or mini facelift—whether due to inhibitions about the surgery or because one’s signs of facial aging aren’t yet very dramatic.
Improvements Can Be Made In Increments
Results of a liquid facelift are evident almost immediately. But since the procedure has so much potential, it’s possible that more than one treatment session would be needed for the best results. This allows improvements to be made incrementally. Some patients appreciate the fact this allows their results to come in more gradually and thus look more natural.
All Areas Of The Face Can Be Improved
A liquid facelift has excellent potential, but it should be understood from the outset that since no incisions are made and no actual surgery is performed, its results will naturally fall shy of what a complete surgical facelift can accomplish. But let’s look at what a liquid facelift can achieve:
They Are More Affordable Than Regular Face Lifts
A liquid facelift is cheaper and more affordable than a facelift or mini facelift, with the exact cost depending upon how much of what types of fillers are needed to help you reach your goals for the procedure. Health insurance does not cover the cost of a facelift or a liquid facelift.
Most Dermal Fillers Used Are Made Of Naturally Occurring Ingredients
A liquid facelift is done with a combination of dermal fillers and neuromodulators. That means fillers like Radiesse®, Juvéderm®, Belotero®, Restylane® will be used to plump and add volume to the skin in deprived areas, while neuromodulators like Botox will be used to reduce the appearance of fine lines and facial wrinkles.
The art of a liquid facelift lies in how it’s done precisely. How much of what fillers are applied in what portions of the face? Dr. Bruce Robinson has mastered this art and looks forward to helping you achieve your facial beauty goals—without surgery, without incisions, and with minimal downtime.
Please contact our office today for more information or a personal consultation.
So many of us struggle from natural hair thinning and hair loss. In fact, according to the International Society of Hair Restoration Surgery, approximately 56 million adults in the United States are affected by hair loss. Different conditions can lead to different symptoms of hair loss, ranging from male pattern baldness, which is characterized by hair loss at the temples followed by thinning along the crown, to thinning or loss that can occur in patches throughout the scalp. Hair loss or hair thinning can occur in both men and women and can be a source of self-consciousness or embarrassment and, up until recently, few non-surgical treatments offered total hair restoration.
Recently, Platelet-Rich Plasma (PRP) has become a popular regenerative treatment in the world of dermatology. PRP treatment for hair restoration, improves hair thickness and reduces hair shedding. The treatment takes platelet-rich plasma from the patient’s own blood and once isolated, the PRP solution is injected into the area affected by hair loss or hair thinning. The PRP triggers the natural hair growth process and strengthens the hair follicles to promote regrowth and prevent hair loss. The procedure is simple and requires minimal downtime or discomfort, making it an excellent option for patients who are wary of surgical options, such as hair transplants.
Board-certified dermatologist Dr. Bruce Robinson is an expert in PRP treatment and was one of the first dermatologists to incorporate PRP into his private NYC practice. PRP has been a boost to patients with hair loss, delivering improved hair growth and hair thickness with his PRP hair restoration patients. Experienced dermatologist, Dr. Bruce Robinson, has been treating patients in his Upper East Side, New York City office for more than 30 years and is an expert in a range of cosmetic and dermatological procedures. If you’re frustrated by thinning hair or hair loss, Dr. Robinson is here to help.
Therapy for hair loss is a three-step medical treatment in which a person's blood is drawn, processed, and then injected into the scalp. Platelet-rich plasma is a concentration of platelets that is 3x the normal blood value, and contains many growth factors that stimulate hair follicles and can safely be performed up to every month, based on how much hair growth is required. PRP is a great solution for hair loss in both men and women, especially when hair transplant surgery is not an option. PRP injections can stimulate new hair growth in men who suffer from androgenetic alopecia (known as male pattern baldness) and women who suffer from female pattern baldness.
The Platelets in the PRP contain proteins that are needed in order to promote the rate of tissue healing and regeneration within inactive hair follicles. Inside these platelets are a variety of intracellular structures such as glycogen (a form of glucose), lysosomes (which break down the proteins), and alpha granules (which contain clotting and growth factors that get released during the cell repair process). Platelet-rich plasma-derived growth factors can also play a part in stem cell differentiation within the wound healing process of the musculoskeletal system.
In multiple studies through the Journal of Cosmetic Dermatology and Aesthetic Plastic Surgery, patients suffering from hair loss were found to benefit from PRP injections. The PRP hair restoration treatment led to a significant local increase in hair number, extended growth phase, and improved hair thickness. Though the treatment is not yet FDA-approved, there is scientific proof that the treatment is beneficial for hair strength and new hair growth at and around a PRP injection site.
The science behind PRP uses proven benefits of PRP to naturally promote new cellular growth. PRP is directly involved in regenerative healing within the body. PRP growth factors can thus influence hair growth and can in fact restore hair follicles, in turn improving the look and feel of a patient’s hair.
PRP hair rejuvenation treatment involves the injection of platelets into the area of the body in which hair loss is occurring, for example the crown of the head. Platelets are taken from the patients own body via a blood draw that occurs at the start of the appointment. After the blood has been drawn, it is placed in a centrifuge, which is a machine that separates the platelet-rich plasma from the red blood cells. When isolated, the platelet-rich plasma is then injected into the treatment area. The platelets release growth factors, which stimulates the dermal papilla cells that are crucial in the hair growth process. For that reason, a series of PRP injections help to trigger hair regrowth to restore lost hair.
Though of course the number of PRP treatments varies depending on the hair condition and aesthetic goals of the individual patient, a typical patient will do three sessions of PRP therapy. Further treatments will be evaluated at the end of the fourth month (after the third PRP treatment).The sessions are typically spaced 4-6 weeks apart, and Dr. Robinson personally performs all consultations and injections. PRP treatments can also be used in tandem with hair transplantation to help accelerate hair growth. At your initial consultation with Dr. Robinson, you will be able to discuss all hair treatment options, including PRP injections. Dr. Robinson will use his expertise to provide the best medical advice, diagnosis, and treatment available for hair loss.
Unfortunately, as PRP hair restoration is considered a cosmetic procedure, PRP for hair loss is not covered by health insurance. For more information, it’s best to contact your insurance company directly to ascertain coverage.
Many patients come into their initial consultation with Dr. Robinson wondering, how fast does PRP work for hair loss? Of course, any results will vary depending on the nature of hair loss and desired results of each patient. However, the majority of patients see initial improved hair thickness and hair growth several weeks after treatment. Optimal results from PRP injections are apparent, on average, about 5-6 months after treatment.
A good candidate for PRP hair restoration is a patient who is showing signs of thinning hair or hair loss. Typically, candidates who have experienced hair loss more recently, or who are dealing with early hair loss, respond best to PRP hair treatment. Those with hair follicles that have been dormant for longer on the scalp are less likely to be improved by PRP therapy. It’s good to note that if you are diagnosed with a underlying disorder such as lupus or thyroid disease, you are unlikely to benefit form PRP injections, as these conditions will continue to worsen hair loss over time. Additionally, patients should not take blood thinners during PRP hair restoration treatment, as the procedure will be significantly less effective.
Call today to schedule an appointment with Dr. Robinson.
Dr. Robinson was a pediatric resident before pursuing dermatology. He enjoys seeing pediatric patients and specializes in difficult to diagnose rashes, birthmarks, acne, warts, molluscum and eczema.
We recommend annual skin cancer screenings for almost everyone. Essentially all skin cancer can be cured if detected early, and an annual skin cancer screening is the best way to find them at this early stage. Patients with a skin cancer history usually require screening every 3 to 6 months. Skin cancer screenings are truly life saving! Don’t be shy—make your appointment today! Contact us today to schedule an appointment.
After years of sun, squinting, laughing, frowning, smoking, and worrying, the skin around the eyes and on the forehead will often develop deep lines and wrinkles called “expression lines.” A frequent concern is that they often make you look older, tired, or stressed. Until recently, these advanced furrows have been difficult to treat. Now, by utilizing this FDA approved temporary muscle-relaxing agent, you can reduce "permanent expression lines". Botox® is a “neuromodulator,” an extremely popular agent used to treat the lines of motion that are accentuated with facial movement and expression. It is one of our favorite procedures to perform because of the extremely high patient satisfaction rate, and a great place to start if you are considering a cosmetic procedure for the first time.
If you want to prevent the earliest fine lines from becoming full-blown wrinkles, preventative Botox can be the solution. Botox is approved for patients who are 18 years and older and most experts agree that patients in their mid to late 20s and early 30s are at a good age for preventative Botox treatment.
With a very fine needle, BOTOX is painlessly injected into the specific muscle that is contracting and causing the lines and wrinkles on the face. No anesthetic is required. Treatment is effective, safe, and takes approximately 10 minutes. Immediately following treatment you may resume regular activities.
The effects usually last 3 to 4 months, and fade away gradually. Following several treatments, the results may last 4 to 8 months or longer. BOTOX offers extended relief over the course of long-term treatment.
Side effects of BOTOX, if any, are usually mild and temporary. Botulinum toxins contain proteins, which in some circumstances may be naturally safeguarded against by the body?s ability to produce antibodies. If antibodies are formed, the therapy will generate a lesser response. Temporary bruising, mild pain and swelling are sometimes experienced, though these symptoms resolve on their own within 3 to 5 days. In rare cases, there can be a slight drooping of an eyelid or asymmetry of expression. If this should happen return to our office.
The do’s:
The don’ts :
Typically, the effect of BOTOX is visible within 5 -7 days. Maximum benefits are reached between 10 to 14 days. Once the muscle becomes dormant and the skin softens, you will have a more relaxed and youthful appearance. BOTOX treatments are not a substitute for the results achieved with a facelift. The optimum appearance may be achieved with BOTOX therapy in conjunction with a facelift, dermal fillers, laser resurfacing, and skin rejuvenation.
BOTOX is a therapeutic muscle-relaxing agent derived from the bacterium, Clostridium Botulinum. For over a decade ophthalmologists have applied BOTOX for it's original intention, the treatment of blepharospasm. Physicians have utilized BOTOX for years as a cosmetic treatment to correct visible signs of stress and aging.
The contractions and movements of the facial muscles are controlled by signals from the brain. BOTOX simple prevents the muscle from allowing responses to these messages. As a result, the muscle relaxes and the overlying skin remains unwrinkled and smooth.
Botox injections have been FDA approved to treat excessive sweating. In the skin, Botox selectively turns off the sweat glands resulting in a normal appearance without wetness. Treatment is performed during an outpatient clinic visit and no recuperative time or special care is needed afterward.
Before and After Images:
Wrinkles are caused by the natural aging process, expressions made by muscles and sun damage. Using Sunscreen daily is the Holy Grail Anti-Aging product. Today there are many treatments available to help reduce fine lines and wrinkles on the skin. For deeper creases, a person may require more aggressive technique. With the latest treatments such as Botox, Fillers, Ultherapy, TempSure, and Fraxel laser skin resurfacing, wrinkles can appear less noticeable and even be prevented. These treatments are easy in office procedures that require little to no social downtime. The results can be immediate or seen in just a few weeks. Say "Good-bye" to wrinkles and fine lines and hello to beautiful, younger, smoother looking skin.
Cosmetic Consultation Reimbursement policy offered to all patients. Come discuss your needs and goals with Dr. Robinson and the office visit cost will be applied to future costs for the discussed procedure. Procedure must be completed within 30 days of your consult visit.
Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). The types of HPV that cause common warts, plantar warts, or flat warts are usually different from the types of HPV that cause genital warts. A vaccine is available to help protect against the types of HPV that cause genital warts (and increase a person's risk of certain types of cancer).
There are several different kinds of warts including:
Common warts usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, for example where fingernails are bitten or hangnails picked. These are often called "seed" warts because the blood vessels to the wart produce black dots that look like seeds.
Foot warts usually appear on the soles (plantar area) of the feet and are called plantar warts. When plantar warts grow in clusters they are known as mosaic warts. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Like common warts, these warts may have black dots. Plantar warts are uncomfortable and painful, feeling like a stone in the shoe.
Flat warts appear as small, smooth usually skin colored, pink or brown bumps on the skin. Common places for flat warts are the face, top of the hands, top of the feet, arms, and legs.
Genital warts (warts in the genital area, also called "condyloma acuminatum"
To prevent warts from spreading, dermatologists recommend the following:
While you can often clear a wart at home, some warts can be stubborn. If the person has a weakened immune system, it can be difficult to get rid of warts. Sometimes, what looks like a wart turns out to be a callus or another type of growth.
A board-certified dermatologist can help by:
Sometimes, warts can be stubborn, so they don’t clear with treatment that you can buy without a prescription. A dermatologist can create an effective treatment plan.
Vitiligo is a skin condition resulting from the loss of pigment which produces white patches. Any part of the body may be affected. Usually both sides of the body are affected. Common areas of involvement are the face, lips, hands, arms, legs, and genital areas.
Vitiligo affects one or two of every 100 people. About half the people who develop it do so before the age of 20; about 1/5 have a family member with this condition. It may be an autoimmune process (the body makes antibodies to its own pigment cells). Most people with vitiligo are in good general health, although vitiligo may occur with other autoimmune diseases such as thyroid disease
Melanin, the pigment that determines color of skin, hair, and eyes, is produced in cells called melanocytes. If these cells die or cannot form melanin, the skin becomes lighter or completely white
Typical vitiligo shows areas of milky-white skin. However, the degree of pigment loss can vary within each vitiligo patch. There may be different shades of pigment in a patch, or a border of darker skin may circle an area of light skin.
Vitiligo often begins with a rapid loss of pigment. This may continue until, for unknown reasons, the process stops. Cycles of pigment loss, followed by times where the pigment doesn't change, may continue indefinitely.
It is rare for skin pigment in vitiligo patients to return on its own. Some people who believe they no longer have vitiligo actually have lost all their pigment and no longer have patches of contrasting skin color. Although their skin is all one color, they still have vitiligo.
The course and severity of pigment loss differ with each person. Light-skinned people usually notice the contrast between areas of vitiligo and suntanned skin in the summer. Year round, vitiligo is more obvious on people with darker skin. Individuals with severe cases can lose pigment all over the body. There is no way to predict how much pigment an individual will lose.
Sometimes the best treatment for vitiligo is no treatment at all. In fair-skinned individuals, avoiding tanning of normal skin can make areas of vitiligo almost unnoticeable because the (no pigment) white skin, of vitiligo has no natural protection from sun. These areas are easily sunburned, and people with vitiligo have an increased risk to skin cancer. A sunscreen with a SPF of at least 30 should be used on all areas of vitiligo not covered by clothing. Avoid the sun when it is most intense to avoid burns.
Disguising vitiligo with make-up, self-tanning compounds or dyes is a safe, easy way to make it less noticeable. Waterproof cosmetics to match almost all skin colors are available. Stains that dye the skin can be used to color the white patches to more closely match normal skin color. These stains gradually wear off. Self-tanning compounds contain a chemical called dihydroxyacetone that does not need melanocytes to make the skin a tan color. The color from self-tanning creams also slowly wears off. None of these change the disease, but they can improve appearance. Micropigmentation tatooing of small areas may be helpful.
If sunscreens and cover-ups are not satisfactory, your doctor may recommend other treatment. Treatment can be aimed at returning normal pigment (repigmentation) or destroying remaining pigment (depigmentation). None of the repigmentation methods are permanent cures.
Aggressive treatment is generally not used in children. Sunscreen and cover-up measures are usually the best treatments. Topical corticosteroids can also be used, but must be monitored. PUVA, an ulta-violet therapy, is usually not recommended until after age 12, and then the risks and benefits of this treatment must be carefully weighed.
Topical Corticosteroids — Creams containing corticosteroid compounds can be effective in returning pigment to small areas of vitiligo. These can be used along with other treatments. These agents can thin the skin or even cause stretch marks in certain areas. They should be used under your dermatologist's care.
PUVA is a form of repigmentation therapy where a type of medication known as psoralen is used. This chemical makes the skin very sensitive to light. Then the skin is treated with a special type of ultraviolet light call UVA. Sometimes, when vitiligo is limited to a few small areas, psoralens can be applied to the vitiligo areas before UVA treatments. Usually, however, psoralens are given in pill form. Treatment with PUVA has a 50 to 70% chance of returning color on the face, trunk, and upper arms and upper legs. Hands and feet respond very poorly. Usually at least a year of twice weekly treatments are required. PUVA must be given under close supervision by your dermatologist. Side effects of PUVA include sunburn-type reactions. When used long-term, freckling of the skin may result and there is an increased risk of skin cancer. Because psoralens also make the eyes more sensitive to light, UVA blocking eyeglasses must be worn from the time of exposure to psoralen until sunset that day to prevent an increased risk of cataracts. PUVA is not usually used in children under the age of 12, in pregnant or breast feeding women, or in individuals with certain medical conditions.
This is a form of phototherapy that requires the skin to be treated two, sometimes three, times a week for a few months. At this time this form of treatment is not widely available. It may be especially useful in treating children with vitiligo.
Transfer of skin from normal to white areas is a treatment available only in certain areas of the country and is useful for only a small group of vitiligo patients. It does not generally result in total return of pigment in treated areas.
Other treatment options include a new topical class of drugs called immunomodulators. Due to their safety profile they may be useful in treating eyelids and children. Excimer lasers may be tried as well.
For some patients with extensive involvement, the most practical treatment for vitiligo is to remove remaining pigment from normal skin and make the whole body an even white color. This is done with a chemical called monobenzylether of hydroquinone. This therapy takes about a year to complete. The pigment removal is permanent.
At this time, the exact cause of vitiligo is not known, however, there may be an inherited component. Although treatment is available, there is no single cure. Research is ongoing in vitiligo and it is hoped that new treatments will be developed.
