by “Dr Kim”, MD, FAAD
Patient: "Can you do Botox?"
Me: "I sure do."
To your mechanic: "Can you replace my serpentine belt?"
Him: "I sure do..."
"...But what you actually need is a new ignition coil and spark plugs."
"Botox", in its fame, has become the common household term for all things cosmetic on the face. In and about the face. That's the same as fillers and chemical peels and Dysport and glycolic peels and IPL and fractional lasers and spark plugs. Synonymous? Right?
Well, consider me your Ms (Dr) Frizzle on this bullet train speed magic school bus expedited tour through the cosmetic medicine jargon wonderland. So you are aware of what tools are out there and available to you to maximize on your units of happy and assist you in preserving your 20's look. Yes, I said maintaining or re-establishing your youth. Not turning you into a different (celebrity) face. Not turning you into a balloon animal. Finding the more rested version of you from a few years back. If someone suspects you've had something done, we as providers need to try harder.
Now excuse the digression but Dr Frizzle has a minor side note that will likely piss some medical folks off, but that's never deterred me from vocalizing my humble board certified dermatologist opinion in past. Hey, sometimes the truth hurts. Especially when you're caught with your hand in the cosmetic industry cookie jar. There are so many places offering cosmetic treatments these days. Family docs. OBGYNs. Dentists. Hey, I have nothing but respect and admiration for my fellow physician colleagues and their highly specialized expertise. I mean, we sat aside one another in medical school. But c'mon. You don't see me offering pap smears or filling cavities. Plastic surgeons and dermatologists, we'll stay outside. Dentists, OBs, stay roughly inside. Your lane. In the immediate vicinity.
Medispas, oh, I haven't forgotten about you. Some of these are great. But some have also committed their share of blatant disfigurement. Mostly as a direct result of poor oversight. Meaning, make sure these are being directed and managed and supervised by a board certified dermatologist or plastic surgeon. Not your podiatrist or proctologist. Or mechanic. Don't get Picasso'd.
Botox is a toxin. That means it can get in your blood and reverse Feng Shui your innards and cause your legs to fall off. And not in a graceful way. Probably right as your announced to receive your Emmy. Hey, guess what? There are so many toxins used in medicine. God bless modern medicine and the nerdy scientists that create it. Venoms line the doctors black bag with treatments for diabetes and auto immune disorders. Yeah, we give people poison. E'ry damn day. Because toxins save lives. Mind blown. Botox, Xeomin and Dysport are all injectable neuromodulators, meaning they locally and temporarily affect nerve impulses. In the case of use in facial muscles of expression, they are used in reducing contraction-induced wrinkles. But this miraculous medication can also be injected to prevent excessive burdensome sweating as well. In addition to numerous additional applications that are being discovered daily. I believe in the power of my B vitamin.
Fillers. The spackle of the cosmetic toolbox. Restalyne, juvederm, sculpta, etc. All with their own special properties to address specific cosmetic issues. Offering volume and filling non dynamic lines and wrinkles (ones that are there when you're not moving your face). The creases that have set in because you didn't Botox the muscles causing them five years ago. Or maybe you want those apple cheek bones that have over time lost volume as they naturally do for the best of us. The youthful plump lips that grow thin with age? Fillers fill. Nuff said. For now.
Chemical peels. Lord there are so many. Categorized into light, medium and deep. The more aggressive, the more potential risk, the more expensive but the more effective in rejuvenating the skin and improving tone and texture overall. Darker skin tones, tread with caution. If when you get a pimple or bug bite, it heals with a dark spot in its wake, you need to be really careful (seek expert opinion) with peels. If you're florescent white and have no idea what I'm talking about here, don't worry about it. You're good, snow puff. A solid medium peel is my friend and makes most patients very happy.
Lasers. "Lasers". I love my job. If it weren't cool enough without, I get to play with lasers too. It's not a one size fits all here, guys. So many lasers, that do so many things. Laser is actually an acronym. Liver Analyzing Suction Exerting Resonator. Livestock Annihilating Smouldering Elemental Rickshaw. Ok, ok. Light Amplification by Stimulated Emission of Radiation. I'm not going to get too far into it here because even learning about it in residency made me wonder if I'd accidentally stumbled into a mind numbing astrophysics dissertation. So unless you want to discourse on mixtures of a noble gases like argon, krypton, or xenon, and halogen gases like fluorine or chlorine, which under suitable conditions of electrical stimulation and high pressure, emit coherent stimulated radiation in the ultraviolet range, I'll get to the punch line. There are lasers that resurface (acne scars, poor skin texture), eliminate redness ('sup rosacea?), smooth skin tone (sun spots), ablate hair follicles (hairs on the chinny chin chin?), destroy tattoo pigment (name of an ex on the left butt cheek), and so much more.
And all with their own risks. Fantastic tools. In the right hands. Ask Austin Powers.
The thread lift. Mini lift. Mint lift. PDO thread lift. New lunchtime lift. For those folks with a little bit of skin hang, but not ready for a full blown face or neck lift. With a few carefully placed, subcutaneous (under the skin) sutures, in under an hour, this can be achieved. No general anesthesia, and far easier on the wallet too.
Far from comprehensive, but in the interest of brevity, that should suffice. Don't be afraid to reach out if there's an area of interest you'd like to further explore. I'm clearly not opposed to running my mouth. I think the bottom line here is, allow your provider to guide you in treatment. The best way to addressing your particular cosmetic concern is by expressing the problem specifically rather than a possible answer. Botox may not fix what you hate. It may need spackle.
So to your mechanic, "What's this? Fix it." To your dermatologist "What's this? Fix it." Then we all walk away happy.
Kimberly A Werner, MD, FAAD
Board Certified Dermatologist (피부과 전문의)
4685 Eldorado Pkwy Suite 100
Frisco TX 75033
1601 W Hebron Pkwy Suite 220
Carrollton, TX 75010
“Dr Kim”, MD, FAAD, is a half Korean, board certified dermatologist, new to the DFW area, fluent in Korean and eager to reach out to the local Korean community. She is a US citizen born abroad in Korea to a Korean mother, and raised in Indonesia, to artist parents that instilled an eye for beauty and detail at an early age.
She earned her Bachelor's of Science at William and Mary with a major in Neuroscience and a minor in Biochemistry and Military Science, graduating Suma Cum Laude, Phi Beta Kappa. Thereafter, Dr Werner completed her medical degree at Eastern Virginia Medical School, where her superior performance academically secured her a coveted dermatology residency position. She completed her intern year at the world-renowned Walter Reed Military Medical Center prior to seizing an opportunity to perform primary care attached to an infantry unit at the DMZ in South Korea, where her fluency in Korean allowed her to excel in her role amongst the Korean forces training alongside the U.S. troops. Upon her return to the United States, Dr Werner completed her Dermatology residency at San Antonio Uniformed Services Health Education Consortium and had thereafter provided medical and surgical care to soldiers, retirees and their dependents, at several U.S. Army bases nationwide.
She is published many times in peer reviewed medical journals and has extensive research experience including that in the fields of neuroscience, family medicine, cosmetic surgery, as well as dermatology. She had also presented at educational conferences before her revered peers, to include at the American Academy of Dermatology conference.
Dr Kim Werner was honorably discharged from the Army in 2018 and is eager to accept all patients, medical, surgical and cosmetic, of all ages, at her new professional home at the Frisco and Carrollton offices with Platinum Dermatology (Dermatology Consultants of Frisco and Precision Dermatology).