Precision Aesthetics MD

A little bit of discomfort with Thermage in my experience. But results were worth it.

We are amongst the first to offer EMface in NYC. Call us for a consult.

This is the first of it’s kind technology to be utilized for facial aesthetics. The company applied proven and tested technology which revolutionized the body contouring market and designed a device to assist the facial aging as well. What is not to love when you can melt fat to slim the face and tone the skin. The excitement is very real. The technology behind EMFACE™ is effective and has been tested. The device has been cleared by the FDA for use on the face.

Both mesh the benefits of radiofrequency and HIFEM technology to melt fat and tone and tighten. A face-lifting product called EMFACE and a body-sculpting product called Emsculpt Neo are available.

Everything. Exilis actually gets rid of more fat than emsculpt or emsculpt neo. Exilis is only for fat and it’s made by the same people, BTL. It uses radio frequency and ultrasound and a wand.Also BTL makes Emtone, which is radio frequency and acoustic wave for cellulite and skin tightening, hand held. You also have to realize emsculpt is only in one spot. Any hand held wand can go exactly where the problems are. That might be flanks, upper lower.Also emsculpt left in one place unattended can’t go to as high a temperature as hand held monitored and constantly moving, That’s just common sense. If you went to hot on emsculpt neo which is left in one place, you would risk burning someone. Actually two more, we do a lot of Thermage on the stomach. Thermage goes precisely to the deepest layers of your collagen for the greatest amount of skin tightening. We also do Carboxytherapy on the stomachs and other areas for stretch marks, which also has some apoptosis or killing of fat cells

We offered six treatments right from the start. We have done a lot of research for BTL, the maker of Emsculpt. We want our patients to get 50% better results. 120,000 crunches will yield much greater results than 80,000. The additive value will yield even more than 50% better results. Many have followed us. One of our patients who was treated elsewhere while traveling, told us our unique placement of the device and our intensity settings were also superior to the place where he was treated. We met BTL's President in Europe while Dr Lisa was lecturing on Thermage skin tightening. They recognized our leadership in non invasive body shaping and allowed us to bring the first BTL Exilis to New York in 2009. I say this for two reasons. One, nobody has more experience with BTL than we do. Two, BTL Exilis shrinks fat and doesnt add bulk. Many patients prefer Exilis to Emsculpt and many do combination treatments. Call us for a consult 212 799 1411 to see what is best for you

There are a variety of Thermage treatment tips. The tips are one use per patient only. With the exception of the eyelid tip the Thermage tips measure 3.0 cm2. The Thermage STC tip is for the face. The eyelid tip is smaller and the heat penetrates less deeply taking into consideration that the eyelid skin is the thinnest skin on the body. The hands also have a special tip that penetrates less deeply because the hands have little subcutaneous fat. The Thermage DC tip is for treating the body and heats a little more deeply. 2022 Update this is the area where you can easily be taken advantage of I believe we have moved on to 1000 pulse treatments for full face and neck, There are unscrupulous practices that would divide one tip on two patients and worse use a counterfeit tip leaving you at risk for too little or too much treatment resulting in a burn or a lesser treatment

Another major advancement was the introduction of the Thermage NXT device in January 2007. I was the first physician in New York City to purchase the Thermage NXT and it has made a big difference for my patient’s and my own comfort level. The new NXT machine, coupled with the new tips, has increased the efficiency of the procedure by 30% so that my patients enjoy more dramatic, immediate effects with less discomfort. Sometimes I have patients who have had Thermage in the past with the old technology, who claim that “nothing ever happened.” These are the hardest patients to win over, but I tell them that with the new machine and the new tips, they will look in the mirror afterwards and see results. Another question that I get asked frequently is, “have you ever treated anybody and not seen a result?” The answer to this question is “no.” If I don’t feel that a patient is a good candidate for Thermage, I offer another collagen boosting procedure such as facial resurfacing –[everybody leav

Obviously an in person consult is the right way. It is a medical procedure. Also there are so many other similar procedures. A good provider will have at least three of four choices and at least a decade of experience. Without an in person consult you will not know if its loose skin ( Thermage), fat (Exilis), maybe you need more muscle or tone ( Emsculpt) or a combination of these different procedures. In fact for the body there are even more technologies like Carboxytherapy for stretch marks and Acoustic Wave for cellulite. Common sense would dictate that someone who has 5 different procedures for your tummy alone has no interest in pushing one technology because its the only one they have. Of course you can have a look at the Thermage before and after photos here to have some idea https://www.precisionaestheticsmd.com/before-after/thermage.html or a starting point. All before and after photos for every procedure are of course the best results

Logically any device sold for home use has to be very low power. Think about the liability. If a home device could reach the temperature necessary to model collagen and stimulate the growth of new collagen that would also be hot enough to burn you. In fact there are laser hair removal devices for home use. That is another high powered laser when used in the office. A very low power version is used for home use. But anything done repeatedly would get some results. When you remove the same hairs with tweezers over and over again. Sometimes you damage the root. When you wax over and over again eventually the hairs dont grow back. Perhaps with repeated home use you might get some results with a radio frequency device. But I seriously doubt it. We get patients from other practices who were not treated aggressively enough with the high powered machines that are for doctors office only. The Thermage treatment requires a very skilled technician even when performed in office

Absolutely not. A doctor or a nurse and a phlebotomist are the only ones allowed to use a needle. But you actually want the person with the most experience. You can be a great doctor, a heart surgeon, who can replace a heart, but if you have not administered many patients you would have no idea which muscles to inject and at what quantity to relax vs paralyze. Lets face it we dont want to look paralyzed like some famous people do.

Great question. Fortunately we offer free consults because the differences might be subtle for loose skin vs fat vs flab. If you have stretch marks cellulite loose skin and fat, which do you treat first ? If you have all of those conditions you might start with acoustic wave, its the least expensive option gets fabulous results for cellulite and some of the other conditions might improve as well. But to your question if it was only loose skin ie you lost all of the "baby weight" and have only loose skin that would be Thermage. If its just fat its Exilis. Exilis takes only weeks and has the side effect of smoother tighter skin. Compare that to Coolsculpting that takes many months and actually causes more loose skin. Carboxytherapy is for stretchmarks. Some people request it for fat, but Exilis is better for fat and FDA approved for fat loss. Call us to schedule your free consult 212 799 1411

Thermage These are estimates only - the actual amount of time depends upon the number of pulses and tips required to achieve the desired effect. Face = 50 minutes Face & Neck = 1 hour and 15 minutes Eyelids = 20-40 minutes Abdomen = 90 minutes to 1 hour and 15 minutes Front of legs = 1 hour and 15 minutes Back of legs = 1 hour and 15 minutes to 2 hours Buttocks = 1 hour and 15 minutes Arms = 1 hour and 15 minutes Hands = 40 minutes Again, these are approximations and the actual time required depends upon individual circumstances.

I tell all of my patients that I know exactly what all of my procedures feel like because the first patient that gets treated with any new technology is me! I have performed Thermage on my face twice and on my eyelids twice. First, the patient washes his or her face, signs a consent form, and then I take pre-treatment photographs. Pain medication as needed is provided after the consent is signed. A sticky patch is placed either on your back, your upper arm, your stomach, or your thigh (depending upon which area is to be treated) and you are then connected to the machine. This is the grounding pad that captures any stray radiowaves circulating in the skin near the treatment area. The first pulse that you feel from the machine will be cool only (no heat) as the machine takes a pre-treatment skin measurement of your skin’s resistance. I start by selecting a setting that I know will be cool, then a little warm, then cool again. This allows you to get used to the whole sensation. Then, I in

Literally head to toe. Our Thermage procedure for the face includes face and neck. We also include two Exilis treatments at the six month mark because we want to extend the time that your face makes collagen which is the best part of the treatment. We also treat arms, legs, tummy. Pretty much head to toe

Thermage is a nonsurgical skin tightening procedure that is performed in the doctor’s office. Thermage uses radiofrequency energy (radiowaves) to lift and tighten the skin. Here is how it works. Our skin is comprised of several layers, the surface layer of the skin is called the epidermis. This is the skin layer that burns or freckles when we are in the sun. Below the epidermis is the dermal layer, which consists of many proteins that give our skin structural support. The two main proteins are collagen which provides tensile strength, and elastin which lets the skin “bounce back” by giving it elastic pull [hence the name]. Below the dermal layer is the layer containing fat, blood vessels, and sensory nerves. When we are younger, the collagen in our skin is abundant and in a tight rope-like meshwork. As we age, sun exposure, genetics, smoking, and gravity makes the collagen less abundant and it loses its organized network, and the rope begins to fray. This is what causes our skin and th

Before I begin to explain to you what Thermage is and how the procedure is performed, you should know a little bit about me. I am on oculoplastic surgeon (a doctor that specializes in eyelid surgery) and a laser skincare specialist. My fellowship training in minimally invasive techniques of facial rejuvenation was a private fellowship with a surgeon who maintained practices in New York City and Rio De Janeiro, Brazil. I am a member of the American Society of Lasers in Medicine and Surgery and have extensive experience with laser and light source technologies in the field of aesthetic medicine. I have the pleasure of treating an international clientele who visit me from all corners of the globe. This compels me to stay in step with the global community by participating in international meetings, most recently the 2008 World Congress on Aesthetic and Anti-Aging Medicine in Paris, France. In brief, I am constantly searching for the best technologies available to offer my elite clientele.

Thanks to evolving technologies in laser and light source medicine more and more men and women are choosing to postpone having a surgical facelift well until their early to late 60’s if at all. Most patients who opt for a nonsurgical approach to rejuvenation site several reasons including fear of an overly- pulled and unnatural look , fear of the risks from general anesthesia, fear of the surgical procedure itself, and an un-willingness to suffer through the necessary downtime to allow for the healing to take place. As an oculoplastic surgeon, it is a given that I like to operate. Surgical procedures do have their place, and in my years of taking care of patients I have developed a keen sense of what people are looking for as far as a result is concerned, and sometimes that means a face-lift (rhytidectomy), or a neck-lift (platysmaplasty), or both. Generally, the conversation begins when I ask my patient to “show me with your hands what you want

HOW IT WORKS The best Thermage procedure tightens the skin, improves skin texture, and minimizes pore size. The technology uses radiofrequency energy (radiowaves) to tighten skin that has lost its elasticity due to aging, sun exposure, and genetics. The skin is comprised of the outer layer (epidermis) which is the superficial layer that tans or burns, and a deeper layer (dermis) where the collagen and elastin give the skin its structural integrity. As we get older, the collagen in the dermal layer loses its organized pattern and becomes less abundant. It works in a manner similar to shrink-wrapping. A cooling phase protects the epidermis, then a short pulse of heat is delivered to the dermal collagen, followed by a cooling phase to keep the heat in the dermis. The procedure gives an instant, subtle improvement due to the immediate contracture of the existing collagen in the dermis.

We treat stretch marks that are many years and even decades old. We use carboxytherapy so the stretch mark is broken up with a needle and with the infusion of Co2 gas there is increased circulation so we get great results.stretchmark before and after Carboxytherapy Before And After Images https://www.precisionaestheticsmd.com/before-after/carboxytherapy.html

You can get about a 60% reduction with microneedling done by a doctor. One of the brand names you can look for is dermatstamp. The .2mm dermaroller for home use is not deep enough to help a scar

Although we receive a lot of revenue treating stretch marks, whether or not to treat them is entirely up to the person, ( man or woman). We would never shame or even suggest anyone seek any treatment of any sort. A good provider of these types of treatments will ask you, what bothers you ? Thats all that matters. Any man who finds stretchmarks disgusting should be the one who should be ashamed of himself. In fact most stretch marks are the result of the most beautiful thing in the world, having your skin stretched from having a baby. To reiterate any man who finds stretch marks disgusting is in fact a disgusting person.

If you want a real treatment look for a provider that has acoustic wave. It is incredibly effective. Its the best treatment we have found in over 10years of research both in the US and at international medical conferences. Its also the machine that Madonna bought for her own personal use.

Technically the FDA does not allow anything to be called "permanent" However Carboxytherapy for stretch marks is probably as close as you can get to a permanent solution. If you have a new baby or do something else to stretch the skin beyond its ability to stretch you can create new stretch marks. However if you dont do anything to stretch your skin you should not see stretch marks any more. Compare that to skin tightening. You lose collagen every day of your life, so without maintenance, or repeating those treatments, depending on your age, anywhere between six and thirty six months, you will definitely see more loose skin.

Carboxytherapy is the best treatment for stretch marks, whether they are old stretch marks, white stretch marks or red stretch marks, as well as on any part of the body. We do these treatment multiple times a week for 15 years If anything comes out better we would be all over it immediately. In fact we have people traveling hundreds of miles to get treated by us. We even have some that fly in from the West Coast.

Day one we went to six treatments vs 4. 50% more crunches your results will be more than 50% greater. We wanted our patients to get the best results Others were slow to follow us. We brought the first device, Exilis, made by (BTL) to the United States in 2010. Exilis is for fat. It combines radio frequency and ultrasound to reduce the greatest amount of fat via a wand that the technician can move to any part of your body. Emsculpt Neo has a tiny amount of radio frequency added to the crunches. It has to remain in one spot so the temperature had to stay low to not burn you and of course as it sits on your abdomen you will not get the benefit of targeting the areas you need it the most like your flanks etc besides the lower temperature of the Emsculpt Neo. Many patients do combo treatments some merely want to lose the most amount of fat with Exilis. Make sure your provider has at least both devices so they are not just selling you the only thing they have

There must be a doctor that is the owner of the machine and supervising the practice. Although many think this is not a big deal there are many contraindications. Recently we saw a patient that had metal in her legs that another practice had treated her. They may have caused damage. Pacemaker ? You can practically kill someone. This is a medical device and should no be treated lightly or provided in a setting that is not a medical office.

Certain treatment require time in between. Many treatments are performed at one week intervals. It depends on what each treatment is doing to the body. For example Emsculpt Neo is delivering radio frequency to the body so you wouldnt perform another radio frequency treatment on the same day. This is why these treatments and devices are all performed in doctor's office under doctor's supervision. I always laugh to myself when a patient calls me for a price. I want to ask them, "are you a doctor", are you an aesthetic doctor that has performed a minimum of 5000 treatments ? Have you even had a consult ? What makes them think they have the slightest idea which of the hundreds of technologies would give them the results they are lookin for let alone the price. You are asking and even more medical question that can only be answered by a doctor at your consult. Thanks for the question because I would never directly insult someone I am on the phone with. But it is laughable.

Go to the gym and lift the one pound weights and call me in a month and show me your before and after photos. Seriously not everyone goes to the highest settings. But, it doesnt hurt, its merely uncomfortable. And the higher the setting the better the results. I know that most of our patients go to 100% a few 90%, But the lowest setting on Emsculpt are barely a tickle.

That is a funny question. Did you find a machine on the street ? Because these machines can only be sold to doctors and come with manuals and extensive training. An EMsculpt machine delivers HIFEM high frequency electromagnetic pulses. You could literally potentially kill someone who has a pacemaker. There are also pages of contraindications for the treatment and an extensive in person training. The question is wrong on so many levels it doesnt deserve an answer.

You should not drop an Emsculpt paddle nor should they touch each other or any other metal. They can break if you drop them and I think it is approximately $10,000 to replace one. Check with your BTL Emsculpt representative.

Every state has different licensing policies. There are different classes of devices that hav different requirements and loosely defined terms such as "anyone can operate the machine as long as the doctor is supervising" which each state has their definition of meaning is on call is close by etc. That being said Emsculpt needs to be owned by a doctor. Each patient requires a medical clearance. Its a super powerful electrical stimulation device. Metal in the body pacemakers and other contraindications must be cleared. We even refused to treat a doctor's child who had seizures. Think about it. Would you want to risk stimulating a seizure ? There are plenty of people in this industry that dont care. Dont be one of those. Personally we think Coolsculpting with the known risk of paradoxical hyperplasia is a risk we would never take for our patients even though its a huge money maker.

You should have some knowledge of the muscles. You would place one paddle on each glute. You would observe if the muscle is being stimulated and adjust if necessary. I think more importantly the people selling the machines are suggesting four treatments. I dont personally know about the glutes, but when I did my abs the difference between four and six treatments was night and day. Going the extra two treatments had a dramatic effect for me, Perhaps I was in the sweet spot because I was 22% body fat but my results on my abs were unbelievable. PS ab placement is even more variable

Since the introduction of Emtone I can say it is the best treatment for cellulite. But most people have combination problems. They have some fat, flab, loose skin and cellulite and might even be helped by a little extra muscles in the area let alone if they have stretch marks. So I would go to a provider that has Emtone plus Thermage for skin tightening or Exilis for a little extra fat reduction or Emsculpt to maybe add a little muscles to the area. Pretty much every one of our clients are getting combination treatments tailored to their specific issues.

The newest and best treatment for cellulite is Emtone. It uses acoustic wave plus radio frequency. Sadly it was introduced in January 2020, literally days before the city of New York was shut down for a few months and subsequently has been somewhat limited in the amount of business activity in the city

Acoustic wave was identified by our own research in 2010 to be the most effective treatment. In 2020 BTL added radio frequency to acoustic wave. The result was Emtone, which in my opinion is the most effective treatment we have tested in our 15 years in business. PS we have vendors knocking on our doors, emailing, and calling us every day to test their new technologies. We look at everything for the benefit of our patients. We absolutely must have the most effective technologies. So far Emtone is it.

I have personally done Thermage treatments for the past 15 years and I can say I look better today then I did 30 years ago. Its quite a miracle to make more collagen. That is THE sign of aging. Just look at a baby compared to your grandparents. You lose collagen every day of your life. Everyone talks about the skin tightening of Thermage. The real miracle of Thermage is that it induces you to make more collagen over the next six months after your treatment. If you get a strong treatment from a very experienced provider. That is the hard part. I spoke to one of the most famous doctors in the country and he admitted that he doesnt do many Thermage treatments because he doesnt trust his staff to deliver an effective treatment without burning someone. Go to someone that has done thousands of treatments and you will be very happy with your treatment. Also depending on your age you will have to repeat it. Assuming you are human you will continue to lose collagen.

Thermage will not affect the fillers in your face

Thermage is literally the first device ever to provide a non invasive treatment. It was FDA approved in 2001. So it literally has the longest safety record. If you google search Thermage Ulthera "law suits" You will see Thermage wining some patent law suits because they have the patent on the most effective radio frequency treatments. As for Ulthera there are people claiming nerve damage. We dont provide Ulthera. We heard about that possibility and chose not to buy the machine. The nerves on the face are too close to the surface. We love Ultrasound for the body but not for the face. You can always search the procedure you are interested in and "adverse events"

Great question. You lose collagen every day of your life. Just look at a baby compared to your grandmother. You are somewhere in between. The fact that Thermage induces you to make more collagen is genius. Much better than spending $30,000 to stretch thin skin over bones. That makes you look like an old person who had a face lift. When I was in my fifties I did my first procedure. It looked like I knocked off 5 years. I didnt do another one for three years. But now that I am in my sixties I seem to need to do it more often. Past 60 probably every year or more. Forty fifties probably every few years, Everyone is different. As well as how much discretionary income they have and the results they desire

If you can promise you found the fountain of youth and are no longer going to age, forever. Assuming you are a human being, you lose collagen every day of your life. So you will have more loose skin. Many repeat the treatment once a year, more or less. My first treatment in my fifties felt like I knocked off 5 years and I did not repeat it for about that many years. As I am a lot older now, I do the treatment one to two times a year. However I have a perfectly straight jaw line, no jowls, no loose skin, no double chin. Its actually quite remarkable. I am surprised. I didnt expect we could actually beat mother nature at her game of making us look older.

There is an immediate skin tightening we can show you during your procedure. You will also notice in about 3 to six months that the procedure has induced you to make more collagen and it will show up. Funny when I did my first procedure I could feel my skin getting tighter, I was actually worried. I had no idea what was going on. But it was that I was making more collagen and it was pushing on my skin and I could feel it. Its amazing that I can keep doing this treatment and there seems to be no end to my having a smooth jaw line, no jowls. Basically a perfect lower face and jaw line. Will see if I can keep it up into my seventies eighties and nineties. So far so good.

Every procedure we offer has no down time. There are actually some procedures like Fraxel that will ablate or remove all the skin on your face and give you baby fresh new skin. However we do not offer those kinds of invasive procedures with commensurate down time. PS if you have all new baby skin, dont even think of going out into the sun at all. That might be right for some people. Think Nicole Kidman, but be prepared to wear sun screen literally 24/7, protective clothing and dont even think of going to the beach.

Please dont do laser treatments for stretch marks. I feel so bad for the people who come to us and explain the thousands of dollars they wasted on laser treatments. You dont have to be a doctor to understand a laser is going to treat the surface of your skin. It will create a red or white mark to try to obscure your stretch mark. A stretch mark is a tear or scar beneath the surface of your skin. Carboxytherapy utilizes a needle to literally break up the stretch mark. The addition of Co2 gas brings circulation to the area to help it heal even better. It is hands down the favorite treatment we offer. We have people who travel from the west coast to do their Carboxy treatments with us. Everyone hates their stretch marks. It treats red, white, old new stretch marks on any color skin. The other issue with a laser it can easily leave dark or light spots ( hyper or hypo pigmentation) Carboxytherapy is safe for all skin types and colors

This is our business and we have the most effective treatment for stretch marks Carboxytherapy. We even have people flying in from the West Coast to be treated. However we have integrity. You should not be embarrassed. People dont notice. They are all too busy worrying whether someone is seeing the one pimple they saw on their face before they left their house this morning. Everyone is completely self centered. No one cares. If it bothers you ( not anyone else) and you have the discretionary income, find a local provider that offers Carboxytherapy. It breaks my heart when I hear that patients spent thousands of dollars on a laser treatment and got no results. A laser is superficial, great for spots on the surface of the skin. A stretch mark is a deep scar. A laser is merely trying to camouflage it. Carboxytherapy treats stretch marks and scars by breaking it up with a needle and infusing Co2 to increase circulation for a one two punch

I have heard that some young people get stretch marks from growth spurts. But that is basically the same reason. You are stretching the skin too quickly by either pregnancy or weight gain. Actually I remember one patient that had some kidney issues or something that caused stretch marks But guess what other than her every one in the past 15 years was extremely happy with their results and did not have to retreat them. If there is no logical reason for the stretch marks like weight gain I would see your doctor first to insure there is no underlying issue. As should everyone for every issue