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As you age beyond 25, it is essential to start preparing for anti-aging measures. Anti-aging should ideally begin early, as waiting until wrinkles appear can be less effective. With increasing age, collagen loss occurs, and skincare products may become less effective. Fotona 4D, the European star in the field of medical aesthetics, offers a rejuvenating experience for your skin.
Many people who are new to medical aesthetics may be unfamiliar with it, but those who have tried it know how effective it can be. Fotona 4D is a highly regarded medical aesthetic procedure that provides a comfortable and warming experience, suitable for those looking to combat the signs of aging comprehensively.
Before delving into the specifics of Fotona 4D, let's analyze the causes of skin aging: Epidermal aging can lead to issues like skin dullness, pigmentation, rough texture, redness, and dark circles. Dermal collagen loss can result in various forms of sagging and drooping. SMAS fascial layer aging can cause a feeling of separation between the skin and muscles. Subcutaneous fat fiber aging can lead to localized fat accumulation and increased sagging, making the face appear less contoured. The principle of action of Fotona 4D: Fotona 4D employs a layered approach to anti-aging treatment. It uses a 2940-nanometer laser combined with thermal effects to target the fascial layer. Because the oral mucosa is closer to the fascial layer, it allows for uniform heating from the inside out, improving skin laxity and enhancing skin elasticity.
Fotona 4D targets the following layers: Epidermal layer Dermal layer Subcutaneous fat layer (adipose layer) Deep mucosal layer (oral mucosa) Target people for Fotona 4D:
Fotona 4D is ideal for individuals with characteristics such as baby fat, thick fat layers, tight jawlines, nasolabial folds, and marionette lines, among other localized wrinkles.
Is it painful?
During the intraoral treatment, the thin and sensitive lip mucosa may cause some discomfort. However, for the facial treatment, there is a warm sensation, and there is no need for anesthesia. A single session typically takes around 60 minutes.

Fotona 4D can address several concerns, including: Tightening and lifting Improving skin tone and reducing dullness Facial sagging and drooping Fine lines around the eyes Nasolabial folds Defining the jawline Lifting the cheek area Reducing under-eye bags and puffiness Fotona 4D has four different modes: Smooth: Internal tightening for nasolabial folds and marionette lines. Frac3: Skin rejuvenation and lightening, targeting dark circles (stimulates collagen production). Piano: Deep heating for fat reduction and skin tightening. Superficial: Acts on the epidermal layer, with options for non-ablative pore reduction, fine line reduction, and superficial peeling. Advantages of Fotona 4D:
Fotona 4D operates in the infrared spectrum, primarily providing thermal effects on the skin's surface. It can help combat aging, hydrate, whiten, and improve skin laxity and elasticity.
Post-procedure care:
After the treatment, mild redness and swelling are normal skin reactions, typically subsiding within two hours or lasting up to two to three days in some cases. Patients should use a mild medical repairing mask for about a week after the procedure. Avoid stimulating or rubbing the skin within seven days after the procedure and refrain from using exfoliating or glycolic acid products for a month. Protect the skin with chemical and physical sunscreen and maintain hydration to prevent pigment deposition. Avoid high-temperature environments like saunas or hot springs within three days. If you experience dryness and increased eye secretions, artificial tears can relieve fatigue symptoms. Fotona 4D is typically performed in a series, with one basic course every month for about 3 to 5 sessions. After completing the course, maintenance can be done every 2 to 3 months as needed.

Revitalizing Anti-Aging Devices: Ultherapy vs. Thermage - Which One is Right for You? Many people may not be aware of the differences in principles and effectiveness between Ultherapy and Thermage. Which one delivers better results? Can Ultherapy and Thermage be combined, and is it necessary? Let's start with Ultherapy: As a comprehensive anti-aging device targeting the SMAS fascia layer, deep dermis, and dermal layer, Ultherapy reaches depths that other anti-aging devices cannot. Its primary focus is on lifting. It primarily tightens the fascia layer, pulling sagging tissues back to achieve tissue repositioning. Suitable for: Those with thicker facial skin and sagging issues, such as sagging cheekbones, blurred jawlines, jowls, double chins, and drooping mouth corners. Now, let's discuss Thermage: Thermage targets the dermal layer and even deeper subcutaneous layers, commonly referred to as the "skin" layers. Its primary objective is to tighten. It employs radiofrequency to heat the dermal and subcutaneous layers, tightening loose skin and stimulating collagen production. Suitable for: Those with thinner skin and skin laxity issues, such as mild aging-related skin sagging, wrinkles, dryness, fine lines, crow's feet, and laugh lines. These two devices differ in their primary effects, energy types, and depth of action. So, is it really necessary to combine Ultherapy and Thermage? The answer is a resounding yes! Combining them is the key to breaking through the anti-aging barrier. When you use both together, the treatments become more comprehensive. Ultherapy reaches deeper layers, primarily focusing on areas with thicker soft tissue to avoid nerve-rich regions. In contrast, Thermage can treat smaller areas with rich nerves that Ultherapy cannot reach, such as the eye area. Thermage for the eyes is an FDA-approved technique and widely used in clinical practice.Therefore, combining both treatments can complement each other's limitations, broaden the selection of treatment areas, and create a synergistic effect where 1+1 > 2. Thermage uses single-level radiofrequency energy to heat the deep dermis, accumulating energy to promote collagen contraction and regeneration. Ultherapy uses focused ultrasound, concentrating ultrasound energy on the SMAS fascia layer, creating tiny individual coagulation points that cause aging collagen to contract and regenerate. In terms of the depth of action, focused ultrasound penetrates deeper than radiofrequency. Therefore, during treatment, ultrasound can provide additional energy to areas that Thermage cannot reach.The combined effect is greater than the sum of its parts. Ultrasound penetrates deeply and emphasizes vertical lifting, similar to reinforcing a building's structure with steel beams. Ultrasound energy, when applied to the fascia layer, forms a series of coagulation points that, when connected, provide targeted elevation. This uplifts the underlying fascia layer, which in turn lifts the muscles and overall fat tissue. In contrast, Thermage has a broader surface effect, emphasizing horizontal tightening, similar to adding a layer of cement to build a house. Thermage evenly heats the entire layer, promoting collagen contraction and regeneration from the outside in. Simultaneously, the heating of the fibrous septa in the superficial fat layer tightens the fat, making it more compact.Therefore, when combined, Ultherapy lifts while Thermage tightens, resulting in a clearer and enhanced overall facial contour. In summary, Thermage excels in comprehensive tightening, using high-energy radiofrequency to promote collagen regeneration, while Ultherapy specializes in targeted lifting, using focused ultrasound to lift sagging skin. Who wouldn't be excited about that?

爆火的抗衰仪器：热玛吉和超声刀，哪个更适合你？ 很多姐妹可能都不知道： 超声刀和热玛吉的原理功效有什么区别？ 哪个效果更好？ 超声刀和热玛吉可以一起做吗？有必要吗？ 先来聊聊超声刀： 作为SMAS筋膜层、真皮深层、真皮层的全层抗衰仪器，SMAS筋膜层这个深度是其他抗衰仪器做不到的！它的功效 重在提升！ 主要是收紧筋膜层，把下垂的组织拉回去，达到 复位软组织 的目的。 适合人群：肉多+下垂的脸！主要表现为：苹果肌下垂、下颌线模糊、发腮、双下巴、口角嘟嘟肉等。 再来聊聊热玛吉： 它的作用层次是真皮层乃至皮下深层，这个层次就是我们俗称的“皮”的层次。它的功效 重在紧致 ！利用射频加热真皮层乃至皮下深层，收紧松弛的皮肤， 刺激胶原蛋白新生 。 适合人群：肉薄+皮松的脸！比如轻度衰老带来的皮肤松弛、皱纹、干瘪和细纹、眼尾纹、法令纹等。 它们两者之间在功效侧重点，能量类型和作用层次上都不一样。 所以热超联合真的有必要吗？答案是非常有必要！热超联合才是抗衰天花板 ！ 1+1治疗 部位更全面 超声刀所达到的层次更深，要避开神经丰富的区域，所以作用点多集中在软组织丰厚的地区。而热玛吉则可以治疗超声项目中不能涉及的神经丰富的细小区域，比如眼部。热玛吉眼部治疗是被FDA允许用于上下眼睑治疗的技术，在临床上也得到了广泛应用噢。 因此二者联合治疗 ，可以弥补对方存在的局限性，拓宽对治疗部位的选择性 能量1+1>2 热玛吉是单级射频能量，通过加热真皮深层，蓄积能量达到的促进真皮胶原收缩、胶原新生的目的。超声刀使用的是聚焦超声，将超声波能量聚焦到SMAS筋膜层，形成一个个微小独立的热凝结点，令老化的胶原蛋白收缩即再生。 在作用层次上，聚集超声要深于射频。 因此在治疗时，超声可以把热玛吉覆盖不到的地方进行能量补充。 效果1+1>2 超声是点的深入，侧重纵向拉升，相当于搭房子中的“打钢筋、做支撑”。超声能量作用到了筋膜层，形成一个个热凝固点后，连点成线，定点 提升，拧紧作为底层支架的筋膜层，带动肌肉，脂肪组织整体提升复位。 而热玛吉是面的广泛，侧重于横向紧致，相当于搭房子中的水泥。热玛吉是全层发热，侧重以面的形式由外向内大面积加热，促进真皮层胶原收缩和新生。同时浅脂肪层中的纤维纵隔受热收缩后，脂肪会连带被兜紧、压实。 因此二者结合，一提拉一收紧，实现整体面部轮廓的清晰和提升。 总结一下，热玛吉主打全面收紧，高能射频促进胶原再生；超声主打点状提升，聚焦超声提拉松垮皮肤，谁不心动哇！？

Q-switched laser freckle removing (beauty freckle removing laser) Action principle The alexandrite lase with that wavelength of 755nm generates a nanosecond beam, which selectively act on the pigment particles, smashing, blasting and disintegrate the pigment particles, and then the pigment particles are eliminated from the body through the natural metabolism of the human body, so as to treat various stable spots, blue-black birthmarks, tattoos and the like. Postoperative prompt Postoperative reaction 1) On the day after treatment, the skin will appear obvious redness and slight heat sensation; After 2-3 days, there is local red-black scab on the treatment site, which usually lasts for 3-7 days. Don't deliberately let the scab skin fall off early. 2) Spot scabbing and temporary desquamation may occur in the treatment area, and obvious scabbing usually lasts for 3-7 days; There will be mild itching during the growth of scab skin, and growth factors or pure moisturizing emulsion can be added; Don't pick the scab skin, it falls off when washing your face or slightly rubbing it, which is a normal situation such as ripe melon and falling off; If blisters appear, apply cold compress in time, or contact a doctor for symptomatic treatment. Daily nursing 1) It is suggested that the scabbed area should not be exposed to raw water within 24 hours after treatment, and growth factors and facial masks can be sprayed externally within 24 hours after treatment, instead of washing your face once in the morning and once in the evening; After 24 hours, you can wash your face with clean water, once in the morning and once in the evening, gently wash your face, do not rub your skin hard, and then apply a mask, growth factor or simple moisturizing lotion. 2) Avoid using irritating skin care products for at least 1-2 weeks, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin. 3) Moisturizing and repairing after treatment: products promoting repair such as growth factors can be used before and after external application of the mask, and growth factors or moisturizing emulsion can be added if the skin feels dry on the third day; It is best to keep the skin in a "wet healing" state. 4) After 3 days, you can wear light makeup (to avoid scabs); 5)Sunscreen: Physical sunscreens are mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After the third day, you can apply light sunscreen (no need to clean with facial cleanser). Life diet 1) Avoid high-temperature environment within 1 week after treatment, such as high-temperature steaming, high-temperature yoga, etc., and avoid strenuous and heavy sweating exercise within 48 hours; 2) Try to avoid smoking, drinking and eating spicy food within 1 week after treatment, and avoid staying up late! Recovery time: 3-8 days Picosecond laser Action principle Picosecond laser technology produces a very short and fast beam of picosecond level, which selectively acts on pigment particles and dermal collagen, producing a light shock effect, smashing and blasting pigment particles; Treat various s table spots, blue-black birthmarks, tattoos, etc. The shock effect around dermal collagen can promote collagen regeneration and achieve the effect of whitening and rejuvenating skin. Postoperative prompt Postoperative reaction 1) On the day after treatment, the skin will appear slight redness and slight heat sensation; The freckle mode has scabs locally, and the scabs usually last for 3-7 days. Don't deliberately let the scabs fall off in advance; There will be red and black spots under the skin in the skin rejuvenation mode, which will repair and fade after 3-7 days; 2) After scab shedding, temporary skin whitening and skin blackening may occur; Whitening skin does not need to be treated, and it can generally restore natural skin color within 3 months; The natural regression period of temporary anti-blackness is 2-3 months, and it is obvious at 1 month. If it is more serious, you need to contact a doctor for follow-up. 3)Acne-like rash may appear after treatment and will recover within 1 week. Daily nursing 1) It is suggested that the scabbed area should not be exposed to raw water within 24 hours after treatment, and growth factors and facial masks can be sprayed externally within 24 hours after treatment, instead of washing your face once in the morning and once in the evening; After 24 hours, you can wash your face with clean water, once in the morning and once in the evening, gently wash your face, do not rub your skin hard, and then apply a mask, growth factor or simple moisturizing lotion. 2) Avoid using irritating skin care products for at least 1-2 weeks, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin; 3) Moisturizing and repairing after treatment: products such as growth factors can be used to promote repair before and after external application of the mask; On the third day, if you feel dry skin, you can also apply growth factor or moisturizing emulsion; It is best to keep the skin in a "wet healing" state. 4) After 3 days, you can wear light makeup (to avoid scabs); 5) Sunscreen: physical sunscreens are mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After the third day, you can apply light sunscreen (no need to clean with facial cleanser); Life diet 1) Avoid high-temperature environment within 1 week after treatment, such as high-temperature steaming, high-temperature yoga, etc., and avoid strenuous and heavy sweating exercise within 48 hours; 2) Try to avoid smoking, drinking and eating spicy food within 1 week after treatment, and avoid staying up late! Recovery period: 3-5 days Chemical skin change (fruit acid/salicylic acid) Action principle Chemical skin exchange is a shallow chemical skin exchange method using fruit acid or salicylic acid, which is mainly used for the treatment of acne, chloasma, skin photoaging (wrinkles), keratinizing diseases, post-inflammatory pigmentation, acne scars and so on. Fruit acid has strong irritation in the treatment of acne, and has great advantages in the treatment of black acne marks, chloasma, melanosis and round angle of hair. Salicylic acid is mild in treatment, tends to inhibit skin inflammation, relieve facial flushing, and has inhibitory effects on acne and rose acne's inflammation. Postoperative prompt Postoperative reaction 1) After treatment, there may be erythema and hoarfrost, which will disappear within 24 hours. If redness and swelling persist for 24 hours, or even blisters appear, apply cold compress in time or come to the clinic for symptomatic treatment; 2) Slight scabbing may occur locally. Pay attention to sun protection, stop using cleaning products such as facial cleanser, and wash your face with clear water to let the scab skin fall off naturally. Daily nursing 1) After treatment, you can wash your face with clean water, once in the morning and once in the evening, gently wash your face, and do not rub your skin hard. After applying a mask (optional), apply a simple moisturizing lotion, and do not use chemical cleaning products such as facial cleanser for at least 24 hours to keep your skin in a "moist" state. 2) Avoid using irritating skin care products for at least 24-72 hours, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin; After 72 hours, it is beneficial to enhance the therapeutic effect with similar products coated with fruit acid or salicylic acid. 3) After 48-72 hours, you can wear light makeup (avoid the micro-scab area); 4) Sun protection: physical sun protection is mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After 2 hours, you can apply light sunscreen (no need to clean with facial cleanser); Life diet 1) Avoid high-temperature environment within 24 hours after treatment, such as high-temperature steaming, high-temperature yoga, etc., and exercise violently and heavily; 2) Try to avoid smoking, drinking and eating spicy food within 48 hours after treatment, and avoid staying up late! Recovery time: 24-72 hours IPL photon rejuvenation/laser hair removal /E light Action principle IPL uses intense pulse composite color light technology to decompose spots, improve acne marks, stimulate collagen regeneration, make skin bright and white, and increase skin elasticity. The therapeutic intensity and repair process of laser hair removal and E-light are similar. Postoperative prompt Postoperative reaction 1) There may be reddish phenomenon after treatment, which will disappear in a few hours; If redness persists for several hours, or even blisters appear, apply cold compress in time or come to the clinic for symptomatic treatment; 2) Slight scabbing may occur locally. Pay attention to sun protection and let the scab skin fall off naturally. Daily nursing 1) After treatment, you can wash your face with clean water, once in the morning and once in the evening, gently wash your face, and don't rub your skin hard. After applying a mask (optional), apply a simple moisturizing lotion; Do not apply chemical cleaning products such as facial cleanser for at least 24 hours, and it is best to keep the skin in a "moist" state. 2) Avoid using irritating skin care products for at least 24-72 hours, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin; 3) After 48-72 hours, light makeup can be applied; 4) Sunscreen: Physical sunscreens are mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After 2 hours, you can apply light sunscreen (no need to clean with facial cleanser). Life diet 1) Avoid high-temperature environment within 24 hours after treatment, such as high-temperature steaming, high-temperature yoga, etc., and exercise violently and heavily; 2) Try to avoid smoking, drinking and eating spicy food within 48 hours after treatment, and avoid staying up late! Recovery time: 24 hours, lunch-style beauty treatment (one beauty treatment can be performed in one lunch). Pulsed dye laser (fotona) Action principle Pulsed dye laser is a kind of pulsed beauty laser, which acts on the blood vessels under the skin to treat red birthmarks, spider nevus, red blood on the face, hypertrophic scars and dark circles. Postoperative prompt Postoperative reaction 1) On the day after treatment, the skin will appear obvious redness and slight heat sensation; After treatment, the area will produce redness, purpura and black spots, which is a normal reaction. The redness and purpura will gradually develop into black spots and gradually fade away. The laser treatment acts on the skin blood vessels, so the repaired marks are obvious, but the epidermal damage is small and the repair is fast; 2) Some people will have tiny scabs after treatment, which will fall off by themselves in 1-2 weeks. If there is obvious exudation scabs and blisters, you need to contact a doctor for a follow-up visit. Daily nursing 1) It is suggested that the scabbed area should not be exposed to raw water within 24 hours after treatment, and growth factors and facial masks can be sprayed externally within 24 hours after treatment, instead of washing your face once in the morning and once in the evening; After 24 hours, you can wash your face with clean water, once in the morning and once in the evening, gently wash your face, do not rub your skin hard, and then apply a mask, growth factor or simple moisturizing lotion. 2) Avoid using irritating skin care products for at least 1-2 weeks, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin; 3) Moisturizing and repairing after treatment: products such as growth factors can be used to promote repair before and after external application of the mask; On the third day, if you feel dry skin, you can also apply growth factor or moisturizing emulsion; It is best to keep the skin in a "wet healing" state. 4) After 3-7 days, you can wear light makeup (avoid the scab area); 5) Sunscreen: physical sunscreens are mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After the third day, you can apply light sunscreen (no need to clean with facial cleanser); Life diet 1) Avoid high-temperature environment within 3 days after treatment, such as high-temperature steaming, high-temperature yoga, etc., and exercise violently and heavily within 24 hours; 2) Try to avoid smoking, drinking and eating spicy food within 1 week after treatment, and avoid staying up late! Recovery time: 3-7 days Non-stripping lattice laser (1550nm) Action principle Lattice laser, also known as shuttle laser, or shuttle laser, is called "laser" in Taiwan Province. Dot-matrix laser is to divide the original large laser spot into small laser beams arranged in a matrix, and accurately act on different layers of skin, repair damaged fibrous tissue, stimulate collagen regeneration in dermis, and achieve skin regeneration effect, which is used to improve concave scar, coarse pores and facial rejuvenation after acne. Postoperative prompt Postoperative reaction 1) After treatment, the area will be reddish or red and swollen, which is a normal reaction and will subside in 1-3 days; 2) Some people will have tiny scabs after treatment, which will fall off on their own in 1-2 weeks, and some people will have matrix-like grid performance, lasting for 1-2 months, and then they will fade away on their own. Daily nursing 1) After treatment, you can wash your face with clean water, once in the morning and once in the evening, gently wash your face, and don't rub your skin hard. After applying a mask, apply a simple moisturizing emulsion; Do not use chemical cleaning products such as facial cleanser for at least 24 hours, and it is best to keep the skin in a "moist" state. 2) Avoid using irritating skin care products for at least 24-72 hours, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin; 3) After 48-72 hours, light makeup can be applied; 4) Sunscreen: Physical sunscreens are mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After 2 hours, you can apply a light sunscreen (no need to clean with facial cleanser). Life diet 1) Avoid high-temperature environment within 3 days after treatment, such as high-temperature steaming, high-temperature yoga, etc., and exercise violently and heavily within 24 hours; 2) Try to avoid smoking, drinking and eating spicy food within 1 week after treatment, and avoid staying up late! Recovery time: 1-3 days Lattice CO2/ lattice Er laser/lattice RF/gold microneedle Action principle Lattice CO2 laser is what we call lattice CO2 laser. It is mainly used to treat concave scars after acne, large pores and hyperplastic scars. Dot-matrix erbium laser, dot-matrix radio frequency and gold microneedle also belong to the treatment of focal micro-trauma, which can refer to the repair process of dot-matrix CO2 laser after operation. Postoperative prompt Postoperative reaction 1) The skin will appear obvious redness and slight heat sensation, and it is normal for most people to have punctate bleeding and punctate exudation within 24 hours after treatment; The scab usually lasts for 5-7 days, so don't deliberately let the scab skin fall off in advance; Don't pick scabs; It is normal to wash your face or scrape the scab skin slightly, which belongs to the normal situation such as melon falling off; The peeling time of scab skin is related to therapeutic energy, dryness of climate, facial care, oily skin and oily area. If blisters appear, apply cold compress in time, or contact a doctor for symptomatic treatment; 2) Very few people will have pigmentation after laser surgery, which is normal and temporary. They must maintain a good attitude and living habits. Under normal circumstances, it will naturally fade after 3-6 months of sun protection and avoiding staying up late; Some people also have grid-like marks after the repair of the treatment area, which will naturally fade after 3-6 months; 3) the treatment area is large, and there is a probability of herpes simplex. If you have facial herpes in the past, you should inform your doctor and ask him to prescribe antiviral drugs to prevent herpes; 4) Acne-like pustules occur within 1 week, and anti-inflammatory ointment can be applied locally. Daily nursing 1) It is suggested that the scabbed area should be treated within 24-48 hours after treatment, so as not to touch raw water as much as possible; Within 24-48 hours of treatment, you can use external spray growth factor and external mask, instead of washing your face once in the morning and evening; After 24-48 hours, you can wash your face with clear water, once in the morning and once in the evening, gently wash your face, do not rub your skin hard, and then apply a mask, growth factor or simple moisturizing lotion. 2) Avoid using irritating skin care products for at least 1-2 weeks, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid/salicylic acid/tretinoin; 3) Moisturizing and repairing after treatment: products such as growth factors can be used to promote repair before and after external application of the mask; On the third day, if you feel dry skin, you can also apply growth factor or moisturizing emulsion; It is best to keep the skin in a "wet healing" state. 4) After 3 days, you can wear light makeup (to avoid scabs); 5) Sunscreen: physical sunscreens are mainly used at home, umbrellas, wide-brimmed hats, sunglasses and breathable masks. After the third day, you can apply light sunscreen (no need to clean with facial cleanser); Life diet 1) Pay attention to avoid high temperature environment, such as high temperature steaming, high temperature yoga, and strenuous sweating exercise within 1 week after treatment; 2) Try to avoid smoking, drinking and eating spicy food within 1 week after treatment, and avoid staying up late! Recovery time: 5-8 days Gemaji Action principle For different treatment sites, special therapeutic probes are used to evenly transmit high-energy radio-frequency heat energy to the deep dermis and fascia layer, so that collagen can contract and regrow, and the subcutaneous fascia can contract and tighten, thus achieving the effects of long-term skin tightening and three-dimensional contour improvement. Choose different treatments for different parts, such as hot Maggie treatment around eyes, hot Maggie treatment on face and neck and facial mask hot Maggie treatment on abdomen. Postoperative prompt Postoperative reaction 1) Most people have no redness and swelling on the skin surface after treatment, and a few people may have slight redness and swelling on their faces. Some cases have reported that in rare cases, temporary local numbness and slight tingling on the edge of bones appear on their faces, which will gradually subside in 1-3 days; 2) After treatment, there is a very small chance that there will be mild blisters and bruises. Cold water can be applied to the face and moisturizing emulsion can be applied externally. When the blisters are large, the blisters can be punctured, and the blister wall can be kept close to the original skin surface. If it is difficult to handle, you can contact a doctor for a follow-up visit. Daily nursing 1) within 1 week after treatment, the treatment site should avoid contact with overheated or supercooled water, and wash your face gently with warm and cold water, without rubbing hard; After 24 hours of treatment, you can clean, moisturize, sunscreen and apply light makeup normally; 2) Avoid using irritating skin care products for at least 7 days after treatment, such as granular facial cleanser, soap, scrub and skin care products containing alcohol/fruit acid; 3) After treatment, it is very important to do a good job of moisturizing, mainly by external application of moisturizing emulsion, adding moisturizing cream in winter or dry climate areas, and mainly by hard sun protection such as home, parasols, wide-brimmed hats, sunglasses and medical breathable masks. Life diet 1) Avoid high-temperature environment within 1 week after operation, such as high-temperature steaming, high-temperature yoga, and strenuous sweating exercise; 2) After finishing eye hot Maggie, wear contact lenses one week later; Don't rub your eyes within 24-48 hours to prevent scratching your conjunctiva or cornea; 3) Try to avoid smoking, drinking and eating spicy food within 1 week after treatment. Recovery time < 24 hours After laser cosmetology, you should also observe the redness, scab and erythema after scab peeling when you go back. The points for attention after each laser surgery are different, but they are also the same, which are arranged as follows:   01 Postoperative skin reaction The treatment area may appear spot-like red spots, and then appear scabs, and then the scabs fall off, usually lasts 3-7 days, do not deliberately let the scabs fall off early; If blisters appear after treatment, apply cold compresses promptly and inform the treating doctor for symptomatic treatment.   02 Daily care, promoting "wet healing".   We usually do basic skin care, mainly three parts: clean, moisturize, sunscreen.   (1) Many people see cosmetic skin laser treatment as open surgery and worry that contact with raw water (tap water) after treatment will cause skin infections, in fact, 24 hours after treatment the skin surface has formed a scab to protect the skin, as long as it is cosmetic skin laser photoelectric treatment, do not worry about any risk of infection;   2) Cleaning after treatment: It is recommended that the first day of cleaning after going home is a mask in the morning and evening; 24-48 hours after treatment can be used completely tap water (to speak some can choose cold boiled water) wash your face, 3 days after warm or cold water gently wash your face; Do not rub the skin, do not buckle peeling scabs, let the scabs fall off naturally; if the process of washing the face or gently touch the face, there are scabs fall off, is a normal phenomenon, basically the scabs have been ripe and fall;   3) Avoid the use of irritating skin care products for at least 1-2 weeks after treatment, such as: granular cleansers, soaps, scrubs, skin care products containing alcohol/fruit acid/salicylic acid/vitamin A acid and other ingredients;   (4) Treatment moisturizing and repair: you can use growth factors and other products that promote repair before and after the external mask, and if you feel dry skin, you can also apply additional growth factors or moisturizing lotion;   (5) sunscreen: home, umbrellas, wide-brimmed hats, sunglasses, breathable masks physical sunscreen is the main, after the 3rd day can be coated with light sunscreen (do not need to wash the cleanser to clean);   6) the later you choose to put on makeup and use facial cleanser, the safer it is!   03 Life Diet (1) Pay attention to avoid high temperature environment, such as: high temperature sweating, high temperature yoga, etc., as well as strenuous and large amount of sweating exercise within 3-7 days after treatment;   2) Avoid staying up late, and try to avoid smoking, drinking, eating spicy food, etc. within 1 week after treatment.   About wearing masks Wearing a mask during an epidemic is a double-edged sword. In the past, the precautions after laser surgery were not to wear masks, especially thick ones. But now because of the epidemic needs, go out and take the bus subway have to wear a mask. Many fairies then feel that now is a good time for cosmetic skin care, because then you do not have to worry about post-laser repair, the next person's curious eyes and can not control the mouth. So how exactly do you wear a mask after this treatment? It is advisable to put on a sterile mask after the procedure, and when the doctor determines that there is no need for further observation, you can go straight home. On the way home, you can put on a mask, wear a breathable medical mask; if it is a private car, it is better not to wear a mask.   After 24 hours, you can wear a normal mask, but also sunscreen.   It is recommended that you do not wear a thick mask such as N95 after surgery, but you should choose a light and breathable medical mask.   About External Mask It is recommended that a sterile moisturizing mask be applied externally for 10-30 minutes immediately after the medical aesthetic treatment, provided that the mask does not dry out.   Many people ask, isn't it not possible to touch water?   Yes, do not touch raw water. The sealed sterile mask is not raw water, so you don't have to worry about infection. Also, the first day of facial cleansing after some minimally invasive lasers is one mask in the morning and one in the evening.   We would like to suggest that the mask should be as medical as possible, as medical is more pure and does not have too many preservative additives.       If you do the project, there is any abnormal phenomenon, customer service if off duty did not reply, please add WeChat. We will be the first time to guide the aftercare, if there is an emergency Can be the first time to give you a prescription drug.

Asian women have been suffering from chloasma , which is the most stubborn and difficult to eliminate among all the color spots that affect the beauty of the face. Even the seemingly omnipotent laser cosmetic technology has a hard time with chloasma, and the financial and time costs of removing melasma are not insignificant. Here is a compilation of dry facts about chloasma awareness and treatments, take a look at the specifics. Recognizing Melasma Genetic susceptibility, sun exposure, and changes in sex hormone levels are the three main factors in the development of chloasma, and there are simple and difficult treatments for different causes. 1. Genetic susceptibility About half of the patients have a family history of chloasma, and the treatment of chloasma with a family history is very slow to take effect and relatively ineffective 2. Sunlight irradiation Medium-wave ultraviolet (UVB) and long-wave ultraviolet (UVA) rays in sunlight directly stimulate melanocytes to synthesize pigments; at the same time, it induces an inflammatory response, which can activate the activity of tyrosinase, enhance the function of melanocytes, and increase the synthesis of melanin particles. 3. Abnormal changes in hormone levels Pregnancy, oral contraceptive pills and oral hormonal drugs can induce and aggravate chloasma in women of childbearing age. Changes in hormone levels such as thyroid diseases, female reproductive system diseases and liver diseases can also induce or aggravate chloasma. Long-term sleep disorders and emotional changes can also affect the changes of hormone levels in the body and aggravate chloasma. Although estrogen and progesterone have a great influence, due to the great changes of hormones at different times in women's physiological cycle, and some male friends also have chloasma, the reference value is not great. What is more valuable is the detection of thyroid hormone levels. If thyroid diseases are found, immediate treatment can alleviate chloasma. These discussions are all external factors, which further cause the damage of skin barrier function, inflammatory reaction and the increase of vascular activity, and then increase the synthesis of melanin particles, resulting in chloasma on the face. 1. The skin barrier is damaged In the lesion area of chloasma, the expression of keratin and ceramidase in the outermost layer of epidermis is abnormal, which shows that the skin barrier on the skin surface of chloasma is damaged, and the damaged skin barrier will cause melanocytes in the basal layer of epidermis to produce more melanocytes in feedback. Factors such as ultraviolet rays and excessive cleaning will aggravate the damage of skin barrier and the occurrence of chloasma. 2. Inflammatory reaction Histologically, it was found that the inflammatory factors in the area of chloasma increased obviously, and these inflammatory factors would further activate tyrosinase and increase the production of melanin particles. The use of inferior cosmetics such as excessive mercury and lead, cooking (peroxide in oil fume), ultraviolet rays and other stimuli will aggravate the inflammatory reaction of the skin. 3. Vascular factors In chloasma lesions, the number and diameter of dermal small vessels will be obviously thickened, and the expressions of vascular endothelial growth factor and endothelin 1 will be obviously increased. 4. Increased melanin synthesis A variety of factors act directly or indirectly on microphthalmia-associated transcription factors in melanocytes to activate melanocyte function and promote melanin synthesis through the upregulation of downstream tyrosinase, tyrosinase-associated protease 1, and dopachrome isomerase. Treating chloasma by stage After knowing the cause, the treatment of chloasma is actually the repair of skin barrier and the treatment of chronic inflammation. On this basis, if we look at the treatment methods, we can understand why we can't easily use laser to remove chloasma. Three-stage treatment Inflammation stage, repair stage and stable stage Why staging? In order to better recognize the pathogenesis of chloasma, to treat it more precisely, and especially to avoid rebound after treatment to maintain the treatment effect. In addition to the staging method for chloasma, clinicians will also classify melasma according to its external manifestations. Staged treatment There is still some controversy about the disease staging of chloasma. There was a time when many doctors believed that inflammation was an important triggering and initiating factor for the development of chloasma, and chloasma was divided into staged treatments: inflammation, repair and stabilization; it is now generally believed that inflammation exists throughout the process of chloasma, so doctors are more willing to accept the staging methods of:active and stabilization. In fact, most chloasma starts from the active stage, passes through oral medication or naturally transits to the stable stage. If there are hormonal changes in the body or the stimulation of ultraviolet rays, it will enter the stable stage again, and it will be an irregular and repeated process. Active stage: recent enlargement of the lesion area, deepening of color, redness of the lesion, redness of the lesion after scratching. Stable stage: no recent expansion of lesion area, no deepening of color, no redness of lesions, no redness of lesions after scratching. Typing treatment: In order to refine the precise treatment and make a personalized treatment plan, it is necessary to classify chloasma: According to the involvement of blood vessels, it is divided into: 1. Simple pigmented type (M type): no discoloration of the lesion on compression of the slide, and an increase in color contrast between the lesion area and the non-lesion area under the Wooch's lamp; 2. Pigmented and vascular (M + V type): partial discoloration of the lesions on compression of a slide, with an insignificant increase in color contrast between the lesion and non-lesion areas under a Wool's lamp. There are also some typing methods, according to the skin level of pigment aggregation is divided into epidermal (epidermal hyperpigmentation) and mixed (epidermal hyperpigmentation + superficial dermal phagocytic melanocytes). The distribution of pigmentation can also be categorized into mid-face, buccal and mandibular types, which are rarely used nowadays. Medication as the main treatment Acid peeling/photoelectricity as a supplement Since melasma is difficult to treat and can hardly be completely resolved by a single treatment, it is especially important to prevent triggering factors. 1. Avoid triggering factors and adjust lifestyle: Avoid sunlight, cooking heat/occupational heat stimulation, avoid the use of poor-quality cosmetics such as those with excessive mercury and lead content; avoid taking medications that cause changes in sex hormone levels and photosensitizing medications; ensure adequate sleep, and a combination of work and rest; and maintain a good state of mind. 2. Repair the skin barrier: The use of efficacious skin care products with scientific basis is beneficial to the prevention and treatment of chloasma. Repairing the skin barrier means applying more moisturizers, which is very understandable. After we wash our face every morning, do we feel that our skin is hydrated and bright and more radiant. 3. Sun protection: I used to say that every chloasma patient needs sun protection every day. Now I will say that everyone needs sun protection every day. It is suggested that long-term physical shading of sunscreen on the basis of external use is beneficial to the prevention and treatment of chloasma and reduce recurrence. 4. Whitening skin care products: Whitening functional skin care products containing licorice extract, levovitamin C, nicotinamide, tranexamic acid, glutathione, ellagic acid, mulberry leaf extract, aloin and other ingredients can lighten chloasma. And some new compound whitening preparations (anti-oxidation, soothing) extracted from plants, such as camellia yunnanensis, purslane, thorn fruit and notoginseng, can also effectively improve the symptoms of chloasma. Staging + TypinggTreatment 1. Active period: avoid photoelectric therapy, and choose skin care products with stability to carry out basic treatment and cooperate with systematic drug treatment. 2. Stable period: On the basis of systematic and external drug treatment, you can choose the medical cosmetic treatment method of beauty. Glutathione: The sulfhydryl group in the glutathione molecule inhibits the activity of tyrosinase by binding to copper ions in the enzyme and reduces melanin production; most are chosen for intravenous infusion, often in combination with vitamin C. Glycyrrhizin: It exerts its therapeutic effect mainly by relieving the inflammatory response of the skin. External medicine Hydroquinone and its derivatives, tretinoin, azelaic acid, tranexamic acid Hydroquinone and its derivatives: The first line of topical treatment for melasma (although less common in clinical practice), commonly used in concentrations of 2% hydroquinone cream and 4% hydroquinone cream, the higher the concentration the stronger the depigmentation effect, but the greater the skin irritation, it is recommended to start with a low concentration, or apply after moisturizing cream to reduce irritation and help build tolerance. Usually used once a night, a small amount of local topical application, treatment 4-6 weeks can have obvious results, use 6-10 weeks the best results. The main adverse effects include irritant contact dermatitis and permanent pigment loss. Arbutin and deoxyarbutin are glucoside derivatives of hydroquinone, which are less irritating than hydroquinone when used topically, and are mainly suitable for simple pigmented types. There is a Kligman triple formula in the medical literature: hydroquinone, retinoic acid and glucocorticoid topical combined use, but because hydroquinone, retinoic acid are skin irritation, the two superimposed use of skin irritation is more pronounced, and glucocorticoid long-term use of the face is prone to dependence on resistance, coupled with the partners are difficult to distinguish between the strong and weak hormone, this treatment has not been popularized and applied. Retinoids: Clinically commonly used 0.05% ~ 0.1% retinoic acid ointment or gel, 1 time per night, the course of treatment is about 6 months; may appear skin dryness, erythema and itching, burning and other adverse reactions; Early C and late A have antioxidant effect, in addition to delay aging, can increase the resistance of stable chloasma skin, the same need to be mainly early local small amount of use, gradually build up tolerance. It is mainly applied to simple pigmented type. Azelaic acid: Clinically, 15% azelaic acid gel and 20% azelaic acid cream are commonly used twice daily for approximately 6 months. Itching, burning, pins and needles, and numbness may occur in a small percentage of individuals. For mild acceptable skin irritation, immediate discontinuation of the drug is not recommended, and tolerance can be built up using small increments. It can be used for both purely pigmented and pigmented-vascular types. (Mainly for purely pigmented types). Tranexamic acid: Commonly used clinically as a 2%-5% cream twice daily for about 4 weeks. Topical use is less irritating than hydroquinone, and adverse effects include erythema, dryness, and flaking. Suitable for purely pigmented and pigmented combined with vascular types. The above is only a list of commonly used topical drugs, most of the topical drugs have different degrees of irritation to the skin, and need to be used in conjunction with efficacious skin care products that have the function of repairing the skin barrier. Medical cosmetic treatments Phototherapy, chemical peeling, plasticizing therapy In terms of photoelectricity treatment, for pure pigment type (M type) melasma in stable period: mainly include picosecond laser, Q-switched laser, intense pulsed light, non-peeling fractional laser and so on; for pigment combined with vascular type (M+V type), you can choose pulsed dye laser and long-pulse-width 1064nm laser. Q-switched laser: The common wavelength is 1064nm Q-switched Nd:YAG laser with large spot and low energy treatment mode, which was once called "white face doll" by the package for a period of time, mainly treating chloasma through selective photothermal effect, accelerating the selective photothermal decomposition of mature melanin vesicles, and the big advantage is destroying melanin vesicles and melanin particles inside the cell, thus avoiding the rebound and aggravation of chloasma induced by damage to melanocytes. The major advantage is that it destroys melanosomes and melanin particles inside the cells, but also maintains the integrity of the cell membrane of the outer layer of the cells, thus avoiding the rebound and aggravation of melasma induced by the damage of melanocytes. Picosecond laser: Compared with Q-modulated lasers, picosecond lasers have shorter pulse widths, act more precisely, and produce a selective mechanical photo-oscillatory effect on pigments, avoiding the risk of thermal stimulation induced by traditional lasers that can cause discoloration to rebound; 755 nm picosecond alexandrite laser can form laser-induced photodestructive effect in the epidermis and stimulate collagen synthesis, which improves photoaging while removing pigmentation and treats melasma from multiple angles; The 1064nm picosecond uses the flat sweep treatment mode of large spot and low energy, and like the 755nm emerald green gemstone picosecond laser, it has lower adverse reactions after treatment, and all of them are the most ideal choices in photoelectricity treatment at present. Non-exfoliative fractional laser: Common wavelengths are 1540 nm, 1550 nm and 1565 nm lasers, which can de-selectively inhibit pigment synthesis and increase collagen in the skin for an overall brighter complexion. IPL (Intense Pulsed Light), commonly known as "photon" and "photorejuvenation". It is a member of the laser family, if the laser is a single wavelength of monochromatic light, IPL is a composite light in a certain range of wavelengths, so it is also known as composite color light. Now some new terms: intense light, OPT, AOPT, DPL, BB light, CC light, milk light and so on are all belong to intense pulsed light. For simple pigmented melasma (M-type) and pigmented combined with vascular melasma in the stable period, different filters are chosen, and the filters of different instruments will be different, which requires higher technical requirements for the operators. Pulsed dye lasers, pulsed dye lasers and intense pulsed light at 585 nm or 595 nm (wavelengths 500-1,200 nm) Targeting pigmentation while selectively acting on capillaries to inhibit vascular proliferation can be an option in patients with pigmented combined vascular (M+V) types. PS: For photoelectricity treatment, we need to pay attention to the single, repeated photoelectricity treatment is easy to lead to hyperpigmentation, hypopigmentation / loss of pigmentation and recurrence, etc. Therefore, the number of consecutive photoelectricity treatment should not be more than 15, and the interval of 1 year can be considered to repeat the treatment. The parameters of photoelectric treatment should be set with mild intensity, the starting energy should not be too high, and the treatment interval should not be too short. Chemical stripping: Common chemical peeling agents include fruit acids and complex acids. Among them, fruit acid resurfacing is an effective adjunct to the treatment of simple pigmented melasma, which reduces hyperpigmentation by promoting the turnover of keratin-forming cells and accelerating the transit and expulsion of melanin particles from the basal layer to the stratum corneum. Main adverse reactions: temporary erythema, mild swelling, tingling, burning and other discomfort. Caution should be exercised if the area to be treated has allergic or herpes simplex infectious diseases, if the head and face have undergone radiotherapy, cryotherapy or dermabrasion in the last 3 months, or if the patient is allergic to fruit acids. For melasma fruit acid treatment, generally we start from a low concentration of 20%, 35%, 50%, 70%, and increase the concentration step by step according to the skin reaction after each treatment. It is usually done at intervals of 2~4 weeks, with 4 times as a course of treatment. The treatment needs to be operated by medical personnel, and improper operation can easily lead to post-inflammatory hyperpigmentation and temporary aggravation of pigmentation, especially dark-skinned patients should be cautious. Mesotherapy It is also called mesotherapy, hydro-electronic injection technology, and is now commonly known as "hydro-photo-needle". Through the row of needles to a group of drugs injected in the dermis layer of the skin, does not belong to the photoelectric project, no photothermal stimulation, the epidermis, the dermis have the corresponding therapeutic effect. The medications used for the injection include, but are not limited to, hyaluronic acid, tranexamic acid, and vitamin C. Hydrotherapy injections precisely deliver the medication to the location of the discoloration, avoiding the side effects of intravenous or oral medication, and facilitating the absorption of the medication into the skin locally. The hyaluronic acid in hydrafacial injections is an important component in maintaining skin hydration and has the ability to repair the skin barrier; increasing the water content of the skin and helping to lock in moisture in our skin. It helps brighten skin tone, lighten pigmentation and refine skin texture, and the chances of melasma temporarily worsening after treatment are very low. The above is a comprehensive discussion of the medical aesthetic treatments available, and the current use is still dominated by chemical peel treatments, picosecond lasers, pulsed dye lasers and hydrafacial treatments. Chinese medicine treatment Choose drugs that are not harmful to the human body, and at the same time, consider the contraindications of the Chinese medicines In Chinese medicine, chloasma is called "liver spot", which is mainly due to liver depression and stagnation of qi, stagnation of qi and blood stasis, weakness of the spleen and stomach, and insufficiency of the liver and kidneys. Treatment is based on the principles of dredging the liver, strengthening the spleen, tonifying the kidney, regulating qi, activating blood circulation and removing blood stasis, and the treatment course is relatively long, usually 3-6 months. About the treatment methods of Chinese medicine. Our first principle is to choose drugs that do not harm the human body, while considering the contraindications of Chinese medicine. The choice of drugs is mainly to activate blood circulation and remove blood stasis to dredge the liver and regulate qi. Chinese medicines such as saffron, rhubarb, stinging insects are mainly used, and the adult medicines are mainly based on Easy Pill, Six-flavored Dihuang Pill, and Tao Hong Si Wu Tang. Others Treatments for Melasma Combined with Other Facial Problems and the Priority of Treatment Melasma with freckles, age spots, brownish green nevus and other skin diseases, you can improve melasma first before considering these combined pigmentation treatments; melasma combined with acne, rosacea, capillary dilatation, sensitive skin combined diseases, it is recommended that these inflammatory and vascular diseases be treated first, because in itself these inflammatory and vascular treatments are helpful for the improvement of melasma as well. Melasma is recognized as one of the more difficult problems to treat. Our goal must be to brighten skin tone, lighten pigmentation, refine overall skin texture, maintain stability and reduce recurrence as the goal. Do no It is recommended that you must go to a professional medical institution in a timely manner to choose a suitable solution for your treatment after a medical consultation. Choose REALR Laser & Skincare Medspa, and we provide the most professional and safe medical beauty service.   REALR Laser & Skincare Medspa is a medical beauty skin management center that provides professional and effective problem-solving solutions. Located on the main street of Allston, Greater Boston, Massachusetts.   REALR Medical Beauty Center has cooperated closely with more than 100 beauty institutions in recent ten years, and personalized skin care for every beauty lover based on a large number of clinical cases and the real needs of customers. In particular, there are different answers to various skin problems, especially in acne, anti-aging and pigment treatment.   At the same time, we are developing a full line of medical beauty products, insisting on combining the scientific skin care concept with international cutting-edge R&D technologies such as cell regeneration technology and bio-bionic technology. After years of exploration, research and practice, we constantly iterate and upgrade the product formula, from taste to skin feeling experience, and repeatedly polish every detail from design to packaging, so as to improve skin problems from the inside out in terms of treatment and maintenance effects of comprehensive skin problems such as whitening and hydrating, acne muscle improvement, sensitive skin improvement, anti-wrinkle and anti-aging repair.   REALR introduces the world's most advanced medical technology, only cooperates with the world's top medical manufacturers, and selects the latest, top-notch and safest medical equipment. We are the first Asian medical and beauty institution in Boston to introduce the fifth generation of Hot Maggie Thermage FLX, and we are officially certified as a diamond member of Hot Maggie FLX. At the same time, we are also the only Asian medical and beauty institution with Fotona Eurostar equipment in Boston, which is strongly recommended by the medical and beauty industry leaders such as Fotona Eurostar. REALR also has the official certification of M22 Photorejuvenation, Ultherapy Ultrasonic Knife, PicoWay and other projects.   REALR has accumulated rich clinical experience of Asian guests and has its own medical research department. We introduce the most advanced medical technology in the world and regularly organize medical teams to participate in cutting-edge medical and aesthetic education projects around the world. We only cooperate with the world's top medical manufacturers and choose the latest, top-notch and safest medical equipment.

Current non-invasive anti-aging focuses on tightening and lifting by heating the tissues to shrink them, with the dermis being the main area of combat regardless of the technique used. To say that the most popular anti-aging medical beauty program, that has to be mentioned is the Thermage . Thermage uses radiofrequency energy, that is, through radiofrequency to achieve tissue heating. The smaller the resistance, the easier the current passes, according to this principle, in the epidermis, dermis and subcutaneous fat in the three levels, with the highest water content of the dermis as the main target of energy, in the process of electric current conduction to the deeper part of the process, so that the fibrous septum inside the fat layer is more susceptible to energy heating and contraction of adipose tissue, resulting in the effect of the deep tissue pulling Thermage although it can play a significant effect of the face lift, but the heat is not as strong as in the other medical aesthetic projects. However, compared with other medical beauty projects, many women who love beauty are discouraged because of their certain pain. So the emergence of the hottest item of the moment, Cenolon 5G Max, can be said to be the gospel of the ladies who are afraid of pain. Then let me bring you a comprehensive science of Senoron 5G Max. Senoron 5G Max R & D company CANDELA believe that we are no strangers to the market popular picoway picoseconds and Co2 and so on the first line of medical equipment are CANDELA company R & D, in the medical community is also a lot of praise. The first generation of Cenolon 5GMax was launched in 1998, and it took more than 20 years of updating and iteration to come up with the current 5G Cenolon 5G Max uses long pulse 755+1064nm lasers to achieve the effect of improving multiple imperfections in a single treatment by five steps: rapid lifting, fine lines repelling, localized tightening, whitening of the whole face, and lipolysis of the face by any lipolysis and slimming, which makes full use of the diversified characteristics of lasers. Facial fine lines fading and whole face whitening and spot reduction are realized by long pulse 755nm laser, which is based on the higher absorption peak of melanin at 755nm and the expanded selective photothermal effect, while the remaining several functions are realized by long pulse 1064nm laser. 5G Max divides the anti-aging process into 5 steps from epidermis, dermis to subcutaneous tissue: Step1: lifting mode Step2: smoothing mode Step3: tightening mode Step4: brightening mode Step5: slimming mode To summarize, 5G Max is a very efficient facial lipolysis and lifting device, and at the same time, it has whitening and skin rejuvenation facial hair removal and redness effect. It is an all-round device that can improve the three main skin problems: skin texture, skin color and skin age. The most important thing is with Candela's patented DCD cooling technology, the whole process is senseless and comfortable, suitable for ladies who are afraid of pain to try! So 5G Max does not need to apply anesthesia! At the same time to ensure the comfort of the treatment process, no epidermal damage, there is almost no need to treat recovery period.

The clinic recently welcomed a special friend. Most people feel sunken and flabby when they have a consultation. Instead, she felt "too full". Seven or eight years ago, she had facial lipofilling done in Korea, filling in her forehead and temples. At the time, she was about 100 pounds. After becoming a mom, she gained more than 20 pounds. Not only is the waist and abdomen accumulated swimming circles, forehead when the fat filling also followed the "bang" out ...... The essence of gaining weight is actually a larger volume of fat and more fat cells. Unlike injectable fillers, fat cells are alive. If you gain weight after having facial lipofillers, the volume of fat cells that survive in your face will follow. This friend asked me what to do, in addition to trying to lose fat, I suggested using Thermage to "compact" the fat and repair the skin. As we all know, the most fascinating effect of Thermage is "tightening", the beginning of RF cosmetic anti-aging. Thermage is effective in fat tightening. When radiofrequency energy is applied to the skin tissue, the subcutaneous fat heats up, and the fat tissue absorbs the energy and shrinks, resulting in a compaction effect. With the right amount of energy, combined with a customized procedure, bulging fat pads can be "ironed out". Collagen denaturation and contraction creates an immediate tightening effect, which also tightens and lifts the "bulging" looking skin. However, Thermage does not destroy fat, let alone "disappear" fat cells. Therefore, if you have a thin face, you don't have to worry, Thermage will not make your face concave under standardized operation. Facial fillers, Botox, etc. are combined with Thermage, following the principles of "top then bottom, outside then inside", "tightening and lifting first, then deep injections and fillers". It really realizes the principle of "growing your own tissues", so as to achieve a more natural and long-lasting state, and to create a healthier and sustainable collagen regeneration power. Finally, I've included aftercare advice from Thermage's standardized practice instructors: ①The local skin is slightly swollen and touched with some pain in one week after treatment, which is normal and will be gradually recovered in about 7 days; ② due to the accumulation of heat, the skin will feel dry, hot, need to strengthen the moisturizing; ③ Avoid the use of irritating skin care products (such as acids, exfoliants, high concentration of VC and A-alcohol, etc.) for one week; ④ Please wash your face with water close to the temperature of your skin and avoid excessive rubbing; ⑤ Pay attention to strict sun protection, sun protection is the foundation of anti-aging; ⑥ It takes some time for collagen to be newborn, 2-6 months after treatment, you will see more tightening changes; Friends who have just finished lipofilling are recommended to have Thermage treatment after 3-6 months.

What is Thermage? Thermage, approved by the U.S. FDA as early as 2002, entered the medical skincare market. Thermage employs a monopolar radiofrequency technology that requires the application of electrode pads to create a circuit. Radiofrequency generates a high-frequency electromagnetic field in the treated area of the body's skin, causing the water molecules within the skin to oscillate and rapidly rotate, generating heat. When a certain temperature is reached, it induces the contraction and regeneration of collagen fibers, thereby achieving skin tightening, lifting, and wrinkle-reducing effects. What are the principles of Thermage? Thermal Response: By forming a focused surface through the radiofrequency electric field at a depth of approximately 2.6 to 3mm beneath the skin, the skin is stimulated to undergo reversible damage. The process of repairing this damage results in the production of collagen fibers, leading to skin tightening and wrinkle reduction. Ion Permeation: The radiofrequency electric field can alter the concentrations of electrons and ions around cell membranes. Through the process of ion dissociation caused by the radiofrequency electric field, water ion channels in cell membranes are opened, enhancing intercellular permeability. Simultaneously, under the influence of electromagnetic wave focal gravitational forces, ionized water and nutrients on the epidermis can more easily permeate into the dermal tissue. Lipolysis Reaction: When the radiofrequency electric field acts on subcutaneous tissue, the ratio of temperature increase between subcutaneous fat and dermal tissue is about 8:1. After absorbing energy, fat tissue softens, contracts, and breaks down, resulting in firmer and more elastic skin. Thermage treatment can help you achieve the following: Facial Anti-Aging: Using the facial treatment head can improve static facial wrinkles, address double chins, and enhance skin firmness. Eye Area Anti-Aging: The eye treatment head can tighten loose skin around the eyes. After treatment, collagen protein contracts, immediately displaying tightened and lifted skin. New collagen protein production takes 3 to 6 months, with effects becoming more noticeable around 3 months after treatment. What is Ultherapy? Ultherapy is a type of ultrasound with excellent penetration capabilities, categorized into medical and cosmetic devices. In the realm of cosmetic applications, the high-intensity focused ultrasound (HIFU) of the Ultherapy targets the skin at depths of 1.5-4.5 millimeters (in the fascia layer). It achieves this by emitting 600-1200 pulses of ultrasonic nanowaves during focal point convergence, generating high-frequency friction that results in thousands of thermal coagulation points. This process instantly generates temperatures of 60 to 75 degrees Celsius. The thermal stimulation produced by the Ultherapy induces a three-phase response in the fascia layer cells: Cellular Thermal Injury Accumulate Self-Energy for Repair Generation of New Cells
After undergoing these three stages of cellular repair, the tightened skin repositions firmly onto the fascial collagen framework, gradually aligning and forming ordered collagen structures. This process truly stimulates cell regeneration and fascial repair, achieving the goals of lifting, tightening, and smoothing the skin. In comparison to other photoelectric procedures, the greatest advantage of the Ultherapy lies in its depth of action.
So far, the only non-invasive cosmetic method that can target the SMAS fascial layer is the Ultherapy. The main characteristic of the Ultherapy is its ability to simultaneously affect both the fascial layer and the dermal layer, providing deep lifting of the fascial layer and superficial tightening of the dermal layer.
In addition to the therapeutic micro-focused ultrasound, the visual ultrasound imaging of the Ultherapy ensures that treatments are maintained at the appropriate depth, preventing inadvertent heating of other tissues and minimizing unnecessary pain and side effects. Currently, the Ultherapy is approved for applications such as browline lifting, improvement of sagging or wrinkles in the lower face and neck, and enhancement of fine lines or wrinkles on the chest. Additionally, the Ultherapy can also be used on various body parts, such as the buttocks, outer thighs, and abdominal loose skin, with great effectiveness. The results of an Ultherapy treatment become evident within 1-3 months, and the full effects may take 3-6 months to manifest.

What is Fotona4D?
Fotona4D Pro is a non-invasive anti-aging and sculpting laser device developed in Germany. It boasts four proprietary technologies that can simultaneously address a variety of skin issues, including skin tightening, fat reduction, dark circle elimination, wrinkle reduction, anti-aging, skin whitening, rejuvenation, and firming effects. With certifications from the European CE, China CFDA, and the U.S. FDA, it is a high-tech, non-invasive anti-aging solution. Overall, it offers a comprehensive anti-aging treatment for the face, eyes, and neck. Fotona 4D utilizes four laser modes, targeting different layers such as the fascia, subcutaneous fat, dermis, and epidermis. This multi-dimensional approach uplifts contours, improves skin texture, and reduces wrinkles, resulting in a broad yet gradual effect that requires multiple sessions. Moreover, the treatment process is relatively gentle, without the need for anesthesia, providing a comfortable experience. It's suitable for beauty seekers who are sensitive to pain and for post-Thermage maintenance. An impressive feature of Fotona 4D Pro is its achievement of combined internal and external treatments through intraoral therapy. The intraoral treatment targets the mucosal tissue, which is closer to the fascial layer. By employing the Smooth tightening mode, it effectively addresses wrinkles such as marionette lines and nasolabial folds, resulting in skin tightening. Below is a detailed explanation of how Fotona 4D Pro achieves the best anti-aging results through a four-step process: Smooth Fast Tightening Mode: Intraoral Operation, this mode differs from other anti-aging devices as it targets the deep fascial layer, rapidly tightening the mucosa from within the oral cavity. By tightening loose skin and diminishing marionette lines and corners of the mouth, this intraoral operation is closer to the fascial layer, allowing for quick heating to 65 degrees Celsius. Research indicates that 65 degrees Celsius is the optimal temperature for tightening collagen fibers and restructuring collagen proteins, resulting in noticeable improvements in nasolabial folds. FRAC3 Three-Dimensional Dot Matrix Mode: The FRAC3 mode targets the dermal layer, using specific pulses to break down localized pigmentation, redness, acne scars, and more to improve uneven skin tone, making the skin appear cleaner. Simultaneously, these pulses create a three-dimensional dot pattern damage in the dermal layer, stimulating the secretion of collagen proteins, achieving firming, rejuvenation, and brightening effects. This mode is suitable for individuals who seek anti-aging while desiring skin whitening and improvement of dull, yellowish skin tones. Piano Super Long-Pulse Heating Mode: Primarily targeting the jawline and areas with more facial fat, this mode employs "super-long pulse width laser" design. It is designed for individuals with an undefined jawline or excessive localized facial fat, effectively uniformly heating the dermal and subcutaneous fat tissues, promoting fat reduction through burning, while also providing a tightening effect. It's ideal for dealing with excess facial fat. Superficial Micron Resurfacing: The Superficial mode targets the epidermal layer, utilizing a cold ablation technique to reshape the epidermis and smooth out fine lines. The principle involves controlled exfoliation, addressing surface-level skin issues. It's particularly effective for concerns such as enlarged pores, rough skin texture, marionette lines, and neck lines, offering significant improvement in fine lines. What is 5GMax?
The first generation of 5GMax was introduced to the market in 1998. After more than 20 years of updates and iterations, we now have the current 5GMax. It employs a long-pulsed 755+1064nm laser to achieve rapid elevation, wrinkle elimination, localized tightening, overall skin whitening, and facial slimming through five steps. Leveraging the versatile characteristics of laser technology, this approach accomplishes the improvement of various flaws in a single treatment. 5GMax divides the anti-aging process into five steps, addressing the epidermis, dermis, and subcutaneous tissues: Step1: Lifting Step2: Smoothing Step3: Tightening Step4: Brightening Step5: Slimming
The 5GMax is an exceptionally efficient facial fat reduction and tightening device, offering simultaneous benefits of skin whitening, rejuvenation, facial hair removal, and redness reduction. It's a versatile device that addresses the three key skin concerns of improving skin texture, complexion, and signs of aging. First of all, when it comes to facial anti-aging, there's no need to overthink the choice between Fotona 4D and Thermage, as their lifting approaches are entirely different, each with its own advantages. Thermage is a radiofrequency tightening and anti-aging device that uses radiofrequency currents to penetrate the skin tissue and create a heating effect, stimulating the synthesis of new collagen protein. This results in improvements in wrinkles, skin tightening, and contour lifting and reshaping. Both Fotona 4D and Thermage can enhance the skin and reduce wrinkles, but which one provides better facial anti-aging results? The fundamental difference between Fotona 4D and Thermage lies in the treatment depth and the sensation of discomfort during treatment. Thermage uses thermal conduction to uniformly affect the deeper layers of the dermis, achieving overall collagen stimulation from within. The effects of purely tightening and lifting can last 1-2 years. Topical anesthesia is applied before treatment, and some discomfort may be experienced during the process. Some people find it more painful, especially around the jaw and cheekbone areas, although it's generally tolerable. Typically, within a certain range, higher energy leads to better results, but this depends on each individual's pain tolerance. In simple terms, Thermage is more focused on the deeper dermal layer, emphasizing firmness. It's a one-time procedure with precise and robust effects. On the other hand, Fotona 4D operates on different levels with its various modes, requiring four sessions for treatment. It involves a course of treatment with broader and more comprehensive effects, albeit with slightly slower results. Combined Anti-Aging Treatment Can Thermage and Ultherapy be used together? Both treatments have their advantages. Thermage is like the cement used in building a house; it permeates the entire structure, affecting all layers it passes through. On the other hand, Ultherapy acts like steel reinforcements, targeting specific points, depths, and positions to stimulate the fascia. It operates at a deeper depth with higher temperatures. Both devices offer contour improvement, lifting, and skin tightening effects. The difference lies in Ultherapy being more suitable for individuals with higher facial fat content and sagging who want to achieve a firmer contour and lift. Thermage is tailored for younger individuals with mild sagging and mild drooping, focusing on mild tightening. In simple terms, one emphasizes lifting, while the other emphasizes tightening. To differentiate, Ultherapy leans more towards fat reduction and contraction. It's capable of reducing fat, making it more suitable for younger people with higher fat content. Those with lower fat content might experience sagging or depressions after Ultherapy . Thermage provides better lifting effects and suits individuals with less fat content and beginning skin sagging. It's ideal for those who want to combat early signs of aging, achieve fullness in the face, and stimulate collagen production. In reality, Ultherapy and Thermage are not conflicting methods. If conditions permit, a "strong combination" of the two can be considered. By combining the distinctive effects of each treatment, a comprehensive anti-aging approach can be achieved that wasn't possible with a single device. Ultherapy uses high-intensity ultrasound energy to focus energy at the skin's deeper layers, generating heat and promoting collagen regeneration for increased skin elasticity. Thermage uses high-frequency waves to conduct high-energy heat to the skin fibers and subcutaneous tissues, causing collagen contraction. These two treatments can complement each other effectively in combating aging. If possible, it's suggested to space the treatments 1-3 months apart. Due to the force of gravity, our facial/body muscle tissues tend to sag as collagen and elastin production decreases. The process of anti-aging is like a parabolic curve, similar to a game of catch. When you choose an anti-aging treatment, it's like throwing the ball upward. However, without proper maintenance and combined treatments, the ball will eventually fall down over time. Here are some common misconceptions: 1. Medical aesthetic procedures, one-time lasting forever: While the immediate lifting effects of current medical aesthetic procedures can be noticeable and have a lasting impact, usually around 1-2 years on average, the aging process itself is irreversible. Factors such as age, collagen loss, and the level of daily care all influence the duration and effectiveness of maintenance. No device or product can achieve permanent anti-aging results with just one treatment. 2. Using luxury skincare products is enough, no need for Ultherapy/Thermage: Wrinkles are categorized into two types: deep wrinkles and fine lines, also known as true wrinkles and expression wrinkles. Expression wrinkles are superficial and result from facial movements. Long-term use of skincare products can improve them to some extent. However, as we age, collagen loss weakens the support structure of the dermal fibers, causing skin sagging and the formation of true wrinkles. Skincare products cannot replace the fundamental effects of Thermage's high-energy stimulation of collagen in the dermal layer or Ultrasound Knife's fundamental solution for sagging and aging issues from the SMAS layer. Ultrasound Knife and Thermage are genuine non-surgical methods for skin tightening and lifting. 3. Can I get Ultherapy after Thermage? Will the skin get burned? Yes, you can. Thermage achieves tightening by heating and contracting collagen proteins, leading to firmer skin. However, it involves external-to-internal volumetric heating. Depending on individual circumstances, temporary redness and warmth may occur. Ultherapy utilizes the principle of HIFU (high-intensity focused ultrasound) to target the SMAS layer. The treatments have different mechanisms, and it's possible to have both procedures, as they address distinct layers of the skin. 4.After undergoing Thermage/Ultherapy, there's nothing to worry about? This question is extremely important. Firstly, post-treatment sun protection and moisturization are crucial. UV exposure and cellular dehydration can significantly accelerate skin aging, so developing an effective, methodical, and not overly complex skincare routine is of utmost importance. Additionally, we recommend considering laser-based anti-aging treatments such as Fotona 4D Pro or 5GMax about 3 months after the initial procedure to maintain optimal skin condition. This completes the "game of catch" and ensures that you stay at the forefront of anti-aging efforts. Furthermore, laser-based anti-aging treatments are recommended in cycles of 3 sessions, with a 2-3 month interval between each treatment based on the skin's recovery progress. Additionally, incorporating appropriate aerobic exercises into your lifestyle—maintaining a heart rate above 100 for 30 minutes, five times a week—can help maintain healthier skin.

Hey guys, cervicofacial subcutaneous emphysema is a rare sequela of dental and head and neck surgeries caused by air entering the soft tissues. It is rarely reported in the dermatologic literature. It is important for dermatologists to recognize this complication, as it can occur with dental procedures following skin projects on the head and neck. Case Details A 42-year-old woman underwent soft tissue filler injections at a US facility for aging. A total of 3.0 mL of calcium hydroxyapatite (microcrystalline porcelain) was injected into the subperiosteum of the patient's temples, zygomaticomandibular cheeks, mandibular line, and premandibular sulcus on both sides. During the informed consent period and prior to the procedure, the patient was advised to avoid any dental work for 2 weeks before and 2 weeks after the soft tissue filler procedure to prevent biofilm-related infections. The patient waited 15 days after the facial injections before her dentist placed a temporary crown on her upper left tooth. During dental treatment, the patient felt vague pain and a tingling sensation on the left side of the face. Within minutes, unilateral left-sided facial swelling in the left cheek rapidly worsened and extended to the periorbital region (Figure 1). Her dentist thought she had angioedema due to a potential allergic reaction to the anesthetic she used during crown placement. After an intramuscular injection of 0.3 mg epinephrine (0.3 mL, 1:1000) and 50 mg oral diphenhydramine, her response was inadequate and her symptoms did not improve. Crown placement was discontinued, and the patient was immediately returned to the authors' dermatological clinic for evaluation of a potential soft-tissue infection associated with the filler injection. Figure 1: Rapid onset of left facial swelling Physical examination revealed that the patient had no fever and stable vital signs. There was extensive swelling in the left periorbital, zygomatic and mandibular subcutis. Palpation revealed a murmur in the affected area (Figure 2). There was no overlapping erythema, palpable nodules, or skin tenderness. The patient denied shortness of breath, neck pain, chest pain, hoarseness or wheezing. The diagnosis was subcutaneous emphysema in the neck and face, and computed tomography (CT) of the head and neck was required to better determine the degree of involvement and guide the further nursing plan. Figure 2: papules and swelling in the left periorbital area The CT film shows extensive soft tissue airways throughout the left face and neck, extending into the thoracic inlet but not significantly into the superior mediastinum. Soft tissue gas extends along the buccal surface and into the left parapharyngeal space. The smallest soft tissue gas crossed the midline into the anterior vascular plane of the anterior neck (Figures 3 and 4). Imaging findings were consistent with the authors' clinical impression that the cervicofacial subcutaneous emphysema had no sequelae to her airway or involvement of the mediastinum. Amoxicillin/clavulanate 875 mg/125 mg twice daily for 10 consecutive days was used to cover any potential oral flora that may have traveled down along the fascial planes into the critical spaces of the head and neck. The patient was closely monitored through daily visits to the author's clinic. Her condition improved daily, and after 7 days, she was in remission with no adverse sequelae and no change in soft tissue enlargement enhancement. Figure 3: Head CT showing air in the parapharyngeal fat and areas of hyperdensity in the soft tissue of the premaxilla associated with previous soft tissue filling with hydroxyapatite. Figure 4: Cervical CT showing air entering the thoracic inlet but not the anterior cervical space connecting the mediastinum Discussion Cervicofacial subcutaneous emphysema is a well-recognized clinical condition caused by the introduction of air or gas into soft tissue planes. It is a rare complication of various dental procedures and is more common in head and neck surgery and maxillofacial trauma. Typically, this condition is caused by the use of high-velocity pneumatic instruments in the oral cavity during dental procedures (e.g., surgical extractions, endodontics, and trauma). Surgical procedures, especially those involving third molars, may increase susceptibility to soft tissue emphysema. These high-speed air heads discharge high pressures that can disrupt the oral mucosa and cause air to travel subcutaneously into the fascial planes of the head and neck. Entry of air into the prevertebral and retropharyngeal spaces connected to the mediastinum can lead to very rare but potentially serious and fatal complications such as mediastinitis, airway injury, air embolism, and necrotizing fasciitis of the neck. With the rise and increasing popularity of several dermatologic procedures, many patients will undergo dermatologic procedures in close proximity to dental procedures, which can be performed with pneumatic instruments. Awareness of this medically induced dental complication is critical in order to distinguish it from complications arising from dermatologic procedures and to allow for proper evaluation and prevention of the rare but potentially life-threatening respiratory sequelae. Choose REALR Laser & Skincare Medspa, and we provide the most professional and safe medical beauty service. REALR Laser & Skincare Medspa is a medical beauty skin management center that provides professional and effective problem-solving solutions. Located on the main street of Allston, Greater Boston, Massachusetts.   REALR Medical Beauty Center has cooperated closely with more than 100 beauty institutions in recent ten years, and personalized skin care for every beauty lover based on a large number of clinical cases and the real needs of customers. In particular, there are different answers to various skin problems, especially in acne, anti-aging and pigment treatment.   At the same time, we are developing a full line of medical beauty products, insisting on combining the scientific skin care concept with international cutting-edge R&D technologies such as cell regeneration technology and bio-bionic technology. After years of exploration, research and practice, we constantly iterate and upgrade the product formula, from taste to skin feeling experience, and repeatedly polish every detail from design to packaging, so as to improve skin problems from the inside out in terms of treatment and maintenance effects of comprehensive skin problems such as whitening and hydrating, acne muscle improvement, sensitive skin improvement, anti-wrinkle and anti-aging repair.   REALR introduces the world's most advanced medical technology, only cooperates with the world's top medical manufacturers, and selects the latest, top-notch and safest medical equipment. We are the first Asian medical and beauty institution in Boston to introduce the fifth generation of Hot Maggie Thermage FLX, and we are officially certified as a diamond member of Hot Maggie FLX. At the same time, we are also the only Asian medical and beauty institution with Fotona Eurostar equipment in Boston, which is strongly recommended by the medical and beauty industry leaders such as Fotona Eurostar. REALR also has the official certification of M22 Photorejuvenation, Ultherapy Ultrasonic Knife, PicoWay and other projects.   REALR has accumulated rich clinical experience of Asian guests and has its own medical research department. We introduce the most advanced medical technology in the world and regularly organize medical teams to participate in cutting-edge medical and aesthetic education projects around the world. We only cooperate with the world's top medical manufacturers and choose the latest, top-notch and safest medical equipment.

Hey guys, today we are going to learn about a complex complication case.Soft tissue filler injection with hyaluronic acid (HA) is one of the most popular treatment methods in reversible, non-invasive and relatively low-risk procedures, which can provide aesthetic improvement. In 2020, HA filler injection is the second most common non-surgical treatment in the world, with more than 4 million patients, second only to botulinum toxin injection. HA is considered safe and biologically inert for use as a soft tissue filler because it occurs naturally in mammalian tissues. However, with the increasing demand for noninvasive cosmetic procedures and the resulting availability of new hyaluronic acid fillers, a number of adverse reactions have been reported. Complications after filler injection are different, which can be roughly divided into early events (occurring a few days after injection) or delayed events (occurring several weeks to several years after injection) according to the incidence related to filler injection. Delayed hypersensitivity reactions, also known as type IV hypersensitivity reactions, are T-cell mediated and usually occur 48 to 72 hours after injection, although they may follow an asymptomatic period of weeks to months. The incidence of delayed hypersensitivity reactions following HA soft tissue filler injections has been reported to be approximately 1.13%. With the emergence of COVID-19 pandemic, people began to worry about the interaction between HA soft tissue filler and Covid-19 infection or vaccination. Because some studies have reported delayed hypersensitivity to soft tissue fillers after COVID-19 infection or vaccination, today we learn from the case of repeated delayed hypersensitivity to HA fillers after the booster dose of Pfizer-BioNTech COVID-19 vaccine reported by Korean doctors. Case report A 61-year-old woman, who had no allergies or basic diseases except hypertension, went to the emergency room in January 2022. She is taking lercanidipine, a dihydropyridine calcium channel blocker (10 mg per day) for the treatment of hypertension. In June 2021, she injected HA soft tissue filler (Cleviel Contour；; PharmaResearch Co., Ltd) to improve the appearance. There were no complications in the first two doses of vaccination. and the mRNA COVID-19 vaccine (Comirnaty；; Pfizer-BioNTech). A few days after intensive vaccination, she was diagnosed with COVID- 19, but the infection passed without obvious symptoms. In mid-December 2021 she received a booster dose of the mRNA COVID-19 vaccine (Comirnaty; Pfizer-BioNTech). A few days after intensive vaccination, she was diagnosed with COVID- 19, but the infection passed without obvious symptoms. In mid-January, about one month after the booster immunization, the nasolabial groove became red and swollen, and gradually spread to the whole face (Figure 1A). The white blood cell (WBC) count and C-reactive protein (CRP) level representing serum inflammation were continuously evaluated. At the time of visit, her WBC increased to 11,400/mm 3, but her CRP was normal, which was 0.5 mg/dL. The results of a computed tomography (CT) scan of the skin were evaluated and showed poorly demarcated soft tissue density suggestive of cellulitis (Figure 1B). She was admitted through the emergency room with an intravenous first-generation cephalosporin (cefazolin, 2 grams every 8 hours), primarily because of symptoms suggestive of possible cellulitis. Three days later, because the effect of antibiotics was not obvious, intravenous corticosteroids (dexamethasone, 5 mg every 24 hours) were added. After that, the symptoms subsided (fig. 1C). A week later, she was discharged from hospital after taking gradually reduced oral corticosteroids. After 2 weeks, the symptoms disappeared without sequelae (Figure 2). Her WBC and CRP levels decreased to 7,900/mm 3 and 0.1 mg/dL respectively. Figure 1: The first delayed hypersensitivity event. (a) Photographs taken by the patient on the day of the visit. (b) Contrast-enhanced facial computed tomography showed unclear soft tissue density, suggesting cellulitis. (c) Photographs of patients taken three days after hospitalization. Figure 2: Symptoms improved after 2 weeks in hospital, with no sequelae. About four months later, in May, 2022, erythema swelling appeared again in nasolabial groove and chin, which was similar to the previous events but more limited (Figure 3A). Subsequent contrast-enhanced CT scans showed unclear soft tissue density, enhancement, skin thickening and subcutaneous fat infiltration, suggesting that cellulitis was accompanied by inflammatory injection granuloma or abscess formation (Figures 3B and c). As in previous events, symptoms subsided through surgical drainage and intravenous and oral corticosteroids and antibiotics (Figure 3D). The treatment reduced her WBC level from 16,500/mm 3 to 7,800/mm 3. The CRP level decreased from 8.6 mg/dL to 0.5 mg/dL. Figure 3: Recurrent delayed hypersensitivity events (A)Photographs taken by the patient on the day of recurrence. Erythema and swelling of nasolabial groove and chin appeared again, which was more limited than previous events. (B, C) Contrast-enhanced facial computed tomography showed more uneven patterns and unclear soft tissue density, indicating that cellulitis and abscess formation were aggravated. (D) Photographs of patients taken 2 days after surgical drainage. Improved erythema and swelling can be seen. Discuss According to reports, the delayed inflammatory reaction associated with COVID-19 usually subsides spontaneously within a few days or weeks. In mild and severe cases, various treatment methods, including hyaluronidase and oral, intralesional or intravenous steroids, have been applied and achieved remarkable results. Mild to moderate reactions were treated with hyaluronidase at a dosage of 10 units per 1 ml of hyaluronic acid filler, or 30 to 300 units were saved per knot. Secondary treatment includes the use of intralesional steroids alone or in combination with 5- fluorouracil. Antibiotics can be added when symptoms suggest infection, and further surgery, such as incision and drainage, is needed when fluctuating masses are found. Some studies questioned the use of immunomodulators such as corticosteroids during the COVID-19 pandemic, for fear that it would inhibit the immune response needed to prevent infection. However, short-term or low-dose steroids used to treat general delayed hypersensitivity can be safely used without increasing the risk of SARS-CoV-2 infection. Other doctors have introduced a new low-dose lisinopril therapy, which is an oral angiotensin converting enzyme inhibitor (ACE-I), and was previously used to treat hypertrophic scars, keloids and several inflammatory skin diseases. In this study, the author successfully treated a patient with repeated delayed hypersensitivity to HA soft tissue filler after COVID-19 vaccination by combining intravenous and oral corticosteroids and antibiotics with surgical drainage. I was worried that COVID-19 infection would worsen, but we confirmed the safety of corticosteroid administration through literature review before prescribing, and no further deterioration of infection was observed. Unfortunately, this patient can't use ACE-I, because she has been taking lercanidipine regularly as an antihypertensive drug, and lisinopril can't be added for fear of hypotension. Several studies have been carried out and molecular studies are under way, but the exact mechanism related to delayed hypersensitivity between HA filler and COVID-19 vaccine is still unknown. However, there are several reasons to conclude that delayed hypersensitivity occurs in this case. First of all, one month after COVID-19 vaccination corresponds to delayed hypersensitivity. In addition, the swelling and redness around the filler injection and the existence of abscess were similar to those reported before. This is also supported by the rapid relief of symptoms through appropriate antibiotics and corticosteroids. Considering that there are no other specific events near the onset of symptoms, it can be reasonably concluded that this is a delayed hypersensitivity reaction caused by COVID-19 vaccine to HA filler. In addition, this case report has the significance of recurrent cases that have not been reported before. Choose REALR Laser & Skincare Medspa, and we provide the most professional and safe medical beauty service.   REALR Laser & Skincare Medspa is a medical beauty skin management center that provides professional and effective problem-solving solutions. Located on the main street of Allston, Greater Boston, Massachusetts.   REALR Medical Beauty Center has cooperated closely with more than 100 beauty institutions in recent ten years, and personalized skin care for every beauty lover based on a large number of clinical cases and the real needs of customers. In particular, there are different answers to various skin problems, especially in acne, anti-aging and pigment treatment.   At the same time, we are developing a full line of medical beauty products, insisting on combining the scientific skin care concept with international cutting-edge R&D technologies such as cell regeneration technology and bio-bionic technology. After years of exploration, research and practice, we constantly iterate and upgrade the product formula, from taste to skin feeling experience, and repeatedly polish every detail from design to packaging, so as to improve skin problems from the inside out in terms of treatment and maintenance effects of comprehensive skin problems such as whitening and hydrating, acne muscle improvement, sensitive skin improvement, anti-wrinkle and anti-aging repair.   REALR introduces the world's most advanced medical technology, only cooperates with the world's top medical manufacturers, and selects the latest, top-notch and safest medical equipment. We are the first Asian medical and beauty institution in Boston to introduce the fifth generation of Hot Maggie Thermage FLX, and we are officially certified as a diamond member of Hot Maggie FLX. At the same time, we are also the only Asian medical and beauty institution with Fotona Eurostar equipment in Boston, which is strongly recommended by the medical and beauty industry leaders such as Fotona Eurostar. REALR also has the official certification of M22 Photorejuvenation, Ultherapy Ultrasonic Knife, PicoWay and other projects.   REALR has accumulated rich clinical experience of Asian guests and has its own medical research department. We introduce the most advanced medical technology in the world and regularly organize medical teams to participate in cutting-edge medical and aesthetic education projects around the world. We only cooperate with the world's top medical manufacturers and choose the latest, top-notch and safest medical equipment.

In the last two years, every morning and evening in the face brush containing vitamin C and vitamin A skin care products, so that "morning C night A" stimulation, so that the skin produced more redness, aggravated skin redness. "C in the morning and A in the evening" does not mean drinking coffee in the morning and drinking at night, but a popular beauty method at present. That is, whitening with products that focus on vitamin C in the morning; In the evening, the main vitamin A product is used for anti-aging, and the combination of two kinds of vitamin gold can protect your skin well. Fresh food is rich in vitamin C(VC), which can not only relieve blood diseases, but also delay aging and improve the photoaging problem of our skin. Many cosmetic ingredients are also added with VC, but is the VC in cosmetics what we usually call VC? No! There is a skin barrier formed by a sebum film on the outermost surface of the skin, but the general VC is water-soluble and difficult to be absorbed by the skin, and it can only be absorbed by the skin if it is transformed into fat-soluble VC. Vitamin C in cosmetics is a fat-soluble levovitamin C, which can be absorbed after entering the skin. This is the basis for using vitamin C cosmetics to protect skin in the morning. Vitamin A, on the other hand, is very effective in reversing skin diseases caused by aging skin. Prescription medications such as Tylenol (isotretinoin pills), Vitamin A capsules, and topical medications such as Adapalene and Tazarotene, used in hospitals for the treatment of acne, belong to the Vitamin A group of medications. The commercialized vitamin A products are called "retinol", "retinaldehyde", and "retinoic acid". Retinoic acid products are photosensitive and should be avoided after topical application, including light and cell phone light, so it is best to use them at night before going to bed. The skin is the largest organ of the human body, and the outermost skin barrier has always protected the skin to be able to accept normal wind and sun exposure. However, skin care products that contain potent properties like VC and VA-based products are irritating and should not be used blindly. It is best to assess your skin and build up a tolerance before use. If you have sensitive skin, you should choose carefully! After all, skincare is not a one-day process. How to correctly use "early C and late A" skin care to establish skin tolerance? # Select low concentration Whether it is retinol, retinoic acid or retinaldehyde, when it enters the skin, it will be converted into tretinoin, which will cause some irritation to the skin, and it has a certain photosensitive nature, so it is a good way to use a low concentration of the product at the beginning. # Choose a low dose It must be used as little as possible. We can use a toothpick dipped in a little bit of ointment and apply it to the face in one gentle stroke without rubbing it away. Or use a topical dabbing method, dabbing here and there without scratching it away and letting it gradually tolerate. # Priming Moisturizing Method Before using tretinoin , apply a good moisturizer to the face, a little thicker, then topical application of Vitamin A, followed by some moisturizing lotion are beneficial to build up the skin's tolerance to the "C in the morning and A in the evening" method. # Use less cleaning products Minimizing the use of cleansers and soaps during the "C in the morning, A in the evening" period allows our skin barrier to be more intact. # Get a good sunscreen This period must do a good job of sunscreen, itself "morning C evening A" on the skin has a certain stimulus, if the aggravation of ultraviolet rays, the stimulation of our skin will be more obvious. In addition to the use of sunscreen products sunscreen, we can also wear hats, sunglasses and other hard sunscreen-based. # Low frequency full face application Regarding A-alcohol, I think Asian skin is easily sensitive and we are more into skincare. So my personal opinion is that it is not recommended to use low concentration of A-alcohol every day. You can start with 0.1, but use it once a month or once every two weeks. Similar to acid brushing, going to the salon and brushing with a high concentration of acid once a month will reduce the likelihood of breakouts compared to using a low concentration salicylic acid face pack every day. Often see some customers with a relatively low concentration of alcohol A every day, and then a period of time after the skin damage is very serious. But they still insist on using it. A alcohol is useful, but at present there is no clear clinical regulations on the use of good methods. Personally, I think the frequency of use is low, improve skin tolerance and gradually increase. Giving the skin some recovery period and paying attention to moisturizing should be the main goal of daily care. Topical medications of adapalene gel, hydroquinone cream, tacrolimus cream, pimecrolimus cream, azelaic acid gel, and Banshee's gel can be used in this way. I often in the clinic, we introduced these creams just started to use the method: outside the application of good moisturizing lotion, the local use of cotton swabs or toothpicks dipped in a little ointment point in the lesions (acne, pigmentation spots, marks), with the hands of the ointment to press the cream open on enough, can not be rubbed open. At first, just use 1 time every night before going to bed, and then gradually over to twice a day. Choose REALR Laser & Skincare Medspa, and we provide the most professional and safe medical beauty service.   REALR Laser & Skincare Medspa is a medical beauty skin management center that provides professional and effective problem-solving solutions. Located on the main street of Allston, Greater Boston, Massachusetts.   REALR Medical Beauty Center has cooperated closely with more than 100 beauty institutions in recent ten years, and personalized skin care for every beauty lover based on a large number of clinical cases and the real needs of customers. In particular, there are different answers to various skin problems, especially in acne, anti-aging and pigment treatment.   At the same time, we are developing a full line of medical beauty products, insisting on combining the scientific skin care concept with international cutting-edge R&D technologies such as cell regeneration technology and bio-bionic technology. After years of exploration, research and practice, we constantly iterate and upgrade the product formula, from taste to skin feeling experience, and repeatedly polish every detail from design to packaging, so as to improve skin problems from the inside out in terms of treatment and maintenance effects of comprehensive skin problems such as whitening and hydrating, acne muscle improvement, sensitive skin improvement, anti-wrinkle and anti-aging repair.   REALR introduces the world's most advanced medical technology, only cooperates with the world's top medical manufacturers, and selects the latest, top-notch and safest medical equipment. We are the first Asian medical and beauty institution in Boston to introduce the fifth generation of Hot Maggie Thermage FLX, and we are officially certified as a diamond member of Hot Maggie FLX. At the same time, we are also the only Asian medical and beauty institution with Fotona Eurostar equipment in Boston, which is strongly recommended by the medical and beauty industry leaders such as Fotona Eurostar. REALR also has the official certification of M22 Photorejuvenation, Ultherapy Ultrasonic Knife, PicoWay and other projects.   REALR has accumulated rich clinical experience of Asian guests and has its own medical research department. We introduce the most advanced medical technology in the world and regularly organize medical teams to participate in cutting-edge medical and aesthetic education projects around the world. We only cooperate with the world's top medical manufacturers and choose the latest, top-notch and safest medical equipment.

Causes of skin aging around eyes When you notice aging around the eyes, do you start with the first fine lines under your eyes? Aging around the eyes manifests itself in the form of upper lid laxity, lower canthus recession, crow's feet, infraorbital lines, eye bags, tear troughs, zygomatic grooves, and dark circles under the eyes. Skin organization, anatomical structure, bone morphology, etc., are all closely related to aging around the eyes. Eyelid skin is the thinnest in the body, usually less than 1 millimeter thick, and has no subcutaneous fat. When young, the eyelid fissure is 10-11 millimeters and slowly shrinks to 8-10 millimeters with age. As the skin in the eyelid area ages, it gradually shrinks, loosens and thins, and wrinkles form. The eye is the most active structural unit of the face, with the eyelid blinking up to tens of thousands of times a day. The orbicularis oculi muscle (OOM) drives movement around the eye and is the muscle that produces dynamic wrinkles in the eye. Over time, the OOM relaxes and sags. After the posture was changed from supine (A) to sitting (B), sagging of the lateral corners of the eyes (circles), the lateral portion of the OOM (light blue arrows), and sagging deformity of the zygomaticus major muscle (yellow arrowheads) were clearly seen. The orbital bone determines the size of the eyes and the shape around the eyes. Affected by aging changes, orbital bone absorption, medial upper and lateral lower direction is more obvious. According to an eye survey from Japan, the orbital changes of East Asians are more obvious after the age of 60. A: 30 years old B: 80 years old Image quoted from: Reference 2 In addition, nowadays, people often stay up late to play cell phones, irregular lifestyle, excessive use of eyes, poor blood circulation leads to eye darkness, fatigue, dark circles, bags under the eyes, so that the eyes are more prone to show their age. With the increase of sun exposure and age, in addition to the skin around the eyes, the white of the eyes become yellow and cloudy, will also make the eyes look less bright. The performance and rating of aging around the eyes There are 2 commonly used criteria: The 3 -grade 9-point scale proposed by Fitzpatrick in 1996 The 6-grade 5-point scale proposed by Lemperle in 2001 You can also use this as a reference to observe the state of your eye area. 0: No wrinkles 1: Just visible wrinkles 2: Shallow wrinkles 3: Moderately deep wrinkles 4: Deep wrinkles with visible borders 5: Very deep wrinkles, extra folds Image quoted from: Reference 4 Based on the literature research, clinically, we usually use the three-level classification method of mild, moderate and severe. Different levels of periocular aging adopt different combined treatment schemes, and the overall treatment principle is: optoelectronic tightening first, then deep injection and filling. Choose REALR Laser & Skincare Medspa, and we provide the most professional and safe medical beauty service. REALR Laser & Skincare Medspa is a medical beauty skin management center that provides professional and effective problem-solving solutions. Located on the main street of Allston, Greater Boston, Massachusetts. REALR Medical Beauty Center has cooperated closely with more than 100 beauty institutions in recent ten years, and personalized skin care for every beauty lover based on a large number of clinical cases and the real needs of customers. In particular, there are different answers to various skin problems, especially in acne, anti-aging and pigment treatment. At the same time, we are developing a full line of medical beauty products, insisting on combining the scientific skin care concept with international cutting-edge R&D technologies such as cell regeneration technology and bio-bionic technology. After years of exploration, research and practice, we constantly iterate and upgrade the product formula, from taste to skin feeling experience, and repeatedly polish every detail from design to packaging, so as to improve skin problems from the inside out in terms of treatment and maintenance effects of comprehensive skin problems such as whitening and hydrating, acne muscle improvement, sensitive skin improvement, anti-wrinkle and anti-aging repair. REALR introduces the world's most advanced medical technology, only cooperates with the world's top medical manufacturers, and selects the latest, top-notch and safest medical equipment. We are the first Asian medical and beauty institution in Boston to introduce the fifth generation of Hot Maggie Thermage FLX, and we are officially certified as a diamond member of Hot Maggie FLX. At the same time, we are also the only Asian medical and beauty institution with Fotona Eurostar equipment in Boston, which is strongly recommended by the medical and beauty industry leaders such as Fotona Eurostar. REALR also has the official certification of M22 Photorejuvenation, Ultherapy Ultrasonic Knife, PicoWay and other projects. REALR has accumulated rich clinical experience of Asian guests and has its own medical research department. We introduce the most advanced medical technology in the world and regularly organize medical teams to participate in cutting-edge medical and aesthetic education projects around the world. We only cooperate with the world's top medical manufacturers and choose the latest, top-notch and safest medical equipment.