Consult or Evaluate?


 

As a physician with a great amount of my practice being devoted to cosmetic concerns, I am aware that many people develop a focus on a particular issue that bothers them above all else.

This is typically what we'll discuss during a consultation and based on their concerns I will make specific recommendations of the most effective procedures for that particular concern. This is, in effect, what a Consultation is.

Over the last few years I have found through surveys and questioning my patients, that often what a great many  really expect is not just a consultation, but an Evaluation.

An Evaluation is a more extensive objective clinical assessment of the issues that I see can be improved. Some of these may go well beyond a patient's primary concern.

You can now request a  Clinical Evaluation

Clinical Evaluations will take into account a broad scope of possibilities which will potentially exceed the initial concern. Evaluation patients will receive a full scope assessment that addresses their appearance on a global level rather than a specific issue level.

An example may be a patient who is bothered by frown lines but who has larger - and potentially unrecognized issues of a receding chin, down-turned lip corners, jowling, etc. In a consult, we'd usually only discuss how to treat the frown problem. In an Evaluation, I would discuss not only the frown, but also how a chin or lip augmentation may make a more profound appearance improvement in lieu of or in addition to the original complaint.

**To request a Clinical Evaluation (at no charge in this initial offering) please be sure to ask for a Clinical Cosmetic Evaluation when you call our office as more time is set aside for your visit.

Clinical Evaluations require that women arrive with no makeup or be willing to remove all makeup before the assessment begins.

TotalDermatology.com

 

 

Dr. Nissan Pilest is Board Certified by the American Board of Dermatology in practice for over 29 years. He is a specially appointed member of the Medical Education Faculty (MEF) for Bioform Medical (makers of Radiesse).

Dr. Pilest is a long-time training physician and Platinum Plus Provider for Botox and Allergan dermal filler products.

As an MEF for Bioform Medical he provided hands-on training for a group of physicians in the proper injection techniques of Radiesse.

As one of the first physicians to use Fraxel, he was a member of the recent exclusive AAD Round Table meeting on Fraxel and has just been published in the American Academy of Dermatology's review for Fraxel skin resurfacing.

Dr. Pilest is a well known Master-Level Injection specialist with patient followings across California, the U.S. and Europe.

Most recently he was selected by Reliant Technologies to act as prefector to train other physicians in the use of the Fraxel Re:pair Laser.

Dr. Pilest...

1-877-DrPilest

(949) 727-3800
 

Dr. Pilest is a
Dermatology Beauty Expert
for NewBeauty Magazine.

You may have seen this unique and very comprehensive Anti-aging and Beauty guide on the shelves at your local bookstore - or possibly in this office.

Dr. Pilest Featured Dermatologist

Fraxel Re:Pair Update

"It's had an amazing effect on my skin--particularly around my eyes, both texture and firming! Total lifting all over from chest to forehead. For the first time in my adult life I do not need foundation makeup. People have noticed a difference--saying I look really good; but no one has asked what I have had 'done'! "Deborah .


Single Treatment Fraxel Re:pair

We brought the Fraxel Re:pair CO2 laser into the practice this past Spring. We've treated a wide variety of skin issues. As with any new technology, there is a learning curve to ascertain which problems respond the best, and which problems may best be left to other procedure choices.

What we've determined thus far and our practice ratings based on 1 to 5 stars:

Fraxel Re:pair is very effective in restoring youthful skin texture. Roughness, enlarged pores, pigmentation, uneven tone and cumulative sun damage are quickly and dramatically improved.

Fraxel Re:pair is an excellent skin tightening procedure for those who have mild to moderate skin laxity. Single treatments may not, however, be sufficient for patients with more significant facial laxity. We have patients who are undergoing a 2nd procedure and those results will be available at the end of the year.

Fraxel Re:pair is proving to be an effective acne scar treatment, but like severe skin laxity, we believe a single procedure may be inadequate for patients with deeper scars. Shortly we will be offering a 2nd level Fraxel procedure in conjunction with the primary treatment in the same session.

Fraxel Re:pair provides some extremely profound improvements in the eye area, both with lid "lift" and tightening of the periorbital area all around the eye. One patient remarked that she felt the procedure left her looking substantially better than her younger sister who had undergone an upper and lower blepharoplasty.

 Fraxel Re:pair is probably not the best procedure for Melasma. The Fraxel Re:store, our no downtime erbium laser, is in our estimation the better laser for this problem. Combined with pigmentation controlling programs, Fraxel Re:store is our preferred choice.

Clinical Study Opportunity

Fraxel Re:pair for Lip Lines. Vertical Lip Lines are still one of the most resistant cosmetic concerns out there. We're in clinical studies using single and combination procedures for this problem. Currently we're utilizing the Re:pair laser plus Botox. If you have perioral wrinkles (lipstick lines, smoker's lines) radiating from the upper lip and would like to be considered for this study, please contact our office through the form linked here. Non-smokers only will be considered.
Clinical Study Evaluation Request _ ***This Study Now Closed. Please watch for future opportunities in our newsletters.

All in all, our patients have had persistent positive comments and appreciation for the laser's effects on their skin. We will continue to assess the treatment results and update our site with photos of patients who have granted us permission to do so.

*Fraxel Re:pair Laser treatments are provided exclusively by Dr. Pilest.

Fraxel Professional Symposium


View a multi-physician discussion of the Fraxel Re:pair at the 2008 ASLMS meeting. Includes a cross section of physicians from around the country and their patient responses.

Additional Information, Video and Patient Before and After Photos.

News Update - Thermage and Fraxel Unite

Two of the top technology companies have merged. Fraxel has accepted an offer by Thermage to merge their technological expertise. We're certainly excited. The potential of a combined ThermaFrax procedure has physicians around the world abuzz.

We'll keep you updated!

Looking Better at Work

Excerpt from the LA Times September 2008

"Last year -- the beginning of the current economic slump -- the American Academy of Facial Plastic and Reconstructive Surgery noted a trend: Two-thirds of its members reported seeing patients (men and women in equal numbers) who sought cosmetic surgery "to remain competitive in the workplace."  Rosa Brooks

We don't subscribe to some of the notions Ms. Brooks presented in her article, but we do note that a number of our patients recognize how appearance can influence how they are perceived in the workforce.

A relaxed and unworried expression can convey far more self confidence than one that is heavily furrowed deep facial folds or a habitual frown. If a minor procedure such as Botox and/or a dermal filler can make you appear more positive and congenial or less stressed, then that's certainly a reasonable justification to invest a little in yourself.

Two of the most requested procedures that we've been told are desired for workplace advantage are Botox for frown and worry lines and Botox for excessive sweating.

The nice aspect of most dermatological procedures is that the results don't look "surgical" - they simply provide a pleasant and natural-looking improvement.


Beauty in the Eye of Allergan
"Your face is the outfit you wear every single day."

Special Pricings

Botox - $11 per unit
 

Always full strength
Always Allergan
Always injected by Dr. Pilest, a Platinum Plus Botox Provider

Botox is still the most popular non surgical cosmetic procedure in the country.

Hyperhidrosis sufferers now have a new option in controlling excessive sweating.  View Botox procedure videos for excessive sweating along with informational links on our website.

Dr. Pilest offers Vibrational Desensitization for the more sensitive areas of the palms, feet and groin for Botox sweat relief. Underarm injections are not painful.

Extended Offer - Botox for Hyperhidrosis is priced at $950 per 100 Units which will treat both underarm areas.

"Thanks Doc! When I was promoted in June my biggest worry was the requirement for presentations to some of our top clients. I still get nervous but knowing I'm not going to sweat like I used to has been better than the promotion itself. I'm completely sold.

Thanks for helping me choose something that's made such a difference. And an extra thanks for making an embarrassing office visit not embarrassing at all. Anyone who has this problem should look into Botox. I'm impressed every single day." Ellen - Botox for Sweat Control

Juvederm - $75 Rebate from Allergan with 2 or more syringes
Restylane - $100 Rebate from Medicis with 2 or more syringes

Thermage 900 MacroPulse for Face and Neck - $2,700