My Recommended Keto Meal Eating Plan

Doing an intermittent fast and then keeping your carbs low during the day is super easy, as long as you focus on what you can eat and do not focus on what you should not eat.

If you are looking to follow this eating lifestyle, I suggest that you go ideally 14-16 hours without eating as part of your intermittent fasting strategy. This means that you don’t eat food, but you can have water, coffee or tea (black or with half and half or unsweetened coconut or almond milk) with cinnamon or any spice but NO sugar or diet sweetners. I am a huge fan of drinking the Pruvit ketone supplements (see my previous blogs on the topic or visit to order them) to put you in a ketogenic state quickly. Of course, this means the earlier you finish eating the night before, the sooner you can eat food the following day. I certainly find that the ketogenic supplements decrease my appetite, making it much easier for me to an intermittent fast. I tend to eat late dinners so this means that most days, I don’t eat any food until the afternoon. Sometimes, I will take a second ketone drink in the late morning to make the fasting last longer or sometimes, I will take my second ketone to use while I exercise. I find them to be an excellent energy source. I never carbo load before or during my workouts anymore.

Once I start eating, either late afternoon or dinner, I try to keep my carbs low.

People have asked me what they can eat?  Below are my top suggestions, though a Google search can generate thousands of ideas as well. I would caution you that since the word “ketogenic” has become very trendy, it behooves you to still read the ingredients. They should be natural and ideally organic, free of sugars or fake sugars (stevia and monk fruit are ok) and free of dyes, chemicals, bad fats etc. You should confirm that the carbs are truly low, as well.

My go-to ideas:

  • I am a big fan of celery with organic peanut butter/almond butter with sunflower seeds on it.
  • Any type of eggs – if fried, use healthy oils like olive oil, coconut or avocado oil
  • Any type of vegetable salad. Avocados are especially good because they are a good source of both protein and healthy fats. You want to watch commercial salad dressings, as they are usually filled with sugar or high fructose syrup and unhealthy fats etc. it is very easy to just add olive oil and either vinegar  or lemon juice plus whatever herbs you like.
  • You can also add tuna or salmon or meat or turkey or seafood (get organic and i would definitely only get wild caught fish, never farm raised) and you can add seeds and/or nuts.
  • I do not personally eat any pork or seafood, but they are very keto-friendly.
  • Most soups will be keto-friendly, but definitely double-check the ingredients.
  • Regarding potatoes: I am more lenient on these. I believe that since you are going to be in a ketogenic state quickly due to the keto supplements, eating these baked, especially with olive oil, is probably perfectly fine. I have seen results with them in my diet, but of course, listen to your body – and your results
  • Cheese is keto-friendly, but i would not eat a ton if you are dairy sensitive or if you are trying to lose a lot of weight.
  • Nuts are great, but again, even though you technically don’t have to count calories, common-sense would suggest not to eat tons of them daily if you are trying to lose a lot of weight, as they are very calorie-dense.
  • I often make wraps with rice paper, as they are very low carb. I will put scrambled egg and avocado in them, or other veggies with cheese. Sometimes, I will just use a very low carb wrap, but rice paper wraps are better in my opinion.

There are a plethora of recipes for keto desserts and keto breads, but I would suggest that you pay attention to the ingredients since some people are very liberal with what they are calling “keto”.

I don’t regularly check my ketone levels, but if you are a “keto-purist”, then go ahead and check them periodically. I personally believe only the blood ketone levels make sense (you can get the meters on Amazon and they use a finger prick). The urine tests are not accurate since once you get efficient using the ketones in your blood, you will stop spilling these in your urine.

As you can probably tell, I love discussing the Keto diet! Feel free to email me with your questions at

To order your ketone supplements, visit I suggest the monthly reorder for a savings of 30%).


The Differences between SculpSure and EmSculpt

SculpSure has been around for 3-4 years now, and we have had our machine for about 2 years. Each treatment consists of 4 paddles (about the size of a small cell phone) that send laser light through the skin, which heats the fat (this is safe for all skin types, by the way). It works because fat has a poor blood supply and is sensitive to heat. The melted fat gets reabsorbed by the body. We recommend treating each area at least twice, with 4-6 weeks between treatments. It has been our experiences that heavier set individuals should plan on more than 2 sessions to get their desired result.

Cynosure demonstrated in one of their studies a 24% reduction in fat in the treated area. Whenever there is a study with a number stating a reduction as high as 24%, it is important to understand that this number is a bell curve with some people getting more and some getting less. I do not believe it is possible to know who is going to get the higher or lower reductions. For many people, the results will be real but will be subtle, so it is important that you take great before and after photos — and I recommend waiting about 12 weeks after the last treatment for the after photos, as you will continue to see improvement following treatment. I always stress with my patients that they can enhance their final result by working on better eating habits. I am a huge fan of intermittent fasting with a low carb diet and ketogenic supplements. This change in diet will often produce life changing prolonged results.

EmSculpt is a newer technology that uses focused electromagnetic energy to stimulate muscle contraction, which is supposed to increase muscle tone, decrease fat and give you a butt lift — all at the same time. Their website recommends 30 minute sessions, performed 2-3 days apart, with a minimum of 4 sessions total.  They claim results are visible in 2-4 weeks. I am extremely skeptical. First of all, we can go the gym and work out for 2 hours for four sessions every other day and most of us will not show any difference in our bodies that quickly. It just takes more time than that. I am even more dubious that for someone who is not already very lean, even if by some miracle the muscle size did increase with just 4 sessions, that it would be remotely visible with a layer of fat overlying it. I am also very reluctant to believe that the butt area will actually lift just because the muscle contracts. As a previous endurance athlete and longtime fitness buff, I am extraordinarily weary of any claim of building up muscle while you do nothing at all. Perhaps I will be proven wrong. There is rampant obesity in America today. There are also a lot of wealthy people in America today. If getting buff were as easy as paying a few thousand dollars, with no incisions and no physical effort, we would be seeing far more in-shape men and women than we do. The reason the 6-pack is so rare is because it is so hard to get. I think it will be many, many years before we have a machine that can do this work for us.

Want to discuss available options for decreasing body fat or cosmetic procedures in general? Call us at 703-406-2444 to schedule your complimentary, private consultation with me – I’d be happy to help you find the right solution for you!

How Winter Affects Your Skin

Winter affects our skin for a number of reasons:

  • Humidity is low both indoors and outdoors.
  • Longer hot showers.
  • Long exposure to artificial heat.
  • Exposure to cold weather.
  • Rich but not so healthy comfort food choices.
  • Hibernation (sedentarism).

All of these factors can really affect the water and oil barrier of the skin, called the acid mantle. The acid mantle regulates the pH of the skin by balancing water and oil on the surface of the skin, making it possible for someone with oily skin to experience dryness and flaking on the skin, which is technically dehydration (lack of water) and not dryness (lack of oil). If your skin is naturally on the dry side, which means it does not have enough oil to retain water, you can suffer from severe dryness.

So how can you repair the damage?
Begin by calling our office to schedule an appointment with one of our Master Estheticians, who are highly trained and experienced skin specialists. They will analyze your skin and determine the appropriate professional treatment and home-care approach.

Water intake and diet will also play an important role during the recovery process.

As a medical spa, we offer the most high-end and advanced skincare products. Below are some of the great options we have to target and restore the healthy glow of a well balanced skin:

This is just a small selection of the most advanced medical skincare options we have for you. If you have any questions regarding your skin concerns, call us at 703-406-2444 to schedule your complimentary, private consultation with one of our Master Estheticians!

John Bobbitt’s Penile Reduction: A Follow-Up from my Dr. Oz Appearance

Since my appearance on the Dr. Oz show on February 5th, 2019, I’ve had quite a few people ask what John Bobbitt was referring to when he said he had a penile reduction by me after his penile augmentation. On the show, John briefly mentioned that he had a penile reduction after his ill-fated penile augmentation, but he provided few details.

As most people are aware, I reattached John’s severed penis on June 23, 1993. Howard Stern paid for John to get a penile enlargement from Dr. Mel Rosenstein. To my surprise, there is a Howard Stern video discussing John’s surgery with both John and his surgeon. John says in the video that his penis looked like he had elephantiasis. Howard Stern commented how deformed it now looked and said that the surgeon no longer performs this surgery. I believe this occurred about one year later. From what I understand, he had a huge amount of fat transferred around the shaft of his penis, as well as a release of the penis from the pelvic bone. John did not ask for my advice about doing this. It’s worth noting that one of John’s porn films is called Frakenpenis, and for good reason. I would have strongly advised him to leave well enough alone. I had lost contact with John a few months after his reattachment and I did not hear from John for nearly 22 years when Reelz TV did a show about the topic. When they interviewed me, they told me that had interviewed John the day before and gave me his contact information. We connected by phone and a few months later, John came into my office. He told me that he had a fat transfer/enlargement that was “messed up” but he was not able to find his surgeon and asked if I could restore him to normalcy. He also said that with the huge amount of fat transferred, it made sexual intercouse difficult, since the fat would shift towards the base of his penis.

He came to my office in early 2016, and under local anesthetic with oral sedation and through a single incision on the dorsum, I was able to remove all of the added fat. I removed more than an overflowing handful of fat from his penis. It took several months for the swelling to completely resolve but he is now comfortable again.

I tried to find any reference on the internet about correction of a penile augmentation/fat transfer gone awry. I have no idea how many men are unhappy with their fat transfer after a penile augmentation but I suspect that there are many.

My Thoughts on Sono Bello

I have seen a few patients in my office who have had experiences with Sono Bello. I know that they spend a huge amount of money on marketing directly to the public.
What is Sono Bello? From what I can gather from their website, they operate over 200 centers, where they perform minimally invasive liposuction (the TriSculpt system), some laser around the face to decrease wrinkles, cellulite reduction and also non-invasive Venus Freeze to reduce fat. I have never been to one of their centers, nor have I worked for them, so my comments are largely based on an internet search.
They do offer free consults. However, what is very strange to me is that the consult is done with a salesperson and NOT the surgeon. For me that sets up a HUGE RED FLAG. The salesperson is almost certainly paid on a commission basis and many reviews suggest that they are extremely pushy. Their only interest is getting surgeries booked. I saw one patient that was treated at Sono Bello. I feel she should never have been treated by liposuction. She was hugely overweight, with a lot of intra-abdominal fat (which is not amenable to any type of liposuction and needs dieting and exercising). She had NO IMPROVEMENT. She spent a huge amount of money. I know the prices they list on their website are very low. However, some of their patients that I have seen, have paid far more than their web site suggests.  Moreover, since those selling the service are not the surgeon, I doubt they can be sued since it is not them that is performing the surgery. When you have a consult regarding a surgical procedure (and even Botox or fillers), I will give you an honest opinion if you are a good candidate and what type of realistic results you can expect. I will also go over the risks and benefits. Moreover, it is me that does both the consult and the surgery.
From what I understand, these clinics employ a number of different surgeons, and which one you get is really luck of the draw. The website for Sono Bello says they have many Board certified plastic surgeons, but I wonder if ALL of their physicians are Board certified plastic surgeons? I am sure they have some good plastic surgeons, but like any place with a number of physicians, some will be better than others. I don’t believe that you don’t get to choose your surgeon. If you come to my office, you know that the only person that is going to perform your surgery is ME!
Their website displays a photo of a woman, Kellie, which I find extremely misleading since she has clearly lost a very large amount of weight in addition to her procedure. From both my experience and expertise, there is simply no way that this result was obtained by their liposuction technique.
The website also states that TriSculpt can be good for gynecomastia. Based on my many years of experience, I rarely do any type of liposuction alone for gynecomastia. The men who are self conscious about their breasts need to have a very aggressive treatment which should include an open excision in most cases. Anything less than this will leave the men dissatisfied with their final result.
It is not clear that there is any real follow up with their patients. I follow my SmartLipo patients for 6 months, if they live within driving distance.
I personally believe that the Sculpsure technology, which works on a heat basis, offers much better technology than the freezing methods, such as Venus Freeze or Coolsculpt. On their web site, they claim that the Venus Freeze will help cellulite, but I suspect it will not be very effective. The Cellulaze treatment is a far more aggressive treatment for cellulite and is much more likely to obtain a long lasting improvement (even this treatment is not always effective in every women). The only other treatment that may have benefit is Cellfina.
I realize that you cannot make everyone happy. I do my very best, but it is just a fact of life that some patients will be disappointed. However, a quick look at the negative comments on Sono Bello should make one wary of them.
This is not to say that they are not a reputable business. However, I would suggest that lowest price should not be your top consideration. It is surgery and there are risks. There is also a professional relationship with the plastic surgeon. I believe in a holistic approach and I strongly encourage most of my patients to work towards a healthier diet and better exercise to continue seeing improvements in their results. In general, you don’t want to have your surgery at a surgery factory whose only goal is to get as many patients in and through as possible. I’d advise candidates for these procedures to find a practice – and surgeon – whom they feel are truly invested in their surgery outcome.

Want to discuss available options for decreasing body fat? Call us at 703-406-2444 to schedule your complimentary, private consultation with me – I’d be happy to help you find the right solution for you!

How Plastic Surgery and Health + Wellness Can Go Hand in Hand

To most people, “plastic surgery” and “health and wellness” are polar opposites. We tend to think of someone ill who has to have surgery. We realize of course that many people electively choose plastic surgery, but the idea that this could somehow connect with — and even facilitate — wellness seems like a far stretch. However, they truly really compliment each other.

Wondering how? 

I have very much been into healthy eating since I was a teenager (my early childhood years were a different story, as I consumed far too much soda, candy, etc) I have always been reasonably fit, but I definitely took it up several notches in 2000 when I started martial arts and then moved to marathons, triathlons, Ironmans (two of them) and then yoga and core exercises.

I personally believe that about 90% of all of our health problems would be resolved if people ate in a healthier manner and fit in exercise most days of the week. Just imagine how much money and time would be saved, rather than wasted on doctors, investigations, feeling lousy and heartache due to serious illness. All of this is preventable. More and more evidence is accumulating each year about how food affects the bacteria in your gut, which in turn leads to things like leaky gut syndrome, which probably plays a major role in autoimmune diseases. We are just learning that a similar phenomena is happening between the blood/brain barrier. We are finding lower incidences of cancer in people that exercise,  and a lower recurrence rate in those individuals that do get cancer who also exercise.

How does this tie in with plastic surgery? There are a number of procedures that can get the quick results needed to motivate a person to change up their life through diet and exercise. Of course, plastic surgery does not directly lead to lower cancer or better health. We all know that switching up your diet is not easy. If it were, there would be no obesity, rather than the current rate of obesity skyrocketing. It can be difficult to switch your diet, and when you do, it is human nature to expect a change in either how your look or in what you weigh, fairly quickly. Everyone who has dieted has had the experience of trying out a new diet, doing it religiously for several weeks and then weighing themselves to see no change. This often creates frustration leading to binge eating… and the cycle repeats.

I am a huge fan of either SmartLipo or SculpSure being done at the same time as a new diet/exercise routine.Both have the ability to decrease fat in the treated areas due to the laser melting of fat. This will oftentimes fast track your seeing results in how you look when you diet (however it still takes time to see the effect from these, and you will keep improving for months after the treatment). This quick shift in appearance can give you encouragement and help you persevere. There is also the added benefit that when you undergo these procedures, you have devoted effort and money and some mild discomfort, which will further increase your resolve to stick with your diet.

I make it very clear at all of my consults for the above that it is a partnership. I can, using technology, decrease fat in specific areas. But if you want your best results, you need to decrease your total body fat and this can only be accomplished by better eating and to a lesser extent, exercise – though doing both exercise and diet is strongly preferred.

So, which diet is best?

Clearly the one that you stick with! I am not a fan of any diet that gives you fake food for weeks/months because once you go back into the real world, there is a high relapse rate from these kinds of diet plans.

For most people, I endorse a combination of intermittent fasting, Ketone supplements  (which make fasting easier) and a low carb/high fat and protein diet that is largely organic with little processed food. And good news, you can still have dry white and red wine and see results. Here are my favorite supplements, which I use to put myself into ketosis quickly and daily.


Want to discuss available options for decreasing body fat? Call us at 703-406-2444 to schedule your complimentary, private consultation with me – I’d be happy to help you find the right solution for you!

Reflections on the Trials of John and Lorena Bobbitt

This blog is going to be non-medical and instead is some of my reflections on the separate trials of both John and Lorena Bobbitt. As many of you know, I was the surgeon who reattached John’s penis back in the 1990’s.

I want to preface my comments by saying that I don’t know what truly happened in their marriage or the night that Lorena intentionally cut off John’s penis and threw it out her car window into a field. I am not a lawyer and I am not paid by anyone to express my views. I want to further stress that the opinions below are my opinions and are not definite “facts,” but I believe them to be correct. I have not consulted with John’s former lawyer and I am remembering things from 25 years ago, so there could be errors.

After re-attaching John’s penis, I quickly learned that he was being charged with rape. I knew that he needed a good lawyer because of the seriousness of the charges. I did not know a good lawyer and I realized that neither did John or his family. An acquaintance of mine recommended Greg Murphy and I passed on that recommendation and John went with him. I have never received any money from Greg for that recommendation, nor any favors. By the way, if you wonder who is smarter – doctors or lawyers… After I reattached John’s penis, he declared bankruptcy and I was never paid. The lawyer’s fee was paid at a later date, after John did his porn film and he received about $350K – so there’s that! I got to know both John, Greg and Paul (who handled all of the John’s public interactions) very well over the next 6 months or so.

I learned that there were a lot of “facts” (as I recall them and I have not personally verified these things) that the public never heard or have not really paid attention to. In addition, John, often has trouble expressing himself clearly and therefore does not present himself well, at all.

John and Lorena clearly had a terrible marriage and like all marriages that end in divorce, it brought the worst out in both of them. They were also young and immature. The police had been called to their home because they both were very physical in their arguments (Lorena was later charged with assaulting her mother, long after she had cut off John’s penis).

John’s trial was simple and straightforward. He was charged with rape and there was no physical evidence of rape. To say that it took place, with no evidence, has always struck me as odd.

The situation with Lorena is much more complicated. John clearly has made some poor choices after this event. Everyone knows he did porn films, got a penis enlargement, and so on. I am not holding up John as a model member of society. He definitely has his flaws, as we all do. However, I do feel that many people are NOT looking at the facts of the case and instead making judgments based on their emotions alone.

  1. We know that she was married to John for several years but not the required 5 years in order to get a green card.
  2. They had a trial separation where he moved to Buffalo, New York for about a year and she remained in Virginia. Phone records show that she called him over a hundred times. John also said that she had sent him cards at Valentine’s Day, etc. (I obtained his information from John’s legal team and I am remembering this fact from 25 years ago)
  3. Many times in an abusive relationship, the woman is dependent on the man – whether it be financially or because of fear of losing her children. However, they had no children. If anything, Lorena was making as much or more money than John. She clearly is more articulate than John. She had an established career doing nails, whereas John was just stocking goods in a retail store.
  4. John came down from Buffalo for a trial week together (after spending almost a year apart) at Lorena’s request, to see if they want to work on their marriage or move on to divorce.  Under a deposition which is under oath, she stated that they had consensual sex several times per day, each day for the week leading up to the incident. John told her that day that he did not want to remain married to her and wanted to move on to divorce. I always questioned why she would ever want to spend that week together, after the claims she made.
  5. Although she claims that she was raped, she was examined as all rape victims by the police and there was no evidence of rape.
  6. Instead of going directly to her friend, Janet’s house, she went to the hair salon at 4 or 5 am. This also struck me personally as odd.
  7. Lorena served no time in jail because she got off the charges due to “irresistible impulse”. Isn’t every crime a case of “irresistible impulse”?
  8. Lorena has never expressed any remorse for trying to kill John and/or trying to  have him permanently go through life without a penis. It was somewhat of a miracle that despite throwing his penis into a field from her car window (it was in the field for hours,) that an animal had not eaten it first! John might have had to live his life without a penis. He also could have bled to death. Our society is based on a judicial system and we don’t allow people to simply mete out justice as they see fit.
  9. I always questioned why she would ever want to spend that week together to see if she could make the marriage work???  If she were truly abused, she would never have reached out to John, even once, let alone many times. She would have been grateful that he was far away from her, living in Buffalo.

This case has been a large part of my life, both personally and professionally. It certainly gave me some notoriety in the 90’s, and it still comes back around to this day, in follow-up media coverage. Below are a few links that may be of interest to you, related to the case:

SculpSure vs. CoolSculpting 

Written by Nicole Hackett, Master Esthetician

SculpSure and CoolSculpting are both non-invasive and FDA-cleared to reduce unwanted fat. They both use lipolysis to breakdown the fat cells, which your body then gets rid of naturally through your lymphatic system. Both are similar in certain ways, including: clinical evidence of fat reduction, little to no downtime, and typically require multiple treatments to see optimal results.

Let’s talk about how they are different and why ultimately, we decided to add SculpSure to our practice versus CoolScupting:



  • Uses heat to melt fat
  • 25 minute treatments
  • Less chance of side effects
  • Heat spreads making results even
  • Customizable paddles


  • Freezes Fat
  • 35 minute treatments
  • More likely to bruise and have swelling
  • Uses suction & only treats that area & can cause unevenness *more painful
  • More likely to have uneven results in fat removal
  • In a small number of patients, they will get nerve damage and require Gabapentin for nerve pain for a year.
  • Uses applicators with vacuum

Overall, both technologies have had successful results and very similar in the percentage of fat reduced. Although CoolSculpting has been around longer and has much more aggressive national marketing, we believe that SculpSure has better technology with better results and a lower risk of complications.

Our 3 Master Estheticians recently returned from Boston, where they were given the most advanced SculpSure training available. Call us at 703-406-2444 to schedule your complimentary, private consultation!

The Transformative Aspects of Plastic Surgery

It is the transformative aspect of plastic surgery where its greatest benefit occurs. I divide this into two main groups. As some of you may know, I also am a fully-trained life coach, having spent a year getting certified with CTI. I explore this in greater detail with patients who I take on as clients for life coaching.

The first aspect is how much better a person feels about themselves following plastic surgery. We are all familiar with the experience that if we feel better about ourselves, our entire attitude changes towards others and the world around us. We are physical and spiritual beings. If we feel more attractive and good about ourselves, this more upbeat attitude will be reflected on our mood towards others. We are likely to treat our partners, family members and co-workers better. We are less likely to be sensitive about small things. There are endless quotes and truths about life being a mirror. If we smile out to the world, the world smiles back at us. It becomes a self-fulfilling prophecy as well. Each day that is good tends to lead to expectations that the next day will be good and so on.

There is a second aspect of plastic surgery that I emphasize a great deal. I do a lot of body reshaping procedures, especially Smartlipo and Sculpture, but also tummy tucks and breast augmentations, breast lifts, and so on. I always stress to my patients that I can definitely improve their bodies. However, there is NO magic. Almost everyone will get a better final result if they can decrease their body fat. Everyone knows that we are experiencing an epidemic of obesity in the Western World. I personally believe (as do many other functional doctors) that our diets play a huge role in all diseases including cancer and heart disease. If I can assist and encourage my patients to eat significantly less processed food, stop all sodas and diet drinks, to eat more vegetables and decrease their carb intake (I firmly believe taking my Ketone Supplements makes this easier), they will be far healthier and will decrease their total body fat.

We are all familiar with situation where a diet is started, but after 4-6 weeks, where there is little change, we give up. However, if someone gets Smartlipo or Sculpsure, this gives them a much greater and quicker change than diet alone would do. It also gives them greater motivation to stick with a better diet and exercise program since they have put in the money and effort to get a procedure done with me. This will lead to long-term life changes both in looking much more toned but also feeling much better. As above, if you feel better about yourself and you also have better health, life will almost certainly find life better for you, and you will make life better for those around you. This will be a change that will last your entire lifetime.

Want to discuss available options for decreasing body fat or cosmetic procedures in general? Call us at 703-406-2444 to schedule your complimentary, private consultation with me – I’d be happy to help you find the right solution for you!

Combining Therapies to Enhance Facial Youthfulness (Rejuvenation)

There is a tendency for people to look for a particular treatment to reverse aging and restore youthfulness. However, as we age, there is not just one thing that changes, but rather a multitude of things. Each treatment can help correct an aspect of these changes. Of course, a single treatment modality is going to be very helpful. However, for many people, there are definitely additional benefits to combining therapies. During the consult, either myself or one of my master estheticians will suggest combination therapies that we believe would be beneficial. For each person, we will customize a specific treatment plan, which we may alter depending on how your respond to your treatment. This is the great thing about going to a high-level plastic surgery spa, versus a medispa or a non-plastic surgeon’s office.

Below is a list of often-combined therapies and a brief rationale for why they are often combined.

  1. Botox and Fillers
    Botox will relax the muscles and is usually used in the upper face, while fillers will fill in the hollowing. Sometimes people have deep lines in the glabellar area – the area between the eyes. The primary treatment is Botox, since the problem occurs due to muscle contraction. However, it can be beneficial to also use fillers to soften these lines so that you look better much quicker. If you use Botox in this area for a year, the lines will gradually get less deep but using filler will help to speed this process up.
  2. Hyper-pigmentation: PicoSure Laser Facial with Hydrafacial
    The Picosure laser is the very best laser in the world for improving hyper-pigmentation and irregular coloration on the face, neck, chest and back of the hands. It also stimulates collagen and elastic fiber growth. You need to plan 3 treatments (though you could need more), spaced one month apart. If you have ethnic skin, we strongly recommend that you do a ViPeel 2-4 weeks before you begin your series of PicoSure lasers, as this will  let the laser penetrate the skin more effectively.Alternating sessions with the Hydrafacial — such as a Hydrafacial at the beginning of each month and a PicoSure laser facial mid-month) — enhances both treatments, giving your skin an unbelievably youthful rejuvenation.
  3. Fine Lines: Fillers with Microneedling or PicoSure
    For lines around the perioral area, I like to combine fillers (usually Volbella) with either microneedling or the Picosure laser. The rationale for this is that the fillers work beneath the skin to soften the lines, and both microneedling and PicoSure laser work from the surface of the skin, stimulating collagen and elastic fibers.
  4. Acne Scars: PicoSure and Microneedling
    For acne scarring, it is best to combine both the Picosure laser, which stimulates your own collagen and elastic fibers (there is little to no downtime) with Microneedling which also stimulates collagen and elastic fibers but through an entirely different mechanism. You would alternate sessions between these 2 modalities. You should plan 5 sessions of each, depending on how deep your scarring is.

Anything done on your face will be enhanced by using our professional-grade skin care. You simply cannot buy skin care this powerful, unless you purchase it from a physician.


If you have any questions regarding your skin concerns, call us at 703-406-2444 to schedule your complimentary, private consultation with one of our Master Estheticians!