the beauty of expertise

November, 2017 Newsletter
Dr. Elliott Uncovers the Truth Behind the Cause of "Smokers' Lines"
Wrinkles around the lips are due to a combination of muscle contraction, thinning skin, and "making that face" too often
Did your  mother ever tell you, "If you keep making that face, its going to s tay that w ay", like mine?  Little did I know then that this would turn out to be yet another of  tho se Mom-statements that I didn't believe but pr oved to be true.
Dr. Elliott's mother tried
A family photo from 1966 with Dr. Elliott on the bottom left, and Dr. Elliott's mother looking down, thinking (for many reasons), "She's going to be sorry"
Dr. Elliott didn't listen
Closeup of the expression (and bangs)

Wrinkles around the lips, sometimes called "smokers' lines", are caused by repetitive mouth  movements, like those used when drinking through a straw or smoking, along with the structural changes in the face that develop with aging.  
Like a piece of paper that's been folded over and over until the crease remains visible even when the paper is flat, after years of repetitive movement, wrinkles develop that become visible even when the muscle is relaxed.
Thick skin resists creasin g better than thin skin, so thick-skinned people tend to get wrinkles later in life than those of us who are thin-skinned, although everyone experiences thinning skin with aging.
So what's the more important cause of smokers' lines - skin thickness or muscle movement? Hint: men don't get smokers' lines even though some of them talk so much.
To solve the question above, I injected the enzyme that dissolves dermal fillers like  Juvederm and Restylane, above the right side of my upper lip, to see how it would look if there wasn't any  filler there. 

Pertinent background: I've used dermal fillers around and in my lips over the past few years to  make my chicken lips more visible, and felt lucky that I hadn't yet developed any "smokers' lines". 

Dr. E's Lip lines
After dissolving dermal filler above the right side of my mouth.
I was shocked and appalled to see the results.  My mother was right! Again! 

Even though I'm scrunching my lips in the photo, the cushioning effect of the filler above the left side of my mouth is preventing the skin creasing, more than the thin, floppy skin on the right. 

My dermal filler results had been hiding my underlying "smokers' lines".

The Aging Mouth
Other depres sing physical changes that occur with aging around the mouth and contribute to the development of smokers' lines, include a decrease in bone, fat, skin elasticity , oil glands and collagen. The bones underlying the nose and teeth resorb, fat compartments shrink and t here's atrophy of the underlying muscles and ligaments. Losing teeth causes even faster bone resorption and accelerates the aging changes.

With less suppo rt, elasticity and skin thickness, the upper lip flattens and turns inward. In profil e, t he elderly mouth appears to  fall backwards. That's me on the right.
Recommended Treatments for Perioral Wrinkles (Smokers' Lines)
My recommended treatments for smokers' lines depends on  the depth of the lines as well as the quality and  thickness of the skin around t he li ps.
If the lines are only visible when the lips are pursed, injected  muscle relaxants like Botox or Dysport can be used, like in other areas of skin creasing due to muscle contraction (examples: crow's feet, frown and forehead lines), to decrease the degree of creasing of the skin. This can prevent the formation of wrinkles when relaxed.
Lip lines with normal skin
An example of thick skin with lip lines
Someone with thic k skin & a few deep lines benefits most from a dermal filler to lift the individual lines. The filler  must be placed precisely in the  plane of skin that will lift the line but not produce a ridge, and our injectors are experts with this treatment.
Someone with thin or aged skin with a lot  of superficial lines, usually does better with ablative laser resurfacing,  and sometimes also a dermal filler to thicken all of th e skin   between the nose & the upper lip.  Like my photo of my mouth after I dissolved the filler on one side, without support below the surface, the skin falls into muscle creases.
Lip lines thin skin
An example of thin, aging skin
Ablative laser resurfacing can be done either by removing the full surface of the treated area, which is also referred to as full surface skin resurfacing, or by removing a percentage, which is called fractionated ablative laser resurfacing. 
I've been performing laser resurfacing for over 10 years and have been an instructor for other practitioners learning laser techniques, and experience is very important with a treatment that removes this much skin. Don't risk being scarred by having your laser resurfacing done by a provider who doesn't have years of experience and plenty of their own (not laser company photos) before and after photos.
before & after laser resurfacing to mouth

If you're bothered by lip lines we can help you learn the best treatment options for you. Click here to request a consult or call us at 727.571.1923.

Tis' the Season to Peel
How to have super fresh skin (minus the beef carpaccio face)
Comic clip of Samantha's Chemical Peel
by Melissa Kennow, licensed esthetician

Chemical Peels were the most popular cosmetic treatment in the late 1990's & early 2000's- even outranking Botox injections. 

Who could ever forget the infamous Sex & the City scene where Samantha hides her post-chemical peel face in what looks like Donatella Versace's version of a bee keepers bonnet?

Though times have changed, chemical peels are still a gold standard anti-aging skincare treatment. They have the ability to effectively treat sun damaged, aging skin as well as acne & acne related scarring. Today's formulations are improved & much more advanced, allowing patients to have a peel & immediately go on about their business without having to hide out for days.

Some of the key benefits associated with chemical peels:
  • Smooth Skin Texture
  • Even Skin Tone & Fade Brown Spots
  • Calm acne breakouts
  • Reduce the appearance of fine lines & wrinkles
  • They allow your skin care to work better by removing dead surface skin that could otherwise block their absorption.
With the holidays right around the corner (T minus 16 days until Thanksgiving), most of us are looking for a way to improve our appearance without a lot of downtime. If you're looking for a way to give your complexion a little boost without downtime, then a series of light to moderate chemical peels with just minimal skin flaking might be just the ticket.
For a limited time we're offering the complete  Let it Glow Skincare Package for $249 (value of more than $325), which 
  • a thorough skin evaluation & consultation with one of our estheticians
  • a series of 3 Glycolic Peel treatments (customized for your skin type)
  • 2 professional strength skincare products chosen for you to use at home.  
This skincare treatment regimen is an affordable & effective way to address sun damaged & aging skin. It's ideal for fading brown spots & evening skin discoloration as well as smoothing & softening skin texture. 

You won't want to pass this up! Call us at 727.571.1923 or email us to make an appointment.

man getting facial
10 Best No-Downtime Aesthetic Treatments 
These 5 treatments have absolutely no social downtime and your skin looks better immediately afterwards.
  1. HydraFacial
  2. Skin Tightening
  3. Dermaplaning
  4. Triple Peel Microdermabrasion
  5. Laser Genesis

The following 5 treatments also have no downtime but the results aren't immediate.


  1. IPL Photofacial
  2. Ultrasonic Fat Cavitation
  3. Laser Nail Fungus Treatment
  4. Laser Hair Reduction
  5. CoolSculpting 


Isn't it nice to know that the saying, "Beauty is Pain", isn't true?



Distraught Women Say Fake Botox Left Them Looking 
'Like A Hamster'
Counterfeit Botox is Still A Problem
From Fox News, Nov. 2, 2017

A jury was shown the before-and-after photos of three woman who claim bogus Botox injections left them disfigured and "looking 50 years older." 

Marcelle King, of Poole, England, is one of the alleged victims who filed claims against Ozan Melin, who prosecutors allege has no medical background and was using a counterfeit solution for injections,  The Daily Echo reported.

King, 62, reportedly texted Melin's then-wife, Lisa Bolster, to complain about the procedure. She was told to use a wet cloth, but wound up in the hospital suffering from anaphylactic shock the next day, The Mirror Online reported. 

A second woman, Jozette Sheppard, testified that a botched procedure led by Melin failed the first time, and a second attempt left her unable to "eat, speak or smile," the news outlet reported.

"During the evening it was like my head was on fire, really burning," Sheppard, 46, said,  according to The Daily Echo. "It started swelling by my eyebrows and I had to lie down because I couldn't open my eyes. When I woke up and couldn't open my eyes and I screamed."

Sheppard said she had trouble moving her face for up to four months, and that Bolster had assured her through a series of text messages that the affects would calm down.  "It sucks, it always goes down though," Bolster allegedly texted to Sheppard.

Melin has denied the charges against him, while Bolster pleaded not guilty to three counts of fraud and one of unauthorized use of a trademark in relation to a counterfeit substance marked "Botox" found in her freezer. 

Refer Your "Friends"
Refer friends who are new to Skinspirations, and get a $50 Skinspirations Gift Card every time one of them has their first treatment with us. 

Thanks to everyone who attended our OBAGI Happy Hour last month.
We had such a great time talking skincare, catching up & indulging in delicious holiday inspired craft cocktails (thank you Bartender Gale!). 

Deborah won a full-size Obagi Nu-Derm product system worth more than $400!
It was such a fun way to spend a Monday evening & get into the holiday spirit. We are looking forward to hosting more intimate events like thi s in the future, so stay tuned to our newsletter for upcoming dates. 

A special thank you to our OBAGI representative, Suzie Hermann, who made the event a possibility (& is pretty much a saint). Last but certainly not least, congratulations to Deborah S., the winner of a complete OBAGI Nuderm system. 

To see more photos from our Obagi happy hour event,  visit our facebook page .

Check out this video for Gale's-not-so-secret recipe for the BEST apple martini you've ever had (we promise).

Mark Your Calendars!

Stay tuned for upcoming details about our Cyber Monday sale from 9 am - 6 pm, Monday, Nov. 27th.
Join These Rewards Programs for Bonuses & Rebates

brilliant distinctions
Earn Redeemable Points When You Buy:
BD Products

You can also shop online at the Brilliant Distinctions® Mall and earn points on every purchase. Buy from many of your favorite retailers and as your gift list gets shorter, your savings on future BD treatments and products get bigger!

BD Mall

Earn Rewards for All Restylane Products, Sculptra Aesthetic & Dysport
Click here to download the Obagi Premier Points app for IOS or Android

 Skinspirations' November Patient Appreciation Specials

Get a $50 Skinspirations Gift Card in time for the holidays, when you purchase at least $300 in services , by Corinn Singletary, PA-C, or  Kate Dellangelo, ARNP 

Let It Glow Complete Skincare Package for $249 (value at least $324) - this includes:
  • a thorough skin evaluation & consultation with one of our estheticians 
  • a series of 3 Glycolic Peel treatments (customized for your skin type)
  • 2 professional strength products chosen for you to use at home. 
Achieve faster body contouring results with a complimentary Ultrasonic Fat Cavitation treatment (value $120) when you buy a CoolSculpting body contouring treatment 

$200 Instant Rebate when you purchase a treatment of 2 syringes of any Restylane filler with Dysport, or a $100 Instant Rebate on a treatment of 1 syringe of any Restylane filler with Dysport

$99 Skincare Special - Our  Pumpkin Enzyme Facial with a lactic acid booster for the face, neck & chest, gently  exfoliates & is packed with antioxidants & vitamins for a more radiant complexion. It's festive way to indulge this holiday season without guilt. (value $120)

Get a free, no-downtime, collagen-building Laser Genesis treatment or IPL Photofacial (value > $120) when you purchase a treatment package

Get longer, fuller, darker lashes and a $20 Instant Rebate (limited quantity) with the purchase of a 5 ml. bottle of Latisse Lash solution

Get a free full size Obagi Sun Shield SPF 50 (value $51.50) to protect your results when you have a Profractional laser treatment of the face, neck or chest.
Monthly client appreciation specials are available only during the month published (unless otherwise stated), quantities are limited, there are no rain checks or substitutions permitted, and they cannot be purchased with Care Credit financing (which takes a percentage from what we are paid). Monthly specials are not valid with any other promotions or discounts.
My Favorite Family Thanksgiving Video
My Favorite Family Thanksgiving Video