Cosmetic Dermatology

Topics include:

Fillers

Restoring a youthful face has now been made possible with the advanced use of long-lasting fillers. The duration and results are dependent on each persons individual bone structure, skin elasticity, baseline volume of collagen, age, site of injections and amount injected. Dr. Rullan was one the pioneers in the use of "cannulas" for injecting these fillers, allowing a safer and more artistic approach, specially when correcting the "tired look" in sensitive areas like the under -eye region. Click here on information to prepare for your procedure.

Hyaluronic Acid Fillers

  • Duration: 1-2 years
  • Areas Injected: Hands, cheek bones, nasolabial, marionette lines,
  • Duration: 6-12 months
  • Areas Injected: Lips, temples, fine lines, nasolabial, marionette lines
  • Duration: 6-12 months
  • Areas Injected: Lips, under eyes, nasolabial, marionette lines, fine lines
  • Duration: 6-12 months
  • Areas Injected: Lips, under eyes, nasolabial, marionette lines, deeper lines

Calcium Hydroxyapatite Filler

  • Duration: 1-2 years
  • Areas Injected: Cheek bones, jaw line, marionette lines, nasolabial, under eyes if mised with other hyaluronic acid fillers

Polylactic Acid Filler

  • Duration: 2-3 years
  • Areas Injected: Cheek bones, temples

Polymethylmethacrylate Filler

  • Duration: 5 years
  • Areas Injected: Cheekbones, temples, nasolabial

Silicone

  • Duration: Permanent
  • Areas Injected: Lips, acne scars

Fat (from the patient)

  • Duration: 9 months - indefinite
  • Areas Injected: Total face and hands

Chemical Peels

  • Light Peels such as Glycolics, Tricloroacetic Acid (TCA)10-15%, Jessner's, Salicylic, ZO 3 Step, and VI Peel's
  • Medium Peels such as TCA Controlled Depth Blue Peel by ZO, VI Precision (30% phenol), & Hetter (30% phenol with croton oil)
  • Dr. Rullan's Award-Winning "Phenol Chemabrasion" for Deep Wrinkles and Acne Scars

Click here to see our "Preferred Peels for Select Skin Conditions"

Glycolic Peel

Glycolic peels are the mildest form of chemical peels, which exfoliate the surface layer of skin to expose the fresher, younger-looking skin beneath. It improves dry, thin wrinkles under the eyes and adds glow to the skin by adding fresh collagen and better hydration.

Jessner's Peel

This Salicylic, Lactic and Resorcinol peel produces a drying exfoliation which then peels like a mild sunburn a few days later. It helps dry out acne, reduce acne scars and pores, and helps rejuvenate sun-damaged skin. Can be applied to the neck, chest and arms.

Salicylic Peel

Salicylic peels are ideal for skin that shows signs of aging, sun damage and the effects of acne. These peels can be customized in strength to be beneficial treatments for wrinkles, pigmentation issues and blemishes on the skin. Salicylic peels are typically used to treat the face and neck, but they can safely be applied to any problem area of the body including the chest, back, hands and shoulders. The Dermatology Institute Providers do over 40 of this peel every day.

TCA 10-15% Peel

TCA peels are could be superficial or medium-depth peels that treat fine surface wrinkles, superficial blemishes and pigment problems. At concentrations of 10-15% it is a superficial exfoliating peel and is the preferred chemical solution for darker-skinned patients and may be used on the neck and other areas of the body.Multiple treatments may be required. Treatments only last 10-15 minutes, and recovery time is fairly short.

ZO 3 Step Peel (New)

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3-step in-office procedure is followed by at-home use of Retinol Crème and 6% Calming Crème the following day.  Treats acne, melasma, sun damage, fine lines, texture roughness, large pores, & dullness. Promotes softer, smoother skin.  Suitable for any skin type or color.

ZO Controlled Depth Blue Peel (New)

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A 26-30% TCA peel that reduces brown spots, age spots and uneven skin pigmentation. It improve the texture of leathery, sun damaged skin and imparts more glow, reduces the appearance of melasma, acne, and post-inflammatory hyper pigmentation, and reduces fine lines and wrinkles.

VI Peel™ & VI Precision™ Booster

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The VI Peel is an advanced chemical peel that combines unique ingredients to produce significant results with no pain, no skin preparation and minimal downtime. Patients can enjoy smoother, fuller and more vibrant skin after just one 20-minute treatment session, which can be repeated regularly to prolong results. The VI Peel can be used to effectively treat the skin of the face, chest, hands and more.

 

Dr. Rullan's Phenol Chemabrasion Peel

- Full Face or Regional | For Acne Scars & Deep Wrinkles

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Dr. Rullan's peel consists of applying a modified phenol formula, taping it for 24 hours, removing the injured skin layer the next day, abrading the scars and wrinkles, reapplying the solution, and covering the face with a green powder which stays on for 7 days until removed by the patient. Dr. Rullan developed this unique procedure from the ExodermTM model. His technique combines meticulous abrasion of acne scars and wrinkles, surgical or chemical subcision of thickened scars, and the use of fillers to correct atrophic scars. Patients typically fly or drive to San Diego and stay at local hotels for 5-10 days. A patient can return to work around 10 days after the peel. If its regional (around the mouth or eyes) downtime is less.  An editorial of the American Journal of Cosmetic Surgery called this peel the most promising new option to laser resurfacing. It can be done on most skin types without the usual "phenol" associated side-effects like loss of skin color, scarring and cardiac toxicity, because of Dr. Rullan's safer anesthesia guidelines and because this modified formula is 1/10th to 1/20th as strong as the other "phenol peel", known as "Baker-Gordon".

 

Laser Therapy

  • Fractionated Ablative CO2 for resurfacing scars and wrinkles
  • Fractional Ablative Erbium for resurfacing scars and wrinkles
  • Soprano XL for permanent hair reduction (Diode)
  • V-Beam Perfecta for rosacea, stretch-marks, solar lentigos and leg veins
  • Harmony XL QS:YAG (532nm & 1064nm) tattoo removal laser
  • IPL Photofacials for photo-damage
  • Radiofrequency skin tightening (Accent®)
Fractional Ablative CO2 Laser Treatment

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Pixel® is a fractional CO2 laser system that can be used for non-ablative skin resurfacing for aging, damaged or scarred skin. The skin is treated by creating thousands of microscopic perforations while leaving the skin of the area intact and able to heal around the edges of the tiny holes for an improved complexion. This treatment can be used to improve the appearance of fine lines and wrinkles, reduce the appearance pores, fill in acne scars and improve overall skin pigmentation.

 

Erbium Fractional Ablative Laser Treatment

The erbium laser is typically used to treat deeper lines and wrinkles within the face, hands, neck and chest. It is also better for darker skin tones.

Soprano xl® Laser Hair Removal

This laser provides pain free, fast, safe and effective laser hair removal for patients of ALL SKIN TYPES. In addition to hair removal, it can also treat razor bumps and ingrown hairs. The advanced diode laser system precisely targets areas of hair growth and delivers narrow-wavelength light to the hair follicles, while the surrounding tissue remains untouched.

V-Beam Perfecta

The V-Beam pulse dye laser by Candela has been a gold standard laser treatment for vascular conditions for decades. This incredibly versatile laser treats a remarkable array of skin conditions, from red and brown discoloration to vascular and pigmented lesions to wrinkles and acne and beyond for dramatic skin rejuvenation.

Harmony XL® Tattoo Removal

This Q-switched laser at 1064nm & 532nm  is safe and effective, and have a number of applications. They are photoacoustic, using a combination of high power and nanosecond pulses to deliver peak energy throughout the layers of skin being treated. This works best for blue and black colored tattoos and requires multiple sessions.

IPL Photofacial

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Photofacial is a non-abrasive and non-invasive rejuvenation of your skin using the remarkable technology of Intense Pulsed Light (IPL). IPL Photofacials can improve the signs of sun damage, rosacea and brown spots on the face, hands and body. It has also been used to reduce the appearance of mild acne scars, dark circles around the eyes and fine lines around the eyes and mouth.

 

Radiofrequency Skin Tightening - ACCENT®

Accent radiofrequency uses both unipolar and bipolar energy to allow the physician to tighten loose or sagging skin, producing a kind of "lift" without an incision. The Accent process uses a device to activate deeper skin tissue and jumpstart collagen production. The treatment is painless but requires an multiple sessions (average of 4-6 sessions).

Dermatologic Cosmetic Surgery

  • Tumescent Liposuction
  • Blepharoplasty (Upper and Lower Eyelid Lift)
  • Injection Lipolysis (Mesotherapy)
Tumescent Liposculpture

Tumescent liposculpture is a vast improvement over traditional liposuction. In the tumescent method, relatively large volumes of diluted local anesthetic are used to "inflate" the fat before it is suction-aspirated. This allows for a very safe and almost painless procedure, with minimal bleeding and very fast healing. As opposed to "smart lipo", "cool-sculpting" and "radio frequency ", this technique is time honored and consistently produces satisfactory results.

Blepharoplasty - (Upper & Lower Eyelid Lift)

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Blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient's field of vision.

 

Injection Lipolysis (Mesotherapy for Fat Removal)

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Mesotherapy is the practice of using microinjections of FDA-approved medications and natural ingredients into the mesoderm (middle layer of skin) to deliver healing or corrective treatment to a specific area of the body.

 

Esthetician Services

  • Free skin care and make-up consultations
  • European facials
  • Oxygen Echo-2 facial to reduce redness and irritation
  • Superficial Peels
  • Acne Facials
  • Microdermabrasion
  • Dermaplaning
  • Rejuvapen™ - Microneedling
FREE Skin Care Consults

Our trained esthetician will assess your current skin care regimen, your skin type, your problem areas, and offer you tips on how to improve your complexion.

Acne Facials

Acne is the term for the blocked pores (blackheads and whiteheads), pimples, and deeper lumps (cysts or nodules) that can appear typically on the face, neck, chest, back, shoulders and upper arms. This procedure may be covered by your insurance, please call your insurance company for more information.

Microdermabrasion

Microdermabrasion improves mild to moderate sun damage, scarring, wrinkles and other superficial skin problems. A gentle stream of tiny particles exfoliates the outer layer of skin and provides a fresh, glowing, younger appearance.

Preparing for Your Procedure

All Procedures

Before any procedure, stop using chemicals on your skin three days ahead of time; that means retinoids, acids, scrubs, benzoyl peroxide, cosmeceuticals, and chemical sunscreens (switch to mineral ones). Take off any makeup before the procedure. If you are prone to herpes, fever blisters, or any kind of infection on your face (even acne), treat it with the proper medication before and after your procedure, since any treatment can cause stress to the skin that may trigger a flare-up.

Injectables, Botox, and Lasers

To help decrease bruising and bleeding, discontinue all medically unnecessary blood-thinning medications and supplements one week beforehand, including aspirin, ibuprofen, St. John’s wort, vitamin E, and omega-3 supplements. You can continue all prescription medications, including aspirin and warfarin; just know that you may have more bruising.

Laser

Lasers zone in on darker pigment in your skin, so a tan (even from a self-tanner) can affect the outcome of the procedure and perhaps cause side effects such as post-inflammatory hyperpigmentation. So you should not have a tan, and stop using self-tanner at least two weeks beforehand.

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"I love what I do because I get to combine my God-given artistic ability with technical skills and passion for helping people."

– Peter Paul Rullan, M.D.