INSIDE: HEALTHY BEAUTY AT ANY AGE, PLUS OUR ANNUAL OPEN HOUSE

SKINNY FALL 2014

THE

BEAUTYSuzanne Bruce & Associates

Dermatology

healthy

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Suzanne Bruce, MDFounded SBA in 1997

Dr. Bruce is founder and President of

Suzanne Bruce and Associates, P.A.

She has been practicing dermatology

since 1985. A graduate of Rice

University and Baylor College of

Medicine, she completed her

dermatology residency training at

Baylor. She has been recognized by

many organizations for excellence,

including Texas Monthly (voted a

Super Doctor), Houstonia (voted a Top

Doctor), H Texas magazine (voted a

Top Doc) and Houston Woman

Magazine (one of Houston’s 50 Most

Influential Women – 2009).

Fall is upon us, and that means it’s time for our 17th Anniversary Open House Celebration set for Saturday, September 27, from 9:00 a.m. to noon. Once again this year’s Open House will be held at our Katy office, 23510 Kingsland Blvd., 3rd Floor, to mark its first full year of operation. I hope our Katy and Galleria office patients will bring a friend and join us at our annual extravaganza, where the latest in skin rejuvenation, body sculpting and skin health will be on full display and knowledgeable professionals will be there to answer your individual questions.

Some of those new procedures are highlighted in this issue. The next-generation VelaShape™ III is here and offers comfortable, no downtime, proven body contouring and cellulite reduction. We also introduce you to CoolSmooth™, the new CoolSculpting® applicator that offers an effective fat reduction treatment for thighs and other non-pinchable fat areas.

This issue also focuses on Healthy Beauty and how to take care of and improve the appearance of your skin at any age. Although skin aging issues for the individual are heavily impacted by genetic and lifestyle factors, we have broken up these aging signs into the decades where they most often surface. You’ll find some of the solutions our providers offer to address these concerns across the ages.

At Suzanne Bruce and Associates, we offer a wide variety of cosmetic services. In this fall edition, you’ll find articles with the latest information on some of our more popular and more unique treatments: Juvéderm Voluma™, miraDry®, acne scar treatments and laser hair removal.

Thanks to all of our patients for making this 17th year of business our best ever. We remain committed to providing you not only the latest in available medical and cosmetic treatments, but also customer service that is second to none. See you at Open House!

Welcome to The Skinny – our magazine devoted to giving you all the inside information to keep your skin healthy and beautiful.

What’s New by Suzanne Bruce, MD

LOCATIONS ANDHOURS OF OPERATION

KATY/CINCO RANCH23510 Kingsland Blvd., 3rd Floor

Katy, Texas 77494

Ph. 713.850.0240

Hours of Operation:

Monday-Friday – 8 a.m.-5 p.m.

Select Saturdays

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GALLERIA/HOUSTON: 1900 St. James Place, 6th Floor

Houston, Texas 77056

Ph. 713.850.0240

Hours of Operation:

Monday-Friday – 8 a.m.-5 p.m.

Saturday 8 a.m. – 2 p.m.

Taking time out of our busy schedules to go to the doctor is often an aggravating experience. Why? Because most offices leave you waiting well past your appointment time. Then after it’s all said and done, you often leave without the “peace of mind” you were looking for in the first place. We at Suzanne Bruce and Associates think that is unacceptable.

Over the last 17 years we have surveyed and listened closely to our patients because you are the true experts on what is defined as “excellent” customer service in the medical field. The answers are simple, run on time and make sure you address all the questions asked and even some that are not.

As a result, we pride ourselves on providing friendly, efficient and intelligent service to our clients. We recognize that your time is as important as our time, and our practitioners rarely run behind schedule. In the last two years, we have added 4 new dermatologists to make sure that this remains the case because on-time, polite, friendly and knowledgeable service is a promise we make to you.

If you ever feel that we are not keeping that promise, please let us know by survey, phone or email. We will do our best to correct any immediate issues as well as improve our processes and service delivery for the future.

Our Service Promise from all of us at Suzanne Bruce and Associates

Cover Art By: Dixie Friend Gay

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This year, Allergan, the makers of BOTOX Cosmetic® and Juvéderm® released a brand new product called Juvéderm Voluma™ that has revolutionized how injectors approach facial aging. It’s a robust hyaluronic acid (HA) filler that we inject deeper on the cheekbone to provide a long-lasting (up to 2 years) lift to the cheeks and jowls.

Before we get into describing why this filler is our new go-to, let’s take a look at how our faces age over time. A good analogy to understand skin aging better compares the underlying facial support structure and skin to that of a table and tablecloth, respectively. As the effects of aging and sun exposure take hold, the tablecloth gets thinner and more lax due to a loss of collagen. Aging also causes the table underneath to recede. We lose fat, muscle and bone over time. As a result, the face loses volume, and sagging skin develops around the eyes and jawline. Sunken areas begin to appear in the temples, under the eyes and on the cheeks.

The research showing all these structural changes

is still relatively new, and traditionally, aesthetics was all about filling folds and wrinkles to correction.

What makes Voluma so great is that it allows us to replace the volume loss in the apex of

the cheeks, thereby lifting the jowl and the smile lines around the mouth for

a subtler, more rejuvenated look. As a result we are able to use less filler in other areas to get to full

correction. Hyaluronic acid fillers have been around for many years, but

Voluma has superior lifting capacity and longer duration than other HA fillers.

Its introduction in January was received with much fanfare, and rightfully so. It has quickly become one of our preferred treatments. We particularly love the combination of Voluma with Ultherapy® skin tightening and have had great results!

If you are interested in learning more, schedule a consultation in either our Galleria area or Katy offices. You can also visit us at Open House on September 27th from 9am to noon!

The International Hyperhidrosis Society (IHS), the world’s largest advocacy organization dedicated to excessive sweating, recently updated its treatment recommendations for axillary (armpit) hyperhidrosis. Microwave thermolysis (destruction of the sweat glands by heat generated from microwave energy) is now recommended as a second line treatment after the first line treatment, topical antiperspirant therapy, has been tried and failed.

Our miraDry® procedure is the only treatment that uses microwave thermolysis to non-invasively treat unwanted underarm sweating. Clinical trials have shown > 90% efficacy with just two treatments. The

miraDry system has been successfully used in over 25,000 procedures, and patients overwhelmingly

approve of the miraDry procedure with a “Worth It” rating of 93% on RealSelf.

com. We have been performing the miraDry procedure at our Galleria area office since its FDA clearance in 2011 with similar degrees of patient

satisfaction. For many of our patients, it has been a life changer.

BOTOX® Cosmetic injections are also an IHS-recommended second line treatment for

this condition. Because we perform both treatments in our clinic, we are ideally suited to help you decide which would work best to solve your excessive sweating problem.

Voluma™ and the Changing Trends in Facial Aesthetics by Syed O. Ali, MD

miraDry® Recommended As Second Line Treatment by Leigh Ellen Eubanks, MD

Leigh Ellen Eubanks, MDJoined SBA in 1999

Dr. Eubanks has been practicing

dermatology since 1999. She is a

graduate of Randolph-Macon

Woman’s College and Tulane

University School of Medicine,

where she completed her dermatology

residency training. She has been

recognized for excellence by H Texas

magazine (voted a Top Doc).

Syed O. Ali, MDJoined SBA in 2012

Dr. Ali has been practicing dermatology

since 2005. A graduate of the United

States Military Academy at West Point

and the University of Chicago Pritzker

School of Medicine, he completed

his dermatology residency training

at San Antonio Uniformed Services

Health Education Consortium.

During his years in the Army,

Dr. Ali served as a flight surgeon and

as the Chief Medical Officer for the

Western Corridor of Korea. He also

served as Chief Medical Officer for

Phipps Troop Medical Clinic in Balad,

Iraq during, Operation Iraqi Freedom.

Dr. Ali is bilingual in both Spanish

and English.

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Generally in our 20s, our skin is looking great. This is the right time to step up your skin care regimen as these are the years we want to preserve and protect your skin. At our practice, we have found the G.R.A.S.S.

method to be an effective and complete skin care regimen. G.R.A.S.S. stands for Growth factors, to stimulate deep collagen and elastic fiber production; Retinoids, to help exfoliate and further encourage collagen growth; Antioxidants, to target sun- and pollution-induced free radicals that damage the skin; Specialty ingredients (skin brighteners, eye creams), to address all aspects of skin rejuvenation; and Sunscreen, applied every day, rain or shine, to prevent sun damage that leads to fine lines and wrinkles. During cosmetic consults, we introduce our patients to the benefits of a good regimen. Our patient care coordinators then help design tailored programs for them.

In our 20s our skin may look great, but that doesn’t mean we have to accept the inevitable aging that follows. There are many treatments that are simple and cost effective that can help keep you looking 20 for as long as possible. Our chemical peels and facials can help with mild superficial pigmentation and adult-onset acne. These treatments help stimulate peeling of the top layer of the epidermis, allowing healthy, newer skin to show.

Because we live in sunny Texas, early signs of skin aging can appear in our 20s. Most common are brown spots, redness and fine lines. Photofacials, also called Intense Pulsed Light (IPL) treatments, can reduce skin pigmentation and help prevent worsening of low grade sun damage. The light used in this treatment is absorbed by the pigmented areas and helps bring the pigment up to the surface of the skin so that it can flake off in a few days. Similarly, the light can shrink facial blood vessels, thus reducing redness. Additionally, IPL helps stimulate collagen, which helps your skin with fine lines and wrinkles. Over the long term, multiple IPL treatments can really make a difference in how you age over the following decades.

As they reach their 30s, many patients see the first signs of skin aging. Leading the charge are fine lines and brown spots. To combat the developing fine lines, we recommend BOTOX® Cosmetic to

soften wrinkles and a G.R.A.S.S. skin care regimen (discussed earlier) to prevent further deepening. Many of our patients begin Botox in their 30’s to help correct and prevent further wrinkle progression in the forehead, crows’ feet, and between the eyebrows. As we discussed earlier, stubborn brown spots, freckles, and hyperpigmentation can be lessened with a comprehensive skin care regimen along with chemical peels and intense pulsed light (IPL) treatments. Additionally, IPL is an easy procedure to work into your schedule,

even if you have a busy career and/or parenting commitments. Following IPL, there is minimal

redness, and makeup can be applied right away. We also recommend non-ablative

fractionated lasers to improve wrinkles, texture and discoloration.

We know that part of the aging process includes decreased exfoliation and loss of collagen, but did you know that there is also loss of fatty tissue and bony support, which begins in the 30s? One of the first areas fatty tissue loss appears is the under-eye area, aka the tear trough. It gives the under-eye area a tired, hollow and shadowed appearance. Ways to combat the tear trough is through a systematic

approach: injectable hyaluronic acid filler to inflate the hollowness and eye

creams to brighten the skin.

Finally, to help preserve your youthful face, we recommend skin tightening devices beginning in your mid to late 30s. These non-surgical devices, known

as Ultherapy® and Thermage®, work to tighten your skin though stimulation

of deep collagen and allow it to snap back into place.

30s20s

BEAUTYhealthy by Tracy Katz, MD, Jennifer Peterson, MD, and April Harrison, MPAS, PA-C

SAGGING SKIN

MARIONETTELINES

BROWNSPOTS

THINNING LIPS

NASOLABIAL FOLDS

VERTICAL LIP LINES

CROW’SFEET

FOREHEAD WRINKLES

LINES BETWEEN THE EYEBROWS

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In our 40s & 50s,the effects of the glory days of

our youth can really begin to make their appearance. Sun spots, uneven, blotchy skin, and rough texture from beachy summers and cumulative sun exposure emerge. Lines and

wrinkles around the eyes and mouth can become more prominent. Also, we notice sagging and greater loss of facial volume at this age.

Once again we recommend a good skin care regimen and BOTOX® Cosmetic to soften wrinkles around the eyes, between the brows and on the forehead. We also use Botox to give a quick neck lift and relax the vertical bands that age the neck.

Fillers are our friend when it comes to restoring the natural proportions and contours to the face. Small amounts of strategically placed filler can lift the cheeks, soften lines around the nose and mouth, and fill sunken temples and under-eye hollows. Filling vertical lip lines and adding subtle volume to the lips with hyaluronic acid fillers give the mouth a more youthful appearance.

To address pigmentation and texture concerns of aging, we offer some great options. Best for wrinkles, pores, lines and brown spots are our non-ablative fractionated resurfacing lasers. A series of several treatments is usually enough to produce radiant, healthy, smoother skin. The more intensive Fraxel® Repair laser is better suited for deeper wrinkles and acne scars and is done in one (sometimes two) treatments. Maintenance is easy with Clear and Brilliant® laser treatments performed in our spa. For sagging and lax skin, we offer two excellent, no downtime procedures – Thermage® and Ultherapy® Both are addressed in our next section.

40sAs we get into our 60s and beyond,laxity and sagging become more apparent. Our favorite one-two punch to address these issues is a skin tightening procedure, either Thermage® or Ultherapy®, followed by Juvéderm Voluma™ filler injections. Thermage utilizes radiofrequency energy

to tighten loose skin on the face and neck. Ultherapy employs focused ultrasound energy to lift and tighten the face, neck and décolleté. Both no-downtime procedures stimulate the skin to produce its own collagen, which improves wrinkles and texture. Combining Thermage or Ultherapy with Voluma lifts the cheeks and jowls. If laxity is pronounced, two skin tightening procedures and several syringes of Voluma may be required to get the best results.

BOTOX® Cosmetic injected into the frown lines between the eyebrows and into the crow’s feet and forehead can soften the lines and provide a nice lifting of the brow. In this age group we are careful to avoid putting in too much Botox in the muscles that cause horizontal forehead lines. If you overdo that area, it can cause the brow to drop. Our providers are very experienced at devising the best treatment plan for you that will maximize the desired effect and minimize any unwanted side effects.

Sometimes we are asked, “Am I too old to be doing any of these procedures?” Our answer is you’re never too old if you have the desire to improve your appearance and have realistic expectations. We have quite a few patients in their 80’s who are doing cosmetic procedures and are thrilled with their results.

60s

IN SUMMARY: Because we’re all aging at different rates and in slightly different ways based on our genetics and life experiences, an individualized plan is ultimately needed to address each person’s unique combination of issues. In spite of these differences, several guiding principles hold true. One, you should start sooner rather than later. It’s always easier to reverse mild aging changes than severe ones. Two, whatever in-office procedures you do, you can enhance your results by being on a good home skin care regimen. Three, you should choose an experienced provider to do your procedures. Most procedures, including Botox® Cosmetic, fillers and lasers, are technique-dependent. Our advice is to trust your skin to a reputable medical professional who has done the procedure many times. Experience counts.

At Suzanne Bruce and Associates, we have six board-certified dermatologists and other experienced skin care providers to assist you in your skin rejuvenation journey. Let us help you take the necessary steps on your path to healthy, beautiful skin.

}Facial aging is so gradual that most of us don’t even notice that it is beginning in our 20s, even in those who take good care of their skin. By the 30s, the first signs of aging become more visible. In our 40s and 50s, most of us do see visible lines around our eyes, mouth and forehead. In the 60s and beyond, loss of facial volume and sagging skin are major concerns. If you become aware of the early signs of skin aging and take measures to prevent and even reverse the damage, you can head off a lot of problems and slow down the skin aging process. There are steps you can take in your 20s, 30s, 40s, 50s and 60s and beyond to improve the health and appearance of your skin. In the decade articles that follow we’ll discuss common skin concerns we see around that age and the things you can do to address them.

BEAUTY by Tracy Katz, MD, Jennifer Peterson, MD, and April Harrison, MPAS, PA-C

50sand

Syed O. Ali, MD I Suzanne Bruce, MD I C. William Doubleday, MD I Leigh Ellen Eubanks, MD I Tracy Katz, MD I Jennifer Peterson, MD I April Harrison, MPAS, PA-C

Board Certified, American Board of Dermatology; Fellows, American Academy of Dermatology

1900 St. James Place, 6th Floor, Houston, Texas 77056 I 23510 Kingsland Blvd., 3rd Floor, Katy, Texas 77494

713.850.0240 I www.sba-skincare.com© 2014. Suzanne Bruce and Associates P.A. All rights reserved.

We would like to thank all of you who participate in our clinical trials. You help science move forward and keep our providers at the forefront of dermatologic advances and treatment. Our Katy Center for Skin Research is now open and busy on a variety of studies.

Both centers are currently enrolling patients in studies. If any of our readers would like to possibly participate, please visit our website at: www.sba-skincare.com/trials.

Improving indented facial scars from acne can be very difficult, and usually multiple modalities are needed. Two recent publications in the medical literature have validated treatments that we have been using in our office to treat acne scars.

The first study was published in JAMD Dermatology in August 2014. It involved a technique called microneedling which uses tiny sterile needles to punch holes in the skin. When the holes heal, new collagen is produced which improves the appearance of the scars. In the study, three treatments were performed at 2 week intervals on one side of the face, and the other side was not treated to serve as a control. At 6 months, the treated side showed a 41% mean improvement in overall scar appearance compared to the untreated side. At SBA we use the Micropen™ device for microneedling. We recommend a minimum of 6 treatments to get the best results.

The other acne scar treatment article which was published recently in the Journal of the American Academy of Dermatology was a clinical trial that I served as a principal investigator. It was a double-blind, controlled trial in which some patients with acne scars were treated with injections of a filler called Artefill® and others served as untreated controls. At the 6 month follow up, success was achieved by 64% of those treated with Artefill vs. 33% of control subjects.

Artefill treatments are also available at SBA. In the majority of acne patients, greater improvements can be seen by combining different types of treatments, for example Micropen and Artefill. If you would like a consultation to explore which options might be best for you, please call our office to schedule an appointment.

Center for Skin Research: Thanks to Our Study Patientsby Brian Murry, Director of Skin Research

Latest on Treating Acne Scars by Suzanne Bruce, MD

SEPT27

KATY SATURDAY EVENTJoin us for our 17th Annual

Open House at our Katy office 9AM - 12PM

OCT15

GALLERIA LUNCH & LEARN“Injectable Fillers A - Z”

Refresh your look just in time for the Holidays

12PM - 1PM

OCT24

KATY LUNCH & PLAY“Put the Sparkle Back in your Eyes” - Interactive event with

samples and demos 12PM - 1PM

NOV7

GALLERIA LUNCH & PLAY“Put the Sparkle Back in your Eyes” - Interactive event with

samples and demos 12PM - 1PM

RSVP

If you would like to attend any of our upcoming events please RSVP to e v e n t s @ s b a - s k i n c a r e . c o m . You can find more information on our website at www.sba-skincare.com.

Upcoming Events!