The what's what in fillers at pdmd

Published June 23rd, 2022

Donna Bilu Martin, MD, FAAD discusses filler treatments at Premier Dermatology, MD.  Dr. Bilu Martin is a board certified dermatologist at Premier Dermatology, MD in Aventura, Florida.  She is an expert in medical, cosmetic, and surgical dermatology. 

The In's and Out's of a full body skin exam at the Dermatologist

Published January 11th, 2022

1. Dermatologists look EVERYWHERE.

Yes, everywhere.  From the top of the head down to in-between toes, including the groin area and buttocks.  Skin cancers and abnormal moles can come up where the sun doesn't shine, so it's important to have a thorough exam.  There's no need to feel shy or embarrassed.  Dermatologists are medical doctors who, in addition to completing four years of medical school, have had an additional four years of internship and residency training.  To become board certified like Dr. Bilu Martin, dermatologists take a rigorous board exam and re-certify every 10 years.  Our medical training and experience make dermatologists the experts in skin conditions.

2. Skin exams should be done once a year.

Just like a yearly checkup at the internist, regular full skin examinations allow for earlier detection and treatment of skin cancer and abnormal moles.  People with a history of melanoma or multiple non-melanoma skin cancers may require more frequent exams, based on their dermatologist's recommendations. 

3. Dermatologists are not concerned with hairy legs or non-pedicured toes.  Or non-matching undergarments.

Your doctor does not care if you haven't shaved all winter long!  Dermatologists are busy looking for suspicious spots when we conduct our exams.

4. Early detection saves lives.

Diagnosing and treating skin cancer such as melanoma in its earliest stages greatly improves prognosis.  In fact, for very early stage melanoma located at the site where it started, the 5 year survival is 99%.  When basal cell carcinomas and squamous cell carcinomas are found early, they can be easily treated in the office.  

5. Kids can get full body skin examinations.

Having family members with melanoma, being fair skinned, having light eyes, and a history of sunburns all increase the risk of melanoma and other types of skin cancer.  Kids with many moles or with risk factors would benefit from skin exams.

Take care of yourself and your loved ones and schedule a full body skin exam in 2022! 

Technology and Beauty

Published October 3rd, 2021

Ah, technology.  The ability to access information and connect with others by using our devices is truly amazing.  We can get what we want and find things out in a matter of seconds, just by clicking an app or a site on our phones or tablets.  But with convenience, comes a price.  And who pays the price?  Our skin!

It's true.  Staring down at our devices, scrolling through social media can lead to the dreaded "tech neck:" horizontal lines and wrinkles on our necks.  And the blue light emitted from devices has been shown to accelerate the aging process by damaging proteins and killing cells-- leading to wrinkles, sagging skin, and dullness.  The light can lead to hyperpigmentation as well: darker spots, the same way ones that come out with too much UV light exposure.  Squinting at our tiny screens can lead to Crow's feet around the eyes.

So what's a technology loving person to do?

First and foremost, a great skin care regimen is key.  Protect skin daily with a broad spectrum sunblock that contains zinc oxide and titanium dioxide.  At Premier Dermatology, MD, we carry multiple sunblocks by EltaMD and Skinceuticals.  Products like Vitamin C serums and topical Resveratrol help repair antioxidant damage.  Peptides and growth factors stimulate collagen and help to tighten the skin.  Retinol creams (not for women who are pregnant or nursing) increase cell turnover and stimulate collagen to improve the appearance of fine lines and wrinkles, as well as work to improve hyperpigmentation.   

Dr. Bilu Martin uses Botox or Dysport to soften Crow's feet.  She injects PRP (platelet rich plasma) under and around the eyes to improve fine lines and texture.  For the neck, Dr. Bilu Martin uses a combination of treatments, including Botox or Dysport to soften vertical and horizontal bands.  She places dissolvable PDO threads to both lift and soften horizontal lines in the neck. In addition, Dr. Bilu Martin performs a series of laser treatments to the face and neck to improve texture and fine lines with minimal discomfort or downtime.  Aquagold, with or without PRP, is another favorite treatment at pdmd to improve the appearence of pores, fine lines, and dull skin.  In this treatment, a combination of Botox/Dysport and hyaluronic acid (plus or minus PRP) is microneedled all over the face, leaving skin glowing.

Audrey, our amazing aesthetician, uses a variety of treatments, including microdermabrasion, dermaplaning, medical grade skincare, masks, and chemical peels to improve damage and hyperpigmentation.  The Vi peel, one of her favorite treatments, is a superficial peel that is usually done in a series.  Skin will peel for a few days, resulting in brighter, smoother skin. 

This October at PDMD is the perfect time to take advantage of our specials and combat damage from technology.  To schedule your appointment with Dr. Bilu Martin and Audrey, call us at 305-521-8971.


Fillers and the Coronavirus Vaccine

Published January 18th, 2021

Coronavirus turned 2020 upside down.  However, there are now two vaccines (Moderna and Pfizer) available for Coronavirus, which is a great step forward in ending this pandemic. 

You may have heard reports in the media of swelling in areas of fillers in some who received the Moderna vaccine during the trial.  Here are the facts and what they mean: there were three reports of swelling in the areas where fillers had previously been injected out of the 15,184 patients who received the Moderna vaccine in the trial.  The swelling occurred 1-2 days after the vaccine was given.  This reaction occurred in less that 0.02% of people who received the vaccine.  Swelling in each case resolved.  Of note, one patient had a similar reaction after a flu vaccine in the past.  No cases in the Pfizer vaccine trial were reported. 

The ASDS (American Society of Dermatologic Surgery) published guidance regarding dermal fillers and the vaccine are as follows:

  • Dermal filler inflammatory events very seldom occur with both hyaluronic acid and non-hyaluronic acid fillers.
  • Evidence suggests these reactions can be immunologically triggered by viral and bacterial illness, vaccinations (i.e., influenza vaccine) and dental procedures.
  • These rare adverse events are temporary and respond to treatments such as oral corticosteroids and hyaluronidase, and often times resolve without treatment.
  • Patients already treated with dermal fillers should not be discouraged or prevented from receiving vaccines of any kind. Patients who have had vaccines should not be prevented from receiving dermal fillers in the future.
  • In the Moderna mRNA-1273 trial, three reactions were possibly related to dermal fillers out of 15,184 vaccine recipients. It is unknown how many subjects in the trial had previous treatment with dermal fillers.
  • Dermal fillers should be administered by board-certified physicians who are experts in both the injection of dermal fillers and management of complications arising from them.

The bottom line: vaccines prevent diseases and having a previous history of fillers is not a reason not to get the vaccine when the opportunity arises. 

Coronavirus and hair loss

Published July 20th, 2020

Coronavirus has changed all of our lives in the past few months.  Many skin changes have been reported to be seen with the virus itself, from hives to rashes to "covid toes."  We've gotten acne from the masks that we are diligently wearing (nicknamed maskne).  And the stress!  The stress seems to be contributing to a hair loss condition that happens to many, called telogen effluvium.

Hair loss is a common issue that affects millions of men and women.

Normally, our hair grows in a cycle.  When hairs are in their growth phase, they are called anagen hairs.  When they are resting (not growing), they are called telogen hairs.  Catagen hairs are transitioning from growth to rest.  Anagen hairs grow for about 3 years on average (the range can be between 2-6 years).  The transition phase lasts about 1-2 weeks, and then hairs rest for 3-5 months.  They shed, and the cycle starts all over again.  At any given time, if you pluck a number of hairs from the scalp, about 85% will be in the growth phase and 10-15% will be resting.  Less than 1% will be in the transition phase.  We can tell this by the shape of the hair and follicle when it's examined under the microscope.

It's normal to shed 100-150 hairs daily.  Think about it- that's a lot of hair.  And even more so on days that you shampoo.  But sometimes, that number increases, and the hair starts thinning or revealing bald patches.  So let's look at some reasons why people lose their hair.

Stress.  Surgeries, illness, and emotional stress can all cause temporary hair loss.  

Pregnancy.  During pregnancy, the anagen (growth) phase is often prolonged and many women enjoy thicker, fuller hair.  On delivery of the baby, however, many follicles change into the telogen phase, and then are shed simultaneously, resulting in thinning/loss of hair 3-5 months after baby comes.  This process is known as telogen effluvium.  And it's one more reason to give your mom a hug-- she brought you into this world and then endured hair loss!

Iron Deficiency.  Low iron levels (seen in a blood test), sometimes caused by mensturation or gastrointestinal blood loss, can also cause a telogen effluvium.  Nutritional deficiencies are often treated with vitamin supplements and a varied, healthy diet. 

Thyroid Deficiency.  Variations in thyroid levels can often cause telogen effluvium as well.  Levels can be checked with a simple blood test.  Seeing an endocrinologist to treat abnormal levels is key. 

Medications.  Lots of medications can cause hair loss.  Drug-induced telogen effluvium has been reported with amphetamines, blood pressure medications (captopril, metoprolol), antipsychotics (lithium), retinoids (etretinate), and more.  Changing/discontinuing medications (under a physician's supervision) can help.

Androgenetic alopecia is another term for male-pattern and female-pattern baldness.  In this condition, a hormone called dihydrotestosterone affects the androgen receptor gene to cause hair loss.  There is likely a genetic component.  Men tend to show a receeding hairline with loss of hair on the top of the scalp.  Women tend to get thinning along the middle part of the hair in a "Christmas tree pattern."  

Other conditions that can lead to hair loss include fungal infections, autoimmune diseases (such as lupus or alopecia areata), psoriasis, bacterial infections, and syphilis.  Trauma to the hair from tight ponytails, frequent relaxer and hair color use, and overstyling can also lead to hair loss.

The good news-- telogen effluvium is limited and hair counts return to normal after a few months.  A healthy diet, supplements such as Viviscal and Nutrafol, sleep, exercise and stress reduction are all helpful.  For other types of hair loss, treatments, such as Rogaine, Finasteride for men, PRP (platelet-rich plasma injections), and hair transplants are options.  Dr. Bilu Martin performs PRP treatments at Premier Dermatology, MD.  Your blood is drawn and spun in a centrifuge.  The plasma is separated from the red blood cells.  The plasma, which contains growth factors, is injected into the scalp in a series of treatments.  For more information about PRP and whether it is right for you, call (305) 521-8971. 

Dermatologists are expert in skin, nails, and hair, and can help!


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The what's what in fillers at pdmd
Published June 23rd, 2022

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