Enhance your Microneedling with the Proper Products

Cappuccino_microneedlingWhen you choose to have a cosmetic treatment such as microneedling, you’re committing to improving the look, feel and health of your skin. To speed up your skin’s recovery and enhance your results, it’s important to take special care of your skin after your microneedling treatment.

Medical-grade skincare is chosen specifically for post-microneedling. The skincare system optimizes results by delivering essential nutrients to skin at the proper time in the healing process. Ingredients that aren’t beneficial to the recovery process are omitted, so the skin is getting exactly what it needs. These products assist in the collagen-building process that is stimulated due to the controlled injury that microneedling creates.

We’re here to help you customize a treatment and after-care plan specific to your skincare goals. Call today to schedule your microneedling series, and protect your investment with the proper post-care products. 301-829-4110

Get Your Beauty in Bloom with Microneedling

Cappuccino-5-17-Promo-Web_1Are you ready to get your beauty in bloom for spring? Perhaps winter left you with dull skin, and you’d like to improve texture, fine lines, and acne scars. Microneedling is a wonderful treatment option for patients that aren’t ready for the downtime associated with laser resurfacing treatments.

How does microneedling work?

Microneedling is a minimally invasive procedure that uses fine needles to make controlled micro-injuries to your skin. The device we use is the Eclipse MicroPen. The needles of the MicroPen puncture the skin to create channels. The body triggers the skin to respond to these micro-injuries by naturally producing new collagen and elastin to fill the channels. As we age, our bodies slow the production of collagen and elastin. By turning back the clock on this collagen and elastin loss, microneedling offers several benefits.

Benefits of Microneedling

Our microneedling treatments can reverse years of sun damage. The MicroPen targets fine lines, texture, acne scarring, large pores, and minor blemishes. The benefits include smoother, firmer, younger looking skin. The depth of the needle and the number of treatments depend on the area and the desired result of the patient. A series of treatments is typically recommended, about one to two months apart. Recovery time with the MicroPen is minimal. You may experience some redness, tenderness, or minimal swelling the first 24 hours post treatment.

You will notice some immediate improvement after your treatment, and your results will continue to improve over the next 6 to 12 months as the collagen and elastin rebuilds. Contact us to schedule your complimentary consultation for microneedling, and we’ll customize a treatment plan based on your skin goals. Follow us on Facebook to stay current on promotions, events, and exclusive giveaways.

Top 5 Benefits of FUE (follicular unit extraction) Hair Transplantation

Here is a list of the top 5 benefits of FUE hair transplantation as compared with the older FUT method:

1. Office based procedure- FUE with NeoGraft is an office based procedure performed entirely under local anesthesia. Patients can drive themselves to and from the office and avoid the costs, inconvenience, and risks associated with the more invasive strip method required for FUT.

2. Quicker recovery time- FUE procedures such as NeoGraft allow patients to return to their normal daily activities in as little as 1-2 days. There are no staples or stitches to remove. The bandage is removed 24-48 hours after the procedure. Special care and washing instructions are given to each patient.

3. No linear scar- There is almost imperceptible scarring when compared to “strip procedure”, which may leave you with a very noticeable scar. This is important for patients who would like to keep a short hairstyle as the scar from the strip method is noticeable. The extraction sites from FUE range from 0.8-1.0mm which close up on their own in just a few days without a noticeable scar.

4. Less painful recovery- Pain is minimal following FUE procedures. Most patients report only needing Tylenol on the evening of the procedure. Long acting local anesthetics make the recovery process quite manageable without the need for narcotics. After 24 hours most patients describe no pain at all.

5. Higher graft survival rate- FUE has a 90-95% graft survival rate as compared with approximately 75% survival rate of FUT method. The precision harvesting of FUE allows less trauma or transection of the hair follicles during the harvesting process.

NeoGraft: A breakthrough in hair restoration


* Individual results may vary. Refer to disclaimer below.

Hereditary hair loss is a medical condition that affects about 50 million American men and 30 million American women. By the age of 35, two-thirds of American men experience some degree of measurable hair loss, and by the age of 50, approximately 85 percent have significantly thinning hair, according to the American Hair Loss Association. This hereditary condition, clinically termed androgenetic alopecia, is characterized by a receding hairline as well as a loss of hair on top of the scalp.

When hair loss is first noticed, initial therapies are aimed at preventing further hair loss. For women a dermatologic workup may be indicated to determine if there is an underlying medical cause of hair loss. Medical therapies include topical Minoxidil and/ or oral Finesteride. Another new and promising treatment is PRP (platelet rich plasma), which uses a patient’s own activated platelets injected into the scalp, to slow and even reverse hair loss. However, once hair follicles are gone for more than a few years, the only method of restoration is hair transplantation. Over the years, hair transplantation has developed a negative image in popular culture due to early poorly executed “hair plug” procedures which left people with a “corn row” or “doll’s hair” appearance. This sends shivers down my spine when I hear patients say these words because for decades now FUT (follicular unit transplantation) has provided very natural appearing hairlines. The FUT method required taking a strip of hair from the back of the scalp and cutting it into individual follicular units and then transplanting them. Due to the invasive nature, this procedure was typically done in an operating room under anesthesia and was both costly and uncomfortable. Many potential patients shy-away from (or are not candidates for) the traditional FUT or “strip method” of hair replacement because of the slow recovery time, the loss of feeling at the incision site, the linear scar on the back of the head, or the amount of post-operative pain involved.

The Maryland Hair Center is excited to announce our newest offering, NeoGraft®. NeoGraft® introduces the “state-of-the-art” solution for hair loss. This game-changing technology automates the Follicular Unit Extraction (FUE) method to give patients more natural looking results with minimal downtime, no linear scaring and no stitches. It is a minimally invasive procedure where individual hair follicles are extracted from the back of the scalp via the NeoGraft machine and then implanted into the areas where hair loss has occurred. The entire procedure is done with local anesthesia only in the comfort of our office while patients binge watch a Netflix series! There is almost imperceptible scarring when compared to “strip procedure”, which may leave you with a very noticeable scar. NeoGraft has a greater that 90% take rate, so pretty much every single hair follicle that is taken out will grow. There is very little downtime after your procedure when compared to strip procedure. Patients can usually resume normal activity within 48 hours excluding strenuous exercise when done via NeoGraft. We incorporate all the latest techniques in hairline design to ensure your transplant will look natural, after all, as you know, the best transplants are the ones you cannot tell are transplants.

We recommend a full consultation with Dr. Cappuccino to ensure you are a good candidate for the NeoGraft procedure and to see how many grafts you would need in order to get the best results. We have a cutting edge simulation visualizer on our website which allows prospective patients to virtually “try on” a full head of hair before their consultation by uploading their own picture. On Thursday March 2nd, The Maryland Hair Center, located in Mt. Airy will be having its annual NeoGraft open house with individual consultations by appointment only and 20% off all procedures. For more information on NeoGraft or for a free simulation, visit www.marylandhaircenter.com or call Dr. Cappuccino at 301-829-4110

Botox Bargain: Buyer Beware

In 2015, nearly 7 million Americans received Botox or similar neuromodulator treatments. Approximately 2.5 million dermal filler treatments were done in the same year. With the overwhelming success of cosmetic injectable treatments, they have become broadly accepted by the American public. However, with this rise in popularity has come the unfortunate emergence of non-core specialty practitioners trying their hand at injectables. When I say “non-core” I am referring to all doctors who are not Board Certified plastic surgeons or dermatologists. Only these specialties include specific didactic and practical training in the use of cosmetic injectables as a part of their board certification process. That is not to say that other doctors cannot get trained later at a training course; however, when your pediatrician or ER doctor offers you Botox, or your hair salon suddenly starts offering Juvederm injections, you should understand that this was not part of their medical training, and you may be putting yourself at risk for more than just an undesirable cosmetic result. Imagine if one day I started offering to color my patients’ hair- the results would be disastrous. Many an unsuspecting person has fallen victim to bargain basement prices on such treatments, but the old adage applies here more than ever, you get what you pay for.

As a Board Certified plastic surgeon I feel it is my obligation not only to provide the highest level of treatment, but also to educate the public on what may or may not be correct for them. Often a patient will come to me asking for Botox for their forehead lines, but the problem is actually a heavy brow or excess skin of their upper eyelids. After explanation of the dynamics of facial aging and anatomy, I make the appropriate recommendation, which often is not an injectable at all. Routinely I see an unhappy patient come to my office complaining how their doctor did Botox in their forehead and now they look unhappy and mad all the time, and ask me if I can fix it. Botox and fillers can provide an amazing non-surgical result when used correctly, but knowing when and how takes correct training and years of experience. This is as much an art as it is a science. It has taken me more than a decade and tens of thousands of injections to master the art of injectables. I have compiled a list of questions that you should routinely ask when you go to a new provider for injectable treatments. My savvy new patients sometimes ask me these questions, and I am more than happy to answer to put their minds at ease.

Always ask your doctor about their experience with injectables: How and when were they trained, how many years of experience they have with each individual injectable as they are all different in their required technique.

Ask if your doctor has reversal agents for hyaluronic acid fillers (such as Juvederm or Restylane) in the event of less than desirable outcome or adverse event.

Ask your doctor if they are able and willing to help you in the event you are not satisfied with your results. I always ask my patients to call me in a week or stop back if things don’t look the way they expect. Often, if there is any issue, it is an easy fix that I don’t charge for.

Always ask to see the actual bottle of Botox or syringe of filler being used. Ask your doctor if they buy the products directly from the manufacturer or if it is obtained from the grey – or worse, black – market where quality control is suspect. Look for the holographic seal on the Botox bottle ensuring it comes directly from Allergan the manufacturer.

Ask how many units of Botox or Dysport are being administered. Dilutions may vary, but units are consistent.

Ask your doctor when the bottle of Botox was opened. Did you know that once opened and reconstituted, Allergan recommends the Botox be used within 4 hours to ensure potency? In a busy injectables practice like mine, that is no problem as we go through multiple bottles daily, but in a slower practice, beware.

Ask to see your doctor’s before and after pictures, especially of his or her injectable filler patients. Nothing gives a prospective patient a better idea of how they will look than seeing the doctor’s actual work!

The most important thing is to seek out a well qualified doctor you trust who has the full compendium of knowledge and tools to help you achieve the best possible result. Most of the time, injectable fillers give a beautiful, near immediate result. But even in the best of hands, aesthetic medicine can have less than perfect results, and those are the times you need your doctor and their office to be at the top of their game.

For more information about cosmetic injectable treatments call our Dr. Guy Cappuccino at 301-829-4110 or visit www.DrCappuccino.com

What is KYBELLA?


* Individual results may vary. Refer to disclaimer below.

What is KYBELLA?

KYBELLA® is the first and only FDA approved injectable drug that contours and improves the appearance of submental fullness. A common cosmetic complaint, submental fullness or lipodystropy, is excess fat in the anterior neck under the chin. Up until recently, the only effective way to remove the fat was liposuction. While effective and economical, some people are opposed to invasive procedures, even minimally invasive techniques like liposuction.

KYBELLA® is an injectable treatment from Allergan. KYBELLA® is a formulation of deoxycholic acid, a naturally-occurring molecule in the body that aids in the breakdown and absorption of dietary fat. When injected into subcutaneous fat, KYBELLA® causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat.
Basically, what it’s doing is disrupting the fat cell membrane. After that, the fat cell releases its fatty contents and the body metabolizes and disposes of the fat. As for the recovery itself, there is an inflammatory component immediately following the injection. There is some swelling and some discomfort for a few days because the body is cleaning up the cellular debris and creating some contraction in the skin.

Typically 2-4 treatment sessions are required to achieve desired results. Each treatment is spaced at least one month apart. After the aesthetic goals are achieved, re-treatment with KYBELLA® is not expected. The cost of KYBELLA varies based on how much fat there is to treat and what your doctor charges, depending on the area in which you live. Each treatment session ranges in price between $800-$1600. Adverse effects include possible numbness, swelling, and bruising.

Are you afraid of needles? COOLMINI™ from CoolSculpting by Zeltiq is achieving good results as well. Zeltiq boasts “no needles, no surgery, no downtime”. COOLMINI™ is FDA cleared for the treatment of submental fat. It was designed for small areas of fat including submental fat, axillary fat (the fat in front of your arm pit), knees and other smaller bulges of stubborn fat. On average patients can expect 20% reduction in fat after each treatment. Typically 2-3 treatments are required for optimal results. Each treatment session is approximately $1000. Adverse effects can include post-treatment discomfort. No bruising or swelling is expected.

For more information on KYBELLA and other treatments we offer, contact Board Certified Plastic Surgeon Dr. Guy Cappuccino in Mount Airy at 301-829-4110.

Treatment of Acne Scarring


* Individual results may vary. Refer to disclaimer below.

Acne can leave noticeable scars that are damaging both cosmetically and emotionally. This has traditionally been a vexing problem for patients and doctors alike. Fortunately there have been recent advances in treatment. Current options for correction of acne scarring include: microdermabrasion, microneedling, laser resurfacing, platelet rich plasma (PRP), highly focused radio-frequency microneedling (INFINI), and certain dermal fillers (Bellafill). All of these treatments are aimed at smoothing the contour of the damaged facial skin.

The acne treatments can be broken down into 4 categories:
1: dermal abrasion (sanding)
2: CIT (collagen induction therapy) healing from within
3: Subcision (surgically releasing the depressed scar)
4: Dermal fillers-filling the scar depressions

1: In the dermal abrasion category we have traditional dermabrasion and microdermabrasion. Microdermabrasion uses a fine spray of crystals with suction to gently sand the outer layer of skin cells. It is a less aggressive version of dermabrasion, once the primary treatment for acne scarring, but now almost abandoned due to it’s significant recovery period. Microdermabrasion is often used in conduction with other modalities to boost effectiveness. When used alone the results are modest.

Fractionated laser resurfacing, (PIXEL) uses beams of laser energy from a carbon dioxide laser to burn tiny channels in the skin. Using varying depths and power levels, impressive smoothing of the outer layer of skin can be achieved with minimal downtime, usually just 2-3 days. When applied deeper, these lasers can also stimulate collagen production adding to the result.

2: Collagen induction therapies involve stimulating the body to heal the scar by developing new collagen and elastin where the damage occurred. Microneedling is a minimally invasive procedure that involves the use of a mechanized device that contains fine needles. The needles are use to puncture the skin to create a controlled skin injury. Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin. New collagen and elastin production can improve acne scars, reverse years of sun damage, and enhance the overall appearance of aging skin. Micro-needling also helps the skin absorb treatment serums (such as hyaluronic acid or vitamin C) 80% more effectively deeper into the skin. Think of it like aerating your lawn when fertilizing.

Platelet rich plasma, or PRP, is an adjunct to microneedling. PRP harvests the patient’s own activated platelets and then directs them to the site of the scarring. The activated platelets cause a significant boost in collagen production when combined with microneedling. The PRP can also be injected directly into the depressed scar to stimulate healing and smoothing.

INFINI is highly focused radio-frequency microneedling. It adds RF energy to the tips of shielded micro needles to apply heat at deeper levels in the skin. The heat causes thermal micro-injury to the skin and boosts the body’s healing process to tighten skin and fill scars. This is the most recent advancement to collagen induction therapies. Downtime is 2-3 days and the results have been impressive.

With any of the collagen induction therapies, results will take time to be noticeable. Rebuilding your collagen will take up to 6 months so your skin will continue to improve over 6-12 months.
The number of sessions required depends on the condition of your skin and your desired outcome. On average for mild acne scarring we recommend 3 to 4 treatments. Deeper scars and stretch marks may require upward of 5 treatments. An interval of 4 to 6 weeks between treatments is typically recommended.

Subcision is simply using a needle or sharp instrument to undermine, or release the tethered scar. When performed alone the results are less than ideal, but when combined with PRP or a dermal filler, it is a powerful tool.

Dermal fillers are the last treatment option for acne scarring. Recently the FDA approved Bellafill for the treatment of some types of acne scars. When combined with subcision, the undermined acne scar is back-filled with Bellafill to immediately smooth the scar. As the Bellafill is dissolved by the body, new collagen is deposited in its place, making the results near permanent.

For more information on the treatment of acne scarring, contact Dr. Guy Cappuccino in Mt. Airy at 301-829-4110 or visit us at www.DrCappuccino.com

Dermal Fillers

Dermal fillers

Dermal fillers are injectable treatments that improve facial appearance by adding volume to the face as needed to combat the aging process or augment natural facial features. Dermal fillers are one way to truly restore your youthful appearance. When celebrities and models age 45 or older have facial skin that looks really smooth, plump, and young, you can bet a big part of the reason is that they have had dermal filler injections.
Fillers are composed of a bio-compatible material that slowly breaks down over time. Dermal fillers fall into three common categories: hyaluronic acid fillers (Juvederm, Restylane, Silk, Belotero) collagen (Cosmoderm), or synthetic materials (Radiesse, Artefill, Sculptra). Short duration fillers last approximately 3 months while the longest lasting temporary fillers can last 2 years or more. Each type of filler has advantages and disadvantages. Which filler to use and where is best determined after consultation with your physician.
When used for facial aging, fillers used to soften the deep lines around the nose and mouth (nasolabial folds), smooth facial wrinkles, restore lost cheek volume, camouflage jowl lines, fill under-eye hollows, or restore lost cheek volume. They can also be used below the skin as volumizers to lift the cheeks, smooth lip wrinkles, enhance lip shape, lift the brow, or enhance the jawline. Fillers can even be used to rejuvenate aging hands! Dermal fillers are not the same as neuromodulators (Botox). Botox treats wrinkles by relaxing the muscles causing the wrinkles. Dermal fillers actually fill the wrinkle. Unlike Botox, the results are immediate.
Many of my patients are reluctant at first to try dermal fillers because they are turned off by some celebrities who look plastic or “overdone”. When celebrities look weird it’s because they specifically want that look. I know it sounds crazy, but hey, they got noticed! I always assure my patients that usually they cannot spot someone who has had fillers done, because those people just look normal, but more youthful.
Side effects and allergic reactions are very rare. Most common concerns after injections involve temporary swelling following injections or bruising. Unevenness, under correction, palpable nodules, and bluish tint (tyndall effect) are less common, but more concerning. In my professional opinion, choosing an expert in dermal fillers is the key to consistent, outstanding results. Only choose a board certified plastic surgeon or dermatologist experienced in cosmetic injections for your procedure. All dermal fillers should be performed in a medical setting with sterile instruments. Treatments done in homes, hotels, spas, or resorts are not being done in medical environments, regardless of who is doing them.

For more information on dermal fillers, contact Dr. Guy Cappuccino at (301) 829-4110

What is a mini-facelift?


* Individual results may vary. Refer to disclaimer below.

One of the most common surgical procedures I perform is the so called mini-facelift. For patients with lower facial laxity, jowls, and sagging cheeks it can offer outstanding correction. But what makes it mini?

Different doctors will define mini-facelift differently. For some it is shorter scars and less undermining, for others it means less dramatic results with shorter downtime. So when researching mini-facelifts, understand there will be different definitions and be sure to ask your doctor exactly what it means for them. Also, the mini-facelift technique can go by different names such as “S lift” or “lifestyle lift”. It is important to realize that with surgical procedures, every patient, surgeon, and operation are unique.

For my patients a mini-facelift has the following features: performed in-office under local anesthesia only, invisible self-dissolving stitches, short inconspicuous scar, no bruising, minimal swelling, minimal discomfort, and just a few days of social downtime at most. I incorporate all of the key features of traditional facelifts to ensure maximal results and longevity while minimizing costs and recovery time.

The mini-facelift takes about three hours to perform. After the procedure, patients can drive themselves home if they wish. The results are visible immediately, but the aesthetics improve over the course of 1-2 weeks as swelling subsides. Typically we incorporate cheek volume restoration in the form of filler, (temporary or permanent) or fat transfer at the time of the mini-facelift. This allows us to create a more youthful look with a less invasive procedure.

One of the biggest concerns I hear when people are considering a facelift is that they don’t want to look, “pulled”, “wind-blown”, “surprised”, or “fake”, and invariably they tell me about a friend or neighbor who had a facelift done and looks ghastly. Well, it’s true, some facelifts can be overdone and yield those results, but that is the rare exception. You see, you can only spot the overdone patients. The people with superior facelifts don’t look obvious, but just look natural. A well done facelift in my hands results in a rested, rejuvenated, youthful look, not weird or obvious.

Expect results to last 5-10 years, but this is very dependent on how well you take care of your face. Sunscreen and good topical skin care products go a long way to maintenance of results. Combined with injectables such as Botox and fillers, results can last even longer.

For more information on mini-facelifts contact Dr. Guy Cappuccino in
Mt. Airy at 301-639-2897 or visit www.DrCappuccino.com

What is PRP hair restoration therapy?

AMGAR-Hair rejuvination.pdf

* Individual results may vary. Refer to disclaimer below.

What is PRP hair restoration therapy?
PRP (platelet rich plasma) therapy for hair loss is an exciting new non-surgical therapeutic option for men and women who require stimulation of hair growth. It is a state of the art, non- surgical, totally natural, alternative medical procedure used for the treatment of hair loss or hair thinning due to androgenic alopecia (common baldness). The treatment involves withdrawing a sample of the patient’s own blood, processing it so only the PRP growth factors remain, and injecting it into the scalp to stimulate natural hair growth. Human blood contains mesenchymal stem cells and blood products that contain essential and specific growth factors that assist in tissue regeneration and healing. Published medical literature from Europe and the United States confirms the safety and use of PRP therapy. The primary purpose of using PRP in hair restoration is to stimulate inactive or newly implanted hair follicles into an active growth phase.

What is involved in the treatment?
The doctor takes a little blood which is then prepared in a centrifuge so that only the enriched cells or platelets (PRP) remain. Topical anesthetic is used to numb the scalp to be treated. The PRP, including essential growth proteins is injected into the scalp or areas to be treated using a special micro needle. The entire procedure takes approximately 45 minutes. 3 sessions are required, each 2 months apart. Maintenance treatments are recommended every 6 months or one year as needed. In addition to the PRP therapy it is recommended to use Minoxidil and DHT blockers. It is possible to use PRP hair restoration therapy alone to promote hair growth or it can also be used in combination with hair transplant or restoration surgery.

Does it really work?
PRP is a potential emerging non-surgical based therapy for natural hair follicle stimulation for thinning hair. Larger clinical studies are pending but the current medical literature contains numerous optimistic results. One recent study of 100 patients undergoing PRP hair restoration showed an increase in hair density of 30% at 3 months following treatment. The life cycle of a hair follicle can last from 2-8 years and has 4 stages: anagen (growth phase), catagen (regression phase), telogen (resting phase), and exogen (shedding phase). New hair only grows in the anagen phase so it may take a few months to see new hair growth after your PRP treatment.

What does it cost?
PRP hair restoration therapy varies from approximately $750 per treatment for smaller balding areas like the vertex of the scalp, temple areas, or frontal hairline, to $1500 for a full scalp treatment. For more information on PRP hair restoration therapy contact Dr. Guy Cappuccino in Mt. Airy at 301-829-4110 or visit www.DrCappuccino.com