EVOLV Medical Aesthetics

Category: Face and Neck

The Many Benefits of Light

Most of us are very familiar with the negative effects of light such as the dangers of excessive sun exposure in causing skin damage, premature aging and increased risk of skin cancer.  This is the direct result of prolonged exposure to ultraviolet (UV) irradiation which is a specific wavelength of the sun’s total light spectrum.  But many patients are not aware of the many therapeutic benefits of other types of light energy and their exciting potential in improving skin health.  evolv Plastic Surgery and Medical Aesthetics has over 25 years of experience and interest in utilizing research proven technology in the rapidly expanding and dynamic uses of light therapy and their many exciting benefits for patients of all ages.

Rosacea and Hyperpigmentation:  

Excessive facial redness and blushing, visible facial blood vessels and spotty pigmentation (freckles, moles, melasma, sun damage) are very common and often not completely responsive to topical medications.  At evolv, we have had great success in reducing and even eliminating these stubborn lesions with a form of high intensity pulsed light (IPL) and more recently a more advanced application called ‘broad band light’ commonly known as ‘BBL’.  BBL by Sciton Corp. is the world’s most powerful form of intense pulsed light and can treat most forms of rosacea and pigmentation as well as sun damage and general premature aging of the skin.  In our experience at evolv, BBL has been the most effective and long-lasting therapeutic option in rosacea and pigmentation treatment and has been proven to stimulate collagen and elastin formation resulting in more youthful texture, tone and overall skin health improvement.  Treatments are done in the office, usually in a series of three, and recovery is typically minimal.

General Skin Aging – Forever Young BBL

 What if there was a clinically proven, no downtime, FDA approved treatment for reducing fine lines, sun and age spots, loss of skin elasticity, tone and firmness, rosacea and acne?  What if that treatment has also been proven to prolong ‘youthful gene’ cell function in research studies?  It may sound too good to be true but that is exactly what Sciton’s Forever Young BBL treatments have been proven to do.  It turns out that the same BBL energy described above to treat skin pigment and rosacea can also be harnessed and applied for ‘preventative maintenance’ in aesthetics and restore and even prolong youthful characteristics at the cellular level.  Thru a process termed ‘photomodulation’, specific light wavelengths and energy levels can stimulate receptors on the cell surface to initiate a biologically beneficial effect.  Long term clinical studies have confirmed that regular maintenance treatments of Forever Young BBL will result in genetic benefits, improved cell function, and long lasting, more youthful skin.  Forever Young BBL treatments take only 15-30 min, do not require any anesthetic or topical numbing, have no downtime and can benefit just about any patient of any age.

Antibiotic Free Acne Treatment – Forever Clear BBL

Regular inflammatoryskin lesions or acne vulgaris and cystic acne are very common not only in the teenage population but also breakouts can be frustratingly experienced by adults and peri and post-menopausal women as well.  Unfortunately, the traditional treatments of chronic or long-term antibiotics are not usually effective and can also result in gastrointestinal issues, resistant infections and other potentially harmful side effects.  At evolv we believe that improving skin health is the most beneficial and preventative physiologic approach to reduce the formation of acne and its severity.  Science has also revealed that powerful broad band light (BBL) can also used to reduce acne lesions and inflammation and prevent acne scarring.  The Sciton Forever Clear BBL light therapy has the combined benefits of directly reducing the inflammatory bacteria that cause acne as well as other light wavelengths that reduce inflammation and excess sebum (oil) production.

For best results the Forever Clear treatment is combined with a comprehensive evolv acne skin care program.  The results of this combined approach are less inflammation and breakouts, prevention of scarring and beautiful healthy skin.

Advanced Skin Aging – Halo Fractional Laser

Patients with more advanced forms of sun damage and aging are often excellent candidates for laser light therapy.  Lasers are powerful forms of polarized light energy that may be ablative (treating the entire skin surface) or non-ablative (often termed ‘fractional’ which treats a measured percentage of the skin surface).  The Halo Fractional Laser is the only device of its kind that uniquely combines the benefits of both an ablative and a non-ablative wavelength to result in more effective outcomes with less downtime than traditional lasers.  The Halo laser is also ’tunable’ and can be precisely regulated for specific skin types and treatment outcomes.  The Halo treatment can also be combined with BBL phototherapy for treating pigment, rosacea, and general skin aging simultaneously.  Topical anesthetic and nitrous oxide/oxygen are used for patient comfort with Halo therapy.

Light Emitting Diodes (LED) – Phototherapy

Light emitting diodes are devices that release non thermal and non-invasive light energy of various wavelengths including blue, red and infrared light for multiple benefits in the skin and tissues.  LED light does not contain ultraviolet rays and is safe and effective for human skin and tissue treatment.  Multiple benefits include inflammation reduction, direct elimination of acne bacteria, collagen production, improved blood flow, reduction in acute and chronic pain, reduction of swelling, and even stimulation of hair growth in the scalp.  Results will depend on the amount of energy output, specific wavelengths, treatment protocols and experience of the provider so be sure to ask an evolv staff professional to learn more about this exciting therapeutic option.

Reducing Skin Cancer and Pre-Cancer – Photodynamic Therapy

Photodynamic therapy or’ PDT’ refers to the application of light activated topical medication to reduce precancerous skin lesions and even early skin cancers and is an exciting treatment option for many patients at high risk for non-melanoma skin cancers.  A photosensitizing agent is applied to the skin and then, after an incubation period, activated by a specific wavelength of light.  The activation results in the destruction of premalignant as well as malignant cells and lesions as well as improvement in the overall aging, texture and tone of the skin.  PDT is an ideal consideration for patients with large areas of sun damage and high cancer risk and can even eliminate small skin cancers without the need for surgical resection.  The photodynamic therapy is usually done after conditioning the skin for best results.

Evolving research has revealed many therapeutic benefits of light treatment that can, along with a customized medical skin care program, improve skin health, reduce the signs of premature aging, and lower the risk and number of skin cancers. The most important consideration is to have a complete evaluation by a skin care professional with experience and training in all the many applications of light therapy.

We encourage anyone interested in these benefits and options to discuss these exciting possibilities with one of our professional staff or licensed aestheticians at evolv Plastic Surgery and Medical Aesthetics.


Even though it was over 30 years ago, I will never forget her face.

She was a young mother and school teacher with 2 small children and I was a first year plastic surgery resident.  She had a mastectomy for breast cancer and was left with a large and painful tight scar.  The implant that had been placed by my instructor under the scar was hard, unnatural and uncomfortable…..at that time in the mid 1980’s there just were not many options or choices. She looked at me and I did not know what to say to comfort her.  That was the day I decided to seek post graduate training in breast reconstruction and that young mother, with the eyes I cannot forget, changed my life forever.

This year an estimated 230,000 women in the U.S. will be diagnosed with breast cancer but less than 25% of those women will be aware of their reconstructive options before treatment.  The breast cancer experience touches not only those women but also their spouses, their children, their families and their lives for years.  The breast cancer experience involves much more than just removing a tumor or having a mastectomy, it is a journey that can involve medical and other post-operative treatments as well as impact a women’s personal life and self-confidence and relationships at every level.  In short it will someday effect all of us and someone we love.

The really exciting news is that the breast cancer experience is changing significantly for the better for a variety of reasons:

Education and Patient Awareness – public awareness and educational efforts by a number of professional     organizations have resulted in women being more informed and aware of their options.  The American Cancer Society, the American Society of Plastic Surgery, the Susan G. Komen Foundation, The Victory Center and many others are doing an incredible job of communicating useful information to patients and their families.  The best informed patients make the best choices!

Identifying Risks and Cancer Prevention – the most effective way to fight cancer is prevention.  New research on nutrition and life style as well as genetic testing to quantify risk factors have actually made a substantial difference in breast cancer incidence.  Advances in genetic mapping have made great progress and resulted in improved options and treatment outcomes for patients at risk.  Prophylactic mastectomy or removing the breast tissue to prevent cancer in high risk individuals, as popularized by actress Angelina Jolie, can reduce cancer risk by 90-95% in appropriate patients and result in excellent aesthetic outcomes.  We encourage everyone to learn more about these exciting advances in order to protect themselves and their families.

– Early Detection – After prevention, the next most effective way to impact breast cancer is early diagnosis.  Improved patient education and self-exam, consistent doctor’s visits, advances in imaging techniques such as mammography, ultrasound, MRI and other scans have resulted in earlier detection of breast cancer and breast ‘pre-cancers’ which will improve the overall patient experience and outcomes as well as reduce breast cancer morbidity.

– Improved Surgical and Reconstructive Techniques – Significant advances in biomaterials for breast implants and implantable materials (acellular dermal matrix) to help shape breast reconstruction procedures, have resulted in much more natural breast shapes as well as improved safety and less recovery.  Earlier detection and research on tumor biology have resulted in less invasive resection procedures (lumpectomy and mastectomy) and options such as sparing the breast skin and nipple in appropriate patients.  Placement of implants above the chest wall muscle (pre-pectoral reconstruction) and advances in tissue flap surgery reduce recovery time and have improved results for patients dramatically.  Our very own Dr. Peter Koltz, an associate with Dr. Barone at evolv Plastic Surgery, completed advanced training in tissue flap surgery for breast reconstruction last year and has been offering these options for patients in the Toledo area.

Post Treatment Quality of Life Improvementthe consequences of breast cancer treatment do not stop after the procedures have ended.  Many patients taking  estrogen blocking medication or other targeted chemotherapy or radiation deal with side effects such as bone and heart health, hair loss, premature skin aging, tissue dryness and laxity, post-menopausal vaginal dryness and urinary incontinence.  This often results in femininity and intimacy challenges, sexual difficulties and overall loss of self-confidence and intimacy.  New advances in clinically proven topicals, non-estrogen growth factors and other therapies can reduce symptoms and help restore confidence and vitality.  Regenerative treatments with platelet rich plasma (PRP) and other stem cell growth factors as well as collagen stimulating noninvasive technologies have given many patients much improvement in these issues and a better quality of life.

October is Breast Cancer Awareness month and October 17th is Breast Cancer Awareness Day (or ‘BRA Day’).  Please support these worthwhile programs and help bring more awareness, education and encouragement for the many women, men and their families that are dealing with this life changing issue.  We invite you to join myself, Dr. Peter Koltz and the evolv staff at Rosie’s on Wednesday, October 17th to support BRA DAY and spread the word on the improving awareness and quality of life for breast cancer patients and families.  

Yes the breast cancer experience is changing for the better and helping improve the quality of life for many.  Advances in clinical research, cancer biology, genetic testing, surgical and reconstructive option have transformed the breast cancer experience in such positive way.  The quality and safety of new reconstruction choices and postoperative treatment options can restore a patient’s self-confidence and lifestyle. As plastic surgeons we now may often hear a post reconstructive patient say, “Doctor, I sometimes forget I had a mastectomy!”

And I am forever grateful to that young mother and cancer survivor that inspired me with her courage so many years ago.

Real Skin Health Takes Work.

The mission of creating and maintaining skin that is optimally healthy, youthful, vibrant and cancer-free is a passion that all of us at evolv Plastic Surgery & Medical Aesthetics share and believe in. As summer comes to a close, it’s an excellent time to evaluate your skin health and make a personalized plan to achieve these goals for yourself. Summer is a time when many patients have had excessive sun exposure, lending itself to hyperpigmentation, fine lines, premature aging and pre-cancerous lesions (actinic keratosis). These skin issues are especially prevalent this time of year, not only in older adults but also in many younger patients.

Unfortunately, we are all inundated by companies promoting the next ‘miracle’ cream that promises to quickly and easily erase skin damage and restore youthful skin. Promotions by celebrities and very clever marketing are all around us in the media and online, convincing even well-educated consumers to buy their product with unproven promises and unrealistic expectations. The sales tactic of ‘snake oil’ in a bottle and promising more youthful and beautiful skin has always been and remains an extremely effective marketing technique. But the truth behind their marketing is that there is rarely any science or credible research to back up these claims, and the majority of consumers end up spending significant amounts of their resources for ineffective products that are cleverly packaged and promoted. There is definitely a lack of trust and credibility in the skin care and cosmetics industry.

After nearly 30 years of involvement and dedication in medical skin care and skin health, I can assure you that the advice of Dr. Obagi, “real skin health takes work,” is spot on! In order to repair, restore and rejuvenate aging or damaged skin, one must understand the physiology of healthy skin and how it is designed to function naturally and optimally. Years of research and the benefits of science and biotechnology have opened the door to many exciting possibilities in achieving and maintaining youthful and healthy skin, as well as reducing cancer risk by utilizing and respecting the natural functions of the skin. Research supports the basic principles of skin health which are the fundamental of the ZO Skin Programs:

  • Effective, but not traumatic, daily cleansing and exfoliation
  • Restoration of a normal maturation cycle through conditioning and stimulation
  • Repair of cell damage, excessive pigmentation, injury and disease
  • Protection and reduction of inflammation
  • Hydration and calming
  • Protection from ultraviolet radiation and reducing skin cancer risk

Because of the interactive nature of the skin, as well as ethnic and environmental factors, every patient’s program must be personalized to each individual’s ethnicity, lifestyle and unique skin characteristics. Obviously no single product or treatment can repair and restore skin health. A medical history, complete evaluation and understanding of the comprehensive nature of skin function and health by an experienced and knowledgeable professional are absolutely necessary for achieving youthful, healthy skin and reducing the signs of aging and risk of skin cancer.

Yes, restoring and maintaining beautiful, youthful skin takes work and commitment, but the results can be not only gratifying, but life changing for those who ‘show up’ every day for their skin workout! If you would like to find out more, please contact an evolv medical aesthetician to learn about what a difference healthy and ageless skin can make in your life.

ensoCLUB Update

We are all more than thrilled to report that after introducing evolv’s ensoCLUB subscription for personalized, aesthetic treatment plans last month, we have had more than 115 new patients subscribe as new members! At evolv, we believe that a comprehensive plan as an ensoCLUB member is the most cost effective and successful way to achieve optimal results for each patient. Be sure to inquire and find out more about the game-changing benefits available to ensoCLUB members, and come see what all the excitement is about!

The Growth of Non Surgical Aesthetics

The latest statistics are quite remarkable: last year in 2017, there were over 20 million non-surgical cosmetic procedures performed in the U.S. and nearly 16 million of that number were injectables of Botox type neuromodulators and soft tissue volume replacement (fillers).  So what could possibly explain this explosive growth?

At evolv Plastic Surgery and Medical Aesthetics, we have a long term commitment and interest in ongoing education for our staff as well as our patients.  So let’s take a look at some of the reasons driving the increased demand and popularity of injectable soft tissue fillers and Botox type neuromodulators.

More natural long lasting results

Gone are the days of simply injecting Botox to the scowl lines of the forehead (glabella) or adding filler to the nasolabial folds to rejuvenate the aging face.  The commitment to comprehensive aesthetics at evolv is a holistic appreciation of all of the parameters of the aging face and body.  Along with the fundamentals of a personalized skin health program, a number of different FDA approved injectable neuromodulators (Botox/Xeomin/Dysport) may be used for different applications and results balancing facial expressions and movement to obtain a more youthful outcome as well as to reduce migraine headache triggers.  Patients may be surprised to learn that there are over 100 medically approved therapeutic indications for current Botox type treatments!  A new Botox type injectable (DaxibotulinumtoxinA or RT002) is scheduled for release soon and has the advantage of lasting 50% longer or up to 6 months.  Combining neuromodulators and soft tissue fillers properly can result in a natural and balanced youthful appearance that can be quite cost effective and lasting.  New ‘flexible’ fillers (Galderma’s Refyne and Defyne) which create volume replacement while maintaining harmonious movement in the face resulting in a more natural result along with less swelling.

Less chance for bruising, swelling and discomfort with treatments

For many patients, the risk of bruising and prolonged swelling with traditional injection is a major concern.  This risk can be minimized by the use of cannulas for soft tissue filler placement in some areas instead of needles.  In addition, advances in bioengineering and technology have resulted in new fillers that last longer and induce significantly less swelling (Allergan’s Voluma, Vollure and Volbella and Bellotero form Merz).  evolv recently introduced the ProNox system for patients which allows them to self-administer nitrous oxide gas to reduce the perception of any discomfort during treatment.  Finally, new formulations in topical numbing or anesthetic creams are more effective in reducing any discomfort during injection and other procedures in the office.  All of the above have significantly improved the patient experience during injectable treatments at evolv.

Expanding patient base and options

Because of the improvement in products and the potential for more natural and affordable outcomes, more patients, male and female, and of all ages, are seeking treatments.  Indications as well as ‘off label’ uses of FDA fillers and neuromodulators are providing more comprehensive and natural appearing results.  A few examples are the use of Botox for migraine prevention, and the use of injectable soft tissue fillers for rejuvenation of the aging hands as well as for correcting depressions and cellulite improvement on the body and buttocks.  A new category of fillers that induce soft tissue growth from the patient’s own cells are called ‘biostimulators’ and they include Sculptra and the new exciting product Renuva which is called an ‘adipose matrix’ and triggers natural fat and tissue growth in areas of scars or depression.

The importance of safety and training

As in all areas of aesthetics, the key to achieving high patient satisfaction and safety is comprehensive and ongoing training for all providers and staff. At evolv, education and patient safety are our passion and we believe it is everyone’s responsibility to keep patients safe and happy with their overall experience.  We take this commitment seriously because, as everyone is aware, complications and unfavorable results are all too common in cosmetic treatments.  The high demand for aesthetic treatments has outpaced the number of properly trained and credentialed service providers so it is especially important for anyone interested in these treatments to carefully research and understand the experience and training credentials of any provider offering services in aesthetic care.  Complications can be very difficult and expensive to treat and correct so we encourage any interested patient to be well informed before making a decision to undergo cosmetic treatment.

The advances in biomaterials, technology and research proven new products and techniques have resulted in significant improvement and new options in non-surgical facial and body rejuvenation with injectable soft tissue filler augmentation and Botox type neuromodulators.  Safety and longevity of results, when performed by a board certified/eligible plastic surgeon or properly trained registered nurse injector, have also resulted in a tremendous increase in the popularity of these procedures.  At evolv Plastic Surgery and Medical Aesthetics, we believe in and emphasize comprehensive aesthetic programs combining these options along with a personalized skin care plan as the most effective way to achieve long lasting and natural appearing outcomes for each patient.  And finally, evolv has recently introduced the ensoClub which is a private membership program with the benefits of reduced cost, preferred bookings and more affordable customized treatment plans.  If you are interested in more information on the ensoClub program be sure to ask any of the evolv professional staff.

evolv Forever Young BBL

What is Forever Young BBL?

Forever Young BBL is a patented technology by Sciton Laser that uses light energy to reduce the signs of aging in the skin and improve areas of pigmentation, vascular lesions, and redness. It has been shown by clinical studies at Stanford University Medical Center that this particular wavelength of light, broadband light or BBL, can actually stimulate skin cells and genes associated with youthfulness and turn back the clock. This technology is an especially exciting finding for patients committed to improving skin health and reducing skin aging.

What does Broadband Light (BBL) do?

Broadband Light treats and reduces brown spots or age spots as well as skin redness and blood vessels. With precise wavelength and power, the light energy is absorbed by pigmentation, spotty areas of sun damage, and melasma. Red areas of the skin also absorb the light energy, including small blood vessels, veins, or rosacea (a chronic inflammation of skin with persistent redness) and are permanently reduced.

In our experience, pulsed light or BBL is the only effective technology that permanently reduces rosacea, redness and pigmentation in the skin. Additionally, BBL can stimulate receptors on the skin cells, improving collagen production, which is critical to create more firmness and maintain youthful skin health.

What to Expect with evolv Forever Young BBL

The Forever Young BBL treatment is very well-tolerated. Most patients do not require topical numbing cream or anesthetic. Once the patient comes into the office and after the skin is cleansed, goggles are applied and the light treatment lasts approximately 15 minutes or less for the face. During treatment, patients will notice a warm sensation, or a warm rubber band snapping sensation in the skin which is usually quite tolerable. Topical numbing cream can be used if needed.

Typically there are no blisters or bruises associated with this treatment. Afterward, the skin may feel slightly red or swollen, but this is often negligible and subsides quickly. Patients may notice a slight amount of redness which generally fades within a few hours.

Evolv Forever Young BBL & Skin Care

In our experience at evolv Plastic Surgery and Medical Aesthetics, incorporating a personalized medical skin care program with light therapy treatments significantly improves results and reduces complications. We feel it is very important to have a balanced, long-term program to maximize the response of the skin, and overall improve the outcomes for each patient. Skin that is prepared prior to treatment will respond more favorably and consistently and also has a quicker healing time as well as avoids complications associated with patients who have no preparation before their laser or light treatments. Working with your professional aesthetician or physician is important when customizing these programs in order to provide comprehensive treatment and optimal outcomes. It should also be emphasized that daily skin care and sun protection are important in obtaining and maintaining these results.

Evolv Forever Young

Evolv Forever Young is unique and exciting, cutting-edge program incorporating balanced skin care combined with maintenance treatments or broadband light therapy once every three or four months to essentially stop the aging clock in the skin. Stanford dermatology studies have shown that patients treated with BBL over 10 years actually looked younger than when they started the program. BBL is proven by laboratory research that these treatments result in unique benefits such as stimulating the ‘genes of youth’ at a molecular level. This innovative treatment is a quite exciting way to basically prevent most of the undesirable changes associated with aging in the skin.

To learn more about this personalized program – contact our office today for more information or request your skin analysis.

The Advanced Mommy Makeover

New Options in Body Contouring 

Pregnancy and its after effects can be tough on a woman’s body. From rapid weight gain, then weight loss, following a rapid expansion of the skin, there is a collective fascination with some of the changes that the body goes through before, during, and after pregnancy. Following pregnancy, there are often deposits of excess fat around the abdomen, hips, and trunk. The breasts may have lost volume, dropped, and lost their support. The skin may also have developed new stretch marks, as well as areas of brown patches or hyperpigmentation on the face and other areas.

New technologies, services, and options have created some exciting new possibilities for women after pregnancy. Dr. Frank Barone, board-certified plastic surgeon in Toledo, OH, explains the many new options available in body contouring today.

Abdomen and Trunk

After pregnancy, there are some permanent changes of the body, buttock, and abdomen. These include the muscles of the abdominal wall and the rectus muscle which can become stretched and separated. They will often not return to their preexisting state where they’re connected in the midline, providing support for the abdomen and back. This condition is called diastasis recti.

Another condition caused by pregnancy is long-lasting laxity and loss of support of the skin, accompanied by stretch marks. The tummy tuck, or abdominoplasty, is a procedure that addresses these issues by removing excess skin and fat in the lower abdomen below the belly button. Separated abdominal muscles are then repaired, and the sides of the body are contoured with liposuction.

-Advanced Concepts in Abdominoplasty and Body Contouring

New concepts of abdominoplasty include extending the contouring and shaping all the way around the body or to the sides. This technique can lift a drooping buttocks or correct laxity on the lateral side and hips as well as cellulite. These extended abdominoplasties, or circumferential abdominoplasties, are categorized as “body lifts.” Augmenting or improving the projection of the buttocks with fat buttock augmentation is also a possibility, as well as thigh lifting.

Other new concepts in body contouring surgery include surgery without the need for traditional suction drains based on a new surgical technique called progressive tension sutures and new options in reducing post-operative discomfort. In our practice, these procedures are always done on an outpatient basis and improving patient comfort is a priority. A new medication called Exparel® is injected by the surgeon during the procedure in order to block sensory nerves, and provides a significant reduction in patient discomfort, reducing the need for post-operative narcotics and improving the overall experience.

-Advanced Concepts in Liposuction

Finally, while contouring the body with an abdominoplasty or body lifting, we are also improving overall body shape contour with selective fat reduction by ultrasonic techniques. In our experience, ultrasonic liposuction, or VASER Liposuction, is the most efficient method of reducing excess fatty deposits. VASER ultrasonic energy releases fat cells, which makes removing the excess far more efficient and less traumatic. It also preserves nerves and blood vessels, consequently reducing post-operative swelling and downtime.

VASER ultrasonic liposuction also has the unique advantage of contracting or tightening the skin, which is very important for improving body contour after fat is removed. This has improved our results for patients having mommy makeovers and abdominal contouring. It is also important to understand that abdominal contouring surgery is not a free pass for poor lifestyle choices. It’s vital that patients remember that their overall health has a major effect on the outcome of their surgery. So, healthy lifestyle habits, such as proper nutritional intake and regular exercise, should be emphasized.

-Advanced Non-Surgical Abdominal Contouring Options

Non-surgical options are also present for abdominal contouring, be reducing both excess and firming skin, such as the new Vanquish ME™, Cellutone and Exilis Ultra™ devices, which remove fat cells by an external applicator. The Vanquish applicators do not touch the skin, and can also improve abdominal contour without any downtime. These procedures are done in the office and do not require anesthesia. The new Cellutone™, which uses sound waves to reduce the appearance of cellulite, is used with Vanquish ME™ to improve results in less time.

Read about the scientific study on Vanquish ME™ for nonsurgical fat reduction here.

Improving Breast Shape and Contour after Pregnancy

The combination of age and gravity will cause a woman’s breasts to droop and lose volume, but when you add pregnancy and breastfeeding to this equation, the changes are much more significant. This after-pregnancy breast change goes beyond actual sagging, but can result in changes in the nipples and the areola, as well as loss or deflation of the breast due to the hormonal changes of pregnancy.

-Breast Lift and Augmentation

To restore youthful shape and size a breast lift can be performed, which will elevate the tissue back to its pre-pregnancy position and restore a youthful shape. For some patients, more volume is necessary if there’s been a deflation of the breasts, and a breast implant and or fat grafting can be beneficial. Dr. Barone has extensive clinical research experience with the FDA approved cohesive gel breast implants. Available in round or anatomic shapes, cohesive gel or ‘gummy bear’ implants are composed of a semi solid soft gel and are more long lasting and will have no issue with potential leakage. They also hold their shape very well and are available in a wide variety of dimensions to correct asymmetry or side differences.

-Fat Grafting for Breast Enhancement

For appropriate patients, Dr. Barone may recommend fat grafting enhanced with PRP, or platelet-rich plasma, to restore natural volume to the breasts. The new breast lift or mastopexy involves shorter scars, and the vertical mastopexy is one example of that short scar procedure for breast lifting. Again, pain control with Exparel® allows this to always be an outpatient procedure, and makes the overall experience much more comfortable.

Skin Rejuvenation for the Post-Pregnant Woman

Telltale stretch marks on the stomach, hips, and buttocks after pregnancy can be very frustrating for women. Topical creams have never been proven to be effective, despite some unsubstantiated marketing claims. Dr. Barone and the professional staff at evolv will only recommend or utilize research proven products and services that have been clinically verified as safe and effective.

-Microneedling, Infini

Stretch marks are physical tares in the deep layers of the skin that are commonly seen after pregnancy or excessive weight gain. There are now promising technologies that can improve them. One option is microneedling, which stimulates collagen production while breaking down the scar and fibrous tissues. Microneedling with radiofrequency energy is even more effective, as has been proven by clinical results with the Infini RF by Lutronic.

Infini RF delivers a radio frequency charge to the tips of the insulated needles which results in a more vigorous response in collagen production and skin tightening than microneedling alone. Adding PRP therapy which is a powerful combination of multiple growth factors and regenerative platelets obtained from the patient’s own blood, to microneedling or Infini RF procedure has resulted in significantly more improvement in stretch marks and overall skin quality.

In addition, treatment of the skin with new formulations of retinol, which is a vitamin A derivative, has been shown to increase collagen production, improve circulation to the skin, and can improve stretch mark appearance, as well as skin health. I prefer Retinol and skin care products from ZO Skin Health because of their unique advanced bioengineering and proven efficacy.

If stretch marks are still pink or red, using light therapy, such as broadband light (BBL), is very effective in reducing their appearance. Fractional lasers are also beneficial in these situations, which is another new and exciting technology for skin improvement. The new HALO laser from Sciton Medical is particularly effective in improving stretch marks.


Pigmentation can be very challenging in the postpartum female. Brown spots and even deeper pigmentation in the lower levels of the skin, called Melasma, can be particularly frustrating. Melasma is often made worse from heat, so the use of lasers can be risky and must be used cautiously with proper skin preparation. Some chemical peels can be very effective for removing excess pigment in Melasma and hyperpigmentation. We have seen significant improvement with the use of medical skincare products from ZO® Skin Health, which has been the world’s leader in treating excess pigmentation in the skin.

Broadband or pulsed light and the use of Hydroquinone and other lightening agents to reduce pigmentation can be very effective if the skin is prepared properly. Of course, sunscreen and limited sun exposure is critically important in pigmentation and Melasma patients, and using a certified medical grade sunscreen with antioxidants is important.

The Advanced Mommy Makeover Summary

In summary, new technology and services have significantly improved the options as well as the results for women after pregnancy in repairing, restoring, and rejuvenating their bodies. These include non-surgical and surgical services. Shorter recovery times with increased comfort and reducing the length of scars are now a reality contouring the body after pregnancy in the advanced mommy makeover, and the combination of procedures has provided even better results.

Finally, the new science of regenerative medicine using fat grafting, stem cells, and growth factors with PRP harvested from the patient’s own blood and tissues are really going to be the future of body contouring due to the long-lasting effects and rejuvenate capabilities.

To learn more about these services, contact evolv Plastic Surgery & Medical Aesthetics today – (419) 464-9422.

Regenerative Medicine at evolv

The Use of PRP Fat Transfer and Stem Cells in Aesthetic Rejuvenation

An exciting new area of aesthetics today is the new science of using the body’s own tissues to heal and rejuvenate. This process involves three primary components: platelet-rich plasma (PRP), fat transfer (using the patient’s own fat cells and transferring them to another area) and the enhancement of fat grafts with stem cells, which are specialized and pluripotent cell components that are isolated from fat grafts. Read on to learn more about what these techniques can do for you, as explained by Dr. Frank Barone.

regenerative medicine

Actual evolv patient – Age: 52 – Regenerative Medicine

Platelet-Rich Plasma Therapy

There are many potential benefits and applications in aesthetics for platelet-rich plasma or PRP.  PRP is a mixture of growth factors and signaling proteins called cytokines that have been shown to improve healing and rejuvenate youthfulness in the skin and tissues. “The applications of PRP are quite broad, as these are the natural growth factors harvested from the patient’s own blood and used in a variety of ways,” explained Dr. Barone.

PRP is obtained by drawing the patient’s blood and placing it into a special tube that isolates certain components. The tube is then placed in a centrifuge, which separates out the components that are not needed. Within the separated material is a layer of special growth factors and proteins along with the concentrated platelets, which is then used in skin care.

“For example, we use it with micro-needling, which is a process to stimulate the repairative functions and production of collagen in the skin,” said Dr. Barone. “And when we add PRP, we see a significant enhancement of the results of micro-needling. It can be used with the actual micro-needling process or injected into the skin after micro-needling, which has been termed the “Vampire Facelift.” PRP can also be used to reduce hair loss and stimulate new hair growth far more significantly than other non-surgical or topical medication options.

Because PRP is obtained from the patient’s own blood, it is a much more natural stimulant than other growth factors that are obtained from plants or other sources outside of the patient. PRP can be used in many ways, including being added to fat grafts to make a natural filler for an aging face, to restore loss of volume in the cheeks or sagging in the skin, and to restore the thickness of the skin and stimulate pro-growth functions. It can also be used in breast reconstruction, breast augmentation, mastectomy or fat grafts to the buttocks to enhance fat intake and healing.

Fat Transfer

Fat transfer is a process of taking the patient’s own fat cells out of an area where there is an excess, such as the abdomen, hips, flanks or legs and then using these natural living cells to repair, restore and rejuvenate. Those fat grafts are then processed, removing the unneeded components and obtaining a purified concentration of fat. “These are living fat cells and can be used as a natural filler, in the face with a facelift procedures or injections to improve volume and many other exciting applications,” explained Dr. Barone.

Fat has been shown to not only fill, but to improve the overlying skin, the production of collagen and the health of the epidermis when it’s grafted to another area. “One of the most exciting areas of fat transfer has been the enrichment of fat grafts with the patient’s own stem cells,” said Dr. Barone. “Stem cells are specialized cells obtained from the fat which have the ability to respond to many signals and actually stimulate growth, repair and rejuvenation.”

Overall, these two techniques have proved themselves as remarkable treatments within any applications. If you are interested in learning more about the exciting possibilities of regenerative medicine with PRP, fat transfer and stem cells, contact us today to schedule your consultation.

Microneedling and Infini RF

Are you unhappy with dull, uneven or sun damaged skin?  If so, evolv Plastic Surgery & Medical Aesthetics offers two treatments to address these issues. Both microneedling and Infini RF treatments can help to naturally rejuvenate your skin. Read on to learn more about these options.

What is Microneedling?

Microneedling, known as collagen induction therapy or CIT, is an aesthetic treatment that utilizes very small surgical-quality fine needles to induce a healing reaction from the body, resulting in an increased production of collagen and elastin. Microneedling stimulates the body’s own natural growth factors to improve sun-damaged skin, fine lines, acne scars as well as skin texture.

At evolv, we use automated microneedling with the Eclipse MicroPen Elite. This technology will create precision controlled micro channels in the skin, allowing the increased absorption of topical products such as growth factors and other beneficial medical skin care products. The microneedling can be adjusted to different levels of penetration, depending on the amount of damage being treated. Any part of the body including the face, neck, chest, arms, legs, abdomen and even the back can be treated with microneedling.

The Microneedling Procedure

The procedure involves cleansing the skin and often using a topical anesthetic to reduce sensation. Your evolv medical skin care professional will then apply a fine layer of gel or other topical product to the skin. The pen will be gently pressed against the skin, gliding it in various directions while the treatment is being done. This may feel like fine sandpaper and is usually not significantly uncomfortable. The procedure takes approximately 20 to 30 minutes. After the treatment, there will be some redness to the skin and healing time is generally just one to two days. Makeup can be applied at 24 hours.  Be sure to inquire about adding on the new CooLifting treatment to enhance results.

What is the Infini Treatment?

Infini RF, is a form of advanced microneedling that uses high-intensity focused radiofrequency energy along with microneedling in the various layers of the skin. This treatment can produce some very impressive results maximizing the effect of microneedling. The heat and energy produced by the radiofrequency energy will significantly improve the results of microneedling. It can help restore the skin’s youthfulness with a firming effect and result in significant improvement in texture and reduction of pores. This kind of technology is unique because the energy is delivered precisely at the level of the skin that is focused for maximal improvement.

The Infini Procedure

The procedure involves cleansing the skin and then applying a topical anesthetic cream for approximately one hour. Some patients will do this at home before the treatment. The settings are then determined after discussion with the physician and the topical gel is removed and the skin treated. It takes approximately 30 to 45 minutes to treat the entire face. Infini is safe for all skin types and can be done in any season of the year. The insulated needles will protect the surface of the skin from any kind of energy damage and reactive pigmentation. There is a very short recovery involved with Infini treatments, though the face of the skin can be red for one to two days. Makeup can be applied after 24 hours and most activities can be resumed after 28 to 48 hours.  Infini RF can also treat the neck and other areas of skin laxity. A new and exciting application of Infini is the permanent reduction in excess seating (hyperhidrosis).  Be sure to ask your evolv nurse or Dr. Barone for more information.

If you are interested in microneedling or Infini treatments in Toledo, OH, please feel free to ask your evolv licensed aesthetician or any of our nurses at our office for more information. Contact us today at 419-464-9422.

The Beautifying Benefits of CooLifting

CooLifting is a new and exciting facial technology that combines a controlled spray of carbon dioxide and a blend of natural hyaluronic acid with plant botanicals. This spray is infused on the skin to generate very beautiful results in lifting and improving the hydration of the skin with no downtime, no injections, and no discomfort. It has been proven in scientific research that a high concentration of carbon dioxide is beneficial to the skin because it results in releasing more oxygen and circulation to the area treated, creating a lifting and firming effect.

How Does CooLifting Work?

CooLifting has a proprietary “dermal delivery system,” which is a technology that improves the application of active ingredients on the skin. In this case, the ingredients include hyaluronic acid, which is made up of the natural sugars found in the skin that help maintain hydration and moisture, combined with soothing plant botanicals that improve the lifting effect using a natural stimulant. Carbon dioxide spray has been used for delivering cold therapy for many years, as well as improving skin conditions, such as inflammation and breakouts.

The CooLifting Treatment

CooLifting treatments take about five to ten minutes, and you can see results almost immediately with maximum results after 12 to 24 hours. A package of three treatments is recommended for optimal effects. After treatment, you can return to your regular skin care regimen and can apply maintenance treatments as well. All skin types can be treated with CooLifting, and it can also be combined with other facial treatments such as micro needling, chemical peels, and microdermabrasion.

Overall, CooLifting has been found to be a new and very effective low-cost treatment that can be used on any skin type without downtime or discomfort. It can help the skin look healthy and youthful, can improve hydration significantly, and can reduce the appearance of fine lines.

If you are interested in CooLifting treatments in the Toledo, OH area, contact us today to learn more or to schedule a consultation.

How to Maintain Your Facial Surgery Results

At evolv Plastic Surgery & Medical Aesthetics in Toledo, Ohio, we see many patients who are candidates for facial aesthetic surgery. Patients of all ages may be motivated to improve the signs of aging or to correct an abnormality that always bothered a patient throughout the years.

The Goal of Aesthetic Surgery

The goal of aesthetic or cosmetic surgery is not to “change” the patient, but rather the enhance their natural look, making them appear more youthful. When done properly for appropriate indications, that is exactly the result. However, one of the most common questions asked by patients is how long the results will last after surgery. This answer will greatly depend on how well the patient was prepared for their surgery, as well as consistently following the maintenance program after their procedure.

Facial Surgery Preparation

The technique and the experience of the plastic surgeon are important for the longevity of the result. It’s also very important how the skin was prepared before surgery and the maintenance program after.  Skin that is prepared with the appropriate medical skin care program will respond to the surgery more effectively. A physician-supervised medical skin care program will improve skin health and increase circulation which will result in quicker healing, less swelling and reduced downtime.  That is why evolv focuses on a pre-operative preparation program for all surgery patients.

Facial Surgery Results & Maintenance

After the procedure is complete, the next important consideration is maintenance. We try to educate all patients on the importance of a regular skin care program, which will involve scientifically-proven medical skin care products and sun protection, as well as healthy lifestyle changes.  We have had long term and very exciting results with our ZO® Skin Health program for patients extending the longevity of their surgical results.  After facial surgery, many patients can maintain the results much longer with the help of these programs by improving skin care.

In addition, new technology has allowed patients who have had surgery to extend the results using in-office or non-surgical maintenance programs. This may involve energy applications, such as radiofrequency with Exilis Ultra. It may include microneedling such as Eclipse MicroPen.  An exciting new technology which combines the benefits of medical microneedling and radiofrequency energy, Infini RF can tighten and improve skin quality to enhance and maintain facial surgery results.  Other programs offered at evolv include advanced chemical skin peels, light energy (IPL Redness Reduction and Photodynamic Therapy (PDT)), and other therapies that focus on increasing collagen production and rejuvenating skin quality which is very beneficial post- surgery in extending and in improving results.

Finally, one of the most advanced programs for maintenance after surgery is the use of fat grafting and stem cells, along with platelet-rich plasma (PRP) or growth factors obtained from the patient’s blood. Once the blood is drawn, it is centrifuged and the growth factors are extracted to enhance the skin response either with injection or mixing them with the patient’s own fat or stem cells. This is an area called regenerative medicine, which Dr. Barone believes will be the future for aesthetic surgery and aesthetic care.

Top Skin Care Tips for Maintenance

The top products for skin care maintenance are fundamental, usually involving a medical cleanser, an exfoliant, a retinol-based application (Vitamin A) and a medical sunscreen containing antioxidants. These are skin products that will reduce the signs of aging and keep the skin youthful and healthy, which will extend the surgical result.

Finally, we emphasize patient education, the importance of healthy nutrition, exercise, reducing stress and appropriate hydration. Your lifestyle and the overall health of your mind and body will affect the longevity of any facial or aesthetic surgical results. We believe in a long-term comprehensive program of general health and integrating medical skin care health as well. Our goal is for our patients to think of the bigger picture to enhance their appearance in addition to making them feel better about themselves, giving them more confidence, restoring their youthfulness and ultimately improving their quality of life.