EVOLV Medical Aesthetics

Category: Skin Care

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 ‘broadband 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 the ‘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 inflammatory skin 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 broadband light (BBL) can also be 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.  The 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.  Photodynamic therapy is usually done after conditioning the skin for the best results.

Evolving research has revealed many therapeutic benefits of light treatment that can, along with a customized medical skincare 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 skincare 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.

Much More Than Skin Deep

New Research shows that improving skin function and health can do much more than previously understood

At evolv Plastic Surgery and Medical Aesthetics we have always believed in and practiced the fundamentals of improving skin health in benefiting overall quality of life for our patients, ourselves and our families.  Now a growing body of evidence in clinical and scientific research is providing answers as to why this may be so essential to our overall health and well-being.

A recently published study in Nature Communications found that skin that is inflamed and has poor barrier function (a common factor in most compromised skin as well as in sun damaged or prematurely aged skin) releases inflammatory  protein messengers called cytokines that can negatively affect not only the surrounding local skin cells but also other remote tissues in the body as well. Our cells contain a variety of cytokines which are basically ‘signaling’ messengers that tell our cells what to do in a variety of situations.

These cytokine protein messengers are many and have a variety of effects in their influence on cell function.   Inflammation, more specifically chronic inflammation at the cellular level, is a common cause of most disease conditions as well as advanced aging and deterioration and can lead to compromised function and disease in our bodies.  Common skin conditions or disorders associated with chronic inflammation include acne, rosacea (chronic redness), excessive pigmentation, various forms of dermatitis, sun damage and even premature skin aging and skin cancers.  Reducing chronic inflammation through anti-inflammatory nutrition and anti-oxidant supplements, regular exercise and stress reduction as well as general healthy lifestyle choices are the fundamental pillars of improving overall health and reducing the signs and symptoms of advanced or premature aging.

 Researchers from the University of California San Francisco (UCSF) recently published their findings in the Journal of the European Academy of Dermatology proving for the first time that improving skin barrier function in otherwise healthy adults may reduce risk of other diseases or conditions associated with chronic inflammation such as Type 2 diabetes, heart disease and even loss of muscle mass associated with aging. Obviously systemic diseases may result from a variety of sources and may have multiple etiologies, however the fact that skin inflammation and compromised function thru inflammatory cytokines can contribute to disease or deterioration elsewhere in the body helps support the importance and wider impact of improving and optimizing skin health.  

The research and vast clinical experience of Dr. Zein Obagi, an internationally recognized dermatologist and educator and inventor of the original Obagi Medical Products and now ZO Skin Health, has progressively defined and revealed the fundamentals of achieving optimal skin function.  One of the major priorities in all of our evolv patients’ individualized medical skin care programs is restoring and improving skin barrier function and reducing inflammation with proper cleansing, exfoliation, stimulation and protection.  The recently published studies from UCSF and Europe researchers help provide why this matters and is so important not only to the skin but also overall systemic health.  Another study from the University of Pennsylvania following 10,000 patients over five years revealed that those patients with an inflammatory skin condition (psoriasis) involving more than 10% of body surface area had an 80% higher risk of death from any cause as well as an increased risk of stroke.  

An additional finding in some of the recent studies was that long term use of topical steroids like cortisone, which are commonly used for many skin conditions associated with irritation, itching and redness, worsened the skin barrier by reducing cellular turnover and function. Based on the above findings, this implies that chronic or excessive use of topical steroid products may have negative effects on local skin as well as general health and their use should be carefully evaluated as needed.  Skin function and cellular turnover, which is optimal in our early years, tends to slow down with aging, stress, in the post reproductive years and especially after menopause.  That is why one of the primary goals in regenerative skin care is the stimulation and restoration of healthy cellular turnover which results in optimal skin barrier function and the reduction of harmful inflammation.

The above recently published research is very compelling in implicating a direct connection between chronic inflammatory skin conditions and other potentially serious health problems.  The basis of this association appears to be cytokines or inflammatory mediators released by irritated skin cells and other immune based pathways that may affect or be associated with other areas of the body.  As further evidence of the ‘mind-body connection’ evolve, we also know that optimally healthy and youthful functioning skin not only has physical health advantages, but also emotional and psychological benefits.  Research has validated that patients who have successful aesthetic treatments and outcomes have measurable increases in the ‘feel good’ neurotransmitters in the brain resulting in improved happiness, confidence and quality of life.  

We now have ever increasing, research supported evidence that improving our skin health and the use of properly selected aesthetic products, services and treatments can result in an overall improvement in physical and emotional health as well as general well-being. And that is what really gets all of us excited at evolv and why we love what we do!

Why You Need Skin Needling

This time of year is typically associated with vacation and less time spent at work.  But we have been very busy at evolv Plastic Surgery and Medical Aesthetics because we have been working on introducing and developing some exciting and potentially game changing technology and services in aesthetic care for our patients.  Although we have not finalized all the details, I would like to introduce some of the basic concepts and the reasons for our excitement:

New excitement with Microneedling?

Harnessing the skin and body’s stored potential to naturally repair, restore and rejuvenate new and healthy, young tissue is the very basic essential of bioregenerative medicine and is the fundamental principle in skin microneedling.  Often termed ‘collagen induction therapy’ because off its unique ability to stimulate new collagen and elastin production in the skin, we are seeing a tremendous resurgence in demand for this aesthetic service because of the natural mechanisms that it stimulates in youthful skin rejuvenation as well as the long-lasting results.

There are two essential types of skin needling:

  – Cosmetic Needling: a home program with very superficial needles, cosmetic skin needling is not painful and does not cause bleeding but can significantly improve skin care product absorption and results.  Environ Skin Care’s state-of-the-art microneedling rollers combined with their proprietary topicals designed specifically for needling can improve wrinkles, sagging and aging of the face, as well as any body area and have been extremely exciting for patients.

  – Medical Needling: a deeper treatment performed at the office by a trained medical aesthetician or nurse, medical needling usually requires a topical anesthetic and can improve fine lines, wrinkles, scars, laxity, stretch marks and general skin aging.  There is a lot of excitement with the results experienced combining medical microneedling and topical biologic products such as platelet rich plasma (PRP) and specific growth factors and peptides such as ZO Skin Health’s Growth Factor Serum, Alastin Skincare’s Regenerating skin Nectar and Defenage Skincare’s Bioserum.  

Infini Genius

Combining the benefits of medical microneedling with the addition of controlled and precise delivery of radio frequency energy to specific levels in the skin make the Infini Genius by Lutronic the most advanced and effective microneedling technology on the market.  The new technology improvements result in not only better results, but also more efficient and comfortable treatments.  Combined with Alastin Skin Nectar pretreatment and then post procedure topical Defenage or PRP, Infini Genius therapy can provide a comfortable and timely service that improves skin tone, texture, pores, fine lines and general signs of skin aging.  Infini Genius has also been used successfully to diminish excess sweating (hyperhidrosis) as swell as deeper acne and other scars.

Plasma Pen Therapy

evolv Medical Aesthetics is excited to introduce the Plasma Pen to the Toledo area.  The Plasma Pen is a handheld device that uses proprietary ionized nitrogen gas to resurface and tighten the skin.  Plasma Pen treatments are particularly effective to tightening skin laxity or creepiness around the eyelids and other facial areas.  This is a minimally invasive office treatment that has already produced some significant results in restoring more youthful and firm eyelids and facial tissues.  

At evolv Plastic Surgery and Medical Aesthetics, we are passionate about providing the most advanced and effective, research proven technology for our patient treatments.  New advances in skin needling and topical biologics, the Infini Genius and the Plasma Pen offer clinically-proven and state of the art technology that provides outcomes in aesthetic treatments that are truly revolutionary and exciting.  We invite you to learn more about these options from your evolv professional.

Now back to those lazy days of summer!

Frank Barone MD FACS

April – National Rosacea Month

Rosacea affects more than 400 million people worldwide and over 16 million Americans!

So, what is ‘rosacea’ anyways?  Rosacea is a chronic inflammatory skin condition that affects adults and is typically seen on the central facial areas.  It is characterized by persistent flushing redness, visible blood vessels (telangiectasias), inflammatory acne like pimples.  In some cases, it may involve the conjunctiva of the eye (ocular rosacea).

Although rosacea may involve anyone, it is more common in middle aged women with fair skin and light features and most often from Scandinavian or northern European descent.  Clinical research reveals that there is a 20 – 40% familial or inherited component in rosacea in addition to certain trigger factors that can influence the frequency and severity of the symptoms. 

Psychological Profile

Although rosacea is not typically harmful and is not contagious, it can have a significant impact on a patient’s quality of life.  The psychosocial impact can involve anxiety, embarrassment, low self-esteem in addition to affecting a patient’s work and dating or personal relationships.

Causes of Rosacea

There are multiple theories regarding the complex causes of rosacea in addition to the genetic or inherited tendencies and subsequently effective treatment.  Most of the latest research on its pathophysiology identify several possibilities including blood vessel disease or inflammation, nerve or neurovascular sensitivities, autoimmune disorders or excessive reactivity of a patient’s immune system, and finally some studies have implicated a microscopic organism that is prevalent in the skin called the Demodex mite.

Proven Options to Reduce Rosacea 

Because of the genetic or inherited component of rosacea, permanent elimination is not likely, but there are several effective and proven treatment options:

 –  Trigger avoidance – rosacea has been clinically linked to smoking, sun exposure (UV light damage), cosmetics and heavy makeup, cosmetic fragrances, certain soaps, spicy foods, excessive alcohol and stress.  Becoming informed and being aware of these triggers can be helpful.  New options in medical grade makeup that reduces inflammation and calms the skin are now available and have proven efficacy.

 –  Photo protection – using a medical grade sunscreen that does not contain fragrances and other additives that can trigger inflammation is extremely important.  The UV component in sunlight is inflammatory and will thin the skin and blood vessels resulting in premature aging and more visible and inflamed vessels.  


It should be emphasized that any patient with severe manifestations or uncontrolled rosacea should seek the evaluation of a board-certified dermatologist.  In addition to the traditional medical management of rosacea, there are now several exciting and clinically proven new options that offer improved outcomes for the rosacea sufferer.

Comprehensive Medical Skincare for Rosacea at evolv

At evolv Medical Aesthetics, we believe in the power of restoring balanced and optimal skin health as the most effective therapy for achieving beautiful and youthful skin.  Treating and controlling chronic inflammation is one of the fundamental steps in our skin health programs and is especially beneficial for the rosacea patient as inflammation is the most influential and universal trigger in all forms of rosacea.

This comprehensive approach will involve 3 essential steps:

  1) Restore Skin Health: Get control of the inflammatory lesions with a ‘cleanse/scrub/oil control’ ZO Skin Health protocol to gently remove inflammatory oil, bacteria and debris that are triggers in inflammation.  Also essential is a topical antioxidant and Vitamin A (retinoids) that neutralize inflammatory mediators and restore a healthy barrier function.  Finally, protecting the rosacea prone skin is paramount and involves non-occlusive medical grade sunscreen with broad spectrum protection.

2) Light Therapy: visible blood vessels and redness can be dramatically improved by broad band light or BBL.  This proprietary technology is not a laser but a high intensity therapeutic light that coagulates the larger vessels and reduces excessive redness associated with rosacea.  Combined with a personalized medical skin care plan and reasonable trigger avoidance, this approach has significantly improved rosacea long term for many patients.

3) Maintenance Programs: Combined with a healthy lifestyle, an anti-inflammatory diet and reasonable stress management, new products that reduce overall redness (Rozatrol from ZO Skin Health) have been clinically tested and have been effective in over 85% of rosacea patients.  Maintenance BBL light therapy and LED red-light therapy are also helpful for long term rosacea control.  New options in medical grade makeup from Colorescience and Jane Iredale have helped improve patient confidence and have health benefits for the skin.

Rosacea is a complex and challenging skin condition that can have a significant impact on quality of life.

At evolv, we have witnessed exciting and long-term improvement for our rosacea patients by utilizing the above comprehensive approach of treating inflammation and restoring skin health.  Healthy skin with more efficient barrier function is less prone to inflammation and disease and can significantly improve quality of life for rosacea patients as well as patients of any age.

If you would like to learn more about rosacea and these new and exciting treatment options, please ask any of our skin care professionals at evolv Medical Aesthetics.

Frank Barone MD FACS

My Acne Journey – Self Esteem And Everything In Between

I was first diagnosed with acne when I was in high school. As a female in my early thirties, I still have periodic breakouts, albeit far less frequent or severe. Having acne weighs on you. It affects your confidence and makes you question what you should be doing differently. Any time you see a new blemish, you play detective to ascertain the cause. Did I consume the wrong food? Did I wear an occlusive makeup? Did I not change my pillowcase? For people who don’t suffer from regular acne, they may not understand the struggle, but even leaving the house can feel daunting when you have a face full of blemishes. Wearing makeup daily can became routine and cancelling plans out of embarrassment a commonplace occurrence. For those who don’t feel comfortable wearing makeup, showing their face to the world is perhaps even more intimidating.

To add insult to injury, after suffering from severe cystic acne, I was left with scarring. And not just post-inflammatory hyperpigmentation (those dark marks left behind after a pimple heals), I had uneven texture and indented scarring. Far more difficult to correct, scarring can be even more traumatizing than the acne itself. You want nothing more than to confidently make eye contact with those around you, but you are constantly wondering, “are they looking at my skin?”

So, where am I in my acne journey? After obtaining a job with evolv Plastic Surgery & Medical Aesthetics, I have been privileged to try new skincare products and treatments geared to addressing my acne and the scarring that was left behind. With visible improvements, I feel hope. I see changes when I look in the mirror, and I am excited to share with my fellow acne/acne scarring suffers what has helped me improve my skin.


Let’s go back to the basics. What is acne? That question is easy to answer. Acne is a skin condition that occurs when oil and dead skin cells get trapped within the oil glands and hair follicle resulting in an infection.  What causes acne? This question is far more difficult to answer and can cause frustration for acne sufferers everywhere. Things like genetics, diet, lifestyle and hormones can all play a role, but not all cases of acne are created equally. One thing is for certain – acne affects us, not just physically but emotionally. Whether it be moderate or more severe, acne can lead to low self-esteem, anxiety, and even depression.

The first step is to see a skincare professional who can diagnose your individualized skin type and concerns. Did you know that rosacea, a common skin condition that can cause redness and swollen bumps, can often be mistaken for acne? Schedule a consultation with a Dermatologist or Plastic Surgeon to establish your skin condition and start developing a plan of action.

Once diagnosed, it is important to note that acne does not resolve quickly. You need to give yourself and your skin a chance to heal. It can take 4-8 weeks to notice a marked improvement in your skin once you start an oral or topical medication and/or treatment program. Be patient because these medications can cause reaction like dryness, redness and flaking.

Topical products that contain ingredients like benzoyl peroxide, salicylic acid and tea tree oil have all been known to help clam and clear the skin. You see many of these ingredients in over-the-counter (OTC) products, but it is best to see a professional to ensure that you are receiving medical-grade skincare.

Antibiotics, oral and topical, have been proven to help kill bacteria and reduce inflammation in the skin. If you are female and hormones play a role in your specific type of acne, birth control can be effective. Isotretinoin can be effective in addressing more severe forms of acne, but it can also have some of the worst side effects and should not be treated lightly. A doctor would need to prescribe any of these medications, so if you want to delve into one of these options, you will need to consult with a physician who specializes in medical skin care.

In-office treatments such as manual extractions, chemical peels, and light therapies have also proven beneficial for acne sufferers. If you are dealing with scarring left behind from acne, chemical peels, microneedling options, and laser-based therapies can yield dramatic improvements. Like anything, however, it takes time to see change in the skin, and you must be patient. Trained skincare specialists, referred to as licensed aestheticians, can perform most of these treatments, depending upon the state in which you reside. In Ohio, laser-based therapies need to be performed by physicians.  Our trained aestheticians at evolv can recommend a comprehensive skincare regimen and treatment program tailored specifically to you and your unique skincare concerns.


Except for Isotretinoin (Accutane), I have tried almost every possible acne therapy under the sun. You need to figure out what ingredients work well for you, but I respond very well to ZO Skin Health products, a medical-grade skincare line that can actually change the skin on a cellular level. Evolv Medical Aesthetics believes that a personalized skin care plan to restore and improve optimal health is the most effective way to treat and prevent acne.  I am lucky to have an aesthetician who can tweak my regimen as needed and make additional recommendations based upon how my skin is behaving.

As for treatments, I feel like my results have been cumulative. Combining at-home skincare with treatments in the office (microneedling, chemical peels and laser therapy), I have seen visible improvements in my skin. I notice smoother skin and a healthy radiance I have never been able to achieve before. I still have redness, because I have also been blessed with rosacea, but my skin clarity and texture are also markedly improved.

My acne and acne scarring journey is not over. I don’t know if it will ever be over. I feel very lucky to be where I am, as a part of the evolv family. I want to continue to share with you what is working for me and my skin. If I am able to help even one person feel more confident in their own skin, I will count it a great success. If you are suffering from acne or acne scarring, you are not alone. You are part of a much bigger family than you realize, and we are here for you. If you want to start discussing options, call the office to learn more!

Fall in Love with Healthy Skin

All of us at evolv Plastic Surgery and Medical Aesthetics would like to welcome you to the Holiday Season!

November is National Healthy Skin Month, and achieving and maintaining optimal skin health is something we strongly believe in and practice every day at evolv.  Our skin health is often neglected or taken for granted with our hectic schedules particularly during the holidays.  In honor of National Healthy Skin Month, here are a few interesting facts to consider:

– The skin is the largest organ in the body, and the average adult has approximately 16-22 square feet of skin weighing around 9-11 pounds.

– The skin surface completely renews itself about every 28 days by constantly shedding dead skin cells (a large part of the dust in your home actually came from your skin surface)!

– Your skin surface is home to millions of bacteria (over 1,000 species) and fungi!

– Healthy skin functions as a very selective barrier to keep out harmful toxins and pathogens while protecting, retaining moisture and regulating temperature.

– The skin is the source of more cancers in humans than all other organs combined…..one in five Americans will be diagnosed with skin cancer in their lifetime, and one person dies of melanoma in the U.S. every hour.

– There are over 60 million Americans living with actinic keratosis, the most common type of pre-cancer of the skin. 

– Multiple studies confirm that skin health and youthfulness has a significant impact on self-confidence, overall well-being and quality of life.

At evolv, we have witnessed how improving skin health can positively and powerfully impact the lives of our patients at any age and in many ways.  We have also experienced how healthy skin can improve results and patient satisfaction in any cosmetic surgical procedure, as well as any non-surgical aesthetic treatment.  Optimal skin health plays an essential role in the comprehensive aesthetic care that we provide for all of our evolv patients.

Personalized medical skin care programs with ZO Skin Health can reduce or prevent many of the signs of aging and restore youthful and ageless skin quality, as well as prevent or reduce the risk of cancer, acne and other inflammatory conditions, treat hyperpigmentation and rosacea.

During the cooler months, dry and dehydrated skin is very common and frustrating but can be effectively controlled or prevented and treated with an individualized skin care plan provided by Dr. Barone, Dr. Koltz or one of our evolv aestheticians.

This Holiday Season we would like to encourage everyone to consider the importance of their skin health and the effect it can have on reducing the risk of cancer, as well as improving quality of life.  The reality is that healthy skin takes work, especially as we get older.  We encourage you to come in and learn about the many exciting new and affordable options in aesthetic skin services, products and treatments that can achieve results in skin health and youthfulness far beyond most patients’ expectations.  We believe in comprehensive, natural appearing outcomes and long term programs and would like to share these concepts with our patients and their families!  So CHEERS from all of us at evolv to your new skin health and younger look!


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.

Skin Peels of the Future

Spring is coming … Finally!

Spring is a season of renewal, and this April evolv Plastic Surgery and Medical Aesthetics would like to focus on the importance of medical skin peels to renew and rejuvenate the skin.

Like so many areas of aesthetics, skin resurfacing by medical peels has evolved significantly.  The peels of the future are now available and this new generation of clinical peel offers some very significant advantages for patients of all ages and all skin types including:

  • Stimulation of deep dermal collagen and elastin to restore youthful skin tone
  • Improved absorption and efficacy of skin care products
  • Reduction of fine lines and ‘age spots’ or hyperpigmentation
  • Removal of aged or damaged outer skin cells for a younger looking complexion
  • Specialized peels that are proven to reduce skin cancer risk
  • Reduced or no ‘down-time’ peels

The natural aging process, menopause, stress and excessive sun damage can all drastically slow down the process of natural exfoliation, or loss of outer surface cells, as well as new collagen production.  The result is dry, pigmented, thin and wrinkled skin that is prematurely aged and a significant increase in skin cancer risk.

The new generation of chemical peels from ZO Skin Health Research provides the unique benefits of gentle removal of aged, outer cells and unique deep tissue stimulation which results in replacement and rejuvenation of the skin.  Another key benefit is a reduction in skin cancer risk and the restoration of optimal skin health and youthfulness.  Many of the fundamental health benefits that we are so passionate about for our patients and families here at evolv can be more effectively achieved with proper skin peels in a medical skin care comprehensive plan.

Because of these fundamental benefits of clinical peeling, for the month of April at evolv we will be featuring all three of our ZO peels as our spotlighted treatments. Not only are there chemical peels promotions this month, but we also have some great value on laser hair removal treatments too!

Interested in learning more about the details of these promotions? Please click on this link http://evolvmedicalaesthetics.com/patient-resources/exclusive-offers/ and learn all about the details and added value we are offering this month to kick off Spring!