Here are 2 links to youtube videos showing the YAG Tattoo removal laser in action:

http://www.youtube.com/watch?v=jm-qwA8nFZo

and

http://www.youtube.com/watch?v=ZBOkEQ6CNC4

Please make an appointment for a complimentary consultaion.

A. David Rahimi,MD,FAAD.FAACS.

Two is better than one! We just added the Pinpoint Footlaser, for the treatment of nail fungus and warts, to our practice. Now we can treat you with the Cooltouch and the Pinpointe laser. The additional laser should increase the effectiveness of the nail fungus laser cure to almost 90 percent!

http://pinpointefootlaser.com/patients

Consultaion is always free.

A. David Rahimi,MD,FAAd,FAACS.

I was recently asked by a patient if she could have a pure laser lift? She did not want to have any scars and basically no “cutting” surgery. The answer is a definitive YES. The procedure needs to be individualized to the patient’s age and skin color/texture.

I use a combination of 4 modalities to achieve a pure laser lift. Here is how:

I use laser micro-liposuction to remove excess fat in the jowl and under the chin/neck.

This is followed by an aggressive Thermage CPT to tighten the eyelids/forehead/and cheeks.

Autologous fat is harvested from the abdomen or thighs and concentrated using the Coleman Centrifuge.  This viable micro fat grafts are then placed into the laugh lines and cheeks as needed.

Finally a fractionated CO2 laser (Mixto Laser) is used to remove sun damaged skin, brown spots and those vertical lines around the mouth and sides of the eyes! The skin basically shrinks back once the production of Collagen and Elastic fibers are stimulated.

The entire procedure is performed under local oral sedation and takes less than 2 hours.

Cost: $5000 to $9000 (includes OR fee, blood work, Garment, and laser /Surgeon’ fees)

Saline (sterile salt water) injections can be a safe, inexpensive option for reducing depressed and rolling acne scars. The rolling and atrophic types of acne scars are caused by many different factors including thick fibrous bands that pull the center of the scars down and cause its adherence to the deeper reticular dermis and fascia.

I have described in the past how needling and subsicion in addition to fat transfer and Mixto CO2 resurfacing can reduce these types of scars.

A less invasive method of improving these scars is to inject the deepest portion of the scars with a bolus of sterile salt water. No one is allergic to salt water (our body is 90 percent salt water) and risks such as infection and bleeding/scarring are very small. Water molecules are very small and can hydro-dissect the acne scars and cause a small amount of bleeding into the deepest portion of the scars. This, in turn, causes Collagen and Elastic fiber synthesis and improves the deeper scars.

Five to seven treatments are usually needed to see a significant improvement. Saline injection is usually used in conjunction with Cooltouch lasers, peels, fat or fillers.

The treatments take 15 to 30 minutes and can be performed under local anesthesia. Downtime is usually 1-3 days .Most patients may return to work or school with minimal bruising and swelling that can last up to a week.

Cost :$250-$500 per treatment (depending on the size of the area involved).

All treatments are performed by Dr. A. David Rahimi. You will be treated by a double board certified Dermatologist and Cosmetic surgeon with over 14 years of clinical experience.

 Dr. David Rahimi has performed over 100000 successful laser and cosmetic treatments.

Melasma in Latin Americans

A recent article in the journal of Drugs and Dermatology by Maritza Perez, et al on Melasma causes and treatments was quite thorough. Although the cause of Melasma remains elusive (combination of genetic predisposition, hormone replacement, pregnancy, thyroid disorder, and sun exposure) better treatments are emerging.

Topical therapies include:

2%, 4%, 6%, 8% Hydroquinone cream

Retin A creams and gels

Differin Gel

Mild Corticosteroids (pulsed)

Azelaic Acid gels

Kojic Acids

Combination therapies of all of the above and SPF 50

Procedural approaches:

Glycolic peels (10%, 20%,30%,50%, 75%)

Beta Glycolic and Salicylic Acid peels

Microdermabrasion and O2 Facials

Lasers and Light Sources:

Photofacial (IPL)

CO2 Fractional Laser (Mixto Fraxel)

Erbium Fraxel (Alma laser)

MED (manual Epidermal Dermabrasions) -see list of procedures on this site

Treating Melasma is challenging and requires a lot of patience from

the patient and the practitioner.

Treatment packages of 5 treatments over 2-3 months start at $500.

Please see us for a complementary evaluation and an individualized treatment regimen.

A. David Rahimi,MD,FAAD,FAACS.

Starting next month we will offer laser Tattoo removal using the Palomar Q-Yag 5 system.

Remove dated Tattoos and get ready for a new job or a new relationship.

Read more about the art and science of tattoo removal :

http://www.palomarmedical.com/treatments/tattoo-removal.aspx

A. David Rahimi,MD,FAAD,FAACS.

The Mind, Body, and Soul

Kathleen Rosenblatt is a licensed Acupuncturist and author of several books.

I recently met her and listened to her CD titled: "Cellular Meditation" and was quite impressed.

Cellular meditation for stress release has been described as: practical advice, guided imagery and breath work to help normalize biochemical imbalances. I strongly believe in the power of  imagery and use it often with my “light sedation approach”.

The 2 volume CD includes several morning and evening meditation sessions.

www.CellularMeditation.com

A. David Rahimi,MD,FAAD,FAACS.

The short answer: Try to sleep on your back! Yes it is easier said than done.

Here is an interesting article from CNN.com

(Health.com) -- Your preferred p.m. pose could be giving you back and neck pain, tummy troubles, even premature wrinkles. Here are the best positions for your body -- plus the one you may want to avoid.

The Best: Back position

Good for: Preventing neck and back pain, reducing acid reflux, minimizing wrinkles, maintaining perky breasts.

Bad for: Snoring

The scoop: Sleeping on your back makes it easy for your head, neck, and spine to maintain a neutral position. You're not forcing any extra curves into your back, says Steven Diamant, a chiropractor in New York City. It's also ideal for fighting acid reflux, says Eric Olson, M.D., co-director of the Mayo Clinic Center for Sleep Medicine in Rochester, Minnesota: "If the head is elevated, your stomach will be below your esophagus so acid or food can't come back up."

Back-sleeping also helps prevent wrinkles, because nothing is pushing against your face, notes Dee Anna Glaser, M.D., a professor of dermatology at Saint Louis University. And the weight of your breasts is fully supported, reducing sagginess.

Consider this: "Snoring is usually most frequent and severe when sleeping on the back," Olson says.

Perfect pillow: One puffy one. The goal is to keep your head and neck supported without propping your head up too much.

Next Best: Side position

Good for: Preventing neck and back pain, reducing acid reflux, snoring less, sleeping during pregnancy

Bad for: Your skin and your breasts

The scoop: Side-sleeping is great for overall health -- it reduces snoring and keeps your spine elongated. If you suffer from acid reflux, this is the next best thing to sleeping on your back.

Now for the downside: "Sleeping on your side can cause you to get wrinkles," Glaser says. Blame all that smushing of one side of your face into the pillow. This pose also contributes to breast sag, since your girls are dangling downward, stretching the ligaments, says Health magazine's Medical Editor Roshini Rajapaksa, M.D.

Consider this: If you're pregnant, sleep on your left side. It's ideal for blood flow.

Perfect pillow: A thick one. "You need to fill the space above your shoulder so your head and neck are supported in a neutral position," says Ken Shannon, a physical therapist at Brigham and Women's Hospital in Boston.

Not Ideal: Fetal position

Good for: Snoring less, sleeping during pregnancy

Bad for: Preventing neck and back pain, minimizing wrinkles, maintaining perky breasts

The scoop: Outside of your mother's uterus, resting in a tight fetal pose isn't a great idea. When you snooze with your knees pulled up high and chin tucked into your chest, you may feel it in the morning, especially if you have an arthritic back or joints, Olson says.

"This curved position also restricts diaphragmatic breathing," adds Dody Chang, a licensed acupuncturist with the Center for Integrative Medicine at Greenwich Hospital in Connecticut. And if you make this your nightly pose, you may bring on premature facial wrinkles and breast sag.

Consider this: Just straighten out a bit -- try not to tuck your body into an extreme curl.

Perfect pillow: One plump pillow -- the same as side position, to give your head and neck support.

The Worst: Stomach position

Good for: Easing snoring

Bad for: Avoiding neck and back pain, minimizing wrinkles, maintaining perky breasts

The scoop: "Stomach-sleeping makes it difficult to maintain a neutral position with your spine," Shannon explains. What's more, the pose puts pressure on joints and muscles, which can irritate nerves and lead to pain, numbness, and tingling.

"Think about the soreness you'd feel if you kept your neck turned to one side for 15 minutes during the day," Diamant explains. In this position you have your head to one side for hours at a time. You won't necessarily feel it the next day, but you may soon start to ache.

Consider this: Do you snore? "Stomach-sleeping may even be good for you," Olson says. Facedown keeps your upper airways more open. So if you snore and aren't suffering from neck or back pain, it's fine to try sleeping on your belly.

Perfect pillow: Just one (and make it a thin one) or none at all.

By: A.David Rahimi,MD,FAAD,FAACS (www.foreveryoung.net)

I recently came across an article on howtogetridofstuff.com that addressed treating acne and acne scarring. The article started out sounding relatively reasonable, urging patients to see a dermatologist if they have “too many” acne scars, but then suggested the following remedies.

I will cover each suggestion and try to give you a more medical perspective. My comments with be highlighted at the end of each paragraph. The article is written by Marvin? – It is not clear what his medical qualifications are.

• Drink lots of water: Water has amazing cleansing and rejuvenating properties. Some experts believe that the best way to treat acne scars naturally is to drink lots of water. Dead skin cells are shed off easier when your body is hydrated with enough water. New skin also grows faster and smoother when you have lots of water in your body.

I spend over 15 minute on pubmed.gov looking for even a single article that definitively shows drinking water affects acne or acne scarring. Pubmed.gov is the definitive research source and has every scientific article written in over 40 languages since the 1960s. It is free and can be accessed from any computer or library.  Drinking lots of water” is going to do little you for your acne and certainly nothing for the scarring. Too much water can cause can cause a variety of problems from electrolyte imbalance to very rare cases of CNS injury. I agree that drinking water should be part of a healthy diet but it won’t do much for your acne scarring.

• Eat fruits and vegetables: Fruits and vegetables contain lots of vitamins and minerals that can help your skin restore its former beauty. They also contain juices which keep your body hydrated every day. Eat lots of fruits and vegetables to make your skin grow healthier and heal acne scars.

Eating lots of fruits and vegetables is healthy but will not heal your acne scars; period.

• Load up on lemon juice: Lemon juice is a kind of citric acid that's very effective in reducing or getting rid of acne scars. Drink several glasses of lemon juice each day to help your dead skin cells shed faster. New skin cells will also grow healthier and add elasticity to your skin if you load up on lemon juice.

Are they serious? Drinking several glasses of lemon juice will cause a big hole in your stomach and may seriously interfere with absorption of naturally occurring nutrients and vitamins. Once again-no scientific basis for this at all.

Before and After photos of scar improvement with needling on our Facebook site:

http://www.facebook.com/#!/photo.php?fbid=189030387793715&set=a.189030057793748.51674.148514725178615

Skin Needling or Micro-Needling is a process that induces the formation of deep dermal collagen and enhances the appearance of deep rolling acne scars.

Acne and depressed scars are treated using very fine sterile needles (such as the Keith needle). The most depressed part of the scar is treated with repeated shallow (1-2mm) penetrations of the sterile needle. This procedure effectively separates the top scarred skin tissue from the deeper bound down scar tissue. These, in turn, produce autologous growth factors and Interleukins. The body is essentially fooled into thinking that trauma has occurred at the depths of the rolling acne scars and repairs itself.

Several treatments two weeks apart are necessary to get a significant improvement. Eventually deep rolling scars level off with the surrounding skin. The needling process can be followed by the application of TCA acids or long wavelength lasers to further stimulate the production of collagen and elastic fibers.

The procedure is performed by Dr. A. David Rahimi and takes about 30 minutes to perform. A thick layer of topical anesthesia (EMLA cream) or local injection of Lidocaine with epinephrine significantly reduces any discomfort.

Like other procedures there are risks of excessive bleeding, infection, and even scarring. I have had good results with Needling; especially with difficult and depressed acne scars and self-inflicted sores on the face and chest area.

The cost depends on the area treated and can range from $250 to $500 per treatment.

Become friends with us on Facebook or on foreveryoung.net and receive special offers.

A. David RAhimi,MD,FAAD,FAACS.

Gummy smile is an aesthetic disorder that can cause both men and women to be self conscious about their appearance and social interactions.

This condition is caused by the complex interaction between several facial muscles:

Levator Labii superioris alaeque nasi

Levator labii superioris

Zygomaticus minor

Risorius

I perform facelifts and am quite familiar with the interactions and positioning of these delicate muscles. A few units of botox, placed judiciously in the right position, can lower the upper lip a few millimeters and correct a "Gummy Smile”.

Allow your teeth to shine without being self conscious about over-exposure from your gums.

The procedure takes about 15 minutes to perform. There is no downtime, results are evident within 3-5 days, and may last up to 6 months.

The cost varies depending on how much Botox or Dysport is injected (Range $250-$500).

A. David Rahimi, MD, FAAD,FAACS.

I believe the question is not "If it is possible?"

The question should be: Is it safe?

I performed several breast augmentaions with autologous fat during my fellowship in 2000 (BAMBI). 

I then learned from Dr. Mel Shiffman and others that the transfered fat can rarely become calcified. The calcification itself is not an issue as it is microscopic but it MAY mask an underlying breast cancer. Five to seven percent of American women develop breast cancer during their lifetime.

I hope that we can develop better modalities to distinguish calcification from fat transfer to the breast from the malignant calcification that is sometimes seen in breast cancer. Until then I recommend to proceed with caution.

Below is an update on fat transfer to the breast by one of the leading doctors in the field:

Update on Cell-Assisted Lipotransfer

by Jeffrey Frentzen