COSMETIC PROCEDURES
 

• BOTOX™(Anti-Wrinkle Injections)
  
  The only way to reduce deep wrinkles without surgery. BOTOX Cosmetic (made by Allergan - the ORIGINAL and only approved one - be wary of generic/imported brands) is delivered by injections with extremely fine insulin syringes (most people don't feel a thing). The effect lasts 3-4 months. The cost of BOTOXÔ is based on the number of units injected. Cost is $12 per unit  of BOTOX with an average of 20-30 units per treated area. Men require more BOTOX units than women due to greater muscle mass. Many upper and lower face applications are available (crow's feet, neck lines, jowls, down-turned lip corners, pebbly chin, etc). Below are examples of areas treated, number of BOTOX units, and approximate prices:
  
  
  
  BOTOX™ APPLICATIONS                                       
  Forehead Lines (Frontalis)... 10units             $120       
  Frown Line (Glabella)...25 units                      $300      
  Eyebrow Lift...10 units                                      $120        
  Crow's Feet (Peri-Orbital Lines)...24 units   $288      
  Bunny Lines (Nasal)...6 units                             $72        
  Mouth Corners (DAO muscles)...10 units      $120        
  Lip Lines (Smoker's Lines)...8 units                  $96        
  Platysmal Bands (Turkey Neck)...10/band   $120⁺            
  Necklace Lines (horizontal)... 10/line            $120⁺     
  Pebbly Chin (Mentalis Muscle)...3 units           $36       
  
  
               Example of Crow's Feet reduction after BOTOX
  
  
  Please note there is a 20 unit minimum per session. BOTOX is reconstituted on a daily basis at our clinic. Dr. Patel gurarantees his work and at your two week follow-up  appointment, if there is any asymmetry, touch-ups are done at no additional charge to you.
  
  A typical BOTOX session takes approximately 15-30 minutes. You can resume your normal activities/work immediately afterwards except for vigorous exercising. It is advisable that you not lay down after BOTOX to avoid inappropriate migration of the BOTOX molecules. AVOIDANCE of alcohol, aspirin or other blood thinners (Vitamin E, Ginko Biloba, Coumadin/Warfarin, anti-inflammatories) for 3 days prior is advised to minimise bruising.
  
  
  
   

• FACIAL FILLERS
  (Restylane, Perlane, ArteColl, Fat Injections)
  
  Synthetic filling materials that are safe and widely enjoyed throughout the world. Fillers come in temporary (months) and semi-permanent (years) formulations. They can be used to soften deep lines/folds, raise acne pits and scars, add volume to cheeks/chin/lips, and to help eliminate "smoker's" lines around the lips. Cost varies by type of filler and the amount needed.
  
  Not all fillers are able to be injected in the same way, nor for the same indications... As such, a consultation with Dr. Patel is required to determine the type of filling agent, amount required, cost, duration of effect, etc.
  
  
  
  
  Some mild swelling and/or bruising can occur for a few days after filler injection, but this can be easily covered with make-up. 
   

  Before Treatment After Treatment

  Example of softening of deep naso-labial folds with Restylane. This effect would last approximately 4-6 months. If a longer duration is wanted, one could choose Perlane (~ 9-12 months) or a semi-permanent filler such as ArteColl (5-10 years).

  Prices for fillers are as follows:
  
     Restylane Fine Lines: $275 (0.5mL)
     Restylane: $275 (0.5 mL); $ 400 (0.7mL); $500 (1.0mL)
     Perlane: $500 (0.7mL); $575 (1.0mL)
           * no test patches necessary 
  
  
      ArteColl: $800 (0.5mL)
            * test patch required 4 weeks prior ($75 fee)
  
  
  
  Booking in 2006
  Fat Transplantation (Fat Autologous Grafting) is another popular choice for filling and augmentation of lips/cheeks/chin. Fat cells are harvested from your own body and are then re-implanted into the desired area. The benefit is a natural filling material derived from your own body. Effects are long-lasting (5-10 years or more). This is a great combination treatment with liposculpture of unwanted fatty zones. One very nice benefit of this system is that fat cells that are removed can be "banked" for future use in a deep freeze -- to be thawed and reconstituted during touch-up  or additional augmentation sessions. 
  
  
   

• CHEMICAL PEELS
  (Glycolic Acid, TCA, Jessner)
  
  A series of precisely timed chemical peels is an excellent method to rid the upper layers of skin of dead and discoloured cells. Using a safe collection of proven peeling agents, you can achieve an absolute reduction in skin irregularities, acne scars, brown spots, and wrinkles. Downtime is minimal and you will experience some mild redness after each application. Cost is based on strength (depth) of the peel and area treated.
  
  Light-Medium and Medium-Deep depth peels usually offer the best overall result. Redness and flaking may persist longer than glycolic acid (approximately 3-7 days) but the end result is worth it. This peel is done in segments making it more comfortable than the glycolic acid peel (usually applied to the full face in one application). A typical full face medium depth peel (combination: Jessner's + TCA 20%/30%) is $350.
  
  
  Glycolic Acid peels are superficial peels and are best suited for mild irregularities and blemishes. They are associated with the least downtime. A series of peels may help with stubborn areas as well as help to reduce fine lines.  Since some pigmentation lies beneath the epidermis, glycolic acid peels may not be able to completely remove all markings. The cost is $200 for the full face.
  
  
   

• MEDICAL MICRODERMABRASION (Exfoliation)
  
  Using a high-speed vacuum jet of micro-crystals, we can literally sandblast the skin on a microcopic  level causing a lifting away of dead cells, de-clogging of pores, improvements in fine lines and scars, and an overall reduction of acne, blemishes, and brown spots. This popular 45 minute full-face treatment is relaxing and painless. A single treatment is $175 (includes post-treatment daily moisturising cream by Alyria - 50 g). A package of five treatments is $750. The best approach to doing multiple microdermabrasion treatments is every two weeks for the first group of 4-5 treatments... then one treatment every few months to maintain the youthful appearance. Post-treatment skin cream programs are available to maintain the achieved results.
  
  
   

• Spider Veins / Telangiectasias
  (Broken Blood Vessels)
  
  By using Laser  or Electrocautery (tiny heated electrical probe), small broken blood vessels (also known as spiders or telangiectasias) can be obliterated permanently. Discomfort is minimal and feels like tiny mosquito bites (numbing cream is applied to the treated areas and this does help reduce sensation during the procedure. Vessels that respond best to electrocautery and laser are generally those that are less than one millimetre in diameter. Larger vessels may require repeated treatments before they diminish.
  
  The fees for this procedure are based on number of vessels requiring treatment. An estimate can be provided at the time of your consultation.
  
  
   

• MINI-FACELIFT
  (Modified S-LIFT, RAPID-Lift)
  Coming Soon...
  
  Full face-lifting requires much downtime, is costly, is generally done in a hospital, can require IV sedation or general anesthesia, and has a longer down-time (weeks). The new RAPID-Lift procedure is an in-office, approximately 1.5 hour procedure that requires only local anesthesia and costs a fraction of the typical facelift fees, recovery is fast (days) -- and most importantly, results are immediate and very dramatic. Results are NOT dependent on the purchase of "threads" and other pull-up devices/implants.
  
         
           Typical results of Modified S-Lift...Courtesy of Dr. D. Brandy, USA
  
  
   

• SCLEROTHERAPY FOR VEINS
  
  Unsightly varicose veins (dilated veins) can be treated by injecting them with a highly concentrated saline (salt water) solution. This causes the vein walls to become irritated and collapse. Facial, bodily and limb veins are all amenable to this standard method. Only a minimal superficial irritation is felt with some temporary bruising of the treated areas afterwards. Under limited circumstances, OHIP does cover the cost of a limited session of sclerotherapy for varicose veins -- a consulltation is required to evaluate for such coverage.
  
  Compression stockings are required for any varicose veins treated in the legs (JOBST stockings are available through our office) and must be worn in the post-operative period for two weeks.
  
  
  
   

• COSMETIC MOLE / BLEMISH REMOVALS
  SKIN TAG REMOVALS
  
  Moles, skin tags, cysts, lipomas (benign fatty growths), and scars can all be removed for cosmetic reasons in the luxury of our private operating room. The smallest possible incisions are used to remove the lesion. Very fine cosmetic sutures are used for closing the wound minimising scarring.  Skin tags and some moles are removed without the need for sutures. All patients are provided with post-surgical dressing kits and topical post-operative ointment during the healing stage. Sutures are removed approximately 7-10 days after surgery (facial sutures are removed in 5-6 days).
  
  Fees for cosmetic skin lesion removal vary by: type, area/size,  or difficulty of removal. Moles/Sunspots that are surgically shaved off start at $75 per lesion.  For cysts and lipomas, fees generally range from $300 to $450 (very large lesions > 10cm diameter are priced on an individual basis). Skin Tags are priced based on the number you have - minimum sessional fees start at $200.
  
  Assessment of suspicious lesions or moles is an OHIP covered service. When necessary, biopsies are done to evaluate for cancerous or pre-cancerous changes.
  
  
  
   

• MICRO-LIPOSUCTION / LIPOSCULPTURE
  coming Soon...
  
  Like traditional liposuction, fat is removed by using surgical cannulas under the skin to contour "hills and valleys". In this case, Micro-cannulas are used to sculpt smaller areas such as jowls (neck), saddlebags, waist rolls, etc. Procedures generally involve infiltration of dilute local anesthetic in the areas of interest followed by painless removal of fat. This procedure is done in-office, you are awake, it is quicker (approximately 1-2 hours), you heal faster (a few weeks), and has minimal downtime (you can resume work in a few days; most activities by two weeks, and gentle exercises as soon as you are comfortable).
  
  Post-operative compression bandages/garments are required during the healing phase -  these are included in the cost. Fees vary by areas and technical time for each individual - they start at approximately $1750 per area.
  
  LIPOMA REMOVAL
  Liposuction is also being used in the removal of lipomas (benign fatty tumours). The advantage is a smaller incision (required only to accomodate the micro-cannula) and faster healing. In some cases, only a single stitch or skin glue is required to close the incision created.
  
  
  
  
   

• LASER FACELIFT
  (COOLTOUCH Thermescent Treatments)
  New to London
  
  Using the ultra-safe COOLTOUCH Laser (Nd:Yag 1320nm), non-invasive skin tightening procedures (based on collagen stimulation and re-modelling) are a great alternate to surgical face-lifting. This unique laser has an in-built process of cryogen spray that is released with the laser so the skin is chilled at the time of lasering (no creams, cold gels, or topical anesthetic required) - see movie clip below.
  
  There is NO downtime to these procedures and they are done as a series of treatments (usually five treatments over a period of four months) - unlike THERMAGE treatments that we did previously whereby one treatment had to achieve the goal making it more painful. The other major benefit to COOLTOUCH  is the fact that with multiple treatments, an additive effect is being achieved by your final treatments.
  
  Crow's feet, lip lines ("smoker's" lines), jowls, and forehead wrinkles are popular areas treated with this technology. The age-reversing effects are long-lived. In combination with BOTOX to reduce wrinkling, this procedure is excellent for individuals not interested in facelifting, deep peels, or dermabrasion.
  
  Click here to see movie
  For more interesting information please see http://www.cooltouch.com/patients.html
  
  Fees for COOLTOUCH are based on area treated. A partial face (approximately one third of the face - forehead, mid-zone, or jowl/mandibular area) costs $1800 for all 5 treatments. A full-face treatment costs $4200 for all 5 treatments. Included in this fee are five microdermabrasion treatments -  usually done two weeks after each COOLTOUCH treatment. The benefit of this combined approach is that you get surface refinishing while simultaneously deeper level collagen remodelling and skin tightening.
  
  
   

• STRETCH MARK REDUCTION
  
  The COOLTOUCH Laser is used in combination with Microdermabrasion and/or chemical peels to help reduce stretchmarks. Multiple treatments are required for visible effects and a custom package can be created for your particular condition.
  
  
  
  
   

• LASER TATTOO REMOVAL
  
  Laser tattoo removal is a popular procedure at VISAGE. We see a large number of clients for this procedure. In some cases, a combination of techniques are used to remove a tattoo (peels, dermabrasion, cryotherapy, electrocauterisation).
  
  Now, tattoo ink particles also can be removed with laser technology. Dark ink colours (black, dark blue, dark brown) will be removed with higher efficiency than lighter colours. Some colours cannot be removed by our lasers (yellow, pink, light orange, white, etc). Usually, 5-10 treatments are required to eliminate most ink particles. It is important to budget for multiple treatments although many clients are happy with results achieved after only two or three sessions.
  
  
  Some scarring and hypo-pigmentation (lightening) of treated areas is expected after treatment. Cost is based on the surface area of the tattoo treated -- $20 per cm². Minimum fee is $100 per treatment. For example, a 3 cm by 3 cm tattoo would cost $180 per treatment (or $900 for 5 treatments).
  
  
  The minimum fee is $100 per treatment. Extensive areas are priced on an individual basis. Treatments are scheduled every 4 weeks to allow for healing after each session.
  
  
   

• DERMABRASION
  
  Dermabrasion is a surgical procedure that essentially re-planes your skin using a high-speed (approximately 20,000 RPM) rotating wirebrush or diamond-wheel. Skin is anesthetised with topical and local analgesics prior to the procedure making it painless. Dermabrasion is reserved for stubborn deep acne pits/scars, depressed wounds, tattoos (not amenable to laser removal), resurfacing deep wrinkles, etc. The downtime associated with dermabrasion is dependent on the area treated. Special dressings are required post-operatively and close supervision is provided during the healing phase.
  
  Fees for Dermabrasion are based on area and depth of treatment.  A minimum session fee of $800 applies to all dermabrasion cases. Occasional touch-up or refinement sessions may be required -- these are subject to additional fees.
  
  
  
   

• ACNE PIT/SCAR REMOVAL  &
  SCAR REVISION THERAPY
  
  Deep acne pits/bodily scars are managed in a number of ways. We can offer treatments such as non-invasive topical creams, lasers and microdermabrasion. Also, deeper chemical peels, dermabrasion, punch excisions/grafting, excision and suture, etc can also be done to soften or eliminate the deeper skin irregularities. As with all procedures of this nature, it is important to understand that the goal is improvement of the condition -- perfection or return to completly flawless skin is generally impossible and unrealistic.
  
  Large, unsightly surgical scars can be revised by cutting out the original scar and re-approximating the skin precisely using cosmetic sutures and glues. Cost is based on length and width of the existing scar. Post-operative Silicone gel/sheeting is included in the surgical fee.
  
  
  
   

• MINOR EAR RESHAPING
  
  Occasionally, slight irregularities/imperfections in the contour of the ear helix can be improved by a reshaping procedure of the underlying cartilage and removal of any redundant skin. Please note: This is not a re-pinning/reduction procedure for outstanding or large ears (for this we can refer you to see a Plastic or ENT surgeon).
  
  
                  
  Unretouched photographs of minor reshaping of the helix/pinna by removal of a small section of cartilage with subsequent rounding and redraping of skin. Scar is hidden and usually almost invisible.
  
  Fees start at $500 per ear.
  Complex/staged repairs start at $1000 per ear.
  
   

• TORN EARLOBES / REPAIR of EARLOBE
  
  
  In cases of ear piercing holes that have been widened/torn due to heavy earring use, trama, or fashion spacers/barrels, surgical revision is possible to restore the earlobe to a prior state.
  
  We excise the irregular surface skin and close the repaired area with combination of extremely fine cosmetic sutures and cosmetic skin glues.
  
  Acutely torn earlobe (within 6 hours) are covered by OHIP -- after this time period, they cannot be closed urgently and must be closed as a cosmetic procedure after a few weeks of initial healing. 
  
  Fees start at $500 per simple earlobe revision.
  Complex repairs start at $1000 per earlobe.