Hair Loss Treatment at MSI. How We Do It?

Minimally invasive procedures to tighten and lift skin give natural results with minimal risk and recovery time. Monopolar radiofrequency delivers a high-frequency electric current—tissue resistance to electrical current results in volumetric heating to the deep dermis and underlying tissue. The resulting heat leads to immediate collagen contraction and a delayed wound healing response, with new collagen formation up to 4 to 6-month post-treatment. INITIALLY, the FDA approved monopolar radiofrequency (RF) devices to treat periorbital wrinkles. Since then, they have been used to treat laxity of the forehead, cheeks, nasolabial folds, marionette, lines, jawline, and neck. Although the results of RF are not as dramatic as a facelift, over 90% of patients obtain noticeable tightening of the treated areas, and it never looks “pulled.” Another benefit of radiofrequency is reducing fat and tightening the skin by directing energy to target collagen. For example, a patient with flabby upper arms may have more loose skin than fat in this area. In this instance, Prof Moawad might use radiofrequency to tighten the skin first and then remove excess fat. However, if he determines that there is fat mainly in an area, he will remove the fat first and then tighten the skin afterward. “Radiofrequency is a versatile procedure that can be used on any area of the body – from large areas like the abdomen to minimal areas such as the chin – with the same degree of success.

At MSI, every treatment option begins with a complimentary video-microscopic hair density test and digital documentation so that results can be calculated and monitored. MSI offers physician formulated hair tonics. Hair tonics contain two drug molecules (i.e., 5% minoxidil solution and finasteride) to stop hair loss and help hair regrowth. During mesotherapy, the minoxidil, finasteride, vitamins, and trace elements are microinjected. Growth Factors for hair regrowth are added to our cocktail when mixed with Platelet-rich plasma (PRP). Several-time weekly application of a laser-emitting device (LED) to "stimulate" hair growth of existing miniaturized hairs is one of the new light therapies for hair loss. The most recent available treatment of both hair preservation and restoration is the newly introduced combination of mesotherapy, infrared technology, and oxygen therapy, platelet-rich plasma (PRP), and nano fat or micro fat (stem cell therapy). Penetration of PRP and nano fat or micro fat is eased with the use of microneedling, dermal roller, or the use of fractional radiofrequency. Hair restoration has become increasingly popular in recent years with both men and women. New technologies such as follicular unit extraction and grafting have made it possible for patients to get a natural-looking result with minimal downtime. In addition to hair loss treatment, a variety of conditions can be successfully treated with hair transplantation. Scarring of the scalp, facial scars due to trauma or surgery, and hair loss due to traction can be repaired with hair transplantation. Finally, hair transplantation can be successfully used to restore hair to the eyebrows; eyelashes; beard, mustache, or goatee area; and even in areas of the body, such as the pubis or chest.

Fractional radiofrequency (FRF) is the newest in the nonabrasive approach. FRF uses an array of microneedles arranged in pairs between which bipolar RF energy is delivered. The fractionally delivered energy creates zones of thermally damaged skin adjacent to unaffected areas. The damaged skin stimulates wound healing and deposits new collagen, elastin, and hyaluronic acid formation. The unaffected areas serve as a reservoir of stem cells that accelerate wound healing.  FRF improves acne scars, large facial pores, and skin quality. FRF devices are safe, tolerable, and effective modalities for wrinkles and facial laxity reduction. I may use a topical anesthetic cream before the treatment to minimize pain. Fractional radiofrequency is combined with PRP with significant amounts of growth factor and heal promoting factors to fasten healing. Recently, Nanofat has been combined with fractional radiofrequency to enhance skin quality and stimulate hair follicles. Fractional radiofrequency gives a wake-up call to your skin to remove injured collagen and elastic fibers, encouraging your fibroblast to synthesize new collagen and stimulate hair follicles to stem cells.

Skin rejuvenation laser peel involves the removal of the outer layer of damaged skin. Many ablative skin resurfacing techniques are available at MSI, broadly grouped as mechanical, chemical, and laser abrasion. All ablative techniques result in upper to the mid-dermal wound. Dermabrasion relies on mechanical 'cold steel' injury, acid peels result in a 'caustic' injury, and lasers result in a thermal injury. All ablative resurfacing treatments work the same way. First, the outer layers of damaged skin are stripped away. Then, as new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. Superficial or medium resurfacing is limited to the epidermis and papillary dermis. For deeper resurfacing, I can also remove the upper levels of the reticular dermis. Unlike chemical peels and dermabrasion, laser skin resurfacing (LSR) with the CO2 laser generates heat, which results in immediate tightening because of the shrinkage of collagen, which forcefully shortens the collagen fibers by 30%. This translates clinically into the smoothing out of superficial irregularities, including wrinkles, acne scars, nevi, epidermal growths, and even tumors, and a tightening effect that improves the skin's overall appearance. The laser stimulates the growth of healthy new collagen and elastic fibers in the skin continuously for six months after resurfacing. Therefore, any wrinkles or scars will continue to improve for up to one year. Nonablative or minimal ablative fractional CO2 holds great promise in both treatments of skin textural abnormalities (acne scarring, wrinkles, and skin mottling associated with photoaging) and pigmentary variation (melasma, hyperpigmented scars, lentigines, and dyschromia

Acne inversa or hidradenitis suppurativa (HS) is a disease that usually begins as pimple-like bumps on the skin. The pimple-like bumps tend to develop in places where everyday pimples do not appear. HS is most common on the underarms and groin. Getting treatment for HS is important. Early diagnosis and treatment can prevent HS from worsening. If HS worsens, the pimple-like bumps can grow deep into the skin and become painful. They can rupture, leaking bloodstained pus onto clothing. This fluid often has a foul odor. As the deep bumps heal, scars can form. Some people develop tunnel-like tracts under their skin. As the skin continues to improve and scar, the scars thicken. When thick scars form in the underarm, moving the arm can be difficult. Thick scars in the groin area can make walking difficult. Because HS can look a lot like acne, folliculitis, or boils, it is best to see a dermatologist for a diagnosis.

A dermatologic surgeon usually does plantar warts removal. Plantar warts are small growths that usually appear on your feet' heels or other weight-bearing areas. This pressure may also cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by HPV. The virus enters your body through tiny cuts, breaks, or other weak spots on the bottom of your feet. Dermatologists have many treatments for warts. The procedure used depends on the patient's age and health. I prefer to cut the callus by scalpel. Then I use a curette to remove the viral material. Then I use a vascular laser to burn or cauterize tiny blood vessels that feed the virus. Then it cauterizes the base using an ablative laser or chemical TCA. A topical antibiotic is applied, and a special dressing is applied. The patient can walk without any pain immediately

There has been a 70% increase in minimally invasive cosmetic procedures and a 50% increase in dermabrasions over the past decade. Dermabrasion has many applications as a skin resurfacing technique and is used to treat fine perioral rhytids and many scars, including acne scars. It is done under local anesthesia with the option of sedation. The area to be dermabraded is marked. The appropriate diamond fraise tip is chosen, the skin is held taut, and the dermabrader is moved across the surface with constant, gentle pressure. A back-and-forth motion is used for the diamond fraise tip. The borders of the treated area are feathered to prevent any noticeable transitions. The depth of skin that is dermabraded is one of the most critical factors that will determine the outcome. Punctate bleeding is visualized when entering the papillary dermis. The papillary reticular junction is the ideal endpoint of Dermabrasion and is identified by increased, confluent bleeding. Immediately following the procedure, saline-soaked gauze moistened with dilute epinephrine may be temporarily placed on the open wounds to achieve hemostasis. A moist environment is necessary to promote wound healing. Dermabrasion is a useful skin-resurfacing tool; when performed correctly, it can achieve dramatic results and can be more effective than chemical peels or lasers, with a low risk of complications in patients with darker complexions

Upper eyelid lift surgery or blepharoplasty is required when the eyelids require recontouring. Specifically, blepharoplasty is most useful when excess skin needs to be removed, the orbicularis oculi muscle is hypertrophic or requires tightening, or orbital fat should be removed or redistributed. Upper eyelid lift surgery typically involves an incision made in the natural crease above the eye. Your cosmetic surgeon will remove a precise amount of excess skin and fat and adjust the surrounding muscles to make the desired improvements.

Lower eyelid lift surgery or blepharoplasty involves several surgical approaches. Cosmetic surgeons can use various surgical techniques to improve the lower eyelids; incisions are located on the outer edge of the lower eyelid, just beneath the eyelashes, or inside the eyelid. Your cosmetic surgeon will explain the approach they determine is best for you. Your cosmetic surgeon will remove or reposition fat through the incisions to create a smooth, natural contour beneath the eyelid. Depending on the case, I may remove excess, sagging skin or tighten the lower eyelid muscle to supply the most natural, effective results. Lower eyelid transconjunctival blepharoplasty is readily carried out using the CO2 laser or standard incisional devices (radiofrequency)

Light skin treatment or photo-rejuvenation encompasses many procedures using light or laser-based technology to reverse the effects of photoaging. Photo-rejuvenation refers to the controlled use of thermal energy to enhance skin rejuvenation without disturbing the overlying epidermis and with minimal to no downtime. Currently employed non-ablative modalities include primarily intense pulsed light (IPL), visible wavelengths including 585nm pulsed dye laser (PDL), and 532 nm green light (KTP laser). Different infrared wavelengths with water as the target are used for remodeling dermal collagen. The primary mechanism of action is thermal injury, either by heating the dermis to stimulate fibroblast proliferation or by heating blood vessels for photocoagulation. The newest way to deliver these wavelengths is by fractionating the dose. The non-thermal mechanism, which represents a fundamental change in thinking, is the theory of photo-modulation. This novel approach to photoaging uses non-thermal light treatments to regulate the activity of cells and not invoke thermal wound healing mechanisms. The two types of photo-rejuvenation available are the Intense-Pulsed Light (IPL) and the Light-Emitting Diode (LED) treatments. It's essential to understand the difference between these technologies to get the results you hope to do. Your best bet for minor skin problems is to schedule an LED (often called a Non-IPL) treatment, and for more severe conditions, you'll book to IPL.