As fall is in full swing and the temperatures are dropping, (except here in Texas!) we need to heat our homes.  This is when more people start to complain of dry skin.  SkinMedica® has an answer to dry skin, with their hydrating product, HA5.

HA5 is a clinically tested hydrating serum containing 5 forms of hyaluronic acid.  These different forms of HA work synergistically together to hydrate the skin, diminishing  the appearance of fine lines and wrinkles.  The product packs a punch of hydration for a light weight feeling product.  The HA is in a sustained release formulation which provides hydration throughout the day. Additionally, HA5 supports the skins ability to replenish its own hyaluronic acid.  We lose HA as the years pass.  We have 50% less by the time we are 50 than we did when we were 20.  This product works well with other products and helps to retain moisture in addition to the moisture it provides.  In addition to the hyaluronic acid this SkinMedica® product contains Vitiscensce™ Technology, a combination of stem cell extracts, antioxidants, peptides and plankton extract.

HA5 has a light silky feel.  It is meant to be used twice a day.  Think of it as an additional dose of moisture during these drier months.  It can be used anywhere to boost hydration so don’t forget about your neck and chest!  The results will be softer, smoother skin with fewer lines.  Rough skin will appear markedly softer.


With continued use the skin improves even more,


This product is available at TOC Medical Spa.

Here are the ingredients, for fellow ingredient deck analyzers!

HA5 Ingredient Deck

Water/Aqua, Dimethicone, HDI/Trimethylol Hexyllactone Crosspolymer, Glycerin, Butylene Glycol, Bis-PEG-8 Dimethicone, Polysilicone-11, Sodium Acrylate/Sodium Acryloyldimethyl Taurate Copolymer, Sodium Hyaluronate Crosspolymer, Hydrolized Hyaluronic Acid, Sodium Hyaluronate, Vitis Vinifera (Grape) Flower Cell Extract, Vibrio Alginolyticus Ferment Filtrate, Alteromonas Ferment Extract, Porphyridium Cruentum Extract, Whey Protein, Plankton Extract, Trehalose, Urea, Serine, Algin, Caprylyl Glycol, Pullulan, Disodium Phosphate, Potassium Phosphate, Pentylene Glycol, Polymethyl-silsesquioxane, Glyceryl Polyacrylate, Sodium Citrate, Sea Water, Sucrose Palmitate, Tocopheryl Acetate, Hydroxyacetophenone, Polysorbate 60, Propanediol, Potassium Sorbate, Citric Acid, Isohexadecane, Polysorbate 80, Silica, Decyl Glucoside, Tromethamine, Ethylhexylglycerine, Phenoxyethanol, Disodium EDTA.




Our skin is a direct reflection of what we are feeding eat.  Want a glowing complexion?  Have an important event, such as a reunion, that you are gearing up for?  Consider making some alterations in your diet to help your skin look its best.

Incorporating the following foods, while minimizing sugars, simple carbohydrates and processed foods, will help your skin by nourishing it from the inside and decreasing inflammation.

The Rule of 5- Try to have at least 5 servings a day of fruits and vegetables.  Vary the colors as much as you can.  Veggies that have been shown to be helpful include tomatoes, varied colored bell peppers, sweet potatoes, pumpkin, kale, spinach, avocadoes and carrots.  Fruits that have been shown to be helpful include berries, pomegranates, citrus fruits and red grapes.  These fruits and veggies are loaded with antioxidants, anti-inflammatories and healthy fats (avocado).  (these were just a few ideas, there are loads more!)

Adding nuts as a snack can also be beneficial.  Walnuts and Brazil Nuts are particularly beneficial due to their omega-3 fatty acids and, in the case of Brazil Nuts, selenium content.  (one Brazil nut has over 100% of the daily recommended Selenium!)  Almonds are also a great addition.  A small serving of nuts can be surprisingly satisfying.

Drinking plenty of fluid each day is also important.  Water, water with fruit or cucumber and green tea are great fluids to keep handy to maintain hydration.  The green tea is a touted antioxidant and anti-inflammatory.  (two servings a day seems to be ideal, more than that may be too much caffeine)

Here is one I love…. Chocolate!  Chocolate with at least 70% cocoa is actually a healthy snack in small quantities (that’s the hard part) as it contains flavonoids.  So, if you have a sweet tooth allow yourself this option knowing it could actually give you a glow!

The diet would ideally contain two servings of fish (for example, salmon) per week.  Healthy fats and lean proteins are recommended.  One exception is incorporating several eggs per week.  The egg yolks are high in saturated fat (approximately 5 grams) but are a great source of Biotin which is beneficial to the skin and hair.

So, if you are up for a little modifying of your diet the above recommendations may leave you with clearer skin with a nice glow in addition to giving all of your other vital organs a diet rich in healthy fats, sufficient protein, omega 3&6 and antioxidants.

Good luck!




Lips are an area that we augment frequently in aesthetic medicine.  Contrary to popular belief, lips can be done to look fuller without looking like a cartoon character or Goldie Hawn in “The First Wives Club”.

We lose volume in our lips with age in addition to a certain amount of inward rotation.  Women frequently complain about the loss of volume and fine lines surrounding the lips in to which lipstick bleeds.  These issues can easily be addressed with dermal fillers such as Juvederm® or Restylane®.    The selection of products keeps growing, allowing you and your provider to select the product which best suits your lips.  The Restylane® family of products has  Restylane®, Restylane® Silk and Restylane® Lyft.  The Juvederm® family of products includes Juvederm® Ultra, Juvederm® Ultra Plus, Juvederm® Voluma and, the newest to the market, Juvederm® Vobella.  These are ALL hyaluronic acid fillers and can be reversed with a product called hyaluronidase if needed.

The fillers differ in characteristics including the mg/ml of hyaluronic acid and the cross linking of the particles.  Some of the products are firmer (more cohesive) and are better for structure while others are softer and more malleable for finer work.  Some of the fillers attract more water, or are more hydrophilic,  than others. Your provider  takes all of these properties in to consideration depending on where the product is being placed and what your goals are.


In terms of the lips we like to add structure and volume.  Redefining the cupids bow and philtral columns in the upper lip can have a dramatic impact without adding any volume to the lip itself.  Our philtral columns tend to flatten with time and we lose the dimensions we had when we were younger.  Your provider will assess with you what you are wanting to achieve while also pointing out to you the anatomy of your lip and where product placement will have the most impact.  The goal is to make your lips look their best, not to make your lips look like somebody else’s lips.  (ie: We have all had patients request Angelina Jolie lips, which would look absurd on most people)

Patients definitely express concern related pain with lip injections.  All of the products contain lidocaine and most providers will numb you with a topical numbing cream prior to injections.  Ice can also be very helpful.  Another option,for those who want to be really numb,is a dental block which numbs the whole region.

Another option around the mouth is small doses of Botox® to weaken the oral muscle that pulls the lip in and creates the fine lip lines.  The dosing needs to be conservative as the goal is to relax the muscle but not paralyze it.

Here is an example of lips before:


And lips after:


The above patient was treated with 1 ml of Restylane® .

If you have ever considered lip filler, hopefully this will help you to better understand what is available and minimize any anxiety surrounding the process.

We inject lips every day at TOC Medical Spa.



I am pretty sure my audience is mostly women, but I wanted to do a quick blog on skin care for men.  Honestly, every post I do for women would also apply to men ,but I thought I would highlight a few treatments and products that male patients  utilize and inquire about.

  1. Skincare– A solid skincare routine can benefit anyone.  A topical antioxidant and sunscreen every day are no brainers.  Male clients tend to like SkinCeuticals antioxidants.  Phloretin CF®, CE Ferulic® and Resveratrol B E are all quality topical antioxidants that can be incorporated in to a daily routine.  The antioxidants support collagen production, protect from free radical damage, protect from UVA/UVB radiation and can help minimize redness by strengthening vessels.  Additionally, there are studies showing that utilizing a topical antioxidant can prevent the development of certain skin cancers.  An antioxidant followed by a quality sunscreen would be the two most important components of a skin care regime.  Ideally, the sunscreen would contain at least 7% Zinc Oxide.  Protecting from the suns radiation is the most important step in any skincare regime. (I would argue that, if nothing else, EVERYONE should be using sunscreen) Elta MD® UV Clear SPF 46 seems to be the most popular sunscreen for men at TOC Medical Spa.  A great moisturizer that men seem to like is SkinMedica® HA5 Rejuvenating Hydrator.  This is a weightless moisturizer, blending five forms of hyaluronic acid, which help to diminish the appearance of fine lines and wrinkles.  Men can also benefit from the use of a retinol/retinoid to increase the skins cellular turnover and stimulate collagen.


  1. Botox®/Fillers– Male clients are no stranger to these mainstays in aesthetic medicine.  Botox® for men is becoming more and more utilized everyday. (one in ten Botox® clients are male)   Maybe as men see their female counterparts experiencing the benefits of these minimally invasive treatments they are wanting to get on board.  In my experience, my male patients seeking Botox® treatments are frequently aging in the work force and feel it gives them a certain edge to keep looking their best.  Allergan has a great resource online for those who are interested, www.botoxcosmetic.com/men.  The same goes for fillers.  Men can benefit from the addition of lost volume.  The midface is the most frequently treated area.  Hyaluronic Acid fillers and Sculptra are great options for men.
  2. Kybella®–  This is new to the tools we have at our disposal in aesthetic medicine.  Kybella® (there is a whole blog on it a few months back) can make a huge difference in the sub-mandibular fat (under the chin).  I see a lot of men who could benefit from this treatment.  Essentially,  fat is dissolved with an acid (deoxycholic acid)  and the appearance of the submental area and jawline are dramatically improved.  I have been very impressed with the results of this treatment.  www.mykybella.com


These are just a few examples of what is available for men seeking aesthetic treatments.  I know women are not the only ones wanting to slow down the appearance of aging as the years go by 🙂