Lasers Leave a Lasting Impression

We’re getting into that time of year when we might start rushing from one thing to the next. After work or a day of handling family obligations, we head straight for the mall to find the perfect gifts. To save time, some head straight to the internet for the same purpose. At the same time, we’ve got to think about how we will balance celebratory evenings with friends and family with an inherent need to rest. Amidst all of this, many of us are also somewhat concerned that we haven’t gotten around to handling those cosmetic concerns that have been hanging around too long. Not to worry, there’s still time to get more radiant before your holiday gathering. Laser treatment may be just what you need.

Aging Is More than Skin Deep

Aging happens at the cellular level. We don’t need to explain that. But when it comes to aging skin, it’s fun to sometimes look at how it all goes down, and where. You see, the skin is more than what we see. We only see the top layer of tissue, the epidermis. Beneath that are two more, the dermis and subcutaneous fat. The epidermis is the protector. It has keratinocytes that fight environmental stressors. The dermis is the supporter, it provides flexibility and firmness to the skin. Subcutaneous fat is the plumper, it provides contouring where needed.

With age, every one of these layers of tissue degrades. The ravaged epidermis becomes thin. Cells stop producing as much collagen and elastin as they once did, which decreases the firmness and flexibility of the dermis. And subcutaneous fat? Well, that layer of tissue breaks down and sags down to the jawline over time.

Lasers Get the Heart of the Matter

Laser skin resurfacing used to be pretty aggressive. Many people still perceive this to be true. It’s not. Most lasers today are fractional or use gentler wavelengths that address only what is absolutely necessary to stimulate specific responses. The light that passes through the epidermis gets absorbed by the mitochondria, which is fuel to the cells. Stimulated, the mitochondria kick cells like fibroblasts into high gear. These cells then regenerate, making new cells, as well as new collagen and elastin. Together, these responses naturally rejuvenate the skin.

Learning how aging happens and how laser treatment can help is entertaining and mildly educational. Seeing what lasers can do for your aging skin is another experience entirely. To schedule a consultation for laser treatment in our Louisville office, call 502-425-5200.

Vanquish™ is Your Liposuction Alternative

If you’ve been looking at your options for fat reduction, then you know that there is a dizzying selection of options. However, there’s no need to undergo a surgical, invasive procedure if you don’t want or are unable to. There are many different non-invasive fat reduction techniques and Vanquish might be the solution for you.

Vanquish Destroys Fat Cells Without the Hassle

While some non-invasive fat removal treatments require a handpiece or technology applied to the skin, Vanquish takes it one step further and requires no contact. It works by applying focused, multipolar radio-frequency transmitters to the fatty areas, which heats the fat cells. This causes them to release their fatty contents, which are gradually absorbed by the body as waste. This means your results only get better over time.

Vanquish Produces Effective Stomach Fat Removal

Vanquish is most effective in the fatty areas around the stomach, where most people carry a little extra fat. The best candidates for Vanquish are those that are at or near their ideal body mass index— more drastic results can require a minimally-invasive procedure like Liposuction or its laser-assisted variants. The best way to determine which procedure is best for you is through a consultation with a board certified plastic surgeon in Louisville.

Vanquish Requires a Quick and Easy Treatment Session

Although the treatment might sound painful or high-tech, Vanquish treatments can be very relaxing and tolerable. Patients usually lay on a table while the RF transmitters go to work on stomach fat, causing a warming sensation which can be adjusted if it becomes too hot. These sessions are usually grouped together in a series of 4 to 6, spaced a week or two apart. You can also speak to your aesthetician about combining Vanquish with non-invasive skin-tightening options.

To learn more about Vanquish and create your treatment plan, contact our office and schedule your consultation, during which you can discuss your options with Vanquish and our other laser treatments.

EMSculpt®: Your Complete Body Sculpting Solution

If you’ve heard of non-invasive fat removal or have even undergone a few treatments, then you should know about EMSculpt. This groundbreaking procedure can be your next step or your finishing touch as the only non-invasive fat removal procedure that also builds muscle at the same time. Interested in EMSculpt? Here’s what you should know.

How Does it Work?

This procedure uses High-Intensity Focused Electromagnetic technology to induce muscle contractions beyond what the body can achieve on its own. This causes the muscles to remodel their structure by building mass and burning fat. This is different from other body sculpting procedures that might use heat or cooling to destroy fat cells without the benefit of muscle toning. EMSculpt can also be used as a non-invasive butt lift technique.

Who is a Candidate?

Unlike other body sculpting procedures, EMSculpt exists for patients interested in putting the finishing touch on their body. If you’re working hard to slim down and want to see more definition or muscle tone, EMSculpt can help you get there. Generally, patients with less than an inch of pinchable fat find best results with EMSculpt.

What is the Treatment Like?

Although it might sound extreme, EMSculpt is not painful and instead feels like an intense workout, although you can rest and relax while the treatment happens— which only requires a 30-minute session to be effective. These are usually spaced 2-3 days apart to allow the body time to rest and recover. This treatment can even be tailored to your specific needs and can be repeated as many times as necessary.

What About Recovery and Results?

Because EMSculpt is non-invasive, there’s no downtime like a surgical procedure would require. That means you can get right back to your busy schedule and don’t need to prepare or take any post-care steps. Most patients see and feel real results right after treatment, with their results improving over the course of a few weeks after.

If you’re interested in learning more about EMSculpt and want to schedule your consultation, contact our office and speak with our skilled and experienced aestheticians to create your EMSculpt treatment plan.

Ablative vs Non-Ablative Laser Skin Resurfacing

Is your complexion looking less than fabulous? If so, you may be able to benefit from a laser procedure. Laser skin resurfacing can greatly diminish the effects of aged or sun damaged skin, acne scars, discoloration and other facial blemishes. There are two types of lasers that can be used during the procedure depending on the severity of your facial lines and blemishes.


If you are experiencing severe skin damage that covers a large part of your face, deep wrinkles, or acne scars, you will probably require ablative laser resurfacing. During this type of laser resurfacing, an intense beam of light is directed at the skin, destroying the damaged layer. The heat from the laser also causes collagen fibers to shrink, lessening the appearance of scars. Ablative laser resurfacing produces significant results, but there are a few things to keep in mind if you require this type of laser.

This is an outpatient procedure sometimes requiring a local or general anesthetic and can require up to a week of recovery and downtime. You may experience some symptoms such as swelling, scabbing, oozing, and redness.


If you have mild facial discoloration or blemishes, you might opt for a non-ablative laser. This type of laser resurfacing, because it is fractional in nature does not produce as dramatic results as ablative lasers; however, multiple treatments can still greatly diminish the look of brown spots, redness, and fine lines.

One major benefit of non-ablative laser resurfacing is that there is minimal downtime and very few side effects after. You may still experience some swelling and redness that should fade within a few days.

Are you interested in laser skin resurfacing to rejuvenate your complexion? If so, schedule a consultation at Salzman Cosmetic Surgery and Spa to determine which type of laser skin resurfacing is right for you!

Why Choose Halo™ Laser Treatments?

Are you unhappy with the appearance of your complexion? Perhaps lines and wrinkles have begun to appear on your face. Or maybe too much time in the sun has left uneven skin tone of sun spots. Don’t waste your time with “miracle creams” that claim to eliminate skin blemishes with no results. Instead, turn to Halo™ Laser for quality, long-lasting results.

How it Works

There are two types of lasers used during aesthetic treatments: ablative and non-ablative. Ablative lasers are more invasive, removing a portion of skin during treatment. Non-ablative lasers do not remove the skin, but rather cause a column of injury in the skin. Both types of lasers work by stimulating collagen production for healthier-looking skin.

Halo™ is the world’s first hybrid fractional laser. This type of laser delivers ablative and non-ablative wavelengths to provide noticeable results with little downtime. This laser treatment can address an array of skin issues, including fine lines, sun spots, and uneven skin tone. See Halo™ featured on The Doctors!

What Sets Halo™ Apart?

Unlike other laser treatments, Halo™ offers three pre-programmed levels for easy treatment. The operator simply chooses one of the three levels, and Halo™ will calculate the precise amount of energy needed to complete an effective and safe treatment session.

Dynamic Thermal Optimization (DTO) technology also continually measures the temperature of the patient’s skin and automatically changes the energy density and pulse width to confirm that the laser is always meeting specific levels. Halo™ is equipped with optical navigation, which measures the speed that the handpiece is moving to ensure an even treatment, while integrated cooling helps to keep the patient’s skin at a comfortable temperature.

If you are located in the Louisville or Lexington area and are interested in Halo™ treatments for a radiant complexion, contact Salzman Cosmetic Surgery and Spa today to schedule a consultation.

What The Sciton Laser Can Do For You

Are you unhappy with an uneven skin tone? Dr. Salzman offers ProFractional, Halo, and BBL Sciton Laser treatments at his Louisville office. These treatments can be used alone or in conjunction with each other to create a youthful, even skin tone. Read on for a breakdown of these lasers, and what they can do for you.


The ProFractional laser is used to resurface the skin with minimal downtime. It creates narrow channels in the skin, initiating the body’s healing process annd creating rejuvenated skin. This laser can improve acne scars, crow’s feet, enlarged pores, facial skin laxity, fine lines, frown lines, melasma, milia, skin texture, stretch marks, scars, and sun damage.


The Halo is the only fractional laser that can deliver both ablative and non-ablative wavelengths. This laser allows for both treatment of the top layer of the skin, as well as treatment of the dermis and deeper layers of the skin. Halo can treat uneven skin tone, sun damage, wrinkles, fine lines, discoloration, and enlarged pores.


The BBL, or BroadBand Light, treatment addresses an array of skin conditions, including acne, aging hands, skin discoloration, melasma, spider veins, stretch marks, scars, sun damage, and under eye circles. This laser offers a broad range of wavelengths, allowing for treatment of many different skin conditions without the use of additional handpieces. It is an extremely versatile treatment, and involves little downtime.

Dr. Salzman trains other doctors from all over the world regarding the Sciton laser and its applications. He most recently visited Japan for the ISAPS Congress where he presented on how multiple laser applications can be used during facelift surgery.

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If you are interested in learning more about Sciton laser treatments in Louisville and Lexington, KY, contact us today to schedule a consultation.

Introducing Vivace!

The Holy Grail it seems in plastic surgery, at least over the last 15 years or so, is skin tightening without surgery. We know that a modern facelift can restore a youthful shape of the face as well as tighten the overlying skin of the face and neck. Because a facelift necessitates making of incisions, some type of anesthesia, as well as the perceived downtime away from work or family, there are a multitude of patients who would opt for a noninvasive or minimally invasive modality to accomplish the same goals. While we do have neurotoxins such as Botox, Dysport and Xeomin, which can paralyze underlying muscles rendering the overlying crease less deep, as well as a plethora of different fillers, either made from hyaluronic acid or other substances, to make the face more youthful, none of these entities will tighten the overlying skin or improve upon fine lines for texture.

For the last 20 years or so we have had ablative lasers using wavelengths of carbon dioxide or Erbium, whether in a fractional or a full field coverage of the face that can produce skin tightening, these lasers need to deliver their energy to the deeper portion of the skin called the dermis and do not have the ability to spare the outer part of the skin called the epidermis. Therefore, when doing ablative laser resurfacing, when the outside layer of skin is removed, some downtime is necessary for healing and, until the outside skin has grown back, make up cannot be used during this healing process. This forced patients scheduling these more aggressive procedures during periods of time in which they could accept these downsides in order to obtain a result of skin tightening, correction of texture and fine lines, as well as the improvement in brownish discolorations.

Some of the newer technology, have used radiofrequency (RF) as a method of tightening skin. These radiofrequency waves, commonly used in telecommunications, have also been used in surgery for over 75 years, mostly in surgical or dermatological applications for both removal of superficial skin blemishes or cutting, and coagulation of blood vessels during surgery. RF works by rapidly stimulating the oscillation of molecules causing internal friction and thereby heat. The heat produced by RF is thought to ‘injure’ the deeper part of the skin causing an inflammatory response by the patient producing new collagen and elastin. Both of these entities, when increased, produce a more elastic and tightened skin appearance.

The first wave of RF devices applied the heat from the outside-in with some type of method of cooling to allow the heat to preferentially be absorbed in the dermis. Because of the human intolerance of outside-in heat of temperatures in excess of 43°C, there was some limitation in how much tightening one could get in a single session. Multiple weekly or biweekly treatments are necessary to produce the desired effect.

The next advancement in the application of RF was to place the heat under the skin using a long insulated needle. Here, using local anesthesia, higher temperatures at the bottom of the skin could be reached and still tolerable by the patient. The technique is called ThermaTyte and we have had this for several years now. It’s very effective for skin laxity around the belly button as well as neck. It does have some downtime, as a fair amount of dilute numbing medicine needs to be placed beneath the skin to make it tolerable.

The latest advancement in the application of RF for the tightening of skin utilizes the placement of this energy through the skin using tiny, hair size needles, known as microneedling. Microneedling involves, either with a roller or piston type stamping method, the insertion of an array of needles into the skin. No skin is removed and the hole simply closes within hours. While open, topical application of serums, that would otherwise not be absorbed, can be placed over the skin allowing them to gain entry to the deeper layers. The improvement in the quality of skin texture is limited only to the length of the linear hole that is made into the skin. Radiofrequency heat energy can be added to the end of the needle so microscopic injuries in the deeper portion of the skin can be made. We can control not only how much energy, but also how long the energy is applied, as well as the exact depth of its placement using a computerized screen. This new device is called Vivace.


Vivace uses an array of 36, 1/3000th of an inch wide, goldplated needles attached to a computerized mechanism that when placed on the skin can pierce the skin and deliver the radiofrequency energy in a fraction of a second. The technique does require the topical application of a numbing cream for about 45 minutes prior to the procedure. Because not all of the skin can be treated in one session, a series of treatments is necessary to produce the desired result. Multiple treatment depths can be done in the same session. We are commonly treating skin laxity of the face, stretch marks of the abdomen and legs, active acne as well as acne scarring using this new exciting technology.

So far, we have found this technique to be extremely useful in producing nice results in all the patients. Because the energy bypasses the outside layer of the skin, any skin color or amount of skin tan is amendable to this treatment regimen. After the procedure, we have seen that the skin is merely red or pink for a few hours. Makeup can easily be applied the following day. Some patients have found that there is a gritty feeling texture to their skin but is usually not visible under makeup. We recommend a series of at least four treatments at 4 to 6 week intervals. It seems we finally have a method to treat all patients in all seasons with issues of acne scars, stretch marks, skin laxity of different areas of the body.

What’s New in Anti-Aging of the Skin

At Skin Spa by Salzman we have been using intense pulse light for many years to reduce the signs of skin discoloration. For the increase in red and brown color spots commonly seen in aging facial skin, certain wavelengths of visible light can be selectively absorbed in these colors and reduce their visibility.

Recent published studies out of Stanford University looked at a specific type of Broad Band Light application in not only reducing the visible signs of aging skin but at the reversing of the actual age of the skin with repeated light treatments. They biopsied patients who had a series of BBL® treatments and showed that the gene expression of proteins that were made after these light treatments were like those of a younger individual. So, not only did the skin look younger with a more uniform color, but also it was younger as measured by the types of proteins in the skin.

These BBL® treatments are done in the Skin Spa by Salzman by a laser technician or RN and require no anesthesia. We recommend a beginning series of 3-5 treatments to start and then 2-4 maintenance treatments per year thereafter. Each treatment takes about 45 minutes and has no downtime. You can read more about the Forever Young BBL® program here.

Fractional Laser Resurfacing

Well, its been about 6 months in search of the Holy Grail of fractional lasers for the removal of wrinkles and discolorations of the face and neck.  The laser story starts in 1995.  At that time, CO2 laser was the rage and I embarked on a course of lasering quite a few people with weathered and wrinkled skin.  There was tremendous healing times attendant to this treatment with a pink hue to the skin that could last several months.  We also noticed that sometime later, the skin could be lighter in color and there would be a line of demarcation at the jawline.  The Fraxel® laser was introduced with the hope of less downtime but similar results to CO2.  We tried the first version of Fraxel® when it was first introduced several years ago.  We found that it hurt too much and wasn’t all that effective.  I introduced fractional lasers to our office with the Affirm® laser.  This laser uses a combination of laser wavelengths that we call non-ablative.  By that we mean that the skin is not removed only “injured” by the laser so the downtime consists of only redness for a few hours.  Like everything in life, you get what you pay for.  With limited downtime’s, multiple treatments are necessary and the results are more subtle.  For mild wrinkles and coarse facial texture the Affirm® laser is great.  Some patients wanted more results for deeper wrinkles and were OK with more downtime.  In the search for a new laser, most companies were using CO2 but in a fractional mode.  I tried several of these and found that CO2, because of the heat it produces can still have some of the unwanted healing characteristics from the early CO2 lasers of the mid 1990’s.  Along comes the Sciton Joule® using a different Erbium wavelength.  Erbium it turns out is more gentle than CO2 and heals more quickly.  However, it is the heat of the CO2 that may tighten the skin and lead to a better result.  With the Joule®, we can actually dial in as much or as little heat as we need and customize for each patient the downtime and the result.  We can mimic the characteristics of three different lasers in one machine. For instance, the Pearl® settings can be simulated on this new laser.  It’s been a few weeks now and our patients have been thrilled with the results.  We can even combine IPL treatments for color with this fractional laser in one session.  We also have combined the effects of both the Affirm® and the Joule® into one treatment package to maximize the benefits of each laser.  Slow or fast results, little or minimal downtimes: we have all the choices to make our patient’s skin look its best.

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