Abdominoplasty: A surgical procedure done to flatten the abdomen by removing extra fat and
skin, and tightening the muscles in the abdominal wall. This procedure is commonly referred to as a
Ablation: Ablation is the removal of material from the surface of an object by vaporization,
chipping, or other erosive processes. In the aesthetic field, ablation refers to the removal of tissue.
Accutane®: A medication used to treat acne; it decreases the amount of oil produced by the skin’s
sebaceous (oil) glands.
Acne: Acne lesions form when the opening of oil glands (called sebaceous glands) in the skin
becomes blocked. Trapped oil builds up within the gland, causing inflammation. The swelling within
the oil gland can become so intense that the oil gland (and associated hair follicle) can rupture,
leading to further inflammation.
Acne scar: Scars due to severe acne. There are different kinds of acne scarring: ice pick scarring,
atrophic scarring, and hypertrophic scarring. Ice pick scars are deep pitted scars with steep
edges. Atrophic scars are pitted but have smooth borders and are not as deep. Hypertrophic scar,
more common on the back and chest, are thick lumpy scars that sit above the surface of the skin.
Actinic Keratosis (AK): An AK is a precancerous growth that is a scaly or crusty bump
that forms on the skin surface. They range in size from as small as a pinhead to over an inch across.
They may be light or dark, tan, pink, red, a combination of these, or the same color as the
patient’s skin. The scale or crust is horn-like, dry, and rough, and is often recognized easier by touch
rather than sight. Occasionally AK’s itch or produce a pricking or tender sensation, especially
after being in the sun. They may disappear only to reappear later. Keratoses are most likely to appear
on sun exposed areas: face, ears, bald scalp, neck, backs of hands and forearms, and lips.
Age spots: Also called liver spots, lentigo simplex and senile lentigines. These flat, gray
brown or black spots affect more than 90 percent of fair-skinned people after age 5O. They range
from freckle-size to a few inches across. They’re most common on the face and the backs of the
hands – areas most exposed to the sun. They may darken with sun exposure. True age spots never
become cancerous and don’t need treatment. However, they can look like cancerous growths.
For cosmetic reasons they can be lightened with skin-bleaching products, BroadBand Light (BBL)
or removed. The patient can help prevent new spots by avoiding the sun and using sunscreen.
Albinism: An inherited disorder in which there is no pigmentation in skin, hair or eyes, due to the
absence of melanin, the substance that gives skin its color.
Alopecia: The complete or partial loss of hair, usually on the scalp.
Alpha Hydroxy Acids: Alpha hydroxy acids are derived from foods, such as fruits and milk, and
are commonly found in skin care products. They can improve the texture of skin by removing
layers of dead cells, a process called exfoliation, and encouraging cell regeneration.
Angiogenesis: Angiogenesis is the development of blood vessels.
Artecoll: A tissue agent comprised of three ingredients. One of the ingredients, PMMA, is a
material used to bind bones and artificial hips. For cosmetic purposes, the PMMA is prepared in
smooth microscopic beads specifically sized to go through a fine needle. The two other ingredients
include collagen, as a delivery system, as well as a trace dose of anesthetic to minimize discomfort.
Artecoll is injected into the target area where the beads provide a lift and the support structure beneath the skin. While the injected collagen eventually dissipates, the procedure stimulates production of the patient’s own collagen so that it can grow around the beads and serve as permanent filler.
Atrophy: Atrophy is the partial or complete wasting away of a part of the body. In aesthetic medicine, it uusually refers to thinning of the epidermis leaving an easily wrinkled and/or shiny surface. Atrophy may also apply to dermal and/or subcutaneous tissue, with or without changes in the epidermis.
Azelaic acid: A naturally occurring substance found in wheat, rye and barley. It has antibacterial properties and is used in skin care products to treat mild acne.
Basal cell carcinoma: BSA or basal cell carcinoma is the most common form of skin
cancer and occurs in the epidermis. These growths are often round and pearly or darkly pigmented.
Benzoyl peroxide: An antibacterial medication used to combat the bacteria that aggravates acne.
BBL/BBLs™- JOULE™ BroadBand Light (BBL)
can treat a wide range of conditions without the need for additional handpieces. Wavelength can be
selected by simply changing filters which are recognized by the smart JOULE control system, making BBL the most affordable and the most valuable intense pulsed light
Beta hydroxy acid: An oil-soluble exfoliant that is commonly found in skin-care products. Beta
hydroxy acid (salicylic acid) is used to treat wrinkles, blackheads and photoaging.
Blepharoplasty: A primarily cosmetic surgical procedure that reduces bagginess from lower eyelids and raises drooping upper eyelids. The procedure involves the removal of excess skin, muscle and underlying fatty tissue.
Brachioplasty: Brachioplasty is a surgical procedure, also known as arm lift, to correct sagging of the upper arms.
Breast augmentation: A surgical procedure done to increase breast size.
Botox®: A substance derived from botulinum toxin that works by preventing nerve impulses
from reaching the muscle, causing the muscle to relax and not be able to contract or move.
Brow lift: A surgical procedure in which the skin of the forehead and eyebrows is lifted and
tightened to eliminate sagging eyebrows and/or correct frown lines in the forehead.
Buccal Fat Pad: Buccal fat pads are located above the jaw line near the corner of the mouth.
They can be removed in individuals with excessively round faces to give a more contoured
look, sometimes referred to as the “waif look.” However, plastic surgeons warn that, in some
individuals, removal of the buccal fat pads can lead to a drawn, hollow-cheeked look as aging progresses.
Buttock Lift: Excess fat and loose skin in the buttock area can be reduced by performing a
buttock lift in combination with lipoplasty (liposuction). Incisions required for skin removal
can often be hidden in the fold beneath the buttocks.
Cafe au Lait spots: Café au Lait spots are pigmented birthmarks. While café au lait spots do not cause any disease themselves, having multiple spots has been linked with neurofibromatosis and
the rare McCune-Albright syndrome. Specifically,
having six or more café au lait spots greater than 5 mm in diameter before puberty, or greater than 15
mm in diameter after puberty, are cardinal diagnostic features of neurofibromatosis type I.
Calf Augmentation: Increased fullness of the calf can be achieved using implants made of hard
silicone which are inserted from behind the knee and moved into position underneath the calf muscle.
Cellulite: Cellulite is a term used to describe the dimpled appearance of skin caused by fat deposits that are just below the surface of the skin. It generally appears on skin in the abdomen, lower limbs, and pelvic region, and it usually occurs after puberty.
Chemical Peel: A chemical peel is a process in which a chemical solution is applied to the skin to
remove dead skin cells and stimulate the production of new skin cells. Peel solutions may
contain alpha hydroxy acids, tricholoracetic acid (TCA) or phenol as the peeling agent. The agent
used depends on the depth of peel desired and on other patient selection factors.
Cherry Hemangiomas: Cherry hemangiomas are small red dots that appear as aging occurs. Cherry hemangiomas are completely harmless and may be hereditary. They often appear on the face, chest and back, although they can appear anywhere.
Chin Augmentation (Mentoplasty): Chin augmentation can strengthen the appearance of a
receding chin by increasing its projection. The procedure does not affect the patient’s bite or jaw. There are two techniques: one is performed through an incision inside the mouth and involves moving the chinbone, then wiring it into position;
the other approach requires insertion of an implant through an incision inside the mouth, between the
lower lip and the gum, or through an external incision underneath the chin. Chin augmentations can also now be done with fillers.
Cholasma: See “melasma”
Chromophore: A chemical group that selectively absorbs light at a specific wavelength.
Hemoglobin, melanin and water are primary targets. In determining absorption it is important
to determine which targets absorb specific wavelengths and also which do not. Absorption in
a secondary target can create additional heat and additional complications in tissue.
ClearScan ALX™: The Joule ClearScan ALX 755 nm laser’s wavelength and pulse duration is
the ideal match for hair reduction in lighter skin patients, as well as pigmented lesions.
ClearScan YAG™: The JOULE™ ClearScan 1064 nm Nd:YAG laser’s wavelength and pulse duration is the ideal match for virtually all vascular lesions from telangiectasias to reticular leg and face veins as well as hair removal.
Collagen: The major structural proteins in the skin that give the skin its strength and resilience.
Collagen Injections: Collagen is an injectable protein that can be used to treat facial wrinkles. Patients to be treated with collagen should first be tested for any allergic reaction as it may be derived from bovine or porcine protein. The results of collagen injections are not permanent, and treatments must be repeated periodically to maintain results.
Collagen regeneration/stimulation: Collagen regeneration or stimulation is the process whereby
the human body produces more collagen and replaces old, worn down collagen secondary to
sun damage and aging. Heating and/or creating controlled wounds in the dermis results in the
body regenerating its own collagen.
Columella: Columella is the tissue that separates the nostrils.
Compression therapy: Compression therapy is the application of sustained, graduated pressure to
the lower leg with bandages, elastic stockings, or rigid supports, in order to prevent edema and
promote re-absorption of existing tissue fluid in patients with varicose veins.
Contour TRL™: JOULE™ Contour TRL – 2940 Erbium:YAG is the most versatile system
available for MicroLaserPeel and full field resurfacing. JOULE’s unique technology allows
the user to select precise levels of ablation and coagulation (20 – 50 micrometers), while the
computer guided scanner ensures maximum precision and treatment uniformity.
Copper Peptide: A common ingredient found in skin care products, copper peptide is used to
promote and produce collagen and elastin in the skin.
Contracture scar: A type of scar in which a permanent tightening of skin occurs, often in response to a burn. This type of scar may affect the underlying muscles and tendons, limiting mobility and possibly damaging the nerves.
Cosmetic unit: A cosmetic unit is an area of the body often treated separately from others.
Examples of cosmetic units: the skin around the eyes, the skin around the mouth, the cheeks.
Crow’s Feet: The fine lines found around the eyes. They are often caused by sun exposure and
over usage of the muscles in that area. However, smoking also contributes to their formation.
Debriding: The process of removing dead or devitalized tissue prior to reconstructive or cosmetic surgery.
Depilation: Depilation is the removal of the part of the hair above the surface of the skin. The most common form of depilation is shaving or trimming. Another option is the use of chemical depilatories, which work by breaking the disulfide bonds that link the protein chains that give hair its strength, making the hair disintegrate.
Deoxygenated vessel – Blood vessel that is stagnant, not close to the capillary supply; blue or purple in color.
Dermabrasion: Dermabrasion is a procedure in which a high-speed rotary wheel, similar to finegrained sandpaper, is used to abrade the skin. It may be recommended when there is extensive sun damage and heavy skin wrinkling. In addition, dermabrasion can be used to improve the texture of pockmarked skin resulting from severe acne or chicken pox. Following treatment, the skin should appear firmer and smoother, but permanent pigment changes may occur.
Dermal Fillers: Dermal fillers are substances that are injected just below the surface of the skin to fill in lines, wrinkles, and scars. Unlike face lifts that stretch the skin, fillers add volume for a more natural youthful appearance. Fillers can also increase the fullness of the lips (see section on lip enhancement) and lessen the downward slant of the corner of lips. The most common areas treated are the smile lines around the nose and mouth, fine lines above the mouth, frown lines between the eyes, and acne scars.
Dermalogen: Dermalogen is a human tissue implant that is administered by injection to treat
lines and wrinkles.
Dermatitis: Dermatitis is an inflammation of the skin caused by an allergic reaction or contact with
an irritant. Typical symptoms of dermatitis include redness and itching.
Dermatologist: A doctor who specializes in the treatment and diagnosis of skin and skin-related problems.
Dermis: The dermis, which lies under the epidermis, makes up about 90 percent of the
thickness of the skin. It contains a dense meshwork of collagen and elastin fibers, two types
of protein. This meshwork supports lymph and blood vessels, nerves, muscle cells, sweat and sebaceous glands and hair follicles. Collagen and elastin fibers give the skin its strength and elasticity. Sebaceous glands produce an oily substance called sebum, which keeps your skin smooth and moist
- Papillary dermis – small elevations of the layer of the skin that lie immediately under the epidermis that indent the inner surface of the epidermis; it is ~113 microns thick.
- Reticular dermis – layer of connective tissue forming the deeper portion of the dermis; lies
beneath the papillary dermis.
Deviated septum: A condition in which the septum (the wall inside the nose that divides it into
two sides) is not located in the middle of the nose where it should be. The condition is commonly
treatable with surgery.
Dyschromia – Irregular or patchy discoloration of the skin that can be caused either by variations in
pigment density (melanin), changes in blood vessels (vascular changes), or growth of foreign organisms on the skin.
Dysport®: Dysport is an injectable form of botulinum toxin Type A, very similar to Botox,
and is used to temporarily improve the look of moderate to severe frown lines between the
eyebrows (glabellar lines). Dysport stops the signal from the nerve to the muscles, ultimately
resulting in a reduction of muscle activity and temporarily preventing contraction of the muscles
that cause frown lines.
Elastin: A protein found with collagen in the dermis that is responsible for giving structure to your skin and organs.
Electrolysis: Electrolysis is a method of removing unwanted hair. A small needle or thin
metal probe is inserted into the opening of the skin where hair grows (small sacs beneath the skin
called hair follicles). Next, a low-level electrical current passes through the needle or probe into
your skin and destroys the hair follicle. Hair is unable to grow back in an area where the follicle
has been destroyed.
Epidermis: The outer layer of the skin. The epidermis is also the thinnest layer, responsible for
protection from the harsh environment. The epidermis is made up of five layers of its own:
stratum germinativum, stratum spinosum, stratum granulosum, stratum lucidum and stratum
Erbium – A rare earth metal used as a laser medium. The wavelength at 2940 nm is strongly absorbed in water and can be used very effectively for light superficial peels as well as deep
resurfacing. Erbium is used for vaporizing and resurfacing with the JOULE Contour. Symbol is
Erythema – Diffuse redness over the skin caused by capillary congestion, usually due to dilatation
of the superficial capillaries as a result of some nervous mechanism within the body,
inflammation, or some external influence such as heat, exposure to sunlight, or cold.
Exfoliate: To remove the top layer of skin. Chemical peels and dermabrasion are examples of
methods in which the skin is exfoliated.
Eczema: A skin condition characterized by itchy, irritated, inflamed skin. Eczema comes in many
forms and can be triggered by a variety of factors, including allergies, environmental factors or
family history. The raised, red, dry, itchy patch or series of patches on the skin can appear anywhere
on your body, including your face, legs, arms or neck.
Eye lift: See “blepharoplasty”
Facelift (Rhytidectomy): A facelift can reduce sagging skin on the face and neck. Incisions are
placed in the hairline and then pass in front of and behind the ears; the exact design of incisions may vary from patient to patient and according to the surgeon’s personal technique. When necessary, removal of fatty deposits beneath the skin and tightening of sagging muscles is performed. The slack in the skin itself is then taken up and the excess removed.
Fat Injections: Fat withdrawn from one body site can be injected into another — for example, to
smooth lines in the face or build up other features such as the lips. In most cases, a percentage of
injected fat is reabsorbed by the body, and the procedure must be repeated. Injection of fat to enlarge the breasts is a dangerous procedure and is not recommended because of the possibility of dense scarring that may seriously hinder accurate interpretation of both breast self-exams and mammograms.
Fascia: Fascia is a layer of fibrous connective tissue covering or binding body tissues. It can
also be used in lip augmentation to produce fuller lips. This product is made from human donor tissue.
Fitzpatrick Skin Types – Description of the various types of skin amongst humans as it relates to pigmentation.
- Type I Very white or freckled, always burns
- Type II White, usually bums, tans less than average (with difficulty)
- Type III White to olive, sometimes mild burn, tans about average
- Type IV Brown, rarely burns, above average – black
- Type V Dark, very rarely burns, risk of pigmentation is common
- Type VI Black, never burns, risk of pigmentation very common
Fluence: Fluence is the amount of Energy per unit area delivered through a surface. Measured in Joules per centimeter squared (J/cm2). Fluence creates a temperature rise in tissue.
Folliculitis: Folliculitis is the inflammation of a follicle or follicles.
Folliculitis barbae: Folliculitis barbae is the inflammation of a follicle or follicles of the beard; commonly seen in black skinned individuals. Often referred to as pseudo folliculitis barbae (PFB).
Freckle (Ephelides): Freckles are small flat brown spots that appear on sun-exposed skin,
especially the face and arms. Freckles are inherited and become darker with consistent sun exposure.
GAG’s (Glycosaminoglycans): Glycosaminoglycans are substances in the skin that hold in its moisture.
Grafting: Grafting is a procedure in which healthy skin and/or muscle is moved from one area of the body and relocated to another area damaged by disease or injury.
Gycomastia: Gynecomastia is a condition of over-developed or enlarged breasts affecting one or both breasts in men.
Hair bulb: The hair bulb is the expanded portion at the lower end of the hair root; growth of a hair
results from the proliferation of cells of the hair bulb.
Hair bulge: The hair bulge has cells that replenish hair matrix germinative cells during the telogen phase.
Hair density: Hair density relates to the thickness of an individual hair.
Hair follicle: A hair follicle is an invagination of the epidermis which forms a cylindrical
depression that penetrates into the connective tissue and holds the hair root from which a hair develops. Attached to the follicle are sebaceous glands that secrete an oily fluid and tiny muscles (arrector pilli) that cause the hair to stand up.
Hair growth cycles: Hair grows in cycles called anagen, catagen and telogen. The cycles are defined as:
- Anagen – hair cells actively dividing,
lengthening the hair shaft; known as the
- Catagen – period between anagen and telogen
cycles (transitional or breakdown stage)
- Telogen – dormant stage where hair is not
Hair shaft: The hair shaft is the portion of a hair which extends from a hair follicle beyond the surface of the epidermis.
Hemangioma: A type of birthmark characterized by concentrations of small blood vessels. They commonly referred to as strawberry marks and often disappear after a few months or years.
Hirsutism: Hirsutism is a condition characterized by the excessive growth of hair or the presence of hair in unusual places, especially in women.
Hyaluronic Acid: Hyaluronic acid is a naturally occurring substance in skin. Its job is to help provide fullness and elasticity. Over time, skin loses hyaluronic acid. As it diminishes, skin loses volume, increasing the chances of folds and wrinkles to appear.
Hypodermis: The fatty layer of skin, home of sweat glands and fat and collagen cells. The hypodermis is responsible for conserving the body’s heat and protecting vital inner organs.
Hyperpigmentation: A skin condition in which there is excessive pigmentation, often seen as dark spots on the skin.
Hypertrichosis: Growth of hair in excess of normal.
Hypertrophic scar: A raised and red scar, similar to a keloid scar, but different in that it stays within the boundaries of the injury site.
Hypopigmentation: A skin condition in which there is a lack of pigmentation.
Joule: Joule is a unit of work or energy equal to the work done by a force of one Newton acting
through a distance of one meter.
Juvéderm®: Juvéderm is a dermal filler made of hyaluronic acid that is injected into lines and wrinkles and lasts for up to one year.
Keloid scar: A type of scar described as an overgrowth of fibroblastic tissue that can arise in an area of injury such as lacerations and surgical scars or occasionally spontaneously. Unlike hypertrophic scars, keloid tissue always extends beyond the area of the original injury. This type of scar is caused by too much collagen forming while the skin is being repaired. The tendency to develop keloid scars is genetic. There is a greater tendency towards keloids in blacks and fair skinned
Caucasians. The etiology is unknown.
Keratin: Keratin is the dominant protein of the skin and it makes up its main material. It is also found in hair and nails. Keratin is what forms the rigidity of your skin.
Kojic Acid: A skin treatment product derived from a fungus that studies have shown is effective as a lightening agent and in inhibiting the production of melanin.
L-ascorbic acid: L-ascorbic acid is a form of Vitamin C and the only form that can penetrate the stratum corneum.
Laser resurfacing: Laser resurfacing is an ablative procedure that changes the surface of the
skin and allows new, healthy skin to form at the treatment site. Wrinkles and acne scars can be
lessened with laser resurfacing.
LATISSE®: Latisse is used to treat of small or thin eyelash growth. When applied regularly on a
daily basis, the LATISSE® product can result in the growth of significantly longer; fuller, darker
upper eyelid lashes
Lip Augmentation: Lip augmentation is a procedure done to improve deflated, drooping or sagging lips, correct their symmetry or to reduce fine lines and wrinkles around them. This is often done through injections or implants.
LipoDissolve: LipoDissolve is a procedure which helps dissolve fat. It is a series of miniscule
injections of chemicals which dissolve localized areas of fat deposits.
Lipoplasty: See “liposuction”
Liposuction: Liposuction is a surgical technique that improves the body’s contour by removing
excess fat from deposits located between the skin and muscle. Liposuction can be achieved by many
different methods and techniques; laser, ultrasound, water, power suction and many more new and developing techniques.
Macular stain: A small birthmark that is often nothing more than a small, mild, red blemish on
Mammoplasty: Any reconstructive or cosmetic surgical procedure that alters the size or shape of
Matting (Neovascularization): Matting is the new appearance of previously unnoticed fine red telangiectasias which occur in a number of patients (5-75%) after either sclerotherapy or surgical ligation of varicose veins and leg telangiectasias as a result of the body’s attempt to create collateral veins to aid in the formation of a new channel for return of blood flow to the heart. Telangiectatic matting may appear anywhere on the leg and almost never on the face, chest, and hands after sclerotherapy. Probable risk factors for the development of telangiectatic matting in patients with leg telangiectasias includes obesity,
use of estrogen containing hormones, pregnancy, and a family history of telangiectatic veins. Excessive standing does not appear to influence their development.
Marionette Lines (Melomental Folds): Marionette lines refer to the lines or wrinkles that
extend from the outer corners of the mouth down toward the chin.
Mastectomy: The surgical removal of part or the entire breast.
Mastopexy: Also called a breast lift, this procedure removes excess skin in order to lift up sagging or drooping breasts.
Melanin: Melanin is the pigment of the skin. The amount of this substance accounts for variations in skin color in different people and different races.
Melanocytes: A pigment producing cell found in the skin, hair and eyes that gives them their color.
Melanoma: Melanoma is the least common skin cancer which occurs in the United States, but it is also potentially the most deadly. Melanoma begins in the melanocytes, the cells which produce
melanin, which are responsible for the skin’s color. Melanoma most often begins to develop in a
mole, but it can take different forms. Melanoma can quickly spread to other areas of the body, and it is imperative to have the condition diagnosed and treated as early as possible.
Melasma: Melasma is an acquired over production of melanin in sun-exposed areas. Melasma presents as symmetric hyperpigmented macules, which can be confluent or punctate. The
cheeks, the upper lip, the chin, and the forehead are the most common locations affected. The
exact cause of Melasma is not known but a direct relationship with female hormonal activity appears to be present because melasma occurs with pregnancy and with the use of oral contraceptive
pills. Other factors implicated in the appearance of melasma are photosensitizing medications, mild ovarian or thyroid dysfunction, and certain cosmetics.
Mesotherapy: Mesotherapy is a non-invasive procedure that involves injections into the
mesoderm, the middle layer of skin, to stimulate the removal of cellulite, wrinkles, excess fat, and
sagging skin. The treatment involves localized injections of homeopathic and traditional medications in addition to vitamins.
Microdermabrasion: Microdermabrasion (often referred to as Microderm) is a family of cosmetic
procedures in which the stratum corneum (dead outermost surface of the skin) is partially or completely removed by light abrasion, to remove sun-damaged skin and to remove or lessen scars
and dark spots on the skin. Different methods include mechanical abrasion from jets of zinc
oxide or aluminum oxide crystals, fine organic particles, or a roughened surface such as a rotating
MicroLaserPeel® (MLP): A MLP is an epidermal laser peel (4 – 50 microns) that precisely removes the outermost layers of the skin. The procedure is individually tailored to the nature of the problem to be corrected: wrinkles, scars, keratoses, or pigmentation problems.
MicroLaserPeel is the ideal treatment for those patients that want improved skin with immediate lasting results, little time off, discomfort, or posttreatment care.
Micropigmentation: Micropigmentation is a form of tattooing commonly used to apply permanent makeup by injecting iron oxide pigment into the middle layer of skin (dermis).
Microvasculature: Microvasculature constitutes the part of the circulatory system made up of minute vessels (as venules or capillaries) that average less than 0.3 millimeters in diameter.
Mottling: Mottling or mottled skin refers specifically to vascular changes in the skin which
cause a patchy appearance.
Nasolabial Folds: Nasolabial folds are the two skin folds that run from each side of the nose to
the corners of the mouth. They separate the cheeks from the upper lip.
Nd:YAG: Metals yttrium, aluminum, garnet and neodymium that are doped together to create an
infrared laser that targets color deep in the skin. Typically used to treat hair and vessels when cutaneous. Nd:YAG can be delivered through a fiber for several minimally invasive applications.
Neovascularization: Development of new blood vessels in a structure.
Nevus of Ota: A benign bluish or gray-brown facial lesion of the eye and the surrounding skin
that has melanosomes lying deeply within the dermis and been reported to occur rarely in Caucasians but is common in Asians (about 1 in 200 people in Japan); it is a dermal melanocytic disease which causes discoloration of the face, induces a remarkable disfigurement to patients and is a serious cosmetic problem for affected individuals; due to its large size and periocular location, has been notoriously difficult to treat. It is an anomaly of the dermal melanocytes, which lies primarily in the deep dermis. It is
characterized by its distinctive cutaneous distribution involving skin innervated by the trigeminal nerve. Most cases clinically manifest at birth or around puberty; however, acquired lesions in adults have been reported. Non-ablative skin rejuvenation: Non-invasive treatment to reduce the signs of aging; does not
require the removal of surface tissue to accomplish collagen regeneration, wrinkle reduction and a
more youthful appearance.
Non-invasive: Devices or procedures which do not require entering the body or puncturing the
Otoplasty: A surgical procedure done to correct misshaped or protruding ears.
Oxygenated telangiectasias: Very small blood vessel that is close to the capillary supply; tends to
be redder in color.
Perlane®: See also Restylane. Perlane is the same as Restylane, only it is composed of a larger
molecule of hyaluronic acid, therefore it is intended to be injected deeper into tissue. The
difference between Restylane and Perlane is the size of the particle (with Perlane containing more
hyaluronic acid). This means that Perlane does a better job of filling deep lines while Restylane is
used in fine lines or in thin skinned people.
Permanent hair reduction: Reduction in hair count lasting 12 months or longer.
Photo-aging: Photo-aging is the changes that occur to the skin due to exposure to the sun. This
includes wrinkles and age spots.
Photodynamic Therapy: PDT combines a medication (called a photosensitizer) that is
preferentially absorbed by certain kinds of cells and a special light source. When used together, the
photosensitizer and the light destroy the targeted cells. PDT is used for photorejuvenation, wrinkles,
discoloration, visible veins, and acne. When used for these conditions, the photosensitizer is applied
to the face and then the skin is exposed to a light source. Rapidly growing cells, oil glands, and
other structures in the skin absorb the photosensitizer and are destroyed by a reaction caused by the light.
Photofacial (FotoFacial™): Photo facial is a generic term for a skin treatment that uses some
kind of light-based technology. Photo facials (sometimes called foto facials) have a number of
different uses, but are mostly used for boosting collagen or treating various skin conditions such
as acne, brown spots, broken capillaries, etc.
Poikiloderma: A skin disorder characterized by pigmentation, telangiectasias, and atrophy.
Port-wine stain: Port-wine stains are a type of hemangioma characterized by a mark on the skin
that resembles the rich red color of port wine. Port-wine stains are caused by an abnormal concentration of capillaries. This type of birthmark is also referred to as nevus flammeus.
ProFractional™ technology: Uses the Er:YAG laser to stimulate collagen. Due to the efficient
water absorption characteristics of 2940 nm wavelength, the ProFractional/ProFractional-XC is
able to penetrate deeply into the dermis by ablating clean channels of tissue to a selected depth and instantly vaporizing the tissue within the channel. These channels are surrounded by healthy tissue, speeding healing time and reducing downtime for the patient. The ProFractional-XC
device can independently add coagulation to the vaporized channel.
Psoriasis: Psoriasis is a non-contagious chronic skin condition which occurs as a result of
abnormalities in the body’s immune system. In individuals with psoriasis, the immune system
erroneously sends out signals that cause an increased production in the growth of skin cells. The condition appears as red, scaly patches, often with a whitish or slivery covering of dead skin
cells. The condition can affect only a small area of the body, or can spread to cover the entire body in
Ptosis: The drooping of a body part, especially the eyelids or the breasts.
Pulse Width: Length in time of a laser pulse. Controls the heat lost through conduction.
Purpura: A condition with various manifestations and diverse causes, characterized by hemorrhages into the skin, mucous membranes, internal organs and other tissues. Hemorrhage into
the skin shows red, darkening into purple, then brownish-yellow and finally disappearing in 2 – 3
weeks. Areas of discoloration do not appear under pressure.
Q-switching: Refers to an electro-optical switch within the laser cavity that allows the release of all
of the laser energy stored up in the laser cavity in one brief powerful pulse. Power outputs in the
megawatt to gigawatt range are common. The target is heated at such a rapid rate that it shatters
and supersonic shockwaves are created in the tissue. Lasers in the 5 – 500 nsec range including Q-switched ruby, alexandrite and Nd:YAG lasers are used to target smaller structures such as
melanosomes and tattoo ink particles.
Radiesse®: Radiesse (formerly Radiance) is a dermal filler made of a compound of calcium
hydroxyl apatite microspheres that are suspended in a gel that reduces the appearance of wrinkles and skin folds around the mouth and nose, and fills certain scars. Once injected into skin, thin connective tissue forms around the microspheres so that the microspheres act as a filler that remains permanently implanted at the site location. Radiesse can last two years or more, but touchups may be necessary throughout this time period.
Restylane®: Restylane is a dermal filler made of non-animal sourced hyaluronic acid. Restylane is
injected under wrinkles and aging lines of the face such as the nasolabial folds, melomental folds,
“crow’s feet” and forehead wrinkles. It may also be used for filling aging-related facial hollows and
“orbital troughs” (under and around the eyes). Results last for typically 6-9 months.
Reticular veins: Abnormally dilated subcutaneous veins that are blue and non-bulging,
measure 1 – 3 mm in diameter, and are directly associated with telangiectasias; most commonly
seen over the posterolateral aspect of the thigh and the lateral aspect of the calf. They appear to drain
toward the popliteal fossa (behind the knee) with the associated telangiectasias radiating away from
Retinol: A derivative of Vitamin A commonly found in many skin care creams.
Rhinoplasty: A cosmetic procedure used to enhance or change the appearance of the nose.
Rhinoplasty is commonly referred to as a nose job.
Rhytidectomy: Commonly called a facelift, this surgical procedure is done to eliminate the
sagging, drooping, and wrinkled skin of the face and neck.
Rosacea: A skin disease of unknown causes that causes an array of symptoms, including redness
and puffiness on several areas of the face, including the cheeks and nose. Rosacea cannot be
cured, but treatment should be sought since the condition can worsen over time if not treated
correctly or promptly.
Salicylic acid: See “beta hydroxy acid”
Sallowness: A term used to describe a yellowish color of the skin.
Scar: A scar is a hard plaque of dense fibrotic tissue covered by a thin epidermis. A mark of
injury from any sort of process (physical or pathologic). The injured tissue has been replaced
by connective tissue. Scars may result from wounds that have healed, lesions of diseases, or
surgical operations. When first developed, a scar is red or purple, later whitish and glistening.
- Atrophic scar – Scar that is depressed below the skin
- Hypertrophic scar – Scar that is raised above the skin
- Keloid scar – A type of scar described as an overgrowth of fibroblastic tissue that can arise in an area of injury such as lacerations and surgical scars or occasionally spontaneously. Unlike hypertrophic scars, keloid tissue always extends beyond the area of the original injury. This type of scar is caused by too much collagen forming while the skin is being repaired. The tendency to develop keloid scars is genetic. There is a greater tendency towards keloids in blacks and fair skinned Caucasians. The etiology is unknown.
Sculptra: Sculptra™ is made of Poly-L-Lactic Acid (PLA). Sculptra™ is used for restoring
volume and improving facial contours. With Sculptra, tiny particles of PLA are diluted in a suspension of sterile water, carefully implanted in the skin, and then molded for optimal results. The particles of PLA stimulate the formation of new collagen in the skin, adding volume over time. Sculptra™ may require a series of three to five treatments every four to six weeks. Improvement in contour occurs gradually over two to six months and results last for up to 2 years.
Sebaceous glands: The glands of the skin that emit oil.
Seborrheic Keratosis: Seborrheic keratoses are noncancerous (benign) growths on the surface of
the skin. They can be located on the face, chest, shoulders, back, or other areas and are usually painless, but may become irritated and itch. They are yellow, brown, black, or other colors and have
a slightly elevated, flat surface that may have a rough or wart-like texture.
Septoplasty: A surgical procedure done to improve the flow of air to your nose by repairing
malformed cartilage and/or the bony portion. The procedure is often performed along with a rhinoplasty.
Sclerotherapy: A medical procedure used to eliminate varicose veins and “spider veins.” During the procedure, an injection of a solution (generally sodium chloride) in placed directly into the vein.
Selective Photothermolysis: Selective Photothermolysis is a theory that lasers selectively
destroy a target with little or no injury to surrounding tissues. Selective light-induced thermal damage occurs by selecting a wavelengthmthat is maximally absorbed by the targeted structure combined with a pulse duration that is less than the thermal relaxation time of the target, or the time required for the target to dissipate 50% of the heat acquired following laser irradiation.
Skin Tag: A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk. Skin tags
are not dangerous. They are usually found on the neck, chest, back, armpits, under the breasts, or in the groin area. Skin tags appear most often in women, especially with weight gain, and in elderly people.
Skin Turgor: Tissue hydration of the skin.
SkinTyte™: The SkinTyte procedure utilizes BBL broadband light energy to deeply heat dermal
collagen. This process promotes partial denaturation and contraction of collagen. The heat
also initiates the body’s natural healing process which creates a renewed collagen foundation leading to increased skin firmness.
Solar elastosis: Excessive exposure to sunlight over many years damages collagen and elastin fibers that support skin. This can lead to loose, sagging, tough skin that can look 15 to 20 yearsmolder than normal. Solar elastosis is most commonmin light-skinned people who are often exposed to intense sunlight.
Spider veins: A branched growth of dilated capillaries on the skin resembling a spider. Linear
and “spider” telangiectasias develop on the legs, especially in women beginning in the second to
third decade, secondary to multiple factors including genetic predisposition, gravity, pregnancy, and trauma.
Stratum corneum: The outer most layer of the epidermis
Subcutaneous: A term referring to below the skin.
Subcutaneous tissue: Under the epidermis and dermis lies subcutaneous tissue composed
primarily of fat. This skin layer insulates and protects your inner organs and helps give young
skin its resilience.
Sun protection factor: Commonly seen on suntan ingredients as “SPF,” the sun protection
factor is the amount of the protection a suntan product provides. The higher the SPF, the greater
Suture: The stitches used to hold tissue together or to close a wound.
Syringomas: Syringomas are harmless sweat duct tumors, typically found clustered on eyelids,
although they may also be found in the armpits, umbilicus, or vulva. They are skin-colored or
yellowish firm rounded bumps, 1-3 mm in diameter, and may be confused with xanthelasma.
Telangiectasias: Telangiectasias are red dilated, broken blood vessels, commonly seen on the face
or thigh. They develop secondary to genetic predisposition, chronic actinic damage, collagen
vascular disease, topical steroid application, and disorders of vascular regulation including acne
rosacea. Linear and “spider” telangiectasias develop on the legs, especially in women
beginning in the second to third decade, secondary to multiple factors including genetic
predisposition, gravity, pregnancy, and trauma. They arise from backflow from reticular veins.
Blue dilated veins are also referred to as telangiectasias however their correct name is venulectasia.
Thermal Relaxation Time: A characteristic “cooling” time is needed for an object to cool about 2/3 of the way down to the ambient temperature after having been heated. For most chromophores in the skin, this time is determined only by the size of the object.
ThermaScan™: JOULE ThermaScan is an Nd:YAG laser that uses the 1319 nm wavelength to target water within the dermis and collagen. The heat delivered stimulates fibroblast activity as
part of the body’s natural wound healing process, leading to collagen remodeling in the dermis and
reducing wrinkles for a more youthful appearance. Sub-dermal heating of the sebaceous gland is also ideal for the treatment of acne.
Tretinoin: A prescription medication related to vitamin A used to treat acne, wrinkles, and other skin disorders.
Urticaria: Medical word for hives. Hives are formed by blood plasma leaking out of small
blood vessels in the skin. This is caused by the release of a chemical called histamine. Histamine
is released from cells called “mast cells” which lie along the blood vessels in the skin. Allergic
reactions, chemicals in foods, or medications can cause histamine release. The most common causes
are foods, drugs, infections, insect bites, internal disease, pressure, cold, sunlight, vibration and
pressure. The best treatment is to find and remove the cause.
Varicose vein: Enlarged, twisted veins found near the surface of the skin.
Venous insufficiency: Any abnormality of the peripheral venous system that reduces or impedes
venous return. Includes not only veins themselves and their patency, wall properties and valves but also the muscle pumps of the foot, calf and thigh which are dependent on proper neuromuscular
function and joint mobility, especially the ankle and connective tissue support by fascia.
Venulectasia: Blue dilated veins which are also referred to as telangiectasias, however their correct
name is venulectasia. See Telangiectasia.
Vitiligo: A condition in which smooth white patches appear on the skin due to a loss of pigment
producing cells. Vitiligo is a non-contagious skin disorder that causes loss of color in the skin, and
appears as white patches. Although it can occur on any area of the body, vitiligo most commonly
occurs on the face, lips, arms, hands, legs, and genital area.
Wrinkle class: The wrinkle class is a way of classifying wrinkles as Class I, ll or III; the description follows:
Glogau Wrinkle Scale
I Mild Wrinkling
II Moderate Wrinkling
III Severe Wrinkling
Wrinkles: With aging, the skin becomes thinner. Oil-producing glands become less active, and skin
becomes drier (which is why moisturizing is one of the best things one can do). The number of
blood vessels in the skin decreases, and the dermis, which lies right under the top layer of the
skin, thins and becomes more fragile. The skin replaces old cells more slowly, and cells repair themselves less effectively. Collagen and elastin, two fibrous proteins that keep skin taut, start to diminish, contributing to wrinkling and sagging.
Xanthelasma: Xanthelasma is a sharply demarcated yellowish collection of cholesterol
underneath the skin, usually on or around the eyelids. Although not harmful or painful, these
minor growths may be disfiguring and can be removed. They are common in people of Asian
origin and those from the Mediterranean region.