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Silhouette Instalift | Changing the face of the Nonsurgical Facelift.

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By Dr. Kally Papapntoniou

Ever pull back on your cheeks while looking in the mirror and wished that your skin could stay like this? Just hoping that this does not mean you actually need a facelift…with so many advances in non-invasive cosmetic procedures, who want to have surgery these days? With the help of injectable dermal fillers and tightening energy devices such as the Ulthera and ThermiTight we have been able to make a big impact on reversing the aging process and rejuvenating skin appearance and facial contours. But, as with anything non-invasive we sometimes reach a point where a few injections and tightening procedures are not going to give us the dramatic lift we are looking for. A new emerging technique only mastered by select Dermatologists and Plastic Surgeons, which first was developed in the European Cosmetic Market and now has become available to patients in the United States, Instalift, may be the game changer we have been looking for.

Instalift is exactly as the name entails, it is a device used in a minimally invasive technique that consists of a patented suture or thread that when placed under the skin helps sculpt and lift facial contours – finally providing a non-surgical facelift that is delivering results that patients are raving about. The way it works is really simple…through several anesthetized insertion points, the suture is delivered into the skin and then adjusted to help lift cheeks, jowls, necks and even brow lines.  The suture material is a combination of Polyglycolide/L-lactide which has been used for years in surgery and is completely broken down and metabolized by the body.



Photo Courtesy of Silhouette Instalift


The results are phenomenal and speak for themselves, lasting for an average of 1.5 years.  The recovery period is very short, usually patients can even go back to work the next day. For those who are easy bruisers pretreating with arnica and bromelin can help reduce this. The only post procedure instructions are for one week after the procedure patients must limit certain activities such as heavy exercise, chewing gum, and should stick to a soft diet.

So how does this change what we are already doing for non-invasive tightening? Well, when we think of rejuvenating as a layering process it makes more sense. We want to volumize to compensate for fat loss and bone changes which occur with aging, all of which you still can do even before or after the Instalift. We still want to resurface, reverse signs of aging with lasers and chemical peels to target discoloration, age spots etc.

We already treat fine lines and wrinkles that happen with strong facial expression with Botox. When we want to tighten the skin, we can still do this with Ulthera or Thermismooth, but now the Instalift provides us instant dramatic improvement that is not achievable with energy devices alone. Energy devices will still have a strong role in tightening skin around eyes, and the submental area for areas that are not able to be treated with the Instalift, and will work well together when combined.

I predict the Instalift will become a quick favorite for patients looking to improve themselves without surgery, because of how simple a procedure it is and how great the results really are. We already are seeing many patients inquiring about the Instalift treatment for midface and jowl tightening.

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Crepey Skin. Who, What, Where, When & How?

What can we do about crepey skin?

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Can Driving Gloves Keep You Looking Younger?

Wearing sun protective driving gloves and or sunscreen daily can prevent your hands from aging prematurely, and will reduce risks of skin cancers in these areas.

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Ask these 7 questions prior to a cosmetic procedure!

Ask these 7 questions prior to a cosmetic procedure!

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Rash Guards, Why Dermatologists Love Them!

Rash Guards are smart and sexy, learn why your Dermatologist loves them and why you need to get one!

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Dr. P gives 5 tips on Spa safety!

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Spa treatments: Dr. P’s 5 tips for what you want, and what you don’t want to go home with.

Who doesn’t want to have a relaxing and refreshing Spa visit now and again to recharge your battery and feel pampered for a moment. It is important that we do indulge in these luxurious treatments for our skin and nails, but we must proceed with caution.

I recently was in a large shopping mall, and was quickly pulled in by a kiosk worker who started to buff my 1 fingernail before I could say yes or no to his administration. After I walked away, I was preoccupied with the thought that the very same emery board had been used on countless other people, and I could potentially develop a wart on that finger now! Sometimes the more you know, the worse off you are. However, this is just an example of how you can pick up a skin virus or infection without even knowing, and it is delayed often and will not present itself for weeks oftentimes. A similar incident once occurred during a massage when the masseuse began to use a cactus bristle brush against my skin as part of her routine, and the entire time I was concerned about the reuse of the tool, and was too polite to request that she not use it.

It may seem paranoid and I may be overthinking things, but this only comes to my attention because of what I see regularly in the practice of dermatology, I have many patients that have acquired warts from nail salons, the gym, and even from facials or waxing. Poor young women who have tiny warts disseminated over the face or body, and they will commonly have a history of frequenting a spa or salons. When you are using instruments on patients and not properly sterilizing them it can lead to the transmission of diseases, though not life threatening in the cases I have presented they are none the less difficult to treat and unpleasant.

1. Seek out a salon or spa that uses a heat autoclave to sterilize their instruments.
You can ask directly if the instruments are autoclaved and they should be able to answer this question. Establishments that use autoclaves will often have their instruments in sealed bags. Other spas or salons will use an alcohol based solution to clean their instruments, this can be helpful, but is inferior to heat autoclaving. Autoclaving entails placing instruments inside a machine which under intense pressure and high heat destroys all organisms on tools and is the gold standard for sterilizing even medical and surgical instruments.

2. Don’t soak your feet in the foot bath in the nail salon.

Unless a disposable liner is being used for each customer, I cannot think of a dirtier place to soak your feet, as appealing as a nice warm soak might sound…I have seen some terrible infections that were picked up at nail salons. One such customer had suffered an amputation of one of her toes due to a salon acquired infection. The issue is that you never know who is going to pick up an infection. The vast majority of people who have these services have no such serious complication, but very commonly will develop a wart or athletes foot.

3. Bring your own nail filers/emery boards, and/or other nail tools if you desire.
When in doubt, you cannot go wrong by being prepared and bringing in your own supplies. You may get a few looks by other customers, and cause the employees to talk a little, but is it worth it to have fewer worries about your health, absolutely! It is not uncommon for many salon goers these days to come prepared with their own trusted equipment.

4. Do not permit the use of any reusable instruments that are not sterilized.
For example: getting a massage and being scrubbed with a brush that is used on other customers. Do not be shy, and don’t let anyone use something that has not been properly sterilized. A nice way of avoiding this awkward moment is to actually be up front and direct with your question before having a service.

5. If you do pick up what appears to be a wart, nail fungus, or another skin infection, do not delay seeking dermatological care, the earlier you start treating the easier it is to fully resolve.

There are so many great treatments to treat warts, and skin or nail fungus, that it makes no sense to waste time before getting treated. In additions, holding off treatment can result in the development of more warts and spreading warts or fungus to your loved ones at home.



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Deodorant Myths

Dr. Papantoniou was recently interviewed by Glamour magazine to read more see here:

Is there a right way to put on deodorant to make it the most effective? Some say put on at night but I hear that is a myth. 

It is important to first find out what kind of deodorant you are using. There are 2 different types of deodorants: those that are used to only mask odors, and then there are deodorants that contain antiperspirants to stop sweating. Some people like to apply deodorants in the morning and will repeat application during the day, but this is mostly for the pleasant scent and masking of odors, and less so for the actual reduction of sweating. So, if you are trying to get control over both sweating and odor use a deodorant that contains antiperspirant.

 The science behind why an antiperspirant works best if applied in the evening is that the area will be more likely to be dry and will penetrate in to the sweat ducts better in order to prevent perspiration in the area, and the ingredients will have stayed in place through the night giving better results for the next day. This is especially true if you shower in the morning, the underarms will be damp and the antiperspirant may not be as effective. In fact the prescription strength antiperspirants that Dermatologists prescribe are recommended to be applied at night for the same reasons. For patients that have difficulty getting control of their sweating I will recommend a prescription strength antiperspirant to be used at night, and then application of a regular deodorant in the morning. If there is still stubborn sweating I will recommend Botox injections every 3 to 6 months, or the Miradry which is a new treatment that has provided a permanent solution for uncontrolled sweating in the patients I have treated.

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How do you moisturize your face in Summer?

See Dr. Papantoniou’s recent interview by Glamour Magazine: see below the interview questions, and visit the site for more information:

Is it possible to over moisturize your face in humidity? (and how to know if you are)

An optimal skin care regimen should be flexible and climate should really be taken into account when choosing the right products to use and how much to put on. We frequently discuss how to take care of skin during periods of cold weather and low humidity, but we often dismiss the management of skincare in humid climates. High humidity can provide a moisture rich environment for your skin, but can be challenging for patients with oily skin types and for those with acne prone skin. The extra hydration on the skin and lack of evaporation can lead to a residue build up on the skin which can result in clogged pores. It can also cause makeup to run and look shiny or dewy.

I often recommend changing up creams that were being used in colder and drier climates and switching to lighter lotions or serums, which are non-comedogenic. A good example of a very nice light lotion with SPF 30 is Cerave AM Lotion. The amount that should be applied will be different for each person, you want to have enough so that the lotion easily rubs into the skin and disappears. Powder makeup or light lotion based makeup that is oil free will perform well in high humidity. A good finishing makeup setting spray can be used to help prevent makeup from running as well.

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The information presented on is not intended as specific medical advice and is not a substitute for professional treatment or diagnosis. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.