To Allied Dermatology and Skin Surgery co-founder Dr. James Libecco, the state of one’s skin is an important investment.
“A lot of people … don’t feel that inner confidence in how they look. They have something that they want to hide, something that prevents them from really being the person that they want to be,” he says. “It’s that one body that you have. Why would you not want to … take care of that?”
At Allied — founded 10 years ago by four partners who’d trained together at the Cleveland Clinic — there are myriad ways to improve your skin.
“Our goal is to continually provide cutting-edge, latest care, latest treatment opportunities,” Libecco says. “If it involves the skin, we can do it, and we can do it in a convenient and cost-effective way.”
Though Allied provides staple dermatological services such as skin checks, psoriasis treatment and skin cancer removal, it also offers a list of cosmetic procedures — including neuromodulators, laser skin resurfacing, dermal fillers and more — in a medically qualified environment. That expertise, says co-founder Dr. Ann Kooken, should be a key factor in deciding where to go for your skin’s cosmetic enhancements.
“With certain cosmetic procedures, you can burn the skin or create a severe injury,” she says. “Experience is important. This is not our side job; skin is what we do all day.”
Similarly, coming in for a cosmetic concern in a medically qualified environment like Allied can reveal more pressing health matters.
“A patient came in worried about some brown spots that they didn’t like, and we found a melanoma,” says Libecco. “Having that skin care being done by people who are trained in managing the complexities of skin, like a dermatologist, it really kind of pulls us together.”
Whether they come to Allied for cosmetic concerns, medical concerns or both, the goal for patients is healthy and beautiful skin.
“We want to keep their skin healthy, whether that’s skin cancer, whether it’s how they’re presenting themselves to the world, how their skin looks,” Libecco says. “We want people to be confident.”
Here are some cosmetic treatments Allied offers to help you obtain an inner — and outer — glow.
Botox
Botox is a neuromodulator that primarily relaxes muscles in areas of the skin prone to wrinkling.
“These are injectables that selectively and temporarily paralyze the muscles that produce an action that we do not want,” Kooken says. “So, when we furrow our brows … the neuromodulators relax the action of that muscle to remove or reduce wrinkling. They can also be used to alter certain movements or pulling of muscles.”
Those with gummy smiles, for example, might benefit from injecting Botox into the muscle that pulls up the lip. Botox can also be used to chisel out the jawline and reduce jowls, lift the brow area, slim the face and narrow the nose.
“There’s always a new indication coming out,” says Kooken. “We can use neuromodulators to relax, lift and smooth various areas of the face and neck.”
Following a consultation, a Botox injection can take as little as five minutes. Afterward, there is no downtime needed for healing. (Unless a vessel is hit, which can cause a temporary bruise.)
“It’s a tiny little needle with a liquid that we inject into our target area,” Kooken says. “The size of the muscle will dictate how many units or injections are needed.”
Results last three to four months.
“It’s a really great treatment,” Kooken says. “It’s very effective for almost everybody. … It’s non-committal in the sense that you could try it, if you hate it, you’re back at baseline in three to four months. … There’s no permanent complications with Botox.”
Hyaluronic Acid Fillers
Hyaluronic Acid fillers, or HA fillers, use a substance found naturally in the body to add volume to the face or other areas.
“These are gel-like products that we inject to restore lost volume, fill wrinkles or smooth skin etching. We are using them to plump up whatever is missing volume,” Kooken explains. “As we age, we absorb our bones, our muscles tend to shrink, our fat tends to shift from our cheeks to our jowls. If we can volumize and lift these areas carefully, we can greatly enhance one’s appearance.”
Hyaluronic acid fillers can be injected with a needle or a cannula.
“If somebody has a very flat cheek, we can use fillers to round out their cheeks,” Kooken says. “If somebody has little thin
lips, we can use it to give them the youthful shape they desire.”
Following an in-depth consultation, an appointment is scheduled. Prior to injections, numbing cream is applied to the area. Filler is selected based on treatment areas and the patient’s anatomy.
“Your cheeks are a thicker area. When we want to volumize something thick, we choose a thick filler that resembles what your natural cheek feels like. So we would use a thick filler that’s designed to stay in place and provide structure to an area that’s normally firm,” Kooken says. “When we are doing a much more delicate area, for example, the fine wrinkles above your lip … you want to use a very fine filler.”
Some swelling or bruising may occur following the injections, which can be covered with makeup and reduced with ice. Results can last about a year — or longer. Though there are other filler options on the market, hyaluronic acid, Kooken says, is the safest.
“They’re much safer, because they can be dissolved,” she says. “Plus, hyaluronic acid fillers resemble the hyaluronic acid in our skin. They feel very natural and last much longer than older options like collagen.”
Ellacor
Using hollow needles, the Ellacor system removes micro-cores of the patient’s skin, reducing the looseness of different areas of the skin.
“Ellacor actually uses little, tiny hypodermic needles that remove roughly 7 percent of the skin,” Libecco says. “As people get older and they get deeper wrinkles … we’re taking out 7 percent of that in a treatment, and that provides lifting and tightening in the skin more so than any other device that I’ve ever used for doing that.”
The procedure — for which patients are numbed — takes about an hour to undergo and requires around three to seven days of healing.
“We’re leaving 93 percent of the skin intact and only taking away that 7 percent. We’re doing it in a very precise pattern,” Libecco says. “You’re leaving that normal skin, which then has to heal. So what it does is it’s going to pull those areas closed, lifting and tightening the skin.”
Positive results, which last for years, include decreased wrinkles and lifting of the lower face.
“We’re permanently removing that 7 percent of the skin with each treatment. And that can be done one, two, three times as needed to get the volume reduction that they want in that lower face,” says Libecco. “It’s providing face-lift-like effects without needing to do a face-lift.”
Ellacor can also be used on the body, to reduce excess skin in areas such as the elbows, knees and abdomen.
“That’s my go-to if people are willing to have some downtime,” Libecco says. “That’s my biggest improvement per treatment that we do.”
Vivace Ultra
Those looking for a similar tightening effect — and who have wrinkles or excess skin in the lower face, neck or around the eyes — can try Vivace Ultra, a radio frequency microneedling treatment.
“We’re using acupuncture needle-sized probes that go down into the dermis in a very controlled fashion, create heat, tightening the collagen in that deep area — again, creating that micro-injury,” Libecco explains. “The body then has to make new collagen and remove that damaged collagen, which again provides tightening and lifting.”
The face, arms, elbows, knees and abdomen are the most common areas for which radio frequency microneedling is used. Depending on the area covered, the procedure can take anywhere from 45 minutes to an hour.
“The advantage of this is very little downtime,” says Libecco. “Most people have some redness that day, occasionally some redness or swelling the next day, but for the most part, with the Vivace, you’re doing these treatments and on your way … that day or the next day.”
Though Vivace Ultra requires more treatments than Ellacor — roughly three, spread out over the course of months — the results are similar and long-lasting.
“Only the Vivace Ultra has its own, built-in ultrasound on there to be able to measure the depth,” says Libecco. “It’s so carefully measuring where you’re doing those treatments, down to a 10th of a millimeter, to make sure we’re heating exactly where we want that to be individually to each patient.”
Sciton TRL
If you’re looking for a total refresh, laser resurfacing may be your best bet.
“What this one is doing is removing superficial layers of skin across the full face, and this works great for fine lines and brown spots, redness on that area, by actually just resurfacing that top layer,” says Libecco.
This treatment works especially well for deep lines around the mouth.
“You can do a relatively deep resurfacing around that area and go from deeply cobbled and lined lips to relatively smooth in a singular treatment,” Libecco says.
“You’re taking off those top layers of skin, and then that heat, again, causes that collagen contraction to occur.”
Depending on the depth of the treatment, recovery can take anywhere from two to five days. Redness and swelling can be managed by using topical creams, as well as icing and soaking the affected area. Results last for years.
No matter the treatment you’re seeking, providers at Allied have one ultimate goal: Making sure your skin is as radiant as it can be.
“I always tell my patients, I want you to head out on a Saturday morning and not think twice about needing to put on makeup before you go,” Libecco says. “I want you to just have that confidence that you can wear that skin freely and openly to the world.”
Allied Dermatology and Skin Surgery
Allied Dermatology and Skin Surgery
