Non-Surgical Procedures

There are many non-surgical procedures for improving skin quality. Most of these procedures are done in the office without anesthesia. Most all of these procedures rejuvenate the skin by improving skin texture, smoothing wrinkles, reducing discolorations or plumping the skin. Dr. Kaplan and Lauren Cowger R.N., the laser specialist, use the Cutera XEO Laser to achieve these outcomes. For more information link to these websites:

Cutera – XEO Platform
The Laser Princess

You can return to normal activities the same day or next day. Each of these non-surgical procedures is described below and highlights of the primary purpose and potential results.

Botox and Dysport Injections

Botox and Dysport flatten wrinkles and depressions caused by muscle activities. Crow’s feet eye lines, frown lines of the brow, forehead furrows, lip wrinkles and cheek laugh lines can all be improved with a single treatment. Botox and Dysport are chemicals derived from the botulinum bacteria that have the can immobilize a muscle for several months. The results are not permanent and can be repeated as desired to retain the improvement. Repeated use of the injections may lead to a longer duration of each treatment’s effect.

Treatments can also be used to alter the shape of the eyebrows. The eyebrows can either be raised or dropped. Botox is only useful in treating expression lines and cannot be used to repair sagging skin caused by aging.

Collagen, Restylane, Juvederm and other injectable fillers

Wrinkles and depressions of the facial skin can be implanted with a syringe prepackaged material. These materials are injected into the skin depressions so that they are elevated to the level of the surrounding skin. These implantable materials have an effect for 6-18 months. As they absorb they can be injected as needed.


  • Collagen (a protein )
    • Zyderm, Zyplast (calf collagen)
    • Cosmoderm, cosmoplast (human collagen)
    • Evolence (pig tendon)
  • Hyaluronic Acid (a sugar)
    • Restylane, Perlane,
    • Juvederm, Juvederm ultra
    • Hydrelle
  • Polylactic Acid (a sugar)
    • Sculptura
    • Newfill
  • Hydroxyapatite (calcium related chemical normally found in coral or bone)
    • Radiesse


  • Silicone (not approved by FDA)
  • Methyl methacrylate coated with collagen
    • Artefill

The Zyderm and Cosmoderm materials had been used for 20 years but they are no longer manufactured because longer results are obtained with other materials . Restylane, Juvederm and others give similar or better results that last much longer. The only collagen now available is Evolence.

Nearly 150 other brands are used world wide but are not approved by the FDA.


The objectives and capabilities of lasers are:

  • Skin wrinkle smoothing
  • Skin tightening
  • Discolorations
    • Brown spots
    • Spider vessels
    • Hair removal


  • IPL (Intense Pulsed Light)
    • Improving texture (laser genesis)
    • Removes discolorations
    • Shrinks spider veins
  • LASER (Light Amplification by the Stimulated Emission of Radiation)
    • A surgical laser, such as the CO2 laser, YAG laser, fractional lasers are high energy beam of light that heats and alters the tissue.
    • Laser light penetrates to a very precise, controlled depth
      • Smoother tighter skin
        • The main benefit is to smooth the multiple fine wrinkles caused by sun damage and aging
        • Minimal lifting of the skin and therefore the laser is not a replacement for face lift and other facial surgeries.
          • The vertical lines (smokers or pucker lines) around the mouth is an area that laser is the best and only method of treatment.
          • Laser is often used to treat the lower eyelid skin instead of a surgical skin removal blepharoplasty.
          • Laser resurfacing can be used as an alternative to chemical peel and dermabrasion.
    • Thermage (Thermacool TC)
    • Titan


These procedures are relatively superficial and not as permanent as a laser. Light peels are most effective when repeated as part of a regular program. These peels are usually achieved with glycolic acid, trichloracetic acid, or a mixture called Jessner’s solution. Light peel can also be achieved with microdermabrasion (a fine spray of sand). Microdermabrasion can be combined with light chemical peels.

The major benefit of light peels are to improve:

  • Skin texture
    • A more refreshed, healthy color and smoother appearance to the facial skin.
    • Wrinkles
  • Irregular pigmentation (age spots).
    • Non-cancerous conditions such as keratoses (thick, rough, reddish scaly growths).

Skin Rejuvenation with skin creams


A skin rejuvenation program is often used in conjunction with either chemical peels or laser wrinkle removal to reduce the fine wrinkles of the face, lighten areas of hyperpigmentation

  • Hydroquinone cream
  • Cortisone cream
  • Sun screens


  • The program can be accomplished separately or in conjunction with the other procedures listed here and is followed at home by the patient after a consultation and a treatment plan is established for the patient’s cosmetic needs. Our skin care department is dedicated to providing you with the latest and most effective skin treatments available are
  • Retin-A (Renova)
  • Glycolic acid (fruit acids)
  • Vitamin E and C creams are also used. There are also many other new treatments such as copper and various enzymes that may have benefit. We invite you to inquire about which of these creams may be helpful for you to achieve smoother, fresher, younger-looking skin.