editor | Pacific Dermatology & Cosmetic Center - Part 2

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A Walk Through Your First Botox Appointment

Botox cosmetic has been used for so many years now that it is virtually a household name. It is a brand of beauty that is well-known and very well-loved. With millions of people getting Botox each year, it can be easy to overlook the fact that many of them have never had injectables before. Regardless of how popular Botox is, if you’re new to this treatment you may have some questions or concerns. Usually, our patients just want to know what to expect. Here, we walk you through what happens at your first Botox appointment.

Your Consultation

People often call our office stating that they want to schedule Botox injections. Still, our first step is to conduct a consultation. The discussion that is had to begin treatment is a discussion that lays the foundation for facial rejuvenation. Botox is popular, yes, but it is also unique in how it smooths wrinkles. When we meet patients for the first time, we discuss this because we must make sure that Botox is the best product for the job at hand. This drug works on dynamic wrinkles, those that relate to facial movements. Examples include frown lines, forehead lines, and crow’s feet.


Once our consultation confirms that Botox is the right approach to your concerns, we can immediately begin treatment. Sometimes, Botox injections are combined with dermal filler injections in the same appointment. This can achieve more dramatic rejuvenation. It is not necessary to apply anesthetic to the skin for Botox or dermal filler treatments. The needle used for injections is so small that patients do not feel pain. We would describe the injections as a momentary pinch. Regardless of where Botox is administered, the injection process typically takes only a few minutes.

Recovery and Results

One of the great things about injectables like Botox is that there is no real downtime for recovery. Being your first time getting injectable treatment, you may want to allow yourself the opportunity to go home after your appointment. Most people experience minor swelling and redness around injection points that last an hour or two, tops. However, you may want to see how your body responds in the comfort of your home rather than at the office or running errands.

If your first appointment involves Botox only, you will begin to see results 5 to 10 days after your visit. If you also get dermal fillers, some of your results will be immediately noticeable. Botox touch-ups can be scheduled every 3 to 6 months as needed to keep lines and creases from re-appearing.

Are you ready for your first Botox appointment? Contact us at 206-859-5777 to schedule a visit to our Renton or Seattle office.

Handling the Signs of Photoaging

Aging is a general term that we hear relatively often. We’re at a point in history at which we understand more about what causes us to age and what effects aging will have on the body. When it comes to cosmetic aging, there is the issue of cellular aging and then there is the issue of photoaging. This is what we will discuss here.

Photoaging is the process of collagen breakdown as a result of UV exposure. Sunlight carries several different kinds of ultraviolet light. Therefore, the biggest risk for photoaging is spending time in the sun without adequate protection. Another risk for photoaging that was hidden for some time is the use of tanning beds. It was once believed that tanning in a controlled atmosphere could limit the effects of ultraviolet light. Research has proven otherwise. People who are exposed to indoor tanning have a significant risk for photoaging as well as serious forms of skin cancer.

What does photoaging look like? You can spot photoaging on various parts of the body that are exposed to sunlight. Too much UV light on the skin on the arms, legs, hands, shoulders, upper back, chest, neck, and face can lead to:

  • Uneven skin tone and spots, including freckles
  • Fine lines and wrinkles
  • Spider veins
  • Precancerous spots called actinic keratosis

What to Do About Photoaging

The best thing we can do about photoaging is to try and prevent it. Several strategies can be used, including wearing broad-spectrum sunscreen and staying in the shade on hot, sunny days. Additionally, we must know what to do if we’ve already started to see the signs of sun damage. Fortunately, there are several ways to approach this problem.

  • Develop a consistent skincare routine using medical-grade products. Ingredients like alpha-hydroxy acids, retinoids, and hyaluronic acid promote optimal cellular turnover to reduce spotting and uneven tone.
  • Nourish the skin with antioxidants. This may be accomplished with skincare containing vitamins A, C, or E. Antioxidants also help promote healthy collagen from the inside out and can be consumed in citrus fruits and leafy greens.
  • Chemical peels. Cellular turnover is paramount to healthy, vibrant skin. Chemical peels are professional treatments we tailor to each patient to help reduce the signs of photoaging and other problems.
  • This professional treatment is all about the collagen. The technique works by creating tiny channels in the upper layers of the skin. Though the channels close right away, the body is stimulated to send more collagen and elastin to the area. Collagen is the healing protein that fades scars, hyperpigmentation, and other flaws.

Within our comprehensive menu of services are several options for reducing the signs of photoaging. To explore what is available in our Seattle and Renton offices, call 206-859-5777.

Cellulite: What Works and What Doesn’t

Cellulite is a problem that, according to statistics, affects approximately 80 percent of all women at some point. Usually, once cellulite develops, it is there for good. The dimpling of the skin on areas like the thighs, hips, and buttocks is so common that creams and potions have been developed to try and manage cellulite externally. On the other hand, some people think that liposuction is the solution to their persistent cottage-cheese thighs. Neither has many merits. If you have cellulite, you want results, not a long list of potential solutions. We’re about to narrow this down for you. But first, let’s look at cellulite and why liposuction is not the ideal solution.

Cellulite, Fat, and Liposuction

When we see a connection between cellulite and fat, it seems natural to assume that liposuction might help. Cellulite occurs when fibrous bands beneath the skin compress subcutaneous fat, causing pockets of fat to protrude. The fibrous bands can do this because they run from the skin inward to deeper tissue. The bands can press against subcutaneous fat regardless of whether or not a person would be considered overweight. We all have subcutaneous fat. We need some degree of it!

Since cellulite is caused by subcutaneous fat pressing out against connective tissue, why not just remove the excess fat? One reason is that, as we mentioned, the fibrous bands press against the layer of fat regardless of how thick it is. The bands are the more prominent factor in skin-dimpling than fat. Additionally, a person’s skin firmness can also influence the visibility and severity of cellulite.

Getting Rid of Cellulite Takes Innovation

There are several factors that contribute to cellulite, including our genes, hormones, and lifestyle choices. While liposuction can reduce unwanted fatty tissue, it does not get to the root of cellulite, which is those fibrous bands beneath the skin. In our practice, with offices in Renton and Seattle, we use the FDA-cleared Cellfina system to smooth the skin. Cellfina is an innovative technique that targets the structural aspect of cellulite. During the brief treatment, a small needle-like instrument is inserted through anesthetized skin. This instrument releases the tension on the bands beneath the skin, achieving immediate results.

Cellfina is a beneficial cellulite treatment for several reasons. As well as being convenient, comfortable, and minimally-invasive, Cellfina is also effective. According to studies, 94 percent of people who have undergone this procedure report continued satisfaction three years after their treatment. We feel that, if cellulite is still improved at that time, it is reasonable to expect long-term improvement from a one-time Cellfina procedure.

Cellulite need not rule your confidence level. Contact us at 206-859-5777 to schedule your Cellfina cellulite reduction treatment.

Clearly, This Facial is Brilliant!

The skin is the most significant indicator of our beauty and wellness. Skin that is firm, smooth, and radiant is associated with youthfulness and vitality. The problem is it can be difficult to keep our skin smooth, firm, and radiant as we enter adulthood. For those who experience chronic acne, the dermatologic difficulties can begin much earlier. It is important to recognize that, whether your skin is showing indications of aging, sun damage, or clogged pores or all seems well on the outside, you can benefit from the occasional professional treatment. One that comes out as a clear candidate is Clear + Brilliant.

What is Clear + Brilliant?

Technically, Clear + Brilliant is categorized as a laser treatment. However, it does not give you the experience that you may expect from this type of technology. Typically, people envision laser treatments as sessions in which the outermost layer of skin is vaporized into oblivion. This isn’t the case with every laser. It certainly isn’t true of Clear + Brilliant. This system, built for uniformity and gentleness, uses customizable settings and optical tracking to stimulate ongoing tissue regeneration with few side effects and little downtime.

The treatment process may take only half an hour, including the brief consultation with your provider. To make you as comfortable as possible, we may apply a topical anesthetic to your skin. Once absorbed, this cream desensitizes the skin so your treatment feels like nothing more than minor, momentary zaps. The laser energy that promotes tissue repair is delivered through a small handpiece that the provider glides over your skin. It may take approximately 20 minutes for a full-face treatment. The process is so gentle that it can be repeated as often as every month.

Why Would You Want Clear + Brilliant Treatment?

This treatment can improve the skin in several ways, according to studies. After Clear + Brilliant, adults have reported:

  • Softer fine lines
  • Smaller, less visible pores
  • Smoother skin
  • A more radiant glow

Benefits of Clear + Brilliant include:

  • Suitable for preventive or corrective goals.
  • Suitable for all skin types.
  • Treatment can be done at any time of year.
  • Can address the signs of aging, sun damage, and more.
  • No downtime is needed.

Do you have a clear picture in mind of how you’d like your skin to look? We have brilliant ways to help you! Call 206-859-5777 to schedule a consultation in our Renton or Seattle office.

Double Chin? Chill Out! We’ve Got You Covered!

The words that are used to describe various objects or actions change with every generation. Lately, we hear young people inviting one another to “chill” when they want to hang out. When one is stressed, they may be encouraged to “chill out.” At Pacific Dermatology and Cosmetic Center, we chill, too. In our offices, though, we use the word to describe what we do to fat using our FDA-cleared CoolSculpting device!

You may have heard of CoolSculpting. This technology has been around for several years now and has been used all around the world. It has become known as one of the leading treatments for its convenience, safety, and effectiveness. In its rise to fame, CoolSculpting has also become known as a great way to eliminate unwanted fat in areas like the abdomen and thighs. There’s more to this device, though, and if you have a double chin, you want to know this.

Over time, the CoolSculpting device has undergone some revisions. One improvement is the development of a variety of applicators. This has allowed providers to treat a wider range of areas, including the backs of the arms and the frustrating problem known as the double chin. This is a game-changer for those who have searched for a nonsurgical strategy for slimming the frame of their face.

Demolishing the Double Chin with CoolSculpting

CoolSculpting is not the only way to get rid of a double chin. Therefore, we begin by consulting with each patient so we understand their needs, expectations, and preferences. One of the reasons so many people opt for this treatment is because it does not involve incisions or recovery. Another is that it does not require multiple injections and swelling. CoolSculpting is non-invasive and does not incur any downtime. There are side effects, though, including temporary redness and tingling or numbness.

Once we have identified CoolSculpting as the most appealing treatment option, we may be able to conduct the procedure immediately. We begin by placing a gel pad over the skin. This prevents sticking. Then, the small applicator can be applied. This small device pulls the area of fat in and holds it with suction. This can feel slightly odd but does not hurt. The cooling applicator is then adjusted to the target temperature and left in place for approximately 30 minutes. It’s that simple! As the tissue cools, patients may feel tingling and slight aching. Nerve endings numb within a few minutes, making the treatment very tolerable. Once done, patients can go right back to their normal activities.

Your double chin doesn’t have to be a defining feature. Call 206-859-5777 to schedule your CoolSculpting consultation with us.

Your Dermatologist Can Serve Your Needs Even in the Age of Telehealth

Today, life feels dramatically different than it did at the start of the new year. Many people have largely been indoors and many of our normal services have been halted for a time. Even with the need to carefully navigate how we can prevent the spread of the COVID-19 virus, we all still have health matters to attend to. In-person visits may be in pause-mode for many people but that does not mean necessary care cannot be provided. We are happy to serve our patients via virtual visits that keep them in the comfort and safety of their own homes.

The Rise of Telehealth

Telehealth, or telemedicine, is a term that is used to describe doctors’ visits that take place virtually. Several innovative ways to conduct virtual visits have been developed. Some offices use smartphone apps while others use Skype, Zoom, or other forms of video chat. We are committed to ensuring our patients receive the care they need even in the midst of this global pause. We make televisits as user-friendly as possible and provide clear instructions to help patients enjoy stress-free appointments. We know what you may be wondering. “How can telemedicine work for dermatology? Doesn’t my dermatologist need to examine my skin?”

Telemedicine for Dermatology

If you have already been under our care for a dermatologic condition, such as acne, your televisits provide us with the touchpoint we need to ensure your current treatment plan is working as intended. Periodic visits held over some form of video chat maintain our records and guide ongoing prescription dosing. But what if you’ve never seen a dermatologist before? Can telemedicine still be effective?

It is true that dermatologists make accurate diagnoses by examining the skin. However, for many of the most common skin conditions that are discovered, a diagnosis does not require special instruments or testing. Your dermatologist could diagnose a number of conditions, including contact dermatitis, eczema, psoriasis, poison ivy, shingles, and more by conducting a thorough consultation and virtual observation of the skin via video.

Are There Exceptions?

Telemedicine is not a perfect model for every situation. For example, a dermatologist does use a special instrument to conduct routine skin cancer screenings so these types of visits may not be the most efficient when conducted virtually. However, it is important to understand that if you notice a suspicious growth on your skin, a virtual visit is better than no visit at all. Our team of physicians has a wealth of experience and can determine how care should proceed based on their discussion with you and observation of your skin.

Regardless of our current pandemic, your skin remains an important aspect of your health. Televisits are helping us provide the care you need to preserve yours. Contact us at 206-859-5777to schedule your visit today.

When Should You See Your Dermatologist for Psoriasis?

Psoriasis is a chronic skin condition that requires ongoing management to keep symptoms under control. Without a proper diagnosis and treatment, psoriasis can cause repeated flare-ups of uncomfortable soreness, itching, burning, redness, and other dermatologic symptoms. If you’ve been diagnosed with psoriasis, you may see your doctor for routine checkups. However, there are times when you may need to make an extra call to the dermatologist to discuss your skin’s health.

  • When something new arises in the skin. People with moderate to severe psoriasis tend to get used to their normal symptoms and how to manage them. If something new arises, though, including minor frustrations such as an increase in red spots on the skin, more severe cracking or itching, or increased inflammation, a call should be made. Another “new” symptom is increased difficulty performing daily tasks due to joint pain. New or worsening symptoms could indicate that treatment needs to change.
  • Itching hasn’t improved. Itching is one of the most frustrating symptoms of psoriasis, according to many patients. While several home remedies can help control itching, the persistence of this symptom calls for evaluation. It could indicate that current treatment is not working efficiently and a new treatment needs to be prescribed. Examples include phototherapy or a change in topical medication.
  • Social events are being avoided. Psoriasis primarily affects the skin. However, there is an emotional component to this condition. Many people feel self-conscious about how their skin looks, especially during flareups. We’ve spent enough time distancing from each other in 2020; psoriasis should not be yet another reason to do so. If you’re feeling self-conscious about your skin, come see us. We’ll find the right approach to keep your psoriasis under control.
  • You’re going on a flight. In recent years, we’ve seen significant changes in air travel. For those who are on medications, especially topical products, taking a flight isn’t as easy as it could be. This is because tubes of topical creams may come in sizes that are too large to take on an airplane. Before flying, talk to your doctor about smaller quantities of medication or getting a copy of the prescription to present to TSA agents.
  • You’re interested in a new remedy for psoriasis. If you are already on a prescribed treatment plan for psoriasis, it is necessary to talk to your doctor if you’re considering making changes. This is relevant even for those who are looking at a natural remedy of some sort. Natural or not, new chemicals may not mix well with those in the current treatment protocol and may cause unnecessary irritation.

We take the health of our patients seriously. For more information on psoriasis and how to manage it well, contact us at 206-859-5777.

Double Chin Problems: What’s the Right Solution?

There is merit to the idea that eating well and exercising regularly can help us maintain a satisfying weight and appearance. For the most part, healthy lifestyle habits do support overall wellness. They don’t, however, guarantee that we will look exactly how we’d like. Most people report that, despite their good choices, they have one or more trouble-spots; areas where fat lingers regardless of ideal weight. One such area is the upper neck. Here, excess fat is referred to as submental fullness or a double chin. No matter what we call it, what people want to know is how to get rid of it. We have two options.

Injectable Fat Reduction

Who would have thought we’d ever be at a point in history where we can inject a chemical into an area of unwanted fat and watch it melt away. This is exactly where we’re at, and it’s pretty exciting. Just a few years ago, the United States FDA approved Kybella, a form of deoxycholic acid. This chemical, which the body makes to break down dietary fat, had been previously used in several other countries long before FDA-approval occurred here. Injections into the submental area and upper neck stimulate the breakdown of targeted fat cells, resulting in their natural elimination.

Points to consider: Kybella does not require downtime. However, significant swelling may last 4 or 5 days after injections. Multiple treatments may be needed to fully resolve a double chin. Results can last indefinitely with good weight management.

Liposuction for Double Chin Fat

Liposuction is known for its value in sculpting larger areas of the body. Rarely do we hear about the benefits of neck liposuction, though. This outpatient procedure suctions unwanted fat cells through a small hollow tube, achieving results that may be noticed immediately. The minor procedure may be performed using a local anesthetic and sedative rather than general anesthesia.

Points to consider: Liposuction does require one or more incisions but these are very small and expected to fade to be barely noticeable, if at all. Bruising and swelling may be managed with a dressing and compression strap, which incurs a few days of downtime at home. Within a few days to a week, most patients can return to normal activities. The results of chin liposuction can last indefinitely with good weight management.

Both Kybella and chin liposuction can achieve excellent results. The choice is not about which is best, but which is best for your needs and preferences. To schedule a consultation in our Seattle or Renton office, call 206-859-5777.

Letter from Dr. Reichel

Dear Valued Patients,

Your health is our first priority. We know that many of you have questions during these unprecedented times and we want to assure you that we are taking the following actions to uphold your safety:

  1. Firstly, we are here for you!! We have receptionists and providers available to answer all questions.
  2. We are screening all patients for risk of COVID-19 and will immediately reschedule any patients who fall into a risk category.
  3. As of March 19, our offices will remain open for Medical Dermatology appointments.
  4. Although it is a difficult decision, we will be postponing all cosmetic patients and cosmetic procedures until April 13th and after. If you are on our schedule prior to April 13th, we will be calling you soon. And rest assured, we are keeping our aesthetic staff busy with no planned lay-offs.
    We are offering telehealth (video) consultations for all cosmetic patients and dermatology patients upon request. We would like to offer you 10% off and FREE SHIPPING on all cosmetic products.
  5. Please check out our facebook and Instagram pages for new content over the next few weeks. We are planning on daily “stay connected” briefs.
    Our community is strong. Through focus on our patients and team, we are even stronger. Thank you for your patience and please take good care of yourselves and your loved ones.


Dr. Jennifer Reichel, and the team at Pacific Dermatology & Cosmetic Center

Save the Date -- Evening of Beauty May 30th

Join us on May 30th from 4:30pm-7:30pm at our Northgate location! At our evening of beauty, you will enjoy special event pricing, raffles, live demonstrations and much more!* Call to RSVP 206-859-5777
*$50 deposit required to reserve your spot. Special pricing available on event night only. 50% deposit required on all packages. Deposits are non-refundable but may be used towards your Botox treatment.

Request an appointment

Thank you for choosing Pacific Dermatology & Cosmetic Center, we look forward to providing you with the very best skin care.

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