Non-surgical nose job

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Phototherapy an Ideal Treatment for Some Cases of Psoriasis


The chronic inflammation and redness of psoriasis can be disruptive to your sense of confidence. The condition is not fully understood, though research has identified it as an autoimmune disorder rather than a clear dermatologic condition. The patches of skin that become noticeable are those on which cellular turnover occurs too quickly. T-cells, in particular, behave abnormally, leading to discomfort, itching, and embarrassment. In order to improve quality of life, it is important for the person with psoriasis to find solutions that will reduce inflammation and flare-ups.

PsoriasisAt Pacific Dermatology, patients receive care that is based on their unique condition. We consider the severity of psoriasis, the type, and its location and extent of coverage. The goal of treatment is to soothe irritation and promote healthier skin by reducing the risk of flare-ups. One of the ways we do this is with phototherapy, a modality that has shown promising results in clinical investigations. Treatment can be obtained in one of our comfortable Washington dermatology offices.

What is Phototherapy?

On a technical level, phototherapy is essentially light therapy. To treat psoriasis, narrow-band UVB light may be used. This is the same UV light that comes from sunshine, and the wavelength that produces the greatest positive effect on the skin. Many experts find narrow-band UVB ideal for patients with chronic plaque psoriasis.

Phototherapy is not the same as lying under the sun! This precision treatment is conducted at recommended intervals and for only short durations each time. The controlled delivery of specific wavelengths improves the condition of the skin without increasing the risk of skin cancer, like tanning or even certain other types of phototherapy. Narrow-band UVB is safe for patients of all ages, even children, and pregnant women.

How Phototherapy Works

The in-office phototherapy treatment is performed in a series. Depending on the condition, sessions may be scheduled every few days for a few weeks. Topical skin treatments may also be prescribed to improve skin health. During sessions, light waves target abnormal cells, slowing their growth. As a result, the existing flare-up has greater opportunity to heal, and further buildup of cells is reduced or prevented altogether.

To see the improvement you desire with your psoriasis, it is necessary to see a physician with specific expertise in the diagnosis and treatment of dermatologic conditions. To schedule a visit to Pacific Dermatology & Cosmetic Center, call 206-859-5777.


Non-surgical nose job with filler

Hi John. Below is your question and my response:

My name is John, I am 37 years old and I live in Northern Virginia (30 mins from Washington D.C.). About a month and a half ago I had surgical Rhinoplasty done to improve the definition of my nose, though there is a significant difference in the way my nose looked before and the way it looks after the surgery (and I was quite pleased with the results) there are still two minor things that maybe I will get done surgical next year but for now I would like to have the improvements done with fillers such as Juvederm, or Radiesse. I would like my nose to have a more defined tip and most importantly I would like the sides of my nose to be more triangular as opposed to the way it looks now. I can send pictures if you want. Please provide me the estimate of the cost and also your availability for me to come in and have this done. I am very serious about getting this done as soon as possible.

Thanks for the inquiry. I guess first things – I am in Seattle in Washington State – so you probably don’t want to travel all the way across the country to come and see me (although non-surgical nose jobs are one of my favorite procedures to do J).   But – to answer a bit of your question – I would say that you may be a little too close to having the surgery to add fillers yet. I would check with your surgeon that did your rhinoplasty to find out what he/she thinks of having fillers done after surgery – how long should you wait? There is no standard answer, but if you came to see me, I would probably ask to wait about 6 months for all the swelling and healing to occur before doing fillers in the nose. I do prefer Radiesse over the other fillers for non-surgical nose jobs. It is easy to define the tip more. Shaping the sides of the nose should also be possible.

Again, thanks for the inquiry – you should be able to find a skilled dermatologic surgeon, facial plastic surgeon, or plastic surgeon to do the treatment. I would ask your doc that did your surgery. You can also check on RealSelf. Good luck.


Jennifer Reichel MD

Director, Pacific Dermatology & Cosmetic Center

11011 Meridian Ave N Ste 102

Seattle WA, 98133



Non-surgical nose job for hump and droopy nose

Hi IG.

Below is your question and my answer.

I am looking for a doctor that does non-surgical nose jobs. I am looking with someone that has done procedures with a Hump and droopy nose...ASAP.

Thank you for your inquiry from RealSelf. Yes, I specialize in non-surgical nose jobs. I would be happy to see you, and we could do your treatment on the same day as your consult if you would like. I like to use Radiesse (filler) to improve the “hump” and straighten the bridge. I also like to use just 2 units of botox to release the nose tip to decrease the “droop”. The consult fee of 80$ is waived when you mention that you came from Realself.

Please call 206-859-5777 to schedule your appointment with me. Thank you again.


Jennifer Reichel MD

Director, Pacific Dermatology & Cosmetic Center

11011 Meridian Ave N Ste 102

Seattle WA, 98133



Filler for nasal correction

Dr R, I am interested in Botox to reduce the width of my nostril flare when I smile and possibly Radiesse to enhance the tip, and make my broad asian nose look longer and slimmer. Can u give me an estimate, pictures, have u done it before?


Hi F,

I have done this before, probably about 10 times for Asian noses, and 20 times for Caucasian noses. The cost for the botox is $30 and the cost for the Radiesse is $450. It is about a 20 minute procedure. The botox lasts about 4-6 months. The first time, the Radiesse lasts about the same amount of time. After you have done the Radiesse a couple of times, it lasts a lot longer. It is amazing how you can make a nose look less flat and more slim by adding a bit of filler product along the bridge of the nose. There are few big risks. You may get bruising, and you will have temporary redness and swelling. Sadly, there have been some cases (very very few) in which the filler caused the skin to break down and develop a sore at the injection site. This is very rare and I have never seen it in person.

This is one of my favorite treatments. Please call to make an appointment for a consultation. I can show you photos then. The consultation fee is waived when you mention realself. Also, we can do the treatment on the same day if you want.

Thank you.


Dr Reichel

I'd like a non-surgical "nose job".

Hi! I am a 19-year old Seattle girl who is slightly unhappy with the width of my nose. I'd love to hear about nonsurgical options that could help. Please let me know. Thank you!
Thank you for your question on non-surgical "nose jobs". For the most part, non-surgical options for nose "improvements" involve the use of fillers, such as Radiesse (my favorite). The filler is injected under the skin of the nose just above the bone to improve nasal humps, or, perhaps, give the nose the appearance of being slimmer. It is amazing how it works by almost tricking the eye of the on-looker into thinking the nose is smaller and more straight. For my patients, I have them come in about 40 minutes before the procedure to have topical numbing placed on the nose for increased comfort. The procedure itself usually takes about 30 minutes and involves injecting and then molding of the nose. Radiesse is pliable, and can be molded. Most patients do report that it is uncomfortable, but they all tollerate it just fine. Once the procedure is over, the area may feel sore, but not painful. Most patients have about 2 days of swelling and redness and then that subsides. You may get a little bit of bruising - so don't plan the procedure right before a fancy event.
The filler usually lasts about 6-12 months, and can be re-done at anytime. Cost is about $400 to $500 depending on the size of the syringe.
Botox can also be used for non-surgical nose jobs to slightly alter the curves of the nose. Botox inhibits the muscles that pull down on the nose tip, or cause a widening of the sides of the nose (the ala).
The best thing would be for you to come in in-person. I would love to see you in consultation (206-859-5777). We can often treat on the same day if you want.
Thanks again.
Dr R.

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