Drs in the house: Medical Aesthetics’ Power Couple, Dr Julie Khanna & Dr Sheetal Sapra

Questions for Dr. Sapra

What are the top four treatments recommended by dermatologists to target signs of aging?

  1. Skincare – Clarisonic brush, vitamin c/anti-oxidant, retinol/vitamin a, sunscreen
  2. Lifting/smoothing & volume loss: Botox, Fillers and Beauty Boosters
  3. Tightening/loose skin concerns: Ultherapy, Thermage and Profound
  4. Textural & pigmentation concerns: IPL, Fractionated Lasers, Fractionated Microneedling (Fractora) and Microneedling with PRP


(top trending procedures & concerns in medical aesthetics in 2018)

What is the downtime to be expected with those three procedures?

(amount of time before patient can resume social activity/things to avoid after treatment/medication or numbing treatment required)

Downtime can only be determined by the results patients are wanting to receive. Not all patients receive treatment at the same level so downtime can widely vary. Fractionated lasers, fractionated microneedling, microneedling +PRP  and IPL can yield anywhere between no downtime at all and up to 1 week before patients can resume their everyday activities and expect their skin to return back to normal. Skin tightening recommendations can vary as well. Thermage and Ultherapy often have no downtime associated at all whereas Profound has significant 1 – 2 week downtime because it is using radio-frequency at a much deeper, more invasive level. Injectable treatments can be administered with zero to minimal downtime. Minimal swelling and/or bruising can be expected with fillers.

3.How many treatments on average would be needed to see visible results?

(recommended treatments in series based on concerns and desired outcomes)

Number of treatments are determined once again by the results patients are looking for. If someone is hoping to prevent the signs of aging rather than correct an existing problem we would take a gentler approach, perhaps suggesting a smaller number of treatments and/or scheduling treatments over a longer period of time. When a patient comes to us with a present concern seeking correction we would then suggest a more aggressive plan with treatments closer together and more often. Fractionated lasers, fractionated microneedling, IPL and microneedling with PRP average 4 to 6 treatments at 4 weeks apart. Skin tightening technologies can often be performed on a yearly or maintenance type basis. Skincare is an on-going, ever changing treatment in which we re-assess and tweak patient’s recommendations as we go along. Botox treatments are required 3 to 4 months apart whereas filler treatments can be anywhere between 6 months to 1 year depending on area’s injected and injectable products used. Beauty Boosters can be done in a series of 3 treatments at 4 weeks apart. Beauty Booster treatments are often added onto many other procedures to boost patient results to the next level.

4. Based on your professional recommendation, how important is an adequate home-care program to enhance results?

(for instance, science-based skincare to extend longevity of treatments, especially when the price-point between science based skincare and non-science based skincare is similar, if not more expensive)

A home-care program for each and every patient is essential. We treat all patients on an individual basis, covering all the bases by recommending the use of a Clarisonic brush, an anti-oxidant/vitamin c such as the SkinCeuticals CE Ferulic or Phloretin CF and a minimum of 30 spf. From there we are able to customize a skincare plan filling any gaps to ensure all patients are preventing, correcting and protecting their skin with the use of the best science based skin care available.

5. If you could give only 1 piece of advice, what would it be?

Wear a quality sunscreen and vitamin c/anti-oxidant daily, 365 days a year.

Questions for Dr. Khanna

  1. What are the most popular surgical procedures requested by patients?
  1. Breast enhancement – breast augmentation, breast lift, fat transfer to the breasts
  2. Body contouring – tummy tuck, vaser & high-definition liposuction, fat transfer to the face, breasts and buttocks
  3. Facial rejuvenation – facelift, brow lift, eyelid lift, neck lift

(top aesthetic trends in Plastic Surgery)

  1. What are the non-surgical options available for patients in a plastic surgery clinic for anti-aging results?

Non-surgical procedures are becoming a number one request from patients I am seeing in consultation. The advancements in non-surgical technologies are now giving patients the benefit of great results without the risks and down-time associated with surgery. While surgery still offers patients their most dramatic improvement, non-surgical options are enabling us to offer customized combination treatment to enhance surgical results ten-fold. Procedures such as Fractora, Profound, BodyTite and FaceTite give me the opportunity to deliver radio-frequency both under the skin and topically to offer tightening/lifting effects like never before. I perform these with many of my surgical procedures to enhance results and as a stand-alone procedure as well.

(for patients that are not necessarily ready for a surgical procedure, what other services are available in a plastic surgeon’s office to help achieve desired outcome)

  1. What is the difference between a cosmetic surgeon and a plastic surgeon?

Though you are likely to see both titles when doing research on surgery and doctors, the two titles are very different.  A Royal College of Physician and Surgeons Board Certified Plastic Surgeon has completed a minimum 5 year training in Plastic Surgery which includes all cosmetic procedures as well as having passed the national fellowship exam.  The term “cosmetic surgeon” has no true definition or specified training and does not meet the standard requirements set out by the Royal College. This means that the surgeon may not have the same level of expertise in risk management, post-operative care or variety of procedures they are able to perform.

(for instance, a general surgeon that has decided to focus on cosmetic surgery vs. a plastic surgeon who has years of academic training and specialization)

  1. What practices do you take to ensure patients optimal safety post-surgery?

The key to ensuring optimal safety post-surgery is to lay the ground work pre-surgically. Picking a patient FOR surgery is key. The patient/surgeon relationship is the most important attribute through-out a surgical journey because myself and that patient are a team. If a patient looks to me to simply fix a problem, that is not going to work because their contribution and dedication is a requirement to see their journey through. Preoperative testing is thorough and absolutely required to ensure a patient is a good candidate for surgery. Doctor availability is extremely important post-operatively. All post-op patients are given my direct cell phone number by me with instruction to call and text me with absolutely any concerns or questions any time, day or night.

(for instance, ICLS in house operating room and the protocols Dr. Khanna has in place to ensure the safety of the patient is prioritized post surgery)

  1. If you could give only 1 piece of advice, what would it be?

Be healthy, be happy – wear your sunscreen.

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