Non-Surgical Procedures

Not every patient wants or needs cosmetic surgery to achieve their cosmetic goals. In fact, one of a plastic surgeon’s primary goals is to stave off the need for cosmetic surgery for as long as possible so that patients see significant benefits and long-lasting results when cosmetic surgery is finally performed.

When combined with an effective skin care regimen, non-invasive laser treatments, injectable fillers, and wrinkle relaxers can correct the signs of aging without surgery. They can also slow the skin’s aging process by preventing wrinkles, stimulating collagen production, and improving skin tone and texture.

A variety of non-surgical anti-aging treatments, facial rejuvenation procedures, and skin care maintenance options are available at Wilmington Health Plastic and Reconstructive Surgery, and Dr. Ljung can help you decide which of the following treatments is right for you.

One of the most popular and widely used wrinkle treatments available in the U.S., Botox Cosmetic injections are used by millions each year to relax dynamic wrinkles caused by movement of facial muscles.

Botox Cosmetic is commonly used to treat the following conditions:

  • Crow’s feet or laugh lines
  • Horizontal forehead wrinkles
  • Frown lines or 11s
  • Neck bands
  • Sagging eyebrows

Botox treatment may also be used to lift sagging eyebrows and correct excessive sweating, as well as treat a variety of medical conditions including migraine headaches, spasticity, dystonia, and TMJ.


Botox treatment is ideal for both men and women who wish to diminish and prevent fine lines and creases on the face and neck or lift mildly drooping brows. According to Allergan, the company that makes Botox, cosmetic treatment with Botox is indicated for patients who are 18-65 years old, while non-cosmetic Botox treatment may be indicated for patients as young as 12.

Dr. Ljung will consult with you to discuss your cosmetic goals, review your medical history, and evaluate your face and neck before determining whether Botox treatment is recommended.


Botox Cosmetic is the brand name for a purified form of a neurotoxin called botulinum toxin A. When Botox injections are administered, the botulinum toxin A prevents acetylcholine, the neurotransmitter needed to create muscle contractions from being released, essentially paralyzing targeted facial muscles.

Because Botox injections block the muscle contractions that—through repetitive movement over time—would cause permanent fine lines and wrinkles, they are a highly effective way to both minimize existing wrinkles and prevent new ones from forming.

So, rather than hiding existing static wrinkles and folds by adding volume like Juvéderm and Restylane, Botox smooths out dynamic wrinkles by limiting movement of facial muscles and lifts slightly drooping eyebrows by manipulating opposing forehead muscles.


Inexperienced injectors are often to blame for Botox side effects; however it is important to know the possible risks before seeking Botox injections. Potential Botox side effects include:

  • Injection site reaction
  • Minor bruising and swelling at the injection site
  • Swollen or droopy eyelids
  • Headache

It is important to note that because the effects of Botox wear off within a few months after injection, any side effects that occur should not last longer than six months maximum.

To avoid Botox side effects and achieve the best possible Botox results, it is important that you see a highly experienced Botox injector. In addition, be sure to avoid rubbing or manipulating the area treated with Botox for at least 24 hours after injections, and avoid consuming aspirin, fish oil, and excess vitamin E for one week before and 24 hours after the Botox injections.


Dysport is another brand name cosmetic injectable used for wrinkle treatment, and it is the only Botox alternative on the market in the U.S.

Like Botox, the active ingredient in Dysport is the neurotoxin botulinum type A, so the effects of Dysport are very similar to the effects of Botox. There is some debate in the medical community as to what, if any, are the significant differences between Dysport vs. Botox results, however duration of onset and duration of effect may vary, and the number of actual units given per dose is different.

When it was first FDA-approved, Radiesse was indicated for treatment of vocal cord disorders. Today, Radiesse has a wide variety of uses and is FDA-approved for facial rejuvenation, including correction of moderate to severe facial wrinkles and folds and correction of lipoatrophy, or facial fat loss.


Radiesse effectively fills wrinkles and restores volume loss in both men and women and is primarily used to treat the following signs of facial aging:

  • Nasolabial folds (creases from the nose to mouth)
  • Marionette lines (wrinkles from the mouth to chin)
  • Oral commissures (smile lines in the corners of the mouth)
  • Jowls (sagging jawline contours)

Radiesse is also often used for cheek augmentation to increase cheek projection and volume, and it’s used for non-surgical nose jobs to improve nasal contours and correct some deformities.

After discussing your cosmetic goals and evaluating your health and medical history, Dr. Ljung may recommend Radiesse if you desire long-term correction of facial wrinkles and volume loss.


Radiesse is made of calcium hydroxylapatite microspheres, a biocompatible, biodegradable mineral component of teeth and bone in a water-based gel carrier. Lidocaine may also be added to the formulation in order to improve patient comfort during injections.

After treatment, Radiesse injections provide immediate volume restoration and plumping of depressed areas. Radiesse also stimulates collagen production in the areas injected, which usually include the face and sometimes the hands. The results of Radiesse may last a year or longer; however occasional touch-up injections may be necessary.

To ensure the best results are achieved, it is important to avoid significant movement or massage, makeup application, and sun exposure for 24 hours after Radiesse injections. You may also be directed to apply a cold compress to the injection site to reduce swelling.

Radiesse can also be seen in X-rays and CT scans, so it is important to notify your other healthcare providers that you have had Radiesse injections.


Radiesse is a comparatively firm wrinkle-filling substance, so the formation of lumps or nodules is the most common Radiesse side effect. For this reason, Radiesse is not recommended for lip augmentation. Product migration and other complications, such as granuloma formation and infection, may also occur.

Like all other injectable fillers, Radiesse may temporarily cause mild post-injection bruising, swelling, and redness.


When comparing Radiesse to Juvéderm or other hyaluronic acid fillers such as Restylane, it is important to consider the problem you wish to correct or the area you wish to enhance.

For instance, while Juvéderm is preferred for lip augmentation, Radiesse is typically preferred for cheek augmentation because Radiesse provides similar results to Juvéderm but also lasts longer.

Whether Radiesse or Juvéderm are used for filling facial creases, such as the nasolabial folds, depends on the depth of the wrinkles—Juvéderm is better for more superficial lines and Radiesse for deeper wrinkles.

Consult with Dr. Ljung to determine whether Radiesse, Juvéderm, or some other injectable filler is the best option for you.

Restylane is a brand name injectable filler made of hyaluronic acid, a naturally occurring sugar compound found in connective tissues of the body. In anti-aging medicine, hyaluronic acid fillers like Restylane are used to restore volume to the face, plump lips, and reduce the appearance of facial folds and wrinkles.


Hyaluronic acid fillers like Restylane, Perlane, and Juvéderm are some of the most versatile injectable fillers. Restylane may be used for a variety of temporary facial rejuvenation purposes, including:

  • Wrinkle reduction
  • Lip enhancement
  • Cheek augmentation
  • Nose contouring
  • Jawline contouring

Restylane is also commonly used to restore volume to the backs of the hands and fill tear trough hollows under the eyes. It may be used in combination with Botox or Dysport and other injectable fillers to perform a procedure called a liquid facelift that provides overall facial rejuvenation. Occasionally, Restylane may also be used to fill skin depressions, such as scars and acne scars.

During consultation, Dr. Ljung will discuss your cosmetic goals with you and evaluate your medical history and overall health before determining whether you are a good candidate for Restylane injections.


When Restylane injections are administered, the hyaluronic acid molecules bind to water molecules under the skin, applying an immediate plumping effect that restores volume and diminishes creases and folds. As the hyaluronic acid molecules slowly break down over time, the effects of Restylane injections fade.

Restylane Lidocaine, a new formulation of Restylane that includes lidocaine anesthetic, is also now available. This product offers all the same benefits of Restylane combined with the pain-reducing effects of lidocaine.

Restylane results typically last about six to nine months in most patients and fade more quickly in areas that experience more movement, such as the lips.


Like all injectable fillers, temporary bruising, swelling, and redness may be present for a few days after Restylane injections. Cold compresses will help minimize these undesirable Restylane side effects, and they will eventually fade. Bruising can also be minimized by avoiding certain medications and supplements for a week prior to Restylane injections.

After your Restylane injections, you may resume normal activities right away, however you should refrain from using makeup to cover any bruising and redness you experience for 24 hours.

Other rare side effects of Restylane injections include infection, usually due to improper hygiene before the injections are administered, and blood vessel blockage. These complications are extremely unlikely if you see an experienced injector for your Restylane injections.


Restylane and Radiesse have many of the same indications, including wrinkle reduction, cheek augmentation, and nasal contouring, and the basis of both formulations is a substance that occurs naturally in the body.

However, Restylane is much softer than Radiesse, so it is more easily shaped and manipulated via massage. This can be an advantage if post-injection lumps and bumps occur, as massaging will help diminish this undesirable effect. In addition, the results of Restylane—both volume restoration and potential side effects like post-injection lumps and bumps—do not last as long as the results of Radiesse.

Juvéderm is an FDA-approved, injectable gel filler used for temporary facial rejuvenation and soft tissue augmentation. Manufactured by Allergan, the makers of Botox, Juvéderm competes with other hyaluronic acid fillers, such as Restylane and Perlane, and offers many of the same facial rejuvenation and anti-aging benefits.


Juvéderm is typically recommended for adults 18-65 years old who wish to add volume and plump the face or the backs of the hands; diminish wrinkles; fill skin depressions, such as scars and acne scars; and augment facial features, such as the cheeks and lips.

Before recommending Juvéderm, Dr. Ljung will consult with you about your cosmetic goals and problem areas, as well as conduct a thorough assessment of your health and medical history.


Juvéderm fillers are available in three formulas of varying density, all composed of a naturally occurring sugar compound found in the connective tissues of the body called hyaluronic acid.

When injected, hyaluronic acid molecules bond to water molecules, plumping the skin and restoring volume to sunken, creased, and depressed areas of the face and hands, as well as to thin lips. Thus, Juvéderm is ideal for:

  • Reducing facial folds and creases, especially smile lines
  • Filling under eye hollows
  • Cheek augmentation
  • Lip enhancement

A new formulation of Juvéderm called Juvéderm XC contains Hylacross, a smooth hyaluronic acid gel infused with lidocaine, a pain-reducing anesthetic.Juvéderm XC offers the same benefits of other Juvéderm formulations along with pain relief.

After Juvéderm injections, volume restoration will be immediately apparent; however it may take a few days for swelling to resolve and for you to see the final results. Normal activities may be resumed immediately, as there is no downtime associated with Juvéderm injections.

Unless directed to massage the area where Juvéderm was injected, refrain from rubbing or manipulating the injection site for 24 hours after Juvéderm injections to avoid product migration.

About six to nine months after Juvéderm injections, the hyaluronic acid molecules will start to dissolve, and Juvéderm results will fade. To maintain results, additional injections of one to two syringes of Juvéderm are necessary.


Temporary redness, bruising, and swelling may be present for a few days after Juvéderm injections, as is the case with all injectable filler treatments.

In order to prevent most bruising, it is best to avoid aspirin and all over-the-counter pain medication except Tylenol. Also avoid fish oil, glucosamine, and other supplements.

Swelling and redness may also be relieved by using a cold compress after Juvéderm injections, and makeup may be used to cover any skin discoloration about 24 hours after treatment. If lumps or bumps occur as side effect of Juvéderm, hyaluronidase, a product that quickly dissolves hyaluronic acid gel fillers, may be injected to diminish the Juvéderm.


It is difficult to compare Juvéderm to Restylane because the two hyaluronic acid fillers are so similar; however Juvéderm Ultra is often characterized as a softer, more pliable filler ideal for under eye hollows, lips, and softer facial wrinkles. Restylane, on the other hand, is firmer and often noted to work best for filling deeper facial folds, enhancing the cheeks, and filling the depressions in the backs of the hands.

The cost of Juvéderm is nearly identical to that of Restylane, but Juvéderm sometimes costs slightly more than Restylane just because the results of Juvéderm may last longer (six to nine months vs. four to six months).

FDA approved for cosmetic use in April 2009, Dysport is the latest injectable wrinkle relaxer to be introduced to the U.S. market since Botox Cosmetic was FDA approved in April 2002. Dysport and Botox are very similar and now compete to treat aesthetic concerns, such as:

  • Frown lines or eyebrow furrows
  • Laugh lines around the eyes
  • Neck bands
  • Forehead wrinkles
  • Mildly droopy eyebrows

Additionally, Dysport is FDA approved for therapeutic use to treat cervical dystonia, or spasmodic torticollis, a condition that causes painful, involuntary muscle contractions in the neck and sometimes shoulders.


Dysport treatment effectively reduces moderate to severe dynamic wrinkles, or wrinkles caused by facial muscle movement, for up to six months in both men and women. Medicis, the company that makes Dysport, suggests that treatment is ideally for adults over 18 and younger than 65, however there is no real age limit for Dysport treatment.

Dr. Ljung may recommend Dysport treatment after talking with you about your facial rejuvenation goals and evaluating your health and medical history. Dysport is not suitable for patients who are allergic to cow’s milk protein or any of the ingredients in Dysport or patients who have had an adverse or allergic reaction to any other botulinum toxin product, such as Botox.


Dysport is a botulinum type A neurotoxin that works by inhibiting the release of acetylcholine, a neurotransmitter that controls facial muscle contractions. When Dysport injections are administered, facial muscles are prevented from contracting, which stops dynamic wrinkles from forming and prevents the creation of static wrinkles that occur due to repeated dynamic wrinkling.

Thus, Dysport injections can effectively reduce the appearance of dynamic wrinkles and prevent permanent static wrinkles from forming over time.


The most common Dysport side effects that have been reported include:

  • Headache
  • Injection site bruising and swelling
  • Temporarily droopy eyelids or eyebrows
  • Skin reaction near the injection site

Most potential side effects can be avoided when Dysport is administered by an experienced injector and all instructions for pre-procedure preparation and post-procedure care are followed.

It is also important to refrain from rubbing or massaging the area treated with Dysport after your injections, as doing so may cause increased Dysport migration to unintended areas of the face.


Although no major differences in the effects of Dysport vs. Botox have been proven, some physicians suggest that Dysport may take effect slightly faster than Botox (within one to 10 days); however both products seem to offer the same duration of results. Dysport has also been noted to spread from the injection site slightly more than Botox.

Dysport is measured in units that each constitute about a third of a Botox unit, so while more units of Dysport will be needed to achieve the same results as Botox, each Dysport unit is priced lower than each Botox unit, causing the overall Dysport cost per treatment to roughly equal the overall Botox cost per treatment.

Skin resurfacing with a chemical peel is an effective way to exfoliate and rejuvenate the skin on your face and neck, essentially by removing old, damaged skin so it may be replaced with new, healthier skin.

Several chemical peel formulations exist, so your treatment can be customized to meet your needs. A chemical peel may be performed using various concentrations of any of the following solutions:

  • Carbolic acid (Phenol peel)
  • Trichloroacetic acid (TCA peel)
  • Beta-hydroxy acid (BHA peel or Salicylic peel)
  • Alpha-hydroxy acid (AHA peel)
  • Glycolic acid (Glycolic peel)


Chemical peels are suited for both adult men and women. Depending on your age, skin condition, and cosmetic goals, we will determine which type of chemical peel is recommended.


  • These are light, superficial chemical peels that usually require no downtime.
  • Mild resurfacing and light exfoliation of the skin can be achieved with an AHA or glycolic acid peel.


  • This moderate-depth chemical peel requires less downtime than phenol and TCA peels but more than AHA and glycolic peels.
  • Uses beta-hydroxy acid, also known as salicylic acid, to reduce acne, and may also improve skin texture and tone.


  • Commonly used to treat moderate sun damage and fine lines and wrinkles, as well as improve skin texture and tone.
  • Concentrations can be manipulated to produce a light TCA peel similar to a glycolic peel, or a deep TCA peel, closer to a phenol peel.
  • Unlike phenol peels, may be effective for patients with darker skin.


  • This very potent chemical peel provides deep skin resurfacing.
  • Treats moderate to severe facial lines and wrinkles, significant sun damage, and acne scars.


During a chemical peel, water is combined with the chemical exfoliant, diluting it to the correct percentage of potency needed to address your skin condition and cosmetic goals. The solution is then painted on the desired skin area with a sponge or brush and is monitored until it must be removed.

A skin chemical peel may not always cause visible skin peeling, however moderate to deep chemical peels will typically cause dead skin to flake away in noticeable layers.

The deeper the chemical peel, the more discomfort and downtime you will experience after your chemical peel, and the longer you will typically have to wait to complete your chemical peel recovery.


A chemical peel may cause the following side effects:

  • Redness
  • Hyperpigmentation
  • Skin burns
  • Hypopigmentation

Side effects, like the results, from a skin chemical peel dissipate faster the lighter and more mild the peel. It is imperative that you protect skin treated with a chemical peel by using sunblock and avoiding sun exposure.


Performing a do-it-yourself (DIY) or at-home chemical peel can be dangerous, as any missteps in diluting chemicals and monitoring chemical concentrations and treatment time could cause significant long-term facial damage, such as chemical skin burns, permanent skin discoloration, and uneven pigmentation.

Virtually any adult or teen, male or female, can safely have microdermabrasion treatments, so the decision regarding whether or how often to pursue microdermabrasion treatments is largely dependent upon what you are trying to accomplish.

Microdermabrasion treatments may be helpful for correcting:

  • Blackheads and whiteheads
  • Fine lines
  • Sun damage and superficial age spots
  • Oily skin
  • Clogged pores or enlarged pores

If you wish to treat skin conditions that affect deeper skin layers, such as wrinkles, scars, or more significant sun damage, microdermabrasion treatment would probably be recommended for a secondary skin maintenance protocol rather than a primary skin treatment.


Microdermabrasion is a mechanical exfoliation procedure that uses hand-held microdermabrasion machines to perform the procedure one of two ways:

  • Crystal microdermabrasion uses tiny crystals that are blasted at high speed onto the face, then suctioned away to exfoliate and remove superficial skin cells.
  • Diamond microdermabrasion uses a diamond-tipped wand to exfoliate skin instead of blasted particles.

No downtime is required with microdermabrasion; however the procedure may leave your skin feeling a bit raw and red, especially if it is more aggressive, so limiting sun exposure directly after treatment is typically recommended to protect your skin.


Microdermabrasion is safe for use on all skin types and skin tones and causes little to no long-term side effects; however, mild redness similar to a windburn may be experienced after more aggressive microdermabrasion treatment, and sensitive skin may experience some additional irritation.

Microdermabrasion side effects may be slightly more likely if a more aggressive microdermabrasion treatment is performed, but you should not see any bleeding with microdermabrasion, as compared to dermabrasion, a surgical skin resurfacing procedure that penetrates to much deeper layers of skin.


Contrary to popular belief, microdermabrasion is not an effective treatment for acne scars. The level of skin resurfacing and exfoliation provided by microdermabrasion is so superficial that it does very little to remove or reduce acne scars.

A moderate to deep chemical peel or fractional CO2 laser treatment is far more appropriate to treat acne scarring than microdermabrasion.


Home microdermabrasion kits provide much more mild results than typical professional microdermabrasion treatments and may be performed more frequently because they are easily tolerated by most skin types. Home microdermabrasion skin care products are not really microdermabrasion treatments but rather physical skin exfoliation treatments that gently remove dead, dull skin.

Home microdermabrasion may help maintain your professional microdermabrasion results and make your skin feel smoother and softer; however, these at-home microdermabrasion treatments are not as effective as professional microdermabrasion treatments offered in a doctor’s office.

The Lumenis One is a versatile laser platform that offers fast, efficient treatment with several types of laser therapies designed to correct a variety of cosmetic skin conditions. Non-surgical treatments available through the Lumenis Laser platform include:

  • IPL skin rejuvenation
  • Laser hair removal
  • Laser vein treatment
  • Vascular birthmark removal
  • Wrinkle treatment
  • Universal IPL

The Universal IPL component of the Lumenis One Laser platform is an excellent skin rejuvenation multi-tasker that can improve skin tone, reduce sun damage, even out skin pigmentation, treat rosacea and skin redness, and even provide hair removal on patients with light skin.

Lumenis Laser comes with seven interchangeable filters that allow the Universal IPL hand piece to operate at the appropriate wavelength to provide each treatment. IPL treatment speed with Lumenis Laser is 3.5 times faster than with other IPL devices, and two built-in SapphireCool Light Guides provide continuous skin cooling during treatment for maximum comfort.


Permanent hair reduction with the LightSheer Laser component of the Lumenis One Laser platform is ideal for patients of all Fitzpatrick skin types (I-VI), including those with dark or tanned skin.

LightSheer Laser hair removal is also an effective treatment for nearly any hair color and hair diameter and can even correct pseudofolliculitis barbae, or ingrown hair.


The Lumenis One Laser’s Multi-Spot Nd:Yag module not only offers laser vein treatment and vascular birthmark removal, it can also provide non-ablative reduction of facial wrinkles.

The Yag Laser targets strawberry birthmarks (or hemangiomas), spider veins, and mild to moderate wrinkles, and its 1064nm wavelength makes it safe for use on all skin types, including dark or tanned skin.


All laser treatments carry some risk; however, the treatments offered by the Lumenis One Laser are generally quite safe. Nonetheless, those considering treatment with the Lumenis One’s IPL, LightSheer Laser, or YAG Laser modules should be aware of the following potential temporary Lumenis Laser side effects:

  • Redness
  • Swelling
  • Blistering
  • Discomfort

Additionally, more serious but less common laser treatment side effects include burns, scarring, and skin discoloration.

Although complications can occur with any laser treatment, choosing an experienced laser practitioner to perform your Lumenis Laser treatment will help you avoid any unwanted side effects.

The Ultrapulse CO2 laser is a versatile skin resurfacing tool that has 34 FDA-approved indications for aesthetics, as well as a surgical cutting instrument used for laser surgery procedures, such as keloid removal and eyelid surgery. The Ultrapulse laser platform offers three variations of fractional resurfacing treatment including:

  • Active FX


Ultrapulse laser treatments are ideal for adults who show signs of facial aging.

Before recommending Ultrapulse laser treatment, Dr. Ljung will review your medical history, evaluate your health and skin quality, and talk with you about your cosmetic goals and the areas of your skin you wish to improve.


Active FX uses a larger pattern of 1.3 mm spots of CO2 energy scattered over the skin, and how much coverage you get depends on the power density of the laser beam, which may be as high as 95% or more with Active FX laser treatment.

Active FX laser resurfacing is ideal for correcting:

  • Sun damage
  • Precancerous lesions
  • Red and brown spots
  • Large pores
  • Wrinkles and fine lines
  • Mild skin laxity
  • Crepey elid skin
  • Acne scars

Although it takes about 10 days to two weeks to fully recover from Ultrapulse CO2 laser resurfacing, Active FX requires four to six days of downtime.


Although potential fractional CO2 laser resurfacing side effects are significantly fewer than potential side effects with traditional CO2 laser resurfacing, some complications are still possible with Ultrapulse laser treatments.

Scarring and permanent pigmentation changes are possible but uncommon Active FX side effects, while redness and swelling are likely to occur after any fractional CO2 laser resurfacing procedure.

Laser resurfacing also makes skin susceptible to bacterial infection and herpes simplex virus outbreaks, so oral antibiotic or anti-viral medication may be recommended in conjunction with Ultrapulse laser treatment.

Intense Pulsed Light (IPL) skin treatments, or Photofacials, are among the most effective procedures available for reducing sun damage and the signs of photoaging on the face, neck, décolleté, and hands. IPL Photofacials are also among the gentlest, non-ablative skin treatments able to offer dramatic skin rejuvenation results in a short period of time.


Male and female adults of all ages with skin pigmentation problems are ideal Photofacial candidates and may want to consider IPL treatment for correction of:

  • Freckles
  • Age spots or sun spots
  • Hyperpigmentation
  • Melasma
  • New, red stretch marks
  • Skin redness
  • Rosacea
  • Broken capillaries

Most IPL Photofacial patients seek the treatment to get rid of facial redness and broken capillaries. In addition to treating uneven pigmentation and discoloration in the skin, IPL treatment may also be used to permanently reduce facial and body hair.


An IPL Photofacial uses broad-spectrum light to seek out brown and red pigmentation in the skin. This allows the IPL to target sun damage and hyperpigmentation, redness, broken capillaries, and hair follicles with ease in fair-skinned patients. However, because IPL is so good at seeking and destroying pigmentation in the skin, it is not suitable for use on patients with darker skin or ethnic skin types.

After IPL treatment, skin gradually turns darker then flakes off over a period of two to three weeks. Depending on the aggressiveness of the Photofacial, no downtime is typically necessary after IPL treatment; however, it is recommended that patients avoid sun exposure to ensure the best possible Photofacial results are achieved.

It is also often necessary to have IPL treatments performed in a series of six to eight treatments spaced one month apart to achieve the best possible results. It is not uncommon to return for IPL touch-ups annually or semi-annually after your initial treatment series to maintain your results.


Immediately following an IPL Photofacial, you may feel a slight burning sensation, and mild itching, swelling, and redness may occur. IPL side effects are typically temporary; however, permanent pigmentation changes can occur if the face is burned during treatment. To avoid facial burns, seek an expert for facial rejuvenation and laser hair removal with IPL and do not seek IPL treatment if you are not fair-skinned.


Photofacial rejuvenation can improve skin tone and even out pigmentation and also help sun worshippers reverse the damage done to their skin over years of unprotected overexposure to harmful UVA and UVB rays.

During consultation, Dr. Ljung will discuss your goals for photofacial rejuvenation with you, as well as any other cosmetic concerns you would like to address. After completing a medical history review and assessing your health, Dr. Ljung may recommend IPL treatment for photofacial rejuvenation or laser hair removal.

The Lumenis Multi-Spot Nd:Yag Laser is part of the powerful, multi-purpose Lumenis One Laser platform that also features the Lumenis LightSheer laser hair removal device and IPL treatment technology. The Lumenis Yag Laser provides safe, effective skin rejuvenation of the legs and face on patients of all skin types and skin tones, including dark skin or ethnic skin.


The Yag Laser may be used for non-ablative facial wrinkle reduction; however, the device is most typically used to for safe, effective laser vein treatment on the legs.

After reviewing your medical history and assessing your health, Dr. Ljung may recommend Yag Laser treatment if you experience any of the following conditions:

  • Mild to moderate facial wrinkles
  • Spider veins
  • Hemangioma (vascular birthmark)
  • Telangiectasias (dilated superficial blood vessels)


The Lumenis Yag Laser emits a long wave of infrared light of 1064nm to penetrate deeply into the lower layer of the skin’s dermis. Not only does this allow for wrinkle reduction and treatment of vascular conditions, it also triggers new collagen formation by producing controlled heat damage in the dermis.

The Lumenis Yag Laser may be used with three spot sizes to ensure precision treatment with computer-enabled Light Guide recognition. One of the key advantages of the Lumenis Nd:Yag Laser is its 2 mm x 9 mm treatment head, which provides the largest spot size on the market and allows treatment with the Lumenis Yag Laser to be performed up to three times faster than with other Yag Lasers.

Like all treatments available with the Lumenis One platform, Yag Laser treatment offers Sapphire Cool Light Guides, which provide continuous contact cooling to the skin during treatment for maximum comfort.


When an Nd:Yag Laser is used to treat spider veins, it penetrates the skin and the superficial blood vessel, or spider vein. The heat generated by the Yag Laser coagulates the blood inside the spider vein causing it to collapse and seal. The collapsed spider vein will disappear over the next few weeks, and the body will naturally and safely dispose of the coagulated blood inside.

The Yag Laser delivers the precise dosage of energy to problematic spider veins without injuring any nearby structures, such as healthy blood vessels or skin tissues.

The entire laser vein removal procedure is typically no more than 20-30 minutes, and no anesthesia is necessary. Spider vein treatment requires two to six treatments every four to six weeks until all unsightly leg veins are no longer visible.


Risk of burns, scars, redness, swelling, and discoloration are possible side effects of any laser treatment; however, these risks are extremely low with an Nd:Yag Laser. The Lumenis Yag Laser is even safe for use on patients with tanned skin or ethnic skin, which is typically more susceptible to burns than light skin or fair skin.

To avoid laser treatment side effects, ensure your laser treatment is performed by a physician who has significant experience with laser procedures and a variety of laser devices.

LightSheer from Lumenis Aesthetic is the new gold standard for laser hair removal. Now with the ability to treat all skin types and even tanned skin, this procedure has become very popular at our office.

Laser hair removal is a long-term or permanent solution to the problem of unwanted body hair. If you are tired of waxing, shaving, or electrolysis, this procedure is probably ideal for you. By heating the hair follicle with laser energy, we can stop hair growth in one or multiple areas of your body. Some of the advantages of the Lumenis LightSheer are:

  • Treats all skin types including tanned skin and most hair colors
  • Patented ChillTip cools the epidermis for safety and comfort
  • Treatment is faster and more efficient than comparable lasers
  • Device can also be used to treat leg veins and pigmented lesions


This procedure may be right for you if you are bothered by unsightly body hair and you are tired of traditional hair removal methods. Those with conditions such as hirsutism or pseudofolliculitus are also good candidates. Laser hair removal can be used to stop hair growth on the chest, face, back, legs, arms, bikini line, or elsewhere.

Before proceeding with laser hair removal, Dr. Ljung will evaluate your skin type and ask you about your medical history. Be sure to notify the doctor if you are taking any photosensitizing medications, have a photo-aggravated skin disease or active skin infection, or are prone to keloid or hypertrophic scars.


Laser hair removal is an outpatient procedure performed in an office setting. Your treatment areas are cleansed and the hair is trimmed down to approximately 1-5 mm. To determine the laser’s energy parameters, the doctor will first evaluate your skin type or perform a test patch on a localized area.

The energy level is set for your individual skin type, and the doctor applies the laser using a special hand piece. Heat from the laser penetrates the pigment within the hair, effectively disabling the hair follicle and stopping hair growth. Because hair follicles are active in different phases, multiple laser hair removal sessions will be needed to achieve satisfactory results.


Once your procedure is finished, you should schedule a series of laser treatments to achieve long-lasting results. You should also cease all bleaching, plucking, or electrolysis procedures. The Lumenis LightSheer hair removal system has a built-in cooling device, but in some cases, an ice pack may still be applied to the treated area. Lotion and sunscreen is typically applied after treatment, and you’ll be instructed to avoid sun exposure.

Possible side effects with laser hair removal include discomfort, blistering, or hyperpigmentation. Ask Dr. Ljung for more information if you are concerned about these possibilities.


How does the LightSheer Laser System work?
The device applies light that is absorbed by the pigment in the hair follicle. The laser emits a pulse lasting only a fraction of a second—just long enough to damage the follicle. Meanwhile, ChillTip helps protect the skin by conductive cooling.

Why is LightSheer superior to other laser hair removal systems?
The Lumenis LightSheer Laser was designed specifically for laser hair removal. All the components and parameters are ideally suited for this procedure.

Can all skin types achieve the same results?
The settings on the device (pulse width and fluences) can be adjusted for each skin type, so all Fitzpatrick skin types (I-VI) can benefit.

Are results permanent?
The LightSheer laser has FDA clearance for hair removal and permanent hair reduction on all skin types. Three to five sessions are typically needed for satisfactory results.

Lip enhancement procedures can augment the size and shape of your lips or reduce lines and wrinkles around your mouth. Using an injectable product such as Juvéderm, Restylane, or collagen, Dr. Ljung can make your lips appear fuller and more youthful.


Good candidates for lip enhancement will be in good health and have realistic expectations for the procedure. During your consultation with Dr. Ljung, you can discuss the procedure and expected results. Be sure to tell the doctor if you smoke, if you commonly experience skin eruptions near the mouth, or if you have dental problems.

A typical lip augmentation procedure can correct one or more of the following conditions:

  • Thin or flat lips
  • Smoker’s lines
  • Drooping lips
  • Perioral wrinkles
  • Marionette lines


The procedure varies depending on the goals of your procedure. You might benefit from an increase in lip volume, lip reshaping, or wrinkle correction for rejuvenation of the mouth area. Once this is determined, Dr. Ljung will use special wrinkle filler, typically one composed of hyaluronic acid. Using a dental block to manage discomfort, the filler is injected evenly along the natural lines of your upper and lower lips.

There are different areas of the lips that may need attention. Your lips consist of skin and mucosa, with the border between them creating what is called the vermillion border. The natural arches of the upper lip are known as the Cupid’s bow. A successful lip enhancement procedure will augment the lips while preserving a natural appearance in these areas. Your plastic surgeon will carefully inject the filler in each area and then massage the material to ensure a proper contour.


Although there are many types of wrinkle fillers on the market, plastic surgeons will choose only particular types for this procedure. Aside from natural fat, permanent fillers or long-lasting fillers are avoided.

Fillers made with smooth hyaluronic acid gel have recently been the products of choice for plastic surgeons performing lip augmentation, largely because of their smooth consistency and short-term (three to six months) duration. Other options are available such as collagen, fat, or SurgiSil lip implants. Ask Dr. Ljung about the best lip augmentation product for you.


It may take some time for the effects of your anesthesia to wear off, so you may not wish to return to your normal routine immediately. You’ll need to minimize movement of the treated area for a while after treatment. Follow Dr. Ljung’s instructions carefully and you should be able to fully appreciate the results in a few days. During the months that follow your lip augmentation, your body will metabolize the injected product and naturally clear it away.


Mild discomfort and swelling can occur, as well as bruising and other effects related to the use of respective dermal fillers. Before treatment, ask the doctor about possible side effects of the product chosen for your lip augmentation.


Latisse is a prescription eyelash enhancement drug that can dramatically change the appearance of your lashes within a matter of weeks. By brushing Latisse on the base of your upper eyelids once daily, you can enhance the length, fullness, and color of your lashes. Made with bimatoprost ophthalmic solution 0.03%, Latisse was derived from a widely used glaucoma medication.

If you have short or sparse eyelashes, you may be a candidate for Latisse. Results can be seen in about eight to 12 weeks. After 16 weeks, you should see the full enhancement in your lashes. In clinical trials, participants achieved lashes that were 25% longer, 18% darker, and over 100% fuller.


Niacin-powered skin therapy from NIA24 is designed to stimulate your skin’s self-protective power 24 hours a day. These products are non-comedogenic and fragrance, color, and dye free. NIA24 skin care products are only available through qualified dermatologists, plastic surgeons, and medically directed spas.

NIA24 products are ideal for your face, neck, chest, and hands. Using a unique micro-delivery system to administer Pro-Niacin, a healing process is stimulated within the skin cells to promote healthier, more beautiful skin. Ask us about these products:

  • Gentle cleansing cream
  • Physical cleansing scrub
  • Skin strengthening complex
  • Intensive recovery complex
  • Eye repair complex
  • Rapid exfoliating serum
  • Sun damage prevention
  • Sun damage repair


The philosophy of SkinMedica is that “everyone deserves to have naturally radiant skin.” Offering a variety of products scientifically based on the skin’s healing ability, SkinMedica is helping people reverse the signs of aging with restorative ingredients that work below the skin surface.

Essential ingredients like vitamins C and E, retinol, and NouriCel-MD® are all contained within SkinMedica’s recovery compounds, as well as a patented blend of growth factors like soluble collagen, antioxidants, and matrix proteins.

Ask us about these SkinMedica Products

  • TNS Recovery Complex
  • Desonate™ Gel 0.05%
  • EpiQuin® Micro (4% hydroquinone) cream
  • VANIQA® (eflornithine hydrochloride) Cream, 13.9%,
  • NeoBenz® Micro Cream
  • NeoBenz® Micro SD


glotherapeutics is a company that makes highly potent skin care and chemical exfoliation treatments. The core of the brand is known as the gloComplex, which consists of ingredients such as spin trap, carnosine, amla, and niacinamide. This powerful blend of ingredients can accelerate results, prevent free radical damage, soothe inflammation, and support healthy skin structure.

glo chemical peels allow us to customize your chemical exfoliation treatments to achieve the results you desire, whether it’s a light, moderate, or deep exfoliation. These peels exfoliate the skin while promoting the healing and skin regeneration process.

Skin care products from glotherapeutics can help you prepare for your professional skin care treatment. Included ingredients are chirally correct, pharmaceutical-grade, and free from dyes and parabens. Ask us how these products can improve the results of your laser treatment or chemical peel.


LUCA broad-spectrum sunscreens are some of the most sophisticated sun protection products available. Offering both UVA and UVB protection, LUCA is hypoallergenic, water-resistant, fragrance free, and ideal for protecting your skin against the hot North Carolina sun. These sunscreens are an excellent choice for people with sensitive skin, including children. Ask us about these high-quality LUCA products:

  • SPF 15 sunscreen
  • SPF 30 sunscreen
  • Max Sport SPF 30
  • Lips SPF 30

LUCA is the only sunscreen company in the United States that places a critical wavelength UVA rating system on its packaging.


SkinCeuticals makes complete skin care solutions available through plastic surgeons and dermatologists around the United States and in over 35 countries worldwide. These are high-quality products supported by science—not trends or gimmicks. View the SkinCeuticals web site to read peer-reviewed articles about the science behind these products.

The SkinCeuticals product line includes different formulas that cleanse, tone, exfoliate, balance, purify, protect, correct, lighten, moisturize, and reverse the signs of aging.

Ask us about designing a SkinCeuticals regimen for you.