Injectables & Skin Care

Lip Enhancement/Augmentation




Skin Care Products

Skin Peels

Andrew Pichler, M.D., F.A.C.S.

All procedures and treatments in our office is personally performed by Dr. Pichler. As the founding physician of the Facial Plastic and Cosmetic Surgery Center of the North Area, Dr Pichler knows about the face and skin. He is highly knowledgeable in the field of facial injectables and fillers and has been doing it successfully for many years for thousands of patients.

During your initial consultation, Dr Pichler spends plenty of time discussing your specific areas of concern and your desired outcome with you. This important conversation enables him to develop the best course of action for you, which may include Dysport®, an injectable dermal filler such as Restylane, Perlane or Radiesse and perhaps advising on the proper skin care and specially formulated skincare products to use.

Lip Enhancement/Augmentation

Lip Augmentation SacramentoAs people age the lip line begins to descend, causing thinning of the red lip (lipstick-bearing part of the lip) and loss of the upper lip crest known as "Cupid’s Bow."

The desire to regain a youthful, shapely lip is causing women today to seek facial plastic procedures to enhance the fullness of their lips.

Several techniques are available for maintaining a pleasing lip contour. One of the most popular is augmentation the lip line with injections (fillers), such as Restylane®, or fat taken from other parts of the body. The results can last 6-8 months and should have periodic repeats or touch ups.

Another procedure that is quite effective for those patients wanting a more permanent solution is the technique of implanting a well-tolerated, neutral material. In the past, Gore-tex, a processed connective tissue and inflatable balloon like devices have been used. Today PermaLip® is the preferred implant, a FDA approved facial implant that is made of soft silicon, has a very natural feel, is relatively easy to place and can easily be removed, replaced or abandoned should any problems arise. This procedure can be performed under mild sedation with local anesthesia in the office. There may be slight bruising, but most patients are back to normal activity within a week. Best of all, this is a permanent solution to enhance the shape and fullness of your lips.

What may ultimately be the procedure of choice for you is best determined by a consultation with Dr. Pichler, as well as a discussion about the desired aesthetic look you want to achieve.

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Restylane® and Perlane®

Restylane SacramentoRestylane is FDA approved and is one of most popular fillers in the US today.
Restylane adds to your own natural hyaluronic acid to make treated areas fuller providing a natural, smooth, and attractive look. Restylane binds to water and replaces volume lost with sun damage and aging. It is used not only to fill in wrinkles, scars and folds but it can provide a mini-facelift by enhancing and filling in the:

  • cheeks hollows
  • under eye hollows
  • cheek bones
  • chin and mid-face areas.

The lips are also wonderful areas for Restylane enhancement.

Restylane Facelift

At our practice in Carmichael, California, Restylane in combination with Dysport is the gold standard for non-surgical lunchtime facial rejuvenation.

Restylane is a stabilized non-animal hyaluronic acid gel. It is clear, transparent and viscous and is supplied in a syringe with a tiny 30-gauge needle. It degrades slowly so it lasts for 6-9 months, Restylane binds water into the skin. Patients actually look better 2-4 days post treatment.

Restylane is non-allergenic so skin testing is not necessary and it can be used immediately. It is a totally non-animal product so that there is no risk of transmitting disease or eliciting an allergic reaction in patient's sensitive to beef, chicken, or eggs. It can safely be used on people allergic to collagen.

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Radiesse SacramentoWomen and men from Sacramento area choose facial cosmetic surgeon Dr. Pichler to help them attain more youthful looking skin. He offers a wide selection of the latest wrinkle treatments including Radiesse®, a long-lasting injectable filler.

Radiesse, one of the many dermal fillers offered by Dr. Pichler, is made of synthetic calcium hydroxlapatite (CaHA) microspheres, a substance commonly found in the body. In addition to adding volume to the skin, Radiesse has been shown to stimulate the production of new collagen. These quick, easy treatments can be used to effectively:

  • Correct facial folds and wrinkles such as forehead creases, marionette lines, and nasolabial folds
  • Smooth wrinkled skin
  • Treat cheek lines
  • Fill in scars
  • Enhance the chin and jaw line
  • Volumize the skin

Injectable fillers like Radiesse are popular with our patients because they are so quick and convenient. Treatments typically take less than 30 minutes. There is usually no recovery time required and the improvements from Radiesse can last up to a year. Dr. Pichler may use Radiesse in conjunction with other fillers to give you the very best result for you.

Radiesse is just one of the many skin rejuvenation treatments Dr. Pichler offers. His selection of the latest skin treatments, and Dysport injections have people looking more youthful with no downtime. During your private consultation, Dr. Pichler will ask you about your desired improvements and recommend a customized treatment plan for you.

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Dysport SacramentoWhen it comes to treating facial wrinkles, choices are always a good thing. Dr. Pichler is  pleased to offer the first FDA-approved alternative to BOTOX® Cosmetic called Dysport® . It was approved by the FDA in April 2009, and now rivals BOTOX®, as the most popular, non-invasive cosmetic procedure in the country.

Dysport's active ingredient is a cosmetic form of botulinum toxin that works in a similar way to BOTOX Cosmetic. Unlike dermal fillers that fill out and add volume to wrinkles, Dysport temporarily relaxes the facial muscles that create wrinkles from repeated facial contractions over time.

Benefits of Dysport
Dr. Pichler's patients have found that, as with BOTOX® Cosmetic, Dysport® can restore a more refreshed, youthful look to their faces. These simple treatments effectively correct:

  • Horizontal creases across the forehead
  • Wrinkles around the outside corners of the eyes
  • Vertical frown lines between the eyebrows
  • Lines and creases around the lips and mouth
  • Vertical and horizontal neck banding
  • Bunny lines on the sides of the nose
  • Puckered chins

Your Procedure

Injections with Dysport are relatively brief, and most patients are in and out of the office within 30 minutes. During this appointment, Dr Pichler first cleanses your face. We then use a little ice just to dull the tiny needle stick. Dr Pichler then makes a series of several injections in and around the targeted areas of your face. His knowledge and experience ensures maximum accuracy. We emphasize a light touch and a conservative approach with these products to create results that are as lasting as they are natural-looking. Each injection lasts only a moment and is no more painful than an insect bite.

Your Recovery & Results

Dysport® treatment does not require any sort of downtime or recuperation. Following your appointment, you can get back to your usual activities immediately. However, you should avoid activities that require you to stoop or bend over, as these can impede the distribution of the product beneath your skin. For even results, it's important to keep your head upright for the remainder of the day.

You may notice some redness, swelling, tenderness, or itchiness near your injection sites, but these side effects can be covered with makeup. Within 1 to 2 days, most patients notice their wrinkles softening, and within about 1 week they have significantly faded revealing a smoother, younger-looking face.

Common Questions:

-What's the difference between Dysport and BOTOX?

While Dysport is similar to BOTOX Cosmetic in the way it treats wrinkles, there are some notable differences, which include:

  • Dysport has been found to spread farther from the injection site than BOTOX Cosmetic. This can be beneficial when treating large areas.
  • Improvements from Dysport often appear earlier than BOTOX Cosmetic, 1 to 2 days for Dysport instead of 3 to 5 days for BOTOX Cosmetic.
  • Dysport is a less expensive alternative to BOTOX Cosmetic.

How long will my results last?

Typically, results following an initial Dysport treatment lasts up to 3-4 months. Eventually, the product is naturally metabolized by your body, and your lines begin to reappear. However, you should visit our practice for an additional treatment to maintain your results for as long as you'd like. After follow up treatments the duration of the effect gradually increases and eventually patients often achieve excellent results with just 1-2 treatment per year.

Is it safe to undergo multiple Dysport procedures?

Yes. Dysport is approved for cosmetic use by the FDA, and their safety is well-documented. When a product is FDA approved, it means it's undergone rigorous testing and evaluation by an objective organization to determine that it is safe to use as directed and does what it claims to do. As a patient, one of the most important things you can do to increase the odds of a beautiful result is to choose an experienced medical practitioner to administer your injectable.

If you're curious about how Dysport® treatments can create natural-looking results for you that can take years off your appearance, request a consultation online, or call our practice at (916) 965-3223.

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Microdermabrasion improves mild to moderate sun damage, scarring, wrinkles and other superficial skin problems. A gentle stream of tiny particles exfoliates the outer layer of skin and provides a fresh, glowing, younger appearance. Only a small amount of skin is removed, so sensitive areas such as the face, chest, neck, arms and hands can be treated. Results are comparable to a light chemical peel and should be immediately visible. Microdermabrasion is often performed in conjunction with other skin renewal procedures, such as laser treatment and chemical peels. Multiple treatments are recommended for full effect.

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Skin Care Products

Our skin care products are specially formulated, medical grade that should have professional guidance in their use for best results.
If you are interested call us to arrange an appointment for skin evaluation to determine the best approach to your unique needs. (916) 965 3223

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Skin Peels

Chemical Peels  SacramentoSkin peels remove (exfoliate) damaged outer layers of skin on the face, hands, neck and chest to smooth texture, reduce scarring and remove blemishes and pre-cancerous growths to produce healthy, glowing skin.

In general, there are three basic types of chemical peels:

Light, such alphahydroxy acids (AHAs, Glycolic acids), sometimes referred to as the “lunch-time peel”, because there is no down time at all and beta hydroxy acids (Obagi Radience Peel), Medium, such as the tricholoroacetic acid (TCA) and the Obagi Blue Peel, which have 4-6 days recovery and Deep, such as phenol, that has largely been replaced by laser resurfacing. Each  of these is designed to provide different results, depending on a patient's skin condition and requirements. But in general, the deeper the peel, the more dramatic the result but also the longer the recovery.

Skin peels are now performed on younger patients as well as they are looking to prevent the signs of aging from appearing too early.
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