Tips & Wisdom
Dermal Filler Recommendations
Cosmetic Uses of Botulinum Toxin
Rosacea Treatment with Lasers
As our skin ages, it loses support and volume. This leads to the formation of wrinkles and folds. Dermal fillers are commonly used to reduce or eliminate wrinkles, smooth depressed scars, enhance lips and replace soft-tissue volume loss.
A dermal filler is injected beneath the surface of the skin where it temporarily plumps and smoothes the skin. There are several classes of FDA-approved dermal fillers, the most common being hyaluronic acid and calcium hydroxyl apatite-based fillers. Each of these products has different properties and characteristics.
I generally recommend the hyaluronic acid fillers, such as Juvederm® and Restylane®. Hyaluronic acid is a natural component of human skin and is the framework in which skin cells live. All hyaluronic acid products bind water and give the skin greater volume. These products offer a combination of safety, smooth and natural appearance, and good duration of benefits. A hyaluronic acid filler, such as Restylane® or Juvederm® can be dissolved with a readily available and safe enzyme injection. Although this is rarely needed, it is reassuring to have that option available.
The improved appearance provided by hyaluronic acid filler usually lasts about 9 months. There are other dermal fillers derived from other substances that provide long-lasting results, such as poly-L-lactic acid. The idea of getting fewer injections may sound appealing at first, but consider what would happen if you had a bad reaction to such a filler, or if you weren’t happy with the results?Learn More
Facial lines caused by facial expression are called "hyperfunctional facial lines". Contractions of facial muscles scrunch the skin and can, over time, damage the collagen and cause prominent lines, such as frown lines, forehead lines and crows feet. Frown lines are often interpreted as anger, anxiety, fatigue, fear or sadness.
Relaxing those muscles with Botox®, Dysport® or Xeomin® are generally very well tolerated.
Botox®, Dysport® and Xeomin® are all proteins produced by a bacteria called “clostridium botulinum”. Botox® was first used in the early 1980?s in the treatment of a number of eye disorders, such as strabismus (crossed eyes). Now it is widely used to treat hyperfunctional facial lines. It is also very useful to reduce overactive sweating of the underarms, palms and soles.
An emerging use is in the treatment of migraine headaches.
Dysport® and Xeomin® are newer forms of botulinum toxin that provide clinical effects similar to Botox®.
These different forms of botulinum toxin all block nerve impulses. If they are injected into a muscle, they prevent the muscle from being activated and stop muscle contractions. Botox® usually takes a week or so to reach full effect. The effects of treatment with Dysport® and Xeomin® may appear a little sooner.
Because the effects tend to wear off after a few months, repeat injections are often performed 2-3 times a year. Botox® has been used in thousands of individuals over many years and has an excellent safety record. However, as with any medical treatment, side effects can occur. Reported side effects include bruising and swelling at the injection site and a transient headache. Ptosis, a drooping of the eyelid and/or eyebrow, occurs in 1-2% of patients and generally resolves within 2 weeks of treatment. Strabismus, a weakening of the eye muscles, is a temporary side effect that has been reported. Although this is a temporary reaction, it could make driving unsafe. This is rare in the doses used for wrinkle treatment.Learn More
While there is no known cure for rosacea, a combination of treatments can often be used to effectively diminish its appearance. Rosacea treatment options include individualized skin care, topical medications (such as azelaic acid, metronidazole), oral antibiotics (such as doxycycline, Oracea®), and laser light therapies.
Laser treatment is usually the most effective treatment option for reducing facial redness. flushing and broken capillaries (telangiectasias). The results of laser treatment for rosacea are long lasting, but periodic treatments are useful to maintain best results.
I have found that what I call Pulsed Light Rejuvenation is an effective treatment for rosacea. I use a combination of intense pulsed light (IPL) and two additional laser wavelengths (532 nm, 940 nm) using the VariLite laser. It can reduce redness, flushing, facial veins and may help reduce rosacea flares. This treatment also reduces splotchy brown sun damage and stimulates some collage production, which improves skin texture.
During the procedure, the laser emits wavelengths of light that target tiny blood vessels just under the skin. Heat from the laser’s energy builds in the vessels, causing them to disintegrate.
When rhinophyma (rosacea subtype 3) occurs, the nose gets larger and bumpy. Rhinophyma can be treated with CO2 laser resurfacing and/or surgery to remove unwanted tissue and reshape the nose.Learn More
- Dr. Zimmet was selected by his peers to be included among the Best Doctors in American 2001-2012 Database. Best Doctors draws from the expertise of 46,000 renowned physicians, representing the top 5% of physicians and affiliations with the top medical institutions across the country. For 20 years, they have conducted the largest continuous peer-to-peer survey, monitoring current licensure, board certification and malpractice incidents, as well as evaluating specific expertise including special research and published work.
- Dr. Zimmet was awarded the American College of Phlebology Leadership Award, bestowed upon persons “who have demonstrate exemplary leadership qualities, traits and skills and substantially made a difference in advancing the mission and vision of the ACP and the Phlebology community as a whole.”
- Dr. Zimmet was named by Vein Magazine as one of the 25 most influential professionals in vein care worldwide. Voting was done by physicians nationally and internationally who also care for patients with vein disease.
- Dr. Zimmet is North American Editor for Phlebology, the Journal of Venous Disease.
- Dr. Zimmet was invited to serve on the Advisory Board of the International Union of Phlebology, with medical associations on venous disease from 35 countries.
- Dr. Zimmet has been named a Fellow Emeritus of the Australasian College of Phlebology. This is awarded by invitation only for long and distinguished service to the specialty of phlebology.
- Dr. Zimmet was awarded the First Place Platinum Abstract Award at the 16th Annual Congress of the American College of Phlebology.
- Dr. Zimmet is a Past President of the American College of Phlebology.
- Dr. Zimmet was the Inaugural Chairman of the American College of Phlebology Foundation.
- Physicians from around the US and other countries visit Dr. Zimmet for training.
- Dr. Zimmet was in the first class to be invited to become a Fellow of the American College of Phlebology.
- Dr. Zimmet helped develop the technique of EndoVenous Laser Treatment (EVLT™) of varicose veins and was involved in obtaining FDA approval for this technique.
- Dr. Zimmet recieved a Research Award in 1992 from the North American Society of Phlebology for outstanding research in the field of Phlebology.
Education & Training
- Residency: Shadyside Hospital
- Medical School: Georgetown University School of Medicine
Zimmet Vein and Dermatology
1500 W. 34th Street,
Austin, Texas, 78703