What Causes Your Skin to Become Photosensitive After IPL?

The skin forms a remarkably strong, protective barrier that regulates our internal temperature, prevents damage, and stops harmful bacteria from entering the body. However, despite how tough it is, this organ is susceptible to changes in the environment and damage from external elements. Even if you don’t have sensitive skin (a highly reactive skin type that is more likely to develop inflammation and negative reactions to products), you can experience damage from the sun. UV radiation from sunlight is one of the main aggressors that takes a toll on the health and appearance of the skin. Although intense pulsed light from our Philadelphia-area practice is a powerful tool for reducing redness, broken capillaries, wrinkles, and sunspots caused by cumulative sun exposure, plastic surgeons caution patients against direct sun exposure after their treatment.

Your skin is much more sensitive to sunlight and more prone to sunburn, blistering, and hyperpigmentation after you’ve had an intense pulsed light (IPL) session. Not to mention, sun exposure can cause additional damage and could reverse all of the time, expense, and effort that went into evening out your complexion with IPL. When you do decide to expose your skin to sunlight again, routinely apply SPF 30+ broad-spectrum sunscreen and take all of the usual steps to avoid sun damage. These include wearing sunglasses and large-brimmed hats, covering up, and avoiding going outside during the hours when the sun’s rays are strongest.

Patients should also watch out for topical products, foods, and medications that have the side effect of increasing photosensitivity, which essentially is decreased tolerance to sunlight or other forms of light that elevates the risk of burns or rashes. Certain chemicals contained in these products or medicines interact with UV radiation. Let your physician know about what you’re using before IPL. Some of the things that increase photosensitivity include:

  • Certain types of antibiotics, like tetracyclines and quinolones
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Certain antifungal drugs
  • Antihistamines
  • Oral contraceptives
  • Oral diabetes medications
  • Diuretics
  • Tricyclic antidepressants
  • St. John’s wort
  • Alpha-hydroxy acids
  • Beta-hydroxy acids
  • Tretinoins
  • Perfumes or oils containing lavender, bitter orange, musk, or lemon verbena
  • Foods such as celery, dill, lime, and parsley

Searching for more info on laser or light-based procedures like intense pulsed light (IPL)? Dr. Timothy Greco’s team can help you find the best solution for enhancing your skin. Give us a call at (610) 664-8830, or fill out a contact form to request a consultation.

3 Things You Should Know Before Having Fillers for the First Time

If you have conspicuous facial wrinkles from depletion of collagen or a loss of elasticity, soft tissue fillers can replenish the fullness the skin has been missing to give it a smoother, thicker, firmer, and more youthful appearance. Any kind of cosmetic treatment to change your facial appearance is a personal decision that you shouldn’t make hastily—even when it comes to a minimally invasive procedure. Although facial fillers are one of the least invasive procedures available and can seem very straightforward, there are some things to know about them. It helps to have a consultation with a board-certified facial plastic surgeon before making any final decisions, be aware of what’s involved, and learn what you can do to optimize your results. Here are some things that patients who are considering facial fillers from our Philadelphia area practice should know before they decide to proceed with them.

1. Hyaluronic Acid Fillers Are Dissolvable

Did you know that if your fillers results aren’t what you imagined, it’s possible to have them reduced or reversed? An enzyme called hyaluronidase is mixed with saline solution and starts breaking down the hyaluronic acid found in Juvéderm® or Restylane® right away. Results of this appear in less than 24 hours, so you have options if you regret your decision. That said, you should know that some swelling is to be expected right after your initial filler injections, so the ultimate look won’t be apparent for several days. Give your results a chance to “settle” before deciding you don’t like them and want them reversed.

2. Some Fillers Are Longer Lasting

Although hyaluronic acid fillers generally last for six to 18 months depending on which one is used, there are some fillers—like Sculptra®—that deliver longer-lasting results. These injectables, which are known as biostimulators, gradually stimulate the body’s own, natural production of collagen, with an enhancing effect that lasts for at least two years on average. Because this collagen is built by your own body, it can’t be reversed. Some patients prefer more temporary fillers for their first go.

3. They Can’t Fix Everything

Fillers reduce the depth of wrinkles caused by aging, damage from external elements, or lifestyle choices such as smoking, but they aren’t meant for dynamic wrinkles which are linked to facial muscle contractions on the forehead, and fine crow’s feet next to the eyes. Botox treats the dynamic nature of these wrinkles.  If you have more severe sagging skin that causes jowls or a double chin, fillers won’t be able to get rid of that redundant tissue. Plastic surgery would be the best choice.

Get more details on what to expect from facial fillers elsewhere on our website. Dr. Timothy Greco’s team can also provide more tips on having fillers or other cosmetic procedures. Call (610) 664-8830, or submit a contact form to request a consultation.

Why It’s Best to Get Laser Work Done During Winter

While other aesthetic procedures and topical products can enhance your skin appearance, there’s no replacement for laser and light treatments when it comes to addressing more pronounced skin texture and tone issues. These therapies clear up and even out your skin in a way you can’t get out of a bottle. Fractional laser treatments are one of the most popular options for skin rejuvenation because they deliver tiny columns of heat to the skin that encourage collagen growth and speed up cell turnover. The fractional laser resurfacing treatments with Pixel® from our Philadelphia-area team give you smoother, clearer, and more youthful skin. If you have been thinking of having laser resurfacing to give your skin a complete makeover, we advise trying it out during the winter months, for a variety of reasons:

Lasers Need Time to Work

Although you’ll notice some improvement to your skin just after a laser resurfacing treatment, results are progressive, and patients can expect the optimal appearance to develop around two to three months later. During this time, the skin is able to fully heal while new collagen and elastin are produced to improve the structure.

The gradual improvements look more natural and subtle rather than making it obvious that you’ve had “work done.” With that said, if you’re hoping to be able to flaunt your new, glowing skin by spring, it’s better to start early. You may also need to have several treatment sessions to get your desired results.

More Time to Recover

Patents usually need a few days off to recover because their skin will be sensitive and red after a laser treatment. The long weekends and time off during the holidays give you more opportunities to heal at home.

Colder Weather Is Ideal for Lasers

After a laser treatment, your skin is very sensitive to heat and especially prone to developing hyperpigmentation and irritations. Try to limit your sun exposure as much as possible. We spend more time covered up in bulky clothes indoors during winter, and the sun’s rays aren’t as strong, so you can take advantage of this and treat yourself to a rejuvenating laser treatment.

Read to try out Pixel®? Dr. Timothy Greco and the rest of the team can get you started. Talk to us about the procedure by calling (610) 664-8830, or submit a contact form to see us for an appointment.

A Beginner’s Guide to Thread Lifts

Many patients are ready for something that gives a more dramatic result for sagging skin than injectable facial fillers, but still aren’t ready for a complete facelift or other facial surgery as yet. Our specialists in minimally invasive procedures from the Philadelphia area office of Dr. Timothy Greco use Silhouette InstaLift to give patients a more youthful and energized appearance without surgery. The results are visible right away, and the new contours last for up to two years. Continue reading to learn about how thread lifts work!

Once we lose collagen, fat, and bone from the face, we often discover that our facial contours no longer look as sharp as they once did. Thinning skin may begin to sag around the lower face area. Injectable wrinkle treatments can only do so much for loose skin when we reach this stage, and fillers are mainly designed to address moderate to severe wrinkles as opposed to more advanced sagging and skin folds.

Silhouette InstaLift repositions and lifts lax skin around the central and lower part of the face by introducing absorbable threads below the surface of the skin. These threads are lined with tiny, barb-like cones that attach to the under surface of the skin and pull it upward, supporting its structure. This treatment gives an additional lift to the jawline and cheek areas as the threads continue to stimulate collagen production in the underlying layers of skin to give it a tighter appearance over the following months.

Some of the major advantages associated with having a thread lift are that as it is minimally invasive, only local anesthesia is used, there is very little recovery time needed, and side effects are minimal. The results will be noticeable as soon as the treatment is over, and they will progressively improve for up to 12 months as your skin builds more collagen.

If you’re interested in having a facial rejuvenation treatment for the New Year, check out our special on thread lifts: Enjoy $400 per thread (originally valued at $600) when you book a consultation for a thread lift before Jan. 31, 2021!

Want to learn more about what to expect from minimally invasive procedures? Our Philadelphia-area team can answer any questions you might have about a thread lift or other cosmetic treatments. Call (610) 664-8830, or submit a contact form to request an appointment with us.

What Causes Laugh Lines, and How Do Fillers Smooth Them Out?

For some people, laugh lines symbolize joy and happiness. For others, these pronounced creases that extend from the sides of the nose to the corners of the mouth and along the inner cheeks are no laughing matter. These lines are often one of the first telltale signs of aging to appear, and they can make you look tired or unhappy—even when you’re not. These indentations—technically called nasolabial folds—are a perfectly normal and harmless feature that are present on almost everyone’s faces starting from early childhood. The exception is newborn babies and people with certain medical conditions. The folds become more noticeable over time due to aging, smoking, weight fluctuations, chronic sun damage, and the impact of gravity. When this happens, you’ll need a filler like JUVÉDERM® from our Bala Cynwyd-based cosmetic team to reverse this particular sign of aging.

Your skin makes less collagen and elastin as you age, so it naturally becomes more lax around the lower face. Loosening skin and years of facial expressions cause laugh lines to be most visible when you’re smiling or laughing, and the repetitive muscle action involved in these expressions usually makes them deeper. The secret to turning back the clock and addressing these wrinkles is restoring the volume that your skin has lost by physically filling in the empty space below the surface. Fillers can be used as an alternative to a surgical facelift for restoring your contours, though the results will not be nearly as dramatic as with surgery.

JUVÉDERM® contains a synthetic form of the organic hyaluronic acid your skin uses to maintain fullness and hydration by pulling in water from the deeper layers and the surrounding tissues. The soft, smooth gel makes the skin firmer, plumper, and more luminous. The filler isn’t injected into the folds themselves, but rather the surrounding areas so that the gel flows into the gaps where it’s needed. The goal is to soften the lines, but still leave some small, natural-looking creases so that your face doesn’t look over-filled or swollen and unnatural.

Talk to our team at Dr. Timothy M. Greco’s office for more advice on reducing facial wrinkles like laugh lines with JUVÉDERM®. Call us at (610) 664-8830, or write us a message to talk more about your goals.

Which Facial Areas Are Appropriate for Off-Label BOTOX®?

BOTOX® is a powerful microbial toxin that has a long history of use for both cosmetic and therapeutic applications. Since the early 2000s, when it was approved for glabellar lines, this breakthrough injection treatment has become the gold standard for diminishing hyperfunctional facial wrinkles. Basically, the injectable causes isolated muscles to relax, keeping wrinkles at bay. Specifically, when injected into particular facial muscles, it temporarily stops the activity that causes wrinkles to appear. It works by blocking the release of the neurotransmitter that initiates muscle contractions. Although Dr. Timothy Greco uses BOTOX® at his Bala Cynwyd practice for three FDA-approved applications (crow’s feet, glabellar lines, and forehead lines), experienced physicians like Dr. Greco also use their clinical judgment to inject it for other uses. Dr. Greco just published a chapter in a medical text as the lead author on the use of BOTOX® throughout the face and neck, Complications in the Minimally Invasive Facial Rejuvenation. Because the treatment is so versatile, physicians are constantly finding new applications for it.

The term “off-label” simply means that the medicine is used for a condition that has not been officially studied or approved for specific uses by the FDA. This is a perfectly safe and common way of using injectables. It’s up to the physician and patient’s discretion to determine whether the off-label use is the right choice in a given case.

BOTOX® is most often used off-label on the following areas:


Sometimes referred to as “Browtox,” the injectable can be used on the eyebrow area to lift and reshape brows, creating a brighter, fresher look.

Bunny Lines

The movements of facial muscles when you scrunch up your nose can cause diagonal wrinkles at the sides of the upper bridge, known as bunny lines. BOTOX® can smooth these out.

Gummy Smiles

BOTOX® relaxes certain overactive muscles so that the upper lip can unfurl, creating a more balanced smile that does not reveal as much gum show.

Lip Lines

Vertical lines around the mouth, which develop due to habitually pursed lips, can fade if the muscles are allowed to rest.

Marionette Lines

These are vertical lines that extend from the downturned corners of the mouth to the chin.

Dimpled Chin

A dimpled or “cobblestone” chin with an orange peel texture (peua d’orange) often occurs when the mentalis muscle is overactive, causing the skin to crease up because of the movement of the muscles below it. BOTOX® gives Philadelphia-area patients a youthful and refreshed-looking appearance by softening wrinkles and improving facial symmetry. Get more advice on this injectable and other cosmetic procedures available from Dr. Timothy Greco’s practice. Call us at (610) 664-8830 to learn more, or submit a contact form to request a consultation.

How Can You Fix Sunken Temples?

Volume loss in the temples and cheeks is a common but unfortunate aspect of aging. Most people strive for a more heart-shaped or oval face with full cheekbones framing a narrower jawline as this is deemed by many to be a youthful look. But when you lose collagen, fat, and bone to support it, the face can become thinner and hollowed around the upper parts, while skin sags around the lower jaw. You also tend to have less bone and muscle mass to support the skin. The temples are one of the areas that many patients overlook when considering cosmetic treatments for the face, perhaps because they don’t realize how volume loss can affect their appearance. A concavity can make you look more tired older, unhealthy, or unhappy. JUVÉDERM® VOLUMA from the Philadelphia-area team at Dr. Timothy Greco’s practice is one of the best options for upper facial rejuvenation. Here’s how it works:

JUVÉDERM® VOLUMA is made of a soft, gel-like substance containing hyaluronic acid and is traditionally injected below the surface of the skin to reduce the depth of facial wrinkles. It is also used for augmenting other parts of the face, such as the cheeks and lips. Experienced injectors can use it to fill out the bony contours and arches of the face, including thinning temples. Dr. Greco recently published an article in the medical literature describing a safer, more effective way of volumizing the temples with a cannula!

Sculptra® is different type of filler, also often used for this area to promote gradual collagen production. Fillers to the temple can also help to lift the brow area and enhance the overall facial shape.

Another method commonly used to restore fullness to the temples is structural fat grafting. In this treatment, some of the patient’s own fat is taken via liposuction from areas where there is an overabundance of it—like problem areas on the stomach or thighs. This fat can then be added to focused areas of the face to add much needed volume. Structural fat grafting can be done on its own or as part of a facelift.

For more information on JUVÉDERM® and other cosmetic treatments for correcting hollowed temples and restoring facial contours, get in touch with Dr. Timothy Greco’s facial plastic surgery practice. We look forward to hearing from you! Call us at (610) 664-8830 to get started or write to us to request a free consultation.

Fall Skincare Tips: 4 Aesthetic Treatments to Rejuvenate Damaged Skin

Sometimes your skin simply looks dull and lackluster when the seasons change. As the year transitions from summer to fall, you may be in need of a complete refresher. Along with the changes in temperature and humidity that can cause your skin to dry out, our patients are often bothered by actinic (sun) damage sustained from spending time outdoors during the warmer months. Common cosmetic problems include wrinkles, fine lines, sunspots, hyperpigmentation and rough patches. At-home skin care routines might not be sufficient enough to address these concerns. Aesthetic treatments such as laser skin resurfacing, chemical peels, microneedling, and HydraFacial®, which our Philadelphia area office offers, will all help to breathe new life into the skin while giving it a more polished and even appearance to your skin in time for the holidays. The options listed below do not require much down time either.

1. Laser Skin Resurfacing

Although you can schedule laser treatments for any month of the year, patients and physicians alike usually refer to the autumn and winter months as “laser season,” because it’s much more convenient to receive light ablative services done when the weather is cooler and the sun is less intense.

When you’re taking shelter indoors more often and wearing heavier layers of clothing against the cold and wet, there’s less of a chance of permanent pigment changes due to sun exposure and damage after laser treatments, such as Pixel® for stimulating new collagen production and improving acne scars, enlarged pores, age spots, wrinkles, and uneven tone and texture.

2. Chemical Peels

The skin’s surface is covered with pores, which are often blocked by debris and dead skin cells that make it difficult for topical products to penetrate and work effectively. With a chemical peel, a solution is applied to the outer, damaged layer of skin, which causes the dead later to gradually peel away revealing a youthful glow to your skin and allowing more effective use of your home skincare regimen.  

3. Microneedling

Microneedling is a treatment uses tiny pinpricks to stimulate collagen production in the skin, with each small “wound” triggering the skin’s organic healing process. Eventually, new, healthier skin is revealed at the surface so acne scars and wrinkles are less prominent.

4. HydraFacial®

HydraFacial® deeply cleanses the skin and is suitable for most skin types. This three-step procedure involves exfoliating, extracting impurities, and nourishing the skin with serums.

Get more info on these options, including HydraFacial®, available from Dr. Timothy Greco’s practice. Want to learn more about the treatments that can help you to restore a more radiant complexion? Call us at (610) 664-8830 to talk about your plans or submit a contact form.

Facial Implants, Fillers, or BOTOX®: Which is the Better Choice for Addressing Facial Asymmetry?

Beauty treatments are often focused on enhancing the skin and individual features, but patients should remember that overall facial harmony is critically important. Faces that are symmetrical are usually deemed to be more attractive and beautiful. A perfectly symmetrical face would have identical sides that match if you were to draw a line down the center. Each side of the face is considered a sibling as opposed to an identical twin. While most faces appear to have a symmetric shape, we all have some mild asymmetry to our features—such as a slightly crooked nose, one eye that looks different from the other, or a misaligned chin. Genetics, aging, injury, and dental work are some of the common causes of asymmetry, but there are also several options for addressing it: Dr. Timothy Greco, a double board-certified facial plastic surgeon near Philadelphia, provides facial implants, fillers, and BOTOX® to correct irregularities and help patients achieve a more balanced appearance.

Facial Implants

If you’re looking for a long-term solution for asymmetry caused by your natural bone structure—such as a weak or recessed chin that you want to improve—implants might be something to consider. This is surgical procedure with lasting results. Implants are made from synthetic materials like silicone and plastic. Implants can be added to the cheeks and chin and further enhanced with autologous fat grafts for a fuller, more natural look.

Soft Tissue Fillers

Soft gel dermal fillers can improve contours that have changed over time. Having a youthful, v-shaped face with high, rounded cheekbones, a slim jawline, and defined chin is a common beauty goal.

Hyaluronic acid-based fillers like JUVÉDERM® Voluma improve facial structure by lifting and volumizing the cheeks, which also makes the jawline look sharper. JUVÉDERM® Ultra, another HA filler, plumps lips that are too small for the face due to genetics, aging, or both. Additionally, these fillers can be used to add volume to hollowed temples and to fix stretched earlobes. You can also straighten, refine, or thin the nose or elevate the nasal tip with fillers.


Neuromodulators relax active muscles in select areas of the face to make eyebrows more even, slim only one side of an enlarged jaw to match the other, or correct wrinkles in the forehead. Injectable treatment sessions are quick, with minimal side effects and recovery time—but keep in mind that the results are temporary. Fortunately, repeat maintenance treatments are possible.

Searching for a skilled facial plastic surgeon near Philadelphia? Talk to the office of Dr. Timothy Greco about our surgical and non-surgical options. Call (610) 664-8830 or request a free consultation.

Facial Liposuction vs. Kybella®: What’s the Difference?

Many people who are otherwise happy with their bodies look in the mirror and are disappointed by an extra layer of fat in the chin area, which makes them appear older and overweight. There are some surgical and non-surgical options to help you get rid of that double chin for a more sculpted, slimmer, and youthful face. Fat reduction with Kybella® is one option for tackling this common trouble zone. Dr. Timothy Greco’s office offers the popular injectable, as well as facial liposuction in the Philadelphia area.

Many patients are uncertain as to which option will be right for them. It’s best to discuss any cosmetic goals with Dr. Greco in order to help determine the ideal treatment.

Facial Liposuction

In addition to its applications for body contouring, liposuction is also useful for surgically removing the resistant fat that can build up in the submental area and be difficult to reduce through conventional weight loss efforts. For this procedure, fat cells are dislodged and suctioned with a cannula. Facial liposuction offers more dramatic rejuvenation of the face than Kybella®. In addition to the chin area, liposuction can also take fat off the cheeks and improve contours along the jawline. Recovery lasts around two weeks.

A neck lift will remove unwanted fat and tighten the muscles in the neck while removing sagging skin. The results of facial liposuction and neck lifting can be enhanced with chin augmentation.


Kybella® is an injectable containing a synthetic version of the same deoxycholic acid the body uses to break down fat during digestion. As a cosmetic treatment, it is used to decrease small to medium double chins. One of its main benefits is how convenient it can be for patients. There is minimal preparation required. The treatment process, which involves a series of injections, only takes 15 to 20 minutes to perform. You won’t have to go under anesthesia or expect much recuperation time.

The fat that is eliminated with either of these methods is gone for good. But remember, fat removal does not directly improve skin laxity, so if you have a lot of excess, droopy skin around the chin—especially after removing volume—a tightening treatment or procedure would be required.

Considering facial liposuction or other contouring options? We offer Kybella®, surgical fat reduction, and other procedures designed to give you the facial shape you want. Schedule a consultation with our Philadelphia-area team at Timothy M. Greco, MD, PC, by calling (610) 664-8830, or write to us to get started.