Drs. Tina Alster, Rebecca Kazin & Brenda L. Pellicane
Send Drs. Tina Alster, Rebecca Kazin & Brenda L. Pellicane an email
About My Practice
What is unique about your practice?
We place equal emphasis on the treatment of both women and men with specially-designed facilities and treatment protocols for each.
Drs. Alster and Tanzi what organizations are the three of you all members of?
We are affiliated with the American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery and American Society for Laser Medicine and Surgery.
Where do your dermatologic interests lie?
I take a particular interest in laser and facial rejuvenation, body contouring, scar revision, vein therapy and hair restoration.
Dr. Tanzi, what achievement speaks to your dermatological prowess?
I am a consultant to L’Oréal USA and medical expert on The Dr. Oz Show.
What vision do you all share when it comes to caring for patients?
We believe in creating individualized treatment plans based on a thorough examination and discussion with each patient.
How does your passion for dermatology benefit patients?
We have a passion for research. More often than not we are involved in researching and expanding upon the latest technologies. Our patients can expect the newest and best treatments available.
Dr. Alster, what accomplishment are you particularly proud of?
Being recognized by my peers and students as a mentor, innovator and leader in cosmetic laser development and clinical practice.
American Board of Dermatology
Affiliation:American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society of Laser Medicine
A Minute With
The biggest misconception about our fieldA single treatment will erase 50 years of sun damage
How we make the best first impressionBy showing a genuine interest in the patient’s concerns
The future of our fieldThere will be more of an integrative approach to patient health, such as innovations and treatment combinations to improve and enhance the patient’s experience and results
What we love most about our professionWe deliver treatments that provide an immediate positive benefit to patients
Our ultimate skin-care adviceApply a topical antioxidant under sunscreen every day
How our profession has evolvedIncreased technological advances and public awareness of the value of noninvasive, transformative dermatologic treatments
Three words that best describe usInnovative, determined, compassionate
What we can’t live withoutOur carefully curated collection of lasers and other technologies
Our philosophyIt’s our passion to help people realize their full potential through a positive self-image
What sets our practice apartWe offer a comprehensive variety of the latest devices and treatments in a world- class setting
What one surgical advancement are you most excited about right now?We are most excited about Silhouette InstaLift™, a new, minimally invasive procedure using absorbable sutures to lift the deeper layers of facial and neck skin for a more youthful appearance. It’s a quick in-office procedure that requires minimal post-treatment recovery and is half the price of a surgical facelift
What are you best known for?Publishing the first textbook on cosmetic laser surgery
What are you doing differently today for facial rejuvenation?We apply a specialized microneedling technique with platelet-rich plasma (PRP) to enhance the effectiveness of our lasers in the treatment of lip lines, enlarged pores and scars
The most unique aspect of our practiceWe are located within a few blocks of the White House and have a separate security entrance for VIPs
What is the latest technique you have added to your treatment arsenal?EMSCULPT® is a great nonsurgical option for toning abs and lifting the buttocks. Our patients love it!
- ARTAS® Hair Transplant
- Birthmark Removal
- Body Contouring
- Botox® Cosmetic / Fillers
- Clear + Brilliant®
- Fraxel® DUAL
- Laser Hair Removal
- Laser Tattoo Removal
- Platelet-Rich Plasma (PRP)
- Scar Revision
- Silhouette InstaLift™
- Skin Rejuvenation
- Thermage® / Ultherapy®
- VelaShape® / UltraShape®
- Viora V30 Laser System
When is a chemical peel the right treatment?What our experts say:
Chemical peels are really great for certain types of acne, like the type where you have superficial blocked pores. A chemical peel that’s either a combination or a salicylic acid chemical peel can open up the individual pores and help clear the acne faster. Another common use for chemical peeling is model brown discoloration like for melasma when people get the brown patches on the face and a series of chemical peels can be used to brighten the skin. And the chemical peels also brighten and smooth fine lines and build collagen as well. We typically use chemical peels for acne and hyperpigmentation. Those are common uses for chemical peeling.
What kind of laser would you use to resurface and rejuvenate the face?What our experts say:
If you don’t have time for recovery then you want a non-ablative fractional resurfacing laser such as the PalomarLux1540 or the Fraxel re:store, also a type of erbium. Those are two really good ones for the non-ablative. If you have time for healing, meaning one week where you can stay out of work, then you can have an ablative laser resurfacing procedure and that again would be Fraxel but it would be the re:pair. You could have the Lumenis Active, DeepFX, StarLux2940 or eMatrix.
How do you keep your lips puffy and plump?What our experts say:
For people who try to overdo lips, it looks very fake. The number one answer to this is that the over-the-counter lip plumpers like the lip glosses that give you a tingly sensation actually work. They’re temporary but they do work. They help to increase blood flow to the lips. For a night out, they’re great. For longer lasting plumping you can use a small amount of filler, and hyaluronic acid is the best. Juvéderm is the best one to use in the lips because it’s the softest. The trick about natural-looking lips is to be conservative with how much is used. Small amounts are best because if you overfill them they can be very waxy and stiff looking.
Do injections like Botox, Dysport, Restylane and others hurt? Do you bruise when you get them? And do you have to stay home from work for a day or two after getting them?What our experts say:
We typically use a topical anesthetic in the office. Just topical lidocaine dissolved in a petrolatum ointment and we apply that just before the procedure to ease the discomfort of the injection. Some people bruise easier than others. Anytime even the smallest needle is used you can get a bruise that can last anywhere from five to 10 days depending on the individual. Whether or not to stay home from work is certainly a personal decision based on the line of work you’re in. Some people choose to stay home because they’re involved in public speaking or on camera. Others sit in a back desk and they don’t mind having a bruise for a week or so, if you get a bruise.
Which lasers work best to tighten skin and do they give a result similar to a facelift?What our experts say:
The best noninvasive system that can tighten skin these days is Ulthera. It is a highly focused ultrasound and like other skin tighteners and lifters like Thermage, it is FDA-approved for use on the face like for lifting the brow. However it can also be used for tightening the arm, knee and thigh skin (off label). Ulthera is the closest we can get to a nonsurgical lift. It does more than just tighten the skin, which is what the Thermage units, the radiofrequency units, have done in the past.
Is tattoo removal a surface procedure or does it have to go as deep as the ink?What our experts say:
There are several types of tattoos. The most popular ones are the professional tattoos, which are the hardest to remove because the amount and depth of ink that’s injected is great. Another type is the amateur tattoo, which are those done in the “back alleys” with carbon based ink. Then you have cosmetic tattoos, such as eye liner and lip liner. Medical tattoos mark radiation ports. Traumatic tattoos are the ones that if you fall on the road and get a road rash you can get gravel embedded in your skin and it looks like your skin has been tattooed. The hardest to remove is the professional tattoos because there’s just so much more ink, which increases the number of treatments that it takes to remove them. We typically use lasers because we can use certain laser wavelengths like a Q switch, which is very brief pulses of red and infrared light. Alexandrite and Yag lasers are the shortcut to get rid of the tattooing. An amateur tattoo, or a traumatic tattoo that doesn’t have as much ink in there, may only take two to four treatments. The lasers hone in on the tattoo ink and blast it. The only other way to remove tattoos is to cut them out then you’re substituting one mark with a pretty significant scar.
Is it common to use a laser for fat melting?What our experts say:
We’ve been trying to use laser lipolysis while doing liposuction. Instead of sucking it out you’re basically melting the fat directly. I do noninvasive fat elimination and there are now three different ways you can do it. One is using Zeltiq, cool sculpting using cryolipolysis that freezes the fat cells and makes them die. You can eliminate the fat from the outside in so There’s a new device called Bella Contour. It has negative pressure, diode laser energy and radiofrequency. It feels like a warm bath but repetitive treatments have been shown to make the fat cell leaky so it drains the fat cells of fat. So the fat cells are still there but they are like deflated balloons. So if you go through a series of these treatments you will definitely slim down and definitely have a better body contour. However, once again, you have to maintain your new look.Another thing that people will body contour with is Thermage. That’s using bulk tissue heating but it’s really not getting the fat as much as it’s contouring the dermis above the fat so it makes it lie more smoothly.there’s no recovery. Those fat cells do not come back because those fat cells are dead. Once those fat cells die they won’t re-grow, however, if you still have fat cells that are adjacent to it or in another area and you gain weight those fat cells are going to increase in size. It’s much like with liposuction, you get rid of some and you still have some there, if you gain weight it’s going to look like it came back and redistribute. All things being equal, if you maintain your body weight it’s gone.
Which laser treatment can get rid of broken blood vessels on my face? There are some tiny vessels near my eyes and some bigger ones on my cheeks. Are these removable with the same laser or do I need multiple appointments?What our experts say:
You can typically treat those in the same appointment and the best lasers for those are called pulse dye lasers. I think the Synergy is a good one because it has the ability to treat multiple size vessels all on the same visit with the same laser. Typically the treatment takes a few minutes to do and afterward people look a little bit pink for maybe an hour or so but after that there’s really no downtime. You can go right back to your regular activities. To get the right response we usually will do anywhere between three and five in a row, roughly at six week intervals. It doesn’t really hurt either, it’s just a little snappy, like the snapping of a rubber band but it’s quick and doesn’t require pain control.
My skin has so much sun damage and lots of brown spots. I’d like to do something on the surface only. What kind of chemical peel goes deepest and is most refreshing?What our experts say:
For brown and sun spots on the surface my favorite peel is called the Vitalize Peel. It’s a combination between an alphahydroxy glycolic peel and also retinoic acid so it really helps to peel the surface of the skin. It does a nice job to refresh and restore a healthy glow and even out skin tone and there’s not too much recovery time. The skin will start to peel two days after the solution is applied and then it will peel for two days. The whole process is done in about four to five days and during the time of the peel it’s not raw skin, it’s just very dry. Once the whole process is over the skin looks nice and refreshed.
My 15-year-old acne scars still bother me. What will make them go away, or at least make them less noticeable?What our experts say:
For old acne scars one of the best acne treatments is called Fraxel re:store. It is done in a series of treatments to try to stimulate collagen to fill up the scars. Typically, depending on the severity of the scars, we may do anywhere between three and six treatments about a month apart. After each you are pink for a couple of days but you can cover it with makeup.
My 15-year-old acne scars still bother me. What will make them go away, or at least make them less noticeable?What our experts say:
Quite frankly I think that sometimes it’s easier to treat older acne scars that are stable because they’re not changing on you. My favorite way to treat them is with lasers, either ablative or non-ablative fractionated resurfacing. The laser does two things that are helpful with scars. One thing it does, as the name describes, is resurfacing, literally vaporizing the top layer of skin. The second thing it does is allow for the skin below to be contracted. When collagen is heated above 60 degrees centigrade, it contracts, transforming into a tightened scaffold on which the new skin is built. You’re basically recovering the skin but you’re also building the skin from below and that’s how it helps the acne scars.
What are the nonsurgical options that provide a similar result to a face lift? How long do they last versus a surgical treatment?What our experts say:
In my experience the best nonsurgical option on the face, to help tone and tighten the skin is Ulthera. It’s ultrasound that essentially seeps through the surface of the skin and targets the support structures, heats them up and over about three months time it stimulates collagen to help lift and tighten. There’s no cutting, no downtime and no recovery time involved. The results are delayed about three months. Typically people do one treatment and then they wait three to six months for all the collagen to be stimulated and the tightening effects to take place. At that point they may choose to do another treatment for additional improvement but not everybody needs to do. The disadvantage of the nonsurgical approach is that the results are not as long lasting. You expect to see the results of a facelift for potentially ten plus years, the non surgical Ulthera option is most likely going to last about two to three years.
Ulthera and Thermage seem like they do similar things. Where is Thermage suited versus Ulthera?What our experts say:
They’re both nonsurgical tightening options. Thermage uses radiofrequency to deliver the heat. The heat placed with Thermage is not quite as deep as you can get with the ultrasound, which is the type of energy used in Ulthera. They both put heat into layers of the skin. They put heat under the surface to stimulate collagen and tighten the skin. Thermage does a nice job on body parts. It does a nice job to help tone up some of the lax skin on the arms, the legs and abdomen. The main difference is that ultrasound does the job a little bit deeper.
I have random veins on my nose and other parts of my body. Are they spider veins and can they be removed?What our experts say:
Some are spider veins and some are so called “broken capillaries.” They can be removed but sometimes they’ll require different lasers. The bigger spider veins on the body may require a different laser than the smaller broken capillaries on the face. Usually it will require more than one treatment for the best response and treatments are often done about six weeks apart.
Who would get a lip implant instead of a filler?What our experts say:
People trying to get a more permanent solution to their thin lips may go for an implant. But in my opinion that’s not a great option because it often can look stiff and unnatural.
I got one Botox injection, how long should it last and will I need to get others to maintain the look?What our experts say:
For one Botox injection the clinical results will normally last three to six months. If you want continued improvement, or if once the effect of this dies down, it will become necessary for you to have another treatment to maintain the cosmetic effect.
What is the difference between a collagen-stimulating filler and a permanent filler and what procedure is appropriate for each one?What our experts say:
Permanent fillers include a non-absorbable substance like Artefill to correct a defect in the skin such as a pock mark or scar. It can also be used to fill in wrinkles, however because wrinkles are dynamic, or change, permanent fillers are not as advisable as collagen-stimulating fillers including hyaluronic acid fillers like Juvéderm and Restylane. Hyaluronic acid filler stimulates collagen, which will enhance the longevity of the filler and improve the clinical results. They are better for wrinkles and for a lot of acne scars rather than just a single scar. If somebody has just one indentation from a pock mark or an indentation of a scar then I like to use a laser. But those are the type of things where permanent fillers are really good for isolated indented scars whereas collagen stimulating fillers which include the hyaluronic acid fillers, like Restylane, Perlane and Juvéderm, are good for all those areas that change because of aging.
I want to relax the wrinkles on my face and make my skin look tighter. Should I use a filler like Juvéderm or a relaxer like Botox? Are there other brands or procedures I should consider?What our experts say:
The answer here may be all of the above. If you do not have wrinkles at rest and you want to minimize the dynamic wrinkling of your brow, then using Botox or Dysport, a neurotoxin alone, would be all that you need. If you have lines that are there even at rest, when you are not actively frowning or moving your face, then you will likely need both a toxin and a filler. What I tell people is that if they have skin discoloration and a lot of wrinkling in areas that are not necessarily dynamic, say across your cheeks, then I think laser resurfacing is a nicer way to tighten and resurface the skin to give you an overall more youthful look.
My skin has so much sun damage and lots of brown spots. What are my options if I want to treat the surface only?What our experts say:
If it’s just sun damage and brown spots without wrinkling, topical lighteners and brighteners like Elure or kojic acid-containing things and Vitamin C can be helpful. If you want to come into the office to speed the lightening, chemical peels are super. The Vitalize Peel by TNS or revitalize peel are options that contain resorcinol, glycolic and lactic acid. There are TCA (trichloroacetic acid) peels as well. And if you have wrinkles in addition to the hyperpigmentation then you might want to add in some of these fractionated lasers, ablative or non-ablative, but that would not be my first choice just for sun spots and hyperpigmentation.
How long will the effects of Ulthera last?What our experts say:
I always tell people they’ll see the most change between one and three months, but it takes up to six months to see the final effect, which can last as long as a facelift but without as much tightening as you get with a facelift. You get some tightening and lifting and that becomes your new starting point. We don’t know how long it lasts but it’s not like you’ll be coming in every year starting at ground zero.
What’s the most natural way to look like I have more hair?What our experts say:
I am starting to do something new called illumiWave. This is a series of treatments, usually performed once a week or as many as twice a week for a total of 36 treatments. This is good for everyone and you come in and sit under the device, which looks like a heat lamp and is directed at wherever you’re losing hair (mostly around the scalp). It takes about 20 minutes, and it stimulates new hair growth. Everybody in the studies showed that hair loss was eliminated so it stabilizes the hair loss. And 40 percent of the people then noticed that there was an increase in hair re-growth. That’s not bad for something that is totally noninvasive.
Does illumiWave look more natural than hair plugs?What our experts say:
It stimulates the cells around the hair follicles to restart, it’s like rebooting your computer, in fact it will send the signal to your hair follicle to start producing hair. These laser lights do increase the vascular network in the area of your scalp. You end up stimulating cells to create hair. The drawback with the illumiWave and the Bella Contour, is that you have to keep doing it. However, you don't have to do it as often as time goes by. Once you reach where you want to be, maintenance is the order of the day.
My mother has the classic turkey wattle below her chin, and I can see my skin getting a little loose, so I worry that I'm going to have the same. Do I do something early or wait until it gets bad?What our experts say:
If you don’t mind looking bad for a while until it looks really bad then wait until you have your necklift. If you don’t ever want it to form, there are things you can do to prevent it from getting that bad. And depending on if there are bands there you can do a little Botox or Dysport. You can do Ulthera or even Thermage and tighten that area so that it never gets the big wattle. Do it preventively or right when it starts happening and that becomes your new starting point. Younger people don’t mind doing the maintenance, older people grew up waiting until it gets really bad and they have to get a facelift.
I am 43 and my chin is still breaking out—shouldn't I be past the pimple stage? What is best way for me to treat/prevent them?What our experts say:
We see a lot of acne in women in their 40s 50s and even 60s. It’s certainly a common problem and the best approach to treating it depends on the cause. Some people have hormonal acne that doesn’t respond to traditional acne therapies. Whether it’s ‘stage of life’ acne varies by individual. Some clues to hormonal acne would be cystic flares that occur just before the period and those are treated by hormonal therapies whereas traditional acne, or inflammatory acne, can be treated in later stage of life just as it is in teenagers. We just individualize the treatment to the cause. There is certainly a treatment and it needs to be targeted to the specific cause and a consultation would be the best first step to determining the cause. Sometimes it requires blood work and a full evaluation to determine whether hormonal therapy is needed.
For injections like Botox, Dysport and Restylane, how long will they last and how many others will I need to get to maintain the look?What our experts say:
The question depends on the type of injectable being used. Botox, Dysport and other neurotoxins tend to last three to four months and we recommend three or more times per year to maintain the look. For injectable fillers they can last anywhere from six months to several years depending on the agent used, and there are permanent agents available as well.
I want to relax the wrinkles on my face and make my skin look tighter, should I use a filler like Juvéderm or a relaxer like Botox? Are there other brands or things I should consider?What our experts say:
Consultation with an expert is the most important in this situation because there are different types of wrinkles. The first type is called dynamic wrinkles which means that when you wrinkle a muscle it creases the skin and then when you relax the muscle the wrinkle disappears. There are other types of wrinkles called etched or folds and those typically appear at rest whether or not you’re wrinkling a muscle and those are more difficult to treat. They typically require a combination of injectables and possibly laser resurfacing.
What is a liquid facelift? Is it surgical?What our experts say:
Liquid facelift is a term used to describe a procedure where volume is restored to different areas of the face, using an injectable filler to fill in those areas of lost volume. And the final result appears something like a lift once you’ve restored the volume to all the areas. So we’re not actually cutting; we're restoring the volume in the different areas of the face. The length of the results depends on the injectable used. Fillers can last anywhere from six months to several years or even be permanent depending on what was used.
Are anti-aging results best achieved by removing wrinkles or tightening skin or a combination?What our experts say:
It’s always a combination of restoring volume, resurfacing texture and filling those grooves and folds and then finally tightening the skin. Typically we use Botox to relax the muscles that are creating the dynamic line. We use the injectable fillers to fill grooves and folds and also restore volume to areas of atrophy where the volume has been lost. And then finally we use tightening devices to actually remodel the collagen or tighten the fascia underneath the skin. And we use lasers over the surface of the skin to smooth the pores and fine lines and to even out red blood vessels and brown spots.
I want to remove the cellulite around or under the buttock area. Can I?What our experts say:
It’s impossible to remove cellulite. At best we can smooth the appearance of cellulite somewhat. Surgery cannot address that area so it’s a very difficult area to treat. To smooth it, you can use radiofrequency, or ultrasound devices like VelaContour. There are also combination devices that combine massage, infrared light and radio frequency and there are newer technologies being developed all the time. VelaShape and VelaSmooth would be a combination device.