Dr. Ruth Hillelson
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About My Practice
How would you describe your operating room style?
It's very focused.
What medical-based organizations are you affiliated with?I am a member of the American Society of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Laser Medicine and Surgery, and the Medical Society of Virginia. I am also a fellow of the American College of Surgeons. My involvement in these organizations enables me to interact with other leaders in the community, sharing techniques, ideas, procedures and advice on what I have found to be effective methods of patient care.
How many years has American Self been operating?
I founded American Self 14 years ago with my husband, orthopedic surgeon and researcher Dr. Terry Whipple. Together we offer our patients a comprehensive menu of care, which includes everything from advanced technology and combination therapies to wellness and orthopedic medicine.
How are you candid with patients when it comes to treatment recommendations?I maintain a gentle yet focused communication style to help patients determine the best methods to achieve their goals, with the least amount of downtime possible.
What is body contouring?Body contouring addresses skin and fat issues with the body through non-invasive technology, dealing with mild to moderate problems or those who just don't want surgery.
What advancements are on the horizon?
The Sciton Forever Young BBLTM laser is proven to change the gene structure of the skin at the molecular level, as well as improve the appearance of acne, sun spots, freckles and vascular conditions. We are one of the only practices in our area to have the laser, which gives us the ability to offer our patients a new, safe and effective treatment for youthful-looking skin now and forever.
What alternative occupation would you choose?
I'd be a research chemist.
What alternative occupation would you choose?
I'd be a research chemist.
What are some of your favorite pastimes?When not in the office, I like horseback riding.
What are you currently reading?I'm reading chemical literature for my skin-care line.
What fascinates you most about the human body?
What attracted you to plastic surgery?
I like a field that is artistic and constantly changing.
American Board of Plastic Surgery
Affiliation:American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Laser Medicine and Surgery, American Society of Plastic Surgeons, Fellow, American College of Surgeons
A Minute With
What has been your happiest professional moment?Being able to help my patients overcome what they consider to be overwhelming physical obstacles to improve their lives
What do you love most about your profession?I love the creativity, the positive mood, the changing technology and techniques and applications
What is the most inspirational thing you have learned this year?Never underestimate the power of listening
What is the future of your field?I believe that we will see enormous increases in the capability of technology and opportunities for combined surgical and technological approaches
Three words that best describe meWarm, interested, empathetic
How would you spend extra time in a day?I would devote more time to the expansion of my skin care line Iridesse
My best advice for patientsFix what bothers you. If it doesn’t bother you, leave it alone
My mottoThe patient is my first priority
How has your profession changed since you started?Plastic surgery in general has always been strong in reconstructive as well as cosmetic—by definition. Now I see more plastic surgeons who go straight to cosmetic and bypass reconstructive surgery
- Botox® Cosmetic
- Restylane® Silk
- Lip Augmentation
- CoolSculpting® “Plus”
- Body Contouring
- Thermage® FLX
- Forma Plus™
- Apollo TriPollar RF
- ProFractionalTM Laser
- Clear + Brilliant®
- BBL Laser Therapies
How does Botox actually work? Is it safe?What our experts say: It's a muscle paralytic, and it is safe when it is used correctly. Make sure you use BOTOX Cosmetic rather than a black market product; and make sure it is used appropriately. Do not overdose.
After facial rejuvenation treatments, what's the best way to maintain the results?What our experts say: If you do nothing else, use sunscreen; but a daily good skin regimen should include sunscreen, an appropriate serum or topical treatment and a good moisturizer. You should also include periodic treatments or microdermabrasion or skin peels, facials, Clear + Brilliant and skin tightening, like Thermage. This is in addition to a healthy diet and lifestyle.
Are different fillers used in specific areas?What our experts say: It depends on the needs and skin type of patient. Around the eyes, I would use a light amount of Restylane or Hylaform, a more dilute hyaluronic acid. Others are too thick. If a patient has delicate skin in their nasolabioal folds, I would use Restylane; if they have heavy lines or acne scars, I would use JUVEDERM.
Are laser skin resurfacing treatments painful?What our experts say: No. With the different laser treatments we use topical Lidocaine for numbing. The patient sits with the topical on their face for 10-15min before the treatment. The lasers themselves are quite tolerable. After Clear + Brilliant the face feels warm, and is pink for a couple of hours, but not red. After fractionating lasers, the face feels like it has a sunburn for a good half-hour to an hour.
Are there different types of chemical peels? How do I know which one is right for my skin?What our experts say: There are different types of light peels - you can use vitamin c; or a very light retinoic acid peel.
Are there non-surgical ways to tighten facial skin that are non-surgical?What our experts say: Thermage is a radiofrequency device that uses Comfort Pulse Technology to tighten the skin.
Can laser treatments be used on other parts of the body for skin resurfacing (other than the face)?What our experts say: Yes, they can. The fractionating treatments and the non-ablative Clear + Brilliant can be used on other parts of the body.
Do chemical peels get rid of dark spots?What our experts say: They will lighten mild spots, but not get rid of them.
How can I reduce belly fat without downtime?What our experts say: Eager to offer her clients the latest in effective technological advancements, Dr. Hillelson is happy to provide Coolsculpting by Zeltiq, which uses cryolipolysis, a noninvasive procedure that freezes fat cells to aid the body in breaking them down over time. The final result is a reduction in fat by 20 to 40 percent without damage to other tissues. During the procedure, patients feel an intense cold sensation, but the experience is not painful. 'the treatment is gentle enough that patients can resume daily activities immediately, Dr. Hillelson says. 'and the results start to show in as little as three weeks.
How is CoolSculpting used in body contouring?What our experts say:
It's a way to freeze localized fat accumulation. It's a device, a non- laser, that has a hand piece with suction. It pulls the affected area and has chill plates that freeze fat cells in the area of concern. Zeltique uses CoolSculpting technology. The membranes are broken down and the contents of the fat cells are metabolized and excreted by the body.
How is Sculptra Aesthetic facial injectable different from other fillers?What our experts say: I've not used it, yet, but I think is a very good product. Initially it got a bad name because patients had little lumps and bumps from it. But, when reconstituted a week ahead, and used in the lower face, I think it works very nicely. It lasts longer, but patients need three to four injections to get to that longer-lasting phase, which is costly.
How long to injectable fillers last?What our experts say: The longevity depends on where you inject it. JUVEDERM usually lasts about 9 months, but you have to boost it at four to six months. .
How much filler to you need per area?What our experts say: The average is between two and three ccs a visit, per patient; but it's variable, it depends on what they need.
Is CoolSculpting better than liposuction?What our experts say:
With CoolSclupting, there is a gradual removal of fat. If a patient has a large amount of fat to be removed or wants to get it removed immediately, then the patient should consider liposuction. The problem with liposuction in the tummy area is that the rapid removal of fat can result in skin laxity; so the patient would also most likely need atummy tuck. CoolSculpting is only FDA approved to be used on the tummy, flanks, bra rolls and saddlebag area. It is not FDA approved for anything below the groin.
Is CoolSculpting by Zeltiq painful?What our experts say:
There is a good pull for the first couple of minutes until the chilling takes effect and numbs it.
Is microdermabrasion better than a peel?What our experts say: It's going to depend on the preference of the person doing it. I like microdermabrasion better than a more aggressive peel because I can pay attention to specific areas. I usually follow it with light peel.
Is there downtime with CoolSculpting? How many treatments do you need for optimal results?What our experts say:
There is no downtime and no special garments that need to be worn after treatment. The patients just get up and go afterwards. The average patient needs 2-3 treatment sessions per site depending on how much fat needs to come out.
Is Thermage a painful treatment?What our experts say: When it initially came out, it was uncomfortable. Now, with the new system that it uses, we get good results with minimal discomfort.
What is a Fraxel laser and how does it work?What our experts say: There are different types of Fraxel lasers. Their resurfacing laser, the re:pair is an ablative laser. The re:store and re:fine are nonablative. The newest one, the 1927, treats brown spots.
What is a ProFractional laser? How is it different than the Fraxel laser?What our experts say:
The ProFractional laser is a fractionating laser made by a different company--Sciton. It's less painful than the Fraxel laser and offers less downtime.
What is microdermabrasion used for? How does it work?What our experts say: Microdermabrasion is best used by a patient who has a thick, outer layer skin that is dull looking. It uses crystals to mechanically abrade, or remove, the very top layers of epidermis.
What is the best treatment for Rosacea or facial redness?What our experts say: It depends on the type of Rosacea (or general redness of the skin). If its caused by small blood vessels, than laser treatment is best. If it's facial flushing, it can also be treated with a laser or medically. Acne is different. Redness from acne is best treated by a dermatologist with a combination of antibiotics and topicals.
What is the best treatment for spider veins in the legs?What our experts say: Sclerotherapy, a treatment where a solution is injected into the veins. The solution irritates the lining of the blood vessels, causing them to collapse and fade from view.
What is the Clear + Brilliant laser treatment and how is it different from other laser treatments?What our experts say: The Clear + Brilliant is a diode laser that provides non-ablative resurfacing. It's different because in a series of treatments, it minimizes discolorations and fine lines, with no downtime. It's a much milder laser. An important aspect of Clear + Brilliant is to pair it with Thermage because you can get skin resurfacing and tightening at the same time, with no downtime. The pairing of the two is really cool.
What is the difference between a fractionated and non-fractionated laser?What our experts say: A non-fractionating laser removes all the surface of cells, whereas a fractionating laser is going to make separate channels in the skin at different concentrations within a designated area. A CO2 laser is a non-fractionating laser. There is a two- to three-day downtime of redness and swelling with a fractionating laser; a 10-day to two-week downtime with a non-fractionating laser.
What is the difference between an ablative vs. a non-ablative laser?What our experts say: A non-ablative laser (Clear + Brilliant) device delivers less energy than an ablative (fractionating, Fraxel) one. It removes the top layers of the skin in more treatments, but with less downtime. A non-ablative laser opens the channels of the skin, allowing the skin to be more amenable to different skincare treatments and topicals, like vitamin C, or, we believe, possibly even stem cells.
What is the difference between injectable fillers such as Restylane, Radiesse, and Juvéderm, Perlane ?What our experts say:
There are two types of filler: Hyaluronic acid fillers, such as Perlane, Juvéderm, and Restylane; and non-hyaluronic acid fillers, which are the rest. Hyaluronic acid fillers are more commonly used. Juvéderm and Perlane are the same, they are just made by different companies. They are more concentrated than the others.
What is the recovery time of Thermage?What our experts say: There is no downtime, and no special garments need to be worn after treatment.
When used on frown lines, how long does BOTOX last?What our experts say: Three to four months.
Who is a good candidate for Clear + Brilliant laser treatments?What our experts say: It's a good treatment for a younger patient who wants to maintain their skin, but wants to keep their skin looking good; or for an older patient who has minimum issues and was to refresh her skin. It's for someone who doesn't need a more aggressive treatment. It's also used for someone who doesn't want to do their whole face, they've use the fractionating laser before, but want to touch up their lip lines.
What is the best way to remove darker brown spots?What our experts say:
A laser. I prefer the BBL, or Broadband Light. It ruptures the melanin. You need a few treatment sessions to remove brown spots, but there is no downtime with that.
Top lip lines I notice they are getting deeper and I am not happy. Would prefer non invasive technique lasers?What our experts say:
This is a stubborn treatment area. The best laser for upper lip is the Sciton, in my opinion. The results have been consistently good. Also, this area can be treated exclusively while other lasers require full face resurfacing. Obviously, if sunning and smoking are ongoing, any type of treatment will be wasted.
Home vs Professional Microdermabrasion (Diamond Tome)What our experts say:
There is a difference between home microdermabrasions as well as medical and spa microdermabrasions. Home microdermabrasions are much weaker. The suction power and abrasions capabilities are reduced. This means it would take multiple treatments to even begin to approach the results that would be attained from a medical office. Furthermore, spa microdermabrasion units are weaker than medical units. The FDA prohibits medical quality equipment from being utilized without medical oversight. It is interesting to keep this in mind, as prices between medical and spa versions might be quite similar. Dollar for dollar, it is far better to have the procedure performed in a medical practice.
What new advancements are you most excited about?What our experts say:
The Sciton Forever Young BBLTM laser is proven to change the gene structure of the skin at the molecular level, as well as improve the appearance of acne, sunspots, freckles and vascular conditions. We are one of the only practices in our area to have the laser, which gives us the ability to offer our patients a new, safe and effective treatment for youthful-looking skin now and forever.