Skin CancerTim Jochen, MD

Associate clinical Professor USCBoard Certified Dermatologist

Fellow American Society of Cosmetic Surgery

What is the most common type of cancer?

What causes skin cancer?

• Fun

Best way to protect yourself from developing skin cancer• Move into a cave• Move to Seattle• Stop living your life

What are the types of skin cancer

• Actinic keratosis• Squamous cell carcinoma (SCC)• Basal Cell Carcinoma (BCC)• Melanoma

How do I detect them?

Actinic Keratosis

Actinic keratosis

BCC

Squamous cell carcinoma

Melanoma

• ABCDE……………………………….

What makes a skin cancer serious?

• Time

Oh no. What am I going to do?

• Precancers • Liquid nitrogen

Topical agents

5 Fluorouracil

Blue light

Non melanoma skin cancers

• Superficial BCC and SCC• Topical therapies

• 5 fluoracil• Aldara• Photodynamic therapy

Electrodessication & Curettage

Surgery

Mohs surgery

• Advantage of Mohs• Indications for mohs• Cosmetic areas• Greater than 2 cm body • Greater than 1 cm face• Recurrence• Sclerosing bcc

Closure

Why contour?

• Professor at USC• Fellow of American society for cosmetic surgery

Radiation therapy

• Non surgical candidates• Poor wound healing• Limited options for further surgery

Melanoma

Staginghow deep into issueulcerationnumber of mitosis

Prevention techniques?

• Sun protective clothing• Sunscreen• Skin exams• Avoid peak hours of the day

Skin CancerTim Jochen, MD

Associate clinical Professor USCBoard Certified Dermatologist

Fellow American Society of Cosmetic Surgery

Non-laser devices

Ultherapy, Sublime, sublative, vela, cool sculpt

Ultherapy, Sublime, Sublative, Vela, Cool sculpting

• The basic premise of most of these devices is the same • Deliver energy into the skin • Wound healing response = neocollagenesis= tissue tightening

Healthy collagen = smooth tight skin!

Ultherapy

• Focused Ultrasound• FDA approved for LIFTING• Bypasses skin surface and targets deeper tissue where

collagen lives• Works from the inside-out

Comparison

Ultherapy

• Delivers tiny deposits of focused ultrasound energy at the same layer that a facelift typically addresses• Coagulation points=Stimulates the growth of new collagen• Can vary depth 4.5, 3, 1.5 mm

Ultherapy

• Minimal downtime• Gradual tightening and lifting of skin over 90 days• For the post surgical, non-surgical pt, and preventative pt• Expectations

How long does ULTHERAPY last?

• Stimulating new collagen but we are continuing to age

Sublime• Combines light and bipolar radiofrequency (ELOS• Stimulates new collagen growth

SublimE

sublime

• An electrical current that is not chromophore specific• Epidermal melanin is not damaged/color blind• All skin types• Heat accumulation= production of new collagen

sublime

• The RF current has preference for pre-heated targets • The epidermis is cooled by the chilled applicator tip protecting

the epidermis• Forcing the RF energy to penetrate deeper into tissue

SUblime

• Safe•No downtime•All skin types•Minimal pain

Sublative RF

• Fractionated RF delivered via 64 electrodes on applicator tip• Deep dermal heating= induces injury = induces healing process =

neocollagenesis

Sublative

• 5% epidermal ablation• Dispersed heat to dermal layers (30% dispersion)• All skin types• social downtime (2-3 days) • 3 treatments needed

sublative

SUBLATIVE TIP

Velashape 3

• Powered by elōs technology, VelaShape III combines IR (infrared), bi-polar RF and vacuum • Deep heating of the fat cells (adipocytes), their surrounding

connective fibrous septae and the underlying dermal collagen fibers

Velashape 3

Vela

• Vacuum• Heats – apoptosis• Brakes fibrous connective tissue• Smooth's • Tightens

result

• A localized reduction in skin laxity, volume and an overall improvement in skin structure and texture.

Layered approach

Cool Sculpt

power of beauty

Tim Jochen MD