With a little planning and the right intervention, it’s easier than ever to blast away anything that’s coming between you and your bikini-season bliss.
Written By Christine Lennon


Any brave soul who enters a dressing room for the first swimwear try-on of the season is well advised to plan ahead with a generous application of self-tanner. Even with that shrewd bit of preparation, the mirror often illuminates issues that even the deepest shade of flaw-concealing bronze can’t camouflage. At that point, the only viable solution is to plan even further ahead (11 weeks until the first day of summer) and banish those worrisome imperfections permanently (or, at the very least, until bikini season ends) before you have to grin and bare it.
VIOLET GREY sought out top dermatologists and their trusted nurses who live to melt away irksome bulges, firm skin, eliminate unwanted veins and treat the less pleasant qualities of feet, and asked them to share their treatment protocols. The trick is to book an appointment, or two, factoring in the appropriate amount of healing time before summer begins in earnest. Then sit back and let the masters work their magic. “We can treat sun damage on your chest while we freeze away your saddle bags,” says KarriAnn Erdmann, a registered nurse and expert multitasker in Dr. Ava Shamban’s Beverly Hills office. “We can do a lot, and I mean a lot, in just three hours.” Which, incidentally, is approximately the same amount of time it takes to shimmy into a waist-cinching MiracleSuit.
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SOLUTION: Cryolipolysis (a.k.a. Fat-Freezing)
To target a stubborn pooch that won’t respond to any number of crunches, melting or freezing is the least invasive, most effective option. Fat-freezing machines like CoolSculpting or Zeltiq operate by vacuuming the skin into a hand-held paddle that’s hollow in the center, and lowering the temperature of the tissue to a level that destroys fat cells (which freeze at a higher degree than skin and muscle) but doesn’t damage other tissues. “During an hour-long procedures, you’ll feel 10 minutes of discomfort, then it goes numb, and you sit and read a book for 50 minutes,” says New York–based dermatologist Dendy Engelman, MD. “I have every handpiece in my office,” says New York–based dermatologist Dr. Macrene Alexiades-Armenakas. She does advise anyone who has recently given birth to be patient with her body, though. “For postpartum patients, I remind them that the skin will tighten into place in about a year,” she says. “If they have passed this point and are very distressed by the laxity, we can treat.”  

RESULTS: Because there may be swelling and fluid shifts, and it takes several weeks for the damaged cells to be absorbed into the blood stream and eliminated, full results won’t be visible for several weeks up to three months. Realistically, one can expect a 20 to 40 percent reduction of fat in the treated area. “We compare the size of what we can reduce or treat to a stick of butter,” says Erdmann. “If you have a roll the size of a stick of butter over the top of your jeans, we can freeze it in one session. If it’s the size of two sticks of butter, it will take more.” The treatment is permanent, to a degree. “It’s not a license to go on a cupcake and pizza binge. The fat cells treated are destroyed, but fat can return to the area,” she advises.

TIMELINE: A trouble spot can be treated once every three months. Multiple areas (inner thigh, tummy) may be treated simultaneously or concurrently.   

COST: Prices range from $500 to $1,500 per treated area. 
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SOLUTION: Intense Pulsed Light, Laser Treatments or Body Peels
Intense Pulsed Light (IPL): The gold standard for eradicating sun damage is still intense pulsed light, LimeLight (when it targets both brown spots and red pigment) or photo facials. It’s affordable, effective and works for everybody. “I love it,” says Engelman. “If you go to a medi-spa, you won’t get the highest quality machine, so I always recommend seeing a dermatologist. That way you’re less likely to get burned.” Face, neck, chest, arms — every body part is fair game. “Once, I gave someone a full-body IPL treatment,” says Erdmann, “and I can tell you that not a single area was spared.”
Body Peels: In-office full-body treatments with glycolic and salicylic acid and other skin-smoothing ingredients like vitamin C can also make a significant difference in skin texture and clarity.    

Intense Pulsed Light (IPL): Treatments typically last an hour, skin remains red and looks sunburned for a few hours, then the destroyed pigment cells emerge as small, peppery flakes on the skin, which fall off in a week to 10 days. On the body, it can take up to a month. Los Angeles dermatologist, Dr. Harold Lancer, uses a more powerful version called VLPL, which addresses vascular redness and pigmented lesions and has a similar recovery time.
Body Peels: “SkinMedica and PCA have beautiful peels for the body that help with hyperpigmentation, rough patches or even acne,” says Engelman. “I recommend a series of three. Each time the skin looks better.”

Intense Pulsed Light (IPL): Depending on the severity of the spots or sun damage and the size of the area that needs treating, several sessions (up to four, spaced three weeks apart) may be required. And don’t forget the SPF 50. New brown spots will surface without proper protection. 
Body Peels: Engelman recommends a series of three peels, spaced two weeks apart, for best results. Factor at least two weeks to recover from the last peel before baring it all at the beach, since newly exposed skin is more sensitive to sun.  

COST: $200 to 500 for IPL / $1,500 for VLPL / $150 to $250 for body peels.
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SOLUTIONS: Radiofrequency and Ultrasound Treatments
Radiofrequency and ultrasound treatments to tighten bat-wing arms or crepey patches around the knees deliver impressive results that can last up to two years, require no downtime and can be performed in an hour, which is all great news for anyone who battles exercise-resistant saggy bits and aging knees. The not-great news: “Sadly, that adage ‘no pain, no gain’ is kind of true in this case,” says Engelman, stating that the most effective skin-tightening treatment, Ultherapy, is also the most excruciating. Doctors often prescribe a pre-session Valium and Percocet to make it more bearable. Radiofrequency is less painful, but the results are subtler and more temporary. Dr. Alexiades-Armenakas prefers Vela III or V Shape for skin laxity, but she is conducting a promising trial of a new minimally invasive radiofrequency device called Profound, which treats the skin more deeply for more profound results. 

RESULTS: Depending on the patient, results can be immediate and last a very long time. Dr. Lancer prefers to use radiofrequency waves on the body to tighten skin and even melt away a little fat (temporarily) with machines like Biora, Exilis and Venus Legacy, which use heat to simulate an injury to the dermis of the skin, stimulate collagen growth and tighten skin in the process. “Some work better on postpartum skin or for bra or back fat — it really depends on the individual diagnosis with Dr. Lancer,” says Natalie Aguilar, a registered nurse in Dr. Lancer’s office. Engelman agrees: “Radiofrequency is really the way to treat excess skin, but not if there’s a significant amount of adipose tissue underneath it — if there’s a lot of fat, you won’t see a lot of improvement.”

TIMELINE: With ultrasound, only one treatment is typically required, and there is no downtime. Radiofrequency treatments are most effective in a series (Lancer’s office recommends six) every two weeks. There’s no recovery time.    

COST: Ultrasound treatments, around $1,500. Radiofrequency body treatments range from $600 to $1,000, depending on the practice and the machine.
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SOLUTIONS: Sclerotherapy or Nd:YAG laser therapy
Sclerotherapy: Broken, visible vascular tissue just beneath the surface of the skin is the result of the physical pressure of child bearing, long periods of standing, rigorous exercise and, yes, genetic predisposition, says Engelman. The traditional method of treating these is sclerotherapy, where a doctor or nurse injects a saline solution into the unused vein, which causes it to collapse. 
Nd:YAG Laser Therapy: Engelman swears by the Nd:YAG laser, which targets both red and blue veins and delivers “beautiful” results with no compression hose, less pain and no downtime.   

Sclerotherapy: “The healing process is a little more involved, because you wear pressure stockings for 72 hours after the treatment, and [doctors] recommend no working out or flying for that long as well. You will most likely have bruises, so the legs won’t look good for at least two weeks after,” says Erdmann. “And you may need multiple treatments spaced one month apart. Unfortunately, if you’re prone to them genetically, it can be an annual commitment.”
Nd:YAG Laser: “I find the lasers to be more life-friendly,” says Engelman, but since the laser is harder to control, the success depends on the skill of the person administering it. Engelman says that results are visible immediately. “When I use the laser, I watch them disappear before my eyes.” 

Sclerotherapy: It may take four to six weeks for the body to absorb the damaged tissue and the small bruises that may appear to vanish completely. 
Nd:YAG Laser: Some redness and bruising may be present for a week or two posttreatment. 

Sclerotherapy: Treatments run about $500, and with Erdmann, she will treat as many veins as she can during the hour appointment. 
Nd:YAG Laser: Treatments cost $400 to $1,200, depending on the amount and severity, and two are typically necessary. 
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SOLUTIONS: Anti-Fungal Preparations, Botox Injections
Anti-Fungals: Making feet prettier, or at least more presentable, requires a commitment well beyond regular pedicures. In fact, pedicures can be part of the problem. Fungal infections, which cause thickening and breakage of nails and occasionally thick calluses on heels, can be transferred even in the most pristine nail spas, and in places you may have never considered: “Hotels are a big problem,” says Aguilar, citing showers and pool decks as big culprits. Doctors Engelman and Lancer recommend Zeasorb anti-fungal powder to sprinkle in shoes to absorb moisture and kill the fungus. If a mild fungus is causing excessive odor, Dr. Alexiades-Armenakas recommends this home remedy: “Add a capful of bleach to a basin full of water and soak feet once a week.” For nail fungus, Shamban prescribes Jublia, a topical solution applied directly to nails. Oral anti-fungals are on their way out. “Dr. Lancer believes that it causes too much potential damage to your liver and that it’s not worth it,” says Aguilar.
Botox Injections: Another common foot issue is excessive sweating, or hyperhidrosis, which can lead to foul-smelling feet. Engelman recommends Dry Sol, a prescription-strength antiperspirant spray, which is applied directly to feet at night to shut down sweat glands and minimize the growth of yeast. Botox injections can control perspiration for up to four months.

Anti-Fungals: With daily use, topical treatments take up to three months to show noticeable improvement in toenails. Odor may be improved in a matter of days.
Botox Injections: As with any Botox injections, full results will be evident in seven to 10 days.  

COST: Prescription anti-fungals can cost as much as $400 but can be covered with insurance. Botox will run you $1,200 to $1,500 because many units of botulism toxin must be injected in multiple sites on both feet.
Kevyn Aucoin
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