Dr. Ringpfeil has been specializing in cosmetic surgery and laser surgery at top cosmetic surgery centers in the U.S. and Germany for over eighteen years.
At Ringpfeil Advanced Dermatology she put together a highly qualified team and built an advanced surgery center to provide you with the best cosmetic services available.
You can now benefit from unmatched services and find affordable ways to restore your skin to a smooth, clear and youthful appearance.
| Skin maintenance and aging |
| Cosmetic consultation |
Complimentary with our aestheticians |
| Custom facial ½ hour or 1 hour |
$65 or $85 |
p
e
e
l
s | Glycolic acid peel |
$100 / $25 for for face / hands - $500 / $125 for a package of 6 |
| Quelage peel + kit |
$150 - for rosacea |
| Gloss peel + kit |
$300 - for rejuvenation or maintenance after melasma treatment |
| Melanage peel + kit |
$850 - for melasma, freckles or other brown marks |
| TCA peel |
$500 for full face, $150 for limited area |
| Laser peel |
$400 / $600 for full face / full chest |
| Micro peel |
$250 full face or full chest |
| Microdermabrasion |
$150, $750 for a package of 6 |
| Laser for brown spots, angiomas or sebaceous hyperplasias |
$105 for the first spot, $20 for any additional
$400 /$600 / $300 for full face / full chest / hands, 1-3 needed |
| Photodynamic therapy |
$450 / treatment |
| CO2 laser resurfacing (ActiveFX & DeepFX) |
$3000 - full face | $1000 - eyes | $500 - upper lip |
| Hand rejuvenation |
$1100 - both hands (Radiesse + a laser treatment for brown spots) |
| Acne |
| Acne facial (30 minutes) |
$65 |
| Glycolic acid peel |
$100, $500 for a package of 6 |
| Salicylic acid peel |
$40 |
| Blue / red light treatments |
$40 |
| Laser treatment |
$250 for full face |
| Photodynamic therapy |
$450 |
| Wrinkles |
| Artefill |
$900 / 0.8 ml syringe
|
| Botox / Xeomin |
$15 / unit |
| Juvederm |
$500 / 0.8 ml syringe |
| Prevelle |
$250 / 1.0 ml syringe |
| Radiesse |
$600 / 1.5 ml syringe |
| Restylane |
$500 / 1.0 ml syringe |
| Veins |
| Laser for rosacea/facial blood vessels |
$400 / treatment, 2-4 needed |
| Sclerolaser for leg veins |
$150-$700 / treatment, price depends on area |
| Sclerotherapy by injection |
$150-$700 / treatment, price depends on area |
| Miscellaneous |
| CO2 scar treatment |
$150-500 / treatment, 2-5 needed |
| Ear lobe repair |
$375 simple tear, $600 gauged ear lobe repair |
| Ear piercing |
$25 |
| Skin tag removal |
$120 for up to 15, $70 each additional 10 |
Laser Surgery Blog
Please feel free to use the blog below to share information about Laser Surgery, or to ask Dr. Ringpfeil a question that might be of interest to others.
Leave a Comment or a Question
Hello,
I am a 38 year old African-American male and I have severe hyperpigmentation on my forehead. I have used dermatologist prescribed Tretinoin .05% and Hydroquinone 4% (independently and blended) to little success. In fact, I believe one or both has worsened the darkening. The dermatologist prescribed these treatments without viewing my skin under a Wood’s Lamp, however I firmly believe the hyperpigmentation is dermal due to the appearance of my skin and lack of success with OTC and prescription topical treatments.
What treatment would you recommend to lessen (or remove) dermal hyperpigmentation? Does the treatment have a track record of success for African American skin? Does your practice offer such treatment?
Treatment of dermal pigmentation is very difficult and not always successful. Hydroquinone in conjunction with retinoid is indicated. Since the retinoid did not seem to agree with your skin, I would reduce the regimen to hydroquinone, and combine with glycolic acid and/or Kojic acid in conjunction with regular microdermabrasion treatments. Lasers can cause paradoxical darkening and are not indicated.
I will be 41 and my skin just looks dull. I have dark circles under my eyes and have always had darker skin at the knees, elbows and knuckles. I have been looking in skin lightening product/procedures such as peels and cryosurgery. What do you suggest?
A consultation with a dermatologist or an experienced aesthetician so that a treatment plan can be customized to you.
I am thinking about getting photodynamic therapy done for acne. Can you explain step by step what occurs during this procedure? Who can perform this procedure in your office (yourself, aesthetician or medical assistant)? How many treatments does it usually take to clear up acne?
Photodynamic therapy is one option to treat moderate, severe or persistent acne. An evaluation by a dermatologist or experienced dermatology physician assistant is needed to determine which are the most suitable treatment options for you.
If photodynamic therapy is an appropriate consideration, treatment can commence. In my experience, methyl-aminolevulinate followed by red light activation works best for acne (in comparison to aminolevulinic acid followed by blue light).
Methyl-aminolevulinate is applied by the nurse or medical assistant to the affected area, such as the face, and left on for 1-3 hours. The skin will also be occluded by saran wrap. After the incubation time, saran wrap is removed and any remnant of the photo sensitizing cream is wiped off with a damp cloth. A red light LED source (or a laser) is then placed immediately over the affected area for up to 20 minutes. The activation by the very bright red light source can be uncomfortable but pain medication is rarely needed. A medical assistant is checking on you every few minutes and depending on your level of comfort, short breaks can be taken during the exposure.
If you are leaving the office in daylight, sunscreen is applied in a darkened room after completion of photo activation. Immediately after the treatment, the skin will be red.
However, the response is highly variable. In most people, redness lasts for 1-3 days. Rarely, the skin will become very inflamed, leading to tightness and scaling that can last 7-10 days as well as prolonged redness for several weeks. On the other hand, redness may be extremely minimal, lasting only minutes after the procedure.
Treated skin must be shielded from direct and indirect sunlight and fluorescent light for 42 hours after application of the photo sensitizer. Therefore, if the face, neck or hands are treated, the incubation time is typically spent in our office. After the procedure, sunscreen must be worn to treated areas that cannot be physically shielded. Acceptable sunscreens that block visible light are those that contain zinc oxide and titanium dioxide.
It takes between 4-6 treatments every 2-4 weeks to treat acne. While it is very effective in the majority of people, it may not be the cure for all and to date we have no predictor who may fail to achieve long lasting remission of acne. Some experts state that the efficacy to eliminate acne by photodynamic therapy is better than that of isotretinoin (Accutane), which is typically stated as 75%. At the same time, photodynamic therapy eliminates the need to expose your entire body to a chemical.
Hello,
Ive had molluscum on my penis for a little while now and ive used just about all methods of getting rid of it from liquid nitrgoen freezing, curette, and imiquimod. I now have a lot of visible scarring. they are mostly white lookin like i’ve lost color on psots of my penis. I really need help and i was wondering what treatment would darken my scars to match my brown skin. Thank you so much for help i would very much like whatever can be done to be done immediately
I understand your concern. It is not easy to reintroduce pigment in areas of treatment especially if scars may be underlying. Our body can restore pigment within a scar only to a certain degree after several years.
Off-label use of some prescription medications might help promote pigment formation sooner than our body does it but it still takes time. You may want to consider a self-tanner for immediate camouflage.
Hi,
I am a male, 48 years old. I have dark circles under my eyes (Tear Trough). I am interested in the laser treatment featured in this video:
http://www.youtube.com/watch?v=lLlRfFQlkN8
I am not interested in any type of injections or other surgery. Do you perform this procedure, or direct me to someone who could help?
Thanks.
Although I do not see the model on the youtube video and did not make out the name when the operator was talking, I would guess he used the MiXto SX. The MiXto SX is a fractionated carbon dioxide laser. Many different fractionated
CO2 laser models are currently on the market. They differ in the way they lay down the fractionated beam and in the amount of energy they emit. We operate what is currently regarded the flagship of fractionated CO2 lasers, the Ultrapulse by Lumenis. It is considered the flagship because it is the most versatile and can deliver any energy level desired. Please note that the operator on TV treated a young woman in her twenties and was able to use very low energy settings. Low energy translates into less downtime with discomfort, redness, scabbing. Ultimately, the amount of laxity of the lower lids as well as the prominence of the under eye fat pad determine which laser settings will deliver results in one sitting. The procedure is one of our most popular and the Ultrapulse laser allows me to customize is it to every person’s needs without undertreating.
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I have one semi-deep line across my forehead. Would Radiesse be an option? I’m not interested in botox and would like something that increases collagin over time.
Thanks!
N. G.
In my opinion, Radiesse is not a suitable substance for forehead lines. If botulinum toxin is not an option for you, hyaluronic acid based fillers are a good alternative. Unfortunately, they do not appear to stimulate collagen production.
Hi doctor!
I am a 30 yr old woman who has sagging skin in the jaw area (jowls?) I was wondering what is the best way to get this corrected? Can it be done with fillers? If so, which ones and how many treatments?
Beginning jowls can often be corrected by several different fillers while moderate to severe jowls require a lower face and neck lift for best results. Radiesse, Juvederm ultra plus XC or Perlane are used in a single treatment. The amount can be determined after examination and may range between 1-2 syringes. These fillers last between 9-12 months for Juvederm and Perlane and between 12-18 months for Radiesse. Sculptra may also be an option, and between 1-3 vials can be injected in 2-3 sittings that are spaced 6 weeks apart. Sculptra last about 2 years. Artefill is a much longer lasting filler and between 1-2 syringes can be injected in 1-2 sittings.
Your facial features, degree of laxity or any volume loss in the cheeks will determine which fillers are best for you.
I am interested in an injectable for under-eye tear troughs as well as one deep brow line. Is there a filler that is more natural and actually builds collagen over time? I know there are new products coming out all the time. I am not interested in Botox.
Also, do under-eye injectables have side effect like noticable bruising (black eyes)??
Thank you.
Hyaluronic acid based fillers are the only injectables currently considered appropriate for visible tear troughs. Unfortunately, none of the hyaluronic acid fillers available stimulate any significant collagen production. The most common brands are Restylane and Juvederm which typically last 6-12 months before our body’s own enzymes dissolve them. Other shorter lasting hyaluronic acid fillers are also available. The same way that any needle stick into our skin may cause a bruise, all fillers may cause bruising. If it occurs, it typically lasts 8-10 days.
Tear troughs can also be corrected by fat injections, which have a high failure rate and are therefore not widely performed. Botox does not correct tear troughs.
Dr. Ringpfeil,
I’m considering having IPL treatments for rosacea. Down the line I would like to have fillers done (under my eyes for deep tear trough) such as Restylane. What I’d like to know is whether the needles (inserted for the filler) could cause damage to the blood vessels treated for the rosacea? Perhaps the blood vessels would already be closed off and “dead” then and it would not matter. However, this would all be in the same general area of the face so that’s why I’m curious.
Thank you.
Fillers do not interfere with any blood vessels, not even those that may have become widened by rosacea. If the needle stick during filler placement scratches an intact blood vessel bruising can occur and may last 8-10 days on average. There is no long lasting effect form bruising, i.e. no widening of blood vessels. Therefore, the sequence in which you want to enhance your face is also interchangeable.
hello dr..what are the risks of sun exposure after q switched nd yag laser on nevi to lighten them and non ablative nd yag laser for post acne scars?can laser increase skin sensitivty or affects its barrier and thereby increase chance for malignant transformation of skin or nevi?thanks a lot.
Sun exposure must be avoided for 4 weeks after every laser treatment, regardless of the type. Laser treatment does not make your skin sun sensitive or vulnerable to skin cancer but intentionally causes inflammation to achieve a specific goal. UVA light that falls on an inflamed area of the skin darkens this area for many months, which can be avoided by diligent use of sunscreen. I assume that you ask about the treatment of a Becker’s nevus, which is a smooth muscle nevus. Please note that at this time we have very little safety data on lasering melanocytic nevi and therefore this procedure is not offered.
Good morning DR
This is my case.I had 6 non ablative laser sessions for post acne scars.During the period of treatment(6 months) i used to apply sunblock(spf 50+zinc and titaniam dioxide) once per day for about 8 morning hours.
Its effect might be deminished with time and it was about 200 hours collectvly i think i wasnot protected during which i was exposed to morning light (indirect sun light) coming through the window when indoors or in my car,some direct sunlight and flourescent light at night.Also my doctor didnot do appropriate cooling to protect the epidermis that might be damaged (which is considered UV protection).So What are the side effects i am prone to develop due to sun on lasered skin? Is there a test to be done to pridect any serious complications due to exposing lasered skin to sun? THANK YOU DR.
If I understand correctly, you are asking about potential side effects of non-ablative laser treatments. In general they should be rare. I trust that every physician who operates a laser discusses common long term side effects of a device prior to a procedure and I also believe that every laser surgeon welcomes any questions you have in regards to a treatment you received. I think it would be best if you asked your laser surgeon as I do not have any specific information available to help. At the least I would need to know what type of non-ablative laser treatments you had.
Your sun block containing zinc oxide and titanium dioxide was appropriate.
We instruct our patients to reapply sunscreen every 1-2 hours if exposed to light including traveling in the car or when sitting immediately next to a window for 3 monts after and ablative or deep reaching non-abaltive procedure. Fluorescent light does not play a major role after laser procedures but must be avoided after photodynamic therapy (this is not a laser procedure).
Thanks dr for your time.But what are the side effects of my history i mentioned of non regular use of sun block after laser treatment during healing period?THANKS AGAIN
i have a couple of acne scars if i do the laser treatment how long before i see results, and i don’t have insurance so will the price be high.
Acne scar treatment is a process. If you only have several scars, spot treatment is recommended. It takes between 3-5 spot treatments every 2-3 months to see significant improvement. Please note that no insurance covers acne scar treatment. The cost per treatment depends on the number of scars treated and can range from $150 to $500 on the face. Near confluent acne scars are not suitable for spot treatment initially and will need resurfacing. If after resurfacing any single scars stand out, they can be improved with additional spot treatments.
Hello Dr. Ringpfeil,
I have come to you before and I have found that I can trust you over the other doctors I have seen in the past. I recently had a small cyst pimple that a derm I used to see injected with cortisone. Now, I have a very noticeable dent where the pimple was. I read online that the cortisone causes “fat atrophy” which some say will be permanent and some say it will fill in over time. I
Dimpling and lighter discoloration are known side effects of steroid injections into the subcutaneous tissue and while they are rare, they can be very bothersome. They will typically resolve after 2 years but realistically, most will hardly be noticeable by 6 months. Saline injections can indeed help and we have performed them with success.
Hello,
I have what a previous dermatologist calls a gravel chin and was told that Botox injections would help. I see the price per unit but can you tell me how many units you generally use on the chin area and forehead (right eyebrow is lower).
I currently live in Mass but am from PA, specifically; Penn Valley and would like to have some work done; hair removal (underarms), brownspot removal (on my left cheek) and would like Botox to my chin and forehead. I’m just trying to determine the approx cost of everything so I can make an appt for the next time I come home (probably March).
Can you give me an approx estimate and tell me if I can get all of the above done at one visit.
Thank you for your help.
Kim
The “gravel” chin is also referred to as “pebbly” chin or “dimpled” chin. It typically takes 2-4 units of Botox to correct it. The adjustment of an eyebrow requires between 1-6 units and the correction of forehead lines takes 8-12 units.
Laser hair reduction is a process and not a onetime procedure. You may refer to our video under the section of laser hair removal for in depth information. However, we should be able to book your appointment in a way that you may receive all services at the same visit. I recommend that you call us as soon as you know your travel plans so that we can accommodate your needs. Please note that you must not be tan prior to treatment of brown spots on the face and you should not have a vacation in the sun scheduled within 4 weeks after treatment.
I had breast reduction that left horrible scars is there anything i can do
I imagine that you meant to describe scars that are thick and perhaps discolored. Nowadays, there are several different treatment options for heaped up, spread or discolored scars available. Please schedule an evaluation.
Hello,
I have Sarcoidosis. It has effected my skin where I have very deep mark from boils. Mostly on my left side of my face. These are not normal acne scars, they are deep. What can I do to make my skin and appearance better?
I know it must sound disappointing but without an actual evaluation I cannot be specific. In sarcoidosis, it is most often the second layer of the skin that suffers and many scars may look sunken in. Excision, laser treatment or any other techniques are dependent on the size of the scars, your skin color and texture and where on the face they are located. I strongly encourage that you be evaluated for the best options for you.
Please understand that without knowing all parameters this question is very difficult to answer and considering that you describe no side effects, I can only answer hypothetically. If you had unopposed UVA exposure during this time (indirect light is not considered unopposed UVA exposure) your skin may have darkened in the treated areas. Darkening from UVA exposure typically takes longer to resolve than darkening that some lasers can cause. I strongly encourage you to pose this question to the laser center where you were treated for less hypothetical answers.