We offer the following Cosmetic Procedures

Dr de Goede is very conservative with the use of Botulinum Toxin: he uses it mainly for frown (glabella), crow’s feet (laugh lines), forehead lines and for upper lip lines. These are the areas where it works the best with excellent visual improvement for the patient.

Superficial chemical peeling involves the use of mild acids to remove surface dead skin cells that make up the stratum corneum. By definition, superficial chemical peels do not enter the dermis or the lower layers of the epidermis. Dissolving of bonds at the different layers of the stratum corneum and epidermis determines the depth of the peel. They are done to obtain desired therapeutic objectives. The goal could be to exfoliate the coneocytes that fail to desquamate, resulting in smoother surface. A mild acid with short contact time will be sufficient. Superficial chemical peels can be used to enhance penetration of other products such as hydroquinone or retinoids. Alternatively acids can be used to carefully remove the stratum corneum and superficial epidermis to achieve an improvement in the appearance of the skin texture and/or skin pigmentation.

The two most effective acids for superficial peels are glycolic acid and salicylic acid.

Glycolic acid is a water-soluble alphahydroxy acid with the smallest molecular weight, it can rapidly penetrate into the skin. It is ffrom fermented sugar, also known as fruit acids. These acids can be buffered and neutralized to limit penetration into the skin but is more effective to use undiluted, unbuffered peeling solutions, as they are more predictable in their effect on skin

Salicylic acid is commonly referred to as a betahydroxy acid. An oil soluble acid that has a keratolytic action, and is able to penetrate into the pore. It can be used as a peel for pations with acne, as it loosens comedones, for sensitive skins as it has an anti-inflammatory action.

A course of 4 to 6 treatments can improve the skin’s clarity and the appearance of fine lines and dark spots. Glycolic and Lactic Acid Peels have proven to be effective in cases of mild to moderate acne

Dr de Goede is Director of Lasermed and performs all his laser procedures at Lasermed Tygervalley. He uses the Mosaic fractional non-ablative laser and the Candela C02 fractional ablative laser for skin rejuvenation and the V-beam PDL laser for the treatment of numerous vascular (Bloodvesel) lesions.

For more information please visit the Lasermed Website.

Microdermabrasion And How It Works

Microdermabrasion is a safe, progressive approach to skin care that was developed in Italy in 1987. Using vacuum, and sometimes positive pressure, the machine and the specially-designed handpiece allow micro-fine crystals to pass over the skin. As the crystals make contact, they actually blast off a thin layer of the outer skin (dermis). The handpiece then vacuums off the dead skin and crystal particles. The procedure exfoliates the dry, dull skin, while stimulating circulation and collagen production.

Each treatment removes one to two layers of dead skin cells, depending on the condition that is being treated. The depth of treatment is determined by the trained operator and controlled through the speed of the handpiece, crystal flow and the number of passes. Since each treatment is customized, patients can be treated at their own comfort levels.

Candidates For Microdermabrasion

Unlike traditional dermabrasion, laser resurfacing or chemical peels, microdermabrasion is safe for men and women of all skin conditions and colors. The best candidate for microdermabrasion is one who wishes to improve the appearance of their skin and is willing to take an active role in protecting and maintaining the results. Microdermabrasion improves the overall appearance and tone of your skin; collagen production and circulation are improved; and the skin surface is smoother and healthier.

Customized Treatment Plan

After your initial consultation, a customized plan will be developed for you.
Microdermabrasion is a progressive skin treatment. Your success depends on multiple treatments on a strict schedule.

Often called “The Lunch Time Peel,” each session may take between 30 minutes to one hour, depending on the areas being treated. Your skin may be slightly reddened for 20 minutes to one hour after the treatment but it is perfectly safe to apply your make-up and return to normal activities. There is no recovery or “down time” associated with microdermabrasion.

Number of Treatments

Your personalized regime will be determined by the skin condition being treated and your desired results. The number of treatments can vary from 4 to 12, depending on the severity of your condition and treatment goals. Stretch marks and acne scars require the greatest number of treatments.

Microdermabrasion treatments should be performed 7 to 10 days apart. It is vitally important that you adhere to the scheduled that is developed for you. Waiting longer than 14 days between treatments can interfere with your progress.
After your desired results have been achieved, you will want to have maintenance treatments at least every three months.

Advance Preparation

If you are using any skin care products containing Retin-A, hydroquinone, or glycolic acid, you will want to stop using them 48 hours before your treatment. You may resume their use 24 hours after treatment. Skin that has been overexposed to the sun and is sunburned should not be treated.

How Soon Will You See Results?

Remember, microdermabrasion is a progressive procedure. You will definitely feel softer, smoother skin and may see subtle improvement after only one visit. You will see visible improvement after four treatments. The benefits continue to multiply with each additional treatment as increased circulation is noted within the dermis and newer, healthier skin cells are seen at the surface.

Treatable Skin Conditions

Microdermabrasion has been clinically proven to significantly reduce the appearance of:

• wrinkles
• fine lines
• acne
• acne scars
• stretch marks
• age/sun spots
• enlarged pores
• clogged pores
• flaking & dry skin
• uneven pigmentation

Is Microdermabrasion Painful?

For normal treatments, you will experience the sensation of vacuum suction and crystal particles making contact with your skin. This should not be a painful experience. Sensitive areas around the eye and upper lip may feel more tender, but the technician will adjust the machine in these areas to prevent discomfort.

Special Products Before or After The Procedure?

Dependent upon the goals of your treatment protocol, certain prescription medications may be recommended, as well as a special series of skin care serums formulated for use specifically during and after microdermabrasion treatments.

Is microdermabrasion safe?

Yes, very safe. This is a shallow depth treatment and is safe and effective for many skin types and conditions.

Does it help acne?

Yes. It has bee found to be very effective for both active and cystic acne. Microdermabrasion is even appropriate for treating teenage acne.

Does it remove scars?

Scars may respond very well to microdermabrasion. Results vary based on several factors such as the age of the scar, depth of the scar tissue, individual skin types, location and the care given to the area between treatments.

Can it help get rid of stretch marks?

Currently there are numerous practice and physicians in the country using this therapy for the treatment of stretch marks. The consensus is that the newer the stretch mark, the better the response seems to be. In most cases, improvement is seen to some degree. A consultation would be recommended in order to better assess the degree of improvement that might be gained.

Will I need time to recuperate?

No. You may return to your normal activities immediately following the procedure. If you so desire, you may reapply your makeup immediately after the procedure. You may experience some pink or slightly red areas, which should fade quickly. If you desire a treatment which leaves you with no redness at all, the technician can adjust the machine in order to give you a very light peel. It is important to note that “redder is better” in the end in that it leads to enhanced dermal circulation and stimulation of collagen production within the dermis. The degree of redness you experience will be directly related to the amount of stimulation during the procedure.

Does it work on wrinkles?

Superficial fine lines and wrinkles respond well to microdermabrasion. Deep wrinkles or dynamic lines may be softened somewhat, but cannot be completely resolved through microdermabrasion. Other treatment such as Botox injections, laser resurfacing and/or surgical facelifts may be necessary to achieve more dramatic results.

Can this replace laser treatment?

No. If your degree of wrinkling is such that laser resurfacing is needed, microdermabrasion may not give you the results you hope to achieve; however, microdermabrasion therapy may be recommended following laser to help maintain results and resolve resulting hyperpigmentation.

Does is get rid of sun spots or skin discolouration?

Yes, It can be very effective in removing unwanted pigmentation, sun damage and uneven skin color and tone. In some cases, the doctor may recommend a prescription product to enhance the results of microdermabrasion. Sun protection is essential however when treating skin discolouration disorders. A sun block will be required during and after the treatment.

Your microdermabrasion treatment has exposed new, vibrant, healthier skin.

Right now, your skin is very receptive to nourishing, therapeutic products and gentle care. At the same time, it is more vulnerable to irritation and damage.

First 48 Hours

Your skin has a greater need for soothing, nourishing products. You may find that you are sensitive to products that you usually use and tolerate well. The following is a partial list of “unfriendly” ingredients that must be avoided: artificial color, artificial fragrance, SD alcohol, lanolin, propylene glycol, white petrolatum, Octyl Methoxy Cinnamate or other chemical sunscreens.

First 72 Hours

The following are some therapeutic products and ingredients that should be avoided for the first three (3) days unless instructed otherwise by your doctor or technician: Retin-A, Renova, any retinal, alpha hydroxy acids (including glycolic acid), beta hydroxy acids, hydroquinone, benzoil peroxide, enyzyme peels or masques, any scrubs or exfoliating agents.

Daily Care

Remember – cleanse, moisturize and protect!

Days 1-3

AM: Cleanse with a gentle, non-AHA cleanser. Pat skin dry.
Suggested: antioxidant serum, hydrating moisturizer, eye cream and SPF 30 imperative.
PM: Cleanse with a gentle, no-AHA cleaners. Pat skin dry.
Suggested: nutritive serum, hydrating moisturizer and eye cream.

Days 4-7

AM: Cleanse with a gentle cleaner. Pat skin dry.


Antioxidant serum, hydrating moisturizer, eye cream and SPF 30 imperative. If treating hyperpigmentation, use of HQ product is recommended.

PM: Cleanse with a gentle cleanser. Pat skin dry. Suggested: nutritive serum, hydrating moisturizer and eye cream. Retinol usage may resume as tolerated. If treating hyperpigmentation, use of HQ product is recommended.

Before Next Treatment

If you are undergoing a series of microdermabrasion treatments, remember to discontinue AHA and retinoid use at least three (3) days before your next appointment. It is strongly suggested that you do not have injections (collagen or Botox) 7-10 days before your treatment.

What is Sclerotherapy?

Sclerotherapy is a popular method of of eliminating varicose veins and superficial Telangiectasias (“spider veins “) in which a solution, called Sclerosing agent, is injected into the veins.

Does Sclerotherapy work for everyone?

The majority of persons who have sclerotherapy performed will be cleared of their varicosities or at least see good improvement.

How many treatments will I need?

The number of treatments needed to clear or improve the condition differs from patient to patient, depending on the extent of varicose and spider veins present. One to six more treatments may be needed; the average is three to four. Individual veins usually require one to three treatments.

What are the most common side effects?

The most common side effects experienced with sclerotherapy treatments are:
Itching – depending on the type of solution used, you may experience mild itching along the vein route. This itching normally lasts 1 to 2 days.

Transient Hyperpigmentation – approximately 30% of patients who undergo sclerotherapy notice a discoloration of light brown streaks after treatment. In almost every patient the veins become darker immediately after the procedure. In rare instances, this darkening of the veins may persist for 4-12 months.

Sloughing – sloughing occurs in less that 3% of patients who receive sclerotherapy. Sloughing consists of a small ulceration at the injection site that heals slowly. A blister may form, open and become ulcerated. The scar that follows should return to a normal colour.

Allergic Reactions – very rarely, a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.

Pain – a few patients may experience moderate to severe pain and some bruising, usually at the site of injection. The veins may be tender to the touch after treatment and an uncomfortable sensation may run along the vein route. This pain is usually temporary, in most cases lasting from 1 to maximum 7 days.

What are the other side effects?

Other side effects include a burning sensation during injection of some solutions, neovascularization (the development – usually temporary – of new tiny blood vessels), transient phlebitic-type reactions (swelling of the veins might cause to ankles to swell), temporary superficial blebs or wheals (similar to hives), and, very rarely, wound injection poor healing, or scarring.

Are there any other types of procedures to treat Telangiectasias?

Laser surgery – to date, this method has only been effective for tiny facial blood vessels. The present laser systems tend to produce a greater risk of scarring. The laser is an expensive devise and treatment is thus more costly. We have recently evaluated the use of a new type of laser (Candela V-Beam) for vessels which do not respond to injection treatment or are to small to be injected. Although more expensive than conventional sclerotherapy, this new laser system is quite effective for treating the tiniest of red blood vessels that may remain after successful treatment of other varicose and telangiectatic leg veins.

Electrodesiccation – This method produces a non-specific destruction of both the vessel and overlaying skin, thus resulting on greater incidence of scarring.

Surgical Ligation or Circumsuture – This operative procedure always results in a scar and is best reserved for large varicose veins.

What if I experience a problem after receiving Sclerotherapy?

If you notice any type of adverse reaction, please call the doctor immediately.

What should I do before my appointment for treatment?

Discontinue aspirin and so-called blood thinning drugs 1 week prior to your appointment. Consult your prescribing physician.
Do not shave your legs 2-3 days prior to your appointment.
Eat a light breakfast of lunch an hour or so prior to your appointment.
What should I do after the procedure?
Walk for 30 minutes immediately following the injections.
If possible, do not drive home yourself, If you have to drive keep your legs moving and make frequent stops for walking
(approx every 20 minutes).
Maintain normal daytime activities; walk at least an hour a day – the more the better.
No hot baths for 2 weeks.
Avoid standing without moving about. If you must stay in one place, move your feet and toes frequently.
If your legs become painful after the injection, walk.
Do not remove your bandages for 48hours. Cover them with a plastic bag when showering.
Avoid strenuous physical activity (aerobics) for the first 48 – 72 hours.

The DermaPen 3™ offers unparalleled collagen induction by harnessing the body’s innate ability to re-grow and repair the skin as a response to micro-damage. This small, hand-held device delivers up to 1,300 micro punctures per second into the skin, thus stimulating the production of collagen and elastin and normalizing various skin functions. DermaPen 3™’s controlled precision promotes the three phases of CIT mechanics, thus allowing for new collagen growth to occur.

The first phase begins with the release of the body’s own growth factors, followed by a cascade of new epidermal growth, fibroblast chemo-taxis, fibroblast proliferation, and matrix production.

This proliferation of the body’s tissue continues to release growth factors from fibroblasts, keratinocytes and monocytes, culminating in the second phase of CIT mechanics, where production of collagen I, III, and IV, elastin, proteoglycans and glycosoaminoglycans, (gag’s)and the process of angiogenesis occur.

The last phase of CIT and the desired result of a DermaPen™ Treatment is the tissue remodeling process, where the skin’s vascular matrix matures, causing skin to tighten. The body’s ability to remodel and heal itself is at the heart of this amazing product.

The process never involves heat or thermal energy, does not use harsh chemicals or cause unnecessary trauma, the skin heals quickly, requiring virtually no downtime.

The process generates new healthy skin cells to replace aged or damaged ones. The device is used to treat visible signs of aging, such as skin atrophy and wrinkles, as well as various types of scarring, stretch marks, several types of pigmentation disorders, sun damaged skin, hair loss, and more.

In addition, the DermaPen™ is a serum delivery device. Any product applied to the skin during or immediately after a DermaPen™ is very easily absorbed into the skin, rendering it much more effective than with a traditional topical application.”