Indoor Tanning Damage and Aging Skin

December 30th, 2014 Kirin

Indoor Tanning Damage Can Result in Aging Skin

Recently, the AMA Wire published the synopsis (shown below) of media coverage on the CDC study about injuries from indoor tanning published in JAMA Internal Medicine .

Unfortunately, consumers are under the general impression that indoor tanning is safe and many are under the false impression that indoor tanning does not have the same effect on aging.  World-renowned Houston facial plastic surgeon, Dr. Russell Kridel comments on indoor tanning damage, “Not only can there be direct injury from indoor tanning like burns, but indoor tanning ages the skin prematurely and can lead to the development of skin cancers; children are especially vulnerable because the damage is cumulative over the years of one’s life.”

At Facial Plastic Surgery Associates, we see the results of women (and to a lesser extent of men) who have spent a great deal of time using indoor tanning facilities.  Since the majority of people start using tanning beds between the ages of 18 and 34, we are seeing patients in their 40s who have skin laxity and pigmentation issues that could have been avoided for many years.  Fortunately, there are a number of facial rejuvenation procedures and laser resurfacing treatments that Dr. Kridel can perform to help address these issues.  For the most significant skin laxity, facelift surgery provides the best results and can turn back the hands of time.  At FPSA, we also have three different laser modalities that can help address skin texture and pigmentation issues.  Dr. Kridel has published extensively in peer-reviewed scientific journals on facial rejuvenation topics and is recognized internationally as an expert in these procedures.

Prevention is still the best defense against aging skin. And one of the important recommendations is to stay away from indoor tanning.


Study: About 3,200 people suffered an indoor tanning injury every year in the US between 2003 and 2012.

USA Today (12/16, Painter) reports that a study by CDC researchers published in JAMA Internal Medicine indicates that “an estimated 1,957 indoor tanners landed in U.S.” emergency departments (EDs) “in 2012 after burning their skin or eyes, fainting or suffering other injuries.” CDC researcher Gery Guy “says the actual number of injuries is certainly higher because the study did not include injured people who did not go to” EDs.

The Today Show Online (12/16) reports that for the study, the investigators “looked at 405 actual reports of indoor tanning related injuries from 66 hospitals, extrapolated them to the whole population, and estimated that on average, 3,200 people suffered an indoor tanning injury every year in the U.S. between 2003 and 2012.”

The Washington Post (12/16, Bernstein) “To Your Health” blog reports that “skin burns are the most common injury and women are more than four times as likely as men to get hurt, probably because they are, by far, the more common practitioners of ‘indoor tanning,’ according to the” study. The blog adds that “younger adults, aged 18-34, sustain well more than half the injuries, again because they are the most frequent users of tanning beds.”

The AP (12/16, Tanner) reports, “The CDC says burns severe enough to require” ED “treatment indicate overexposure to UV radiation.” Although “manufacturers are required to install timers to limit exposure…the CDC study found some patients had fallen asleep while tanning.”

melanoma.” The researchers “also noted other sources for eye injuries, like when tanning bulbs broke and shattered into people’s eyes, Guy adds.” Reuters (12/16, Doyle) and HealthDay (12/16, Reinberg) also cover the story.

— Kirin, Facial Plastic Surgery Associates, Houston

To make an appointment with Dr. Kridel for an MVP Facelift, facial rejuvenation or laser resurfacing consultation, please call 713/526-5665.

To learn more about Dr. Kridel’s MVP Lift click here.

You can also go to Dr. Kridel’s You Tube channel for a few of his videos on facelift and facial rejuvenation procedures.


About Voluma Injections in Houston

February 18th, 2014 Kirin


In Houston Voluma injections are a hot topic.   Here are ten of the most frequently asked questions about Juvederm Voluma XC, commonly known as Voluma.

Juvederm Voluma XC


Juvederm Voluma XC is the newest HA (hyaluronic acid) soft tissue filler to gain FDA approval to instantly add lift to the cheek area in patients over the age of 21.  It is commonly referred to as Voluma.


To learn if Voluma is right for you, Dr. Kridel or Dr. Sturm will perform a thorough consultation.  They have extensive experience with the wide array of different fillers and wrinkle relaxers and will select the best treatment plan for your specific needs.


At Facial Plastic Surgery Associates Voluma treatments are performed by one of our physicians —- Dr. Russell Kridel and Dr. Angela Sturm. As top facial plastic surgeons in Houston, Dr. Kridel and Dr. Sturm are considered leading experts in facial fillers. They customize treatments for each patient, which may include a combination of different fillers and techniques in order to achieve the best outcomes. Dr. Kridel is always on the leading edge of aesthetic treatments and as a result, Facial Plastic Surgery Associates is one of the first cosmetic medical practices in Houston to offer Juvederm Voluma XC.


Virtually anyone 21 years or older with volume loss in their cheek area is a candidate for treatment with Voluma. Many patients in their 30s, 40s, and 50s may not be appropriate candidates for surgery, or are not ready for downtime associated with surgery and will benefit instead from Voluma treatment.


There is no downtime after treatment, and patients may return to their normal activities.  However, we suggest that you avoid strenuous activities in the first 24 hrs after Voluma injections or other injectable treatments.


Results are immediate and can last up to 2 years. The duration of filler correction depends on the facial area treated, the injection technique, and the rate that the patient ‘s tissues break down the filler. The majority of patients can resume their daily activities immediately after treatment. Some patients may experience slight swelling and bruising, but this typically improves rapidly.


Side effects include are considered mild to moderate and can last two to four weeks. The most common side effects are tenderness swellings firmness bumps bruising redness itching or discoloration at the entry site.


Voluma is made up of hyaluronic acid (ha), which is a naturally occurring substance that helps to bind water to cells. Its extensive cross-linking helps to provide lifting capacity, which makes it an excellent choice for restoring volume in the cheeks and midface.

Juvederm Voluma is unique in that the HA is cross-linked through a process called Vycross that helps provide good lifting capacity. This special cross-linking also helps to avoid degradation, making Voluma last longer.


Voluma is an injectable filler made from hyaluronic acid. Sculptra is not a filler.  It is made of Poly-L-Lactic Acid (PLLA), a synthetic biodegradable polymer that is both resorbable and bio-compatible. It works by stimulating the body to produce new collagen at the sites of injection, thereby replacing lost volume and contours to restore a fuller, more youthful appearance. Houston Sculptra injections do not give immediate results like the true fillers do. Since Sculptra has to stimulate the body to create new collagen, this process takes time. Sculptra can last at least two or more years because it causes the body to stimulate its own collagen. Two to three sessions generally 4-6 weeks apart are usually needed to accomplish optimum volume.


Voluma is made by the same company that manufactures Juvederm XC, Latisse and Botox— Allergan, Inc.  So, yes, this is part of the Brilliant Distinctions Program.

To make an appointment with Houston facial plastic surgeon Dr. Kridel or Dr. Sturm phone us at 713/526-5665. Feel free to contact Dr. Kridel or Dr. Sturm also.

— Kirin, Facial Plastic Surgery Associates

Dr. Kridel shares news: Botox Gets FDA Approval for Crow’s Feet

September 13th, 2013 Kirin

Botox, also known as a wrinkle relaxer, has been officially approved by the Food and Drug Administration (FDA) for treating crow’s feet (wrinkles around the eyes).  Like other areas of the face, the effects of the Botox injection for crow’s feet will last approximately 3 to 6 months, although results vary by individual.

As a reminder, Botox is a prescription medicine that is injected into muscles.  It works by blocking nerve impulses to the injected muscles. This reduces muscle activity that causes moderate to severe lines to form.  At Facial Plastic Surgery Associates, only our physicians — Dr. Russell Kridel or Dr. Angela Sturm — inject our patients (not a nurse or aesthetician).  This is important because they are facial plastic surgeons with significant training in the anatomy of the head and neck area. Dr. Kridel was one of the first facial plastic surgeons in Houston to treat aesthetic patients with Botox and is considered an expert on injectables of all types.

The news of FDA approval for crow’s feet, will undoubtedly add even greater popularity to Botox treatment, which is already considered the most popular minimally invasive physician administered aesthetic procedure for both women and men.  There has been an increase each year in men coming in for Botox injections to address the moderate to severe glabellar lines between their eyebrows and will now add crow’s feet to their requests.

If you are not familiar with the range of injectable wrinkle relaxers (like Botox & Dysport) or wrinkle fillers (like Restylane & Juvederm) you can check out multiple videos by Dr. Russell Kridel on You Tube or on our todaysface site that explain many aspects of having Botox injections.

To read coverage of the FDA announcement on

Also, Facial Plastic Surgery Associate, Dr. Angela Sturm has a special offer for injectables on Fresh Face Fridays.  Click here for more details.

— Kirin, Facial Plastic Surgery Associates, Houston

Facial Plastic Surgery Associates Now Offers Belotero, the New Dermal Filler

June 23rd, 2013 Kirin

Facial plastic surgeons, Dr. Russell Kridel and Dr. Angela Sturm now offer the new dermal filler, Belotero.  Belotero is made of hyaluronic acid (or HA). It has been approved by the FDA to safely and effectively treat moderate to severe wrinkles and folds.

While BELOTERO BALANCE® Dermal Filler is made of the same material (hyaluronic acid) as some other dermal fillers (also known as wrinkle fillers), like Juvederm and Restylane, Belotero has a unique manufacturing process that offers a soft, cohesive gel that is able to fill in your wrinkles.  By binding to water, it can fill in wrinkles and folds for immediate correction that can last for six months or so.

The versatility of the product makes it strong enough to handle deep treatment areas such as nasolabial folds (smile lines around the mouth), yet soft enough to treat more delicate areas such as vertical lip lines (thin lines that appear above the lip line).

Based on the positive results and patient experience with Belotero thus far, Dr. Kridel and Dr. Sturm have found that while it can be used in deep nasolabial folds, they have found Belotero to be particularly beneficial for small areas that need softening, such as the corners of the mouth and vertical lines above the lip.  So patients often elect to use other fillers like Juvederm or Restylane for deeper folds, like nasolabial folds (crease between your nose and mouth), and complement it with Belotero for these other fine line areas.

You can also check out the Belotero website

For more information about Dr. Kridel.

For more information about Dr. Sturm.

To make an appointment with Dr. Russell Kridel or Dr. Angela Sturm call 713/526-5665.

— Kirin, Facial Plastic Surgery Associates

Dr. Russell Kridel explains how Botox really works

January 3rd, 2013 Kirin

One of the most popular ways to get rid of wrinkles is to use Botox. In 2011,      it was the top nonsurgical cosmetic procedure in the U.S. among both women and men, with more than 2 million treatments performed by physicians.

At Facial Plastic Surgery Associaties (FPSA), we believe it is important that patients are educated about the treatments that interest them. And, while Botox is very popular, it is important to also understand how it works.

Check out this brief video of Dr. Kridel explaining how a wrinkle relaxer, like Botox, works: How do wrinkle relaxers (neuromodulators) work?

Botox is just one of the many trade names for the neurotoxic protein called botulinum toxin, that is produced by the bacterium Clostridium botulinum. It is known as a Neuromodulator. Neuromodulators are sold commercially under the brand names Botox, Dysport and Xeomin.

Since this terminology is rather cumbersome, Dr. Kridel states that it is easier to think of a neuromodulator as a Wrinkle Relaxers.  A neuromodulator is a wrinkle relaxer because it is an inhibitor of neuromuscular activity. It blocks the communication between the nerve fiber and the muscle preventing contraction and temporarily relaxing the muscle.

Botox (or Dysport or Xeomin) is injected into muscles, where it blocks nerve impulses to those tissues. The muscle activity that causes the frown lines is reduced, and a smoother look results. Without a contracting muscle beneath it, the skin has a difficult time wrinkling.

A wrinkle in the skin is typically formed perpendicular to a contracting muscle located directly beneath it. For example, the muscle in the forehead is a vertical muscle.  When you raise your eyebrows it contracts and the lines (or wrinkles) that form will be horizontal.In a similar fashion, the two muscles that are responsible for the frown lines are positioned horizontally between the eyebrows, so when they contract, the frown lines appear vertical.

When a wrinkle relaxer, like Botox, Dysport or Xeomin, is injected into a muscle, it blocks nerve impulses to those tissues. The muscle activity that causes the frown lines is then reduced, and a smoother look results. The skin has a difficult time wrinkling without a contracting muscle beneath it.

“Neuromodulators work by weakening the muscles of facial expression,” says Dr. Russell Kridel, Houston TX. “Once the resting tone of these muscles is weakened, the pull of the muscles relaxes and the skin flattens out.”

Botox, or any other neuromodulator, requires two to four days for it to attach to the nerve ending that would normally stimulate the muscle to contract. The maximum effect usually occurs at about 10-14 days and can last for a few months.

One last word on Wrinkle Relaxers —- Please do NOT get injections at a “Botox Party” at somebody’s house.  A medical setting is safer, and any side effects can be treated immediately. Remember, this is a medical treatment and should be used with the utmost care and skill in the hands of a highly qualified physician. The best practitioners know the correct sites of injection to avoid side effects such as droopy eyelids — which further underscores the importance of finding a facial plastic surgeon who has significant experience giving Botox injections, like Dr. Kridel.

To learn more about the difference between a Wrinkle Relaxer (like Botox) and a Wrinkle Filler (like Restylane), check out these videos 

For a great deal more information about injectables and fillers, including multiple videos, visit our site.

— Kirin, Facial Plastic Surgery Associates, Houston TX

It’s Not Too Late to Give the Gift of Beauty by FPSA and Dr. Kridel

December 21st, 2012 Kirin





This holiday give the Gift of Beauty by FPSA!

Are you looking for the unique holiday gift that keeps on giving? Why not pamper someone special in your life with an FPSA “Gift of Beauty “certificate.


  • Is your husband looking for the perfect stocking stuffer for you?
  • Does a friend keep hinting about wanting Botox or fillers?
  • Has a family member expressed an interest in facial plastic surgery, or been inspired by how youthful you look after a recent procedure?
  • Or would you like to treat yourself to a more youthful look?

An FPSA (Facial Plastic Surgery Associates) “Gift of Beauty” gift certificate can be used for any of our skin care products or cosmetic surgery services— from consultation with Dr. Russell Kridel or Dr. Angela Sturm-O’Brien, to nonsurgical rejuvenation treatments (think Botox, Restylane, Ulthera, Thermage, and Fraxel) or to our signature facial plastic surgery procedures. Gift Certificates for Plastic Surgery Products and Services are available for any amount.

Your loved ones will be thrilled to receive the “Gift of Beauty” with the best facial plastic surgeon in Houston.  Give us a call at 713/526-5665 today!

*** Of course, we will examine the recipient of your gift to decide if they are a candidate for a given procedure, and make recommendations based on their goals, exam, and overall medical status.

— Kirin, Facial Plastic Surgery Associates, Houston TX

Facial fillers become more popular

March 2nd, 2010 Dr. Kridel

As seen on ABC 13 Houston HealthCheck with Medical Reporter Christi Myers Thursday, February 25th at 10PM

HOUSTON (KTRK) Looking younger isn’t vanity any more; it’s a way to compete in today’s job market. But fewer people can afford or want an extensive face lift. It’s a look at the procedure people are asking for especially men and it’s called facial fillers.  Dr. Russ Kridel talks about how new injectables like Sculptra, Juvederm, Perlane, and other injectable facial fillers have become more popular than ever in the past few years.


Click the link below to read the whole story:

Facial fillers become more popular

Do It Yourself [DIY] Injectable Fillers -Risks and Safety Concerns

November 16th, 2009 Dr. Kridel

Botox and Dysport and all the injectables can only be sold legally in the US only to physicians; these products must be legally approved and labeled by the FDA. Depending on state law, which varies, generally only physicians, nurse practitioners, and nurses may inject these substances. Doctors’ offices are probably the safest place to have such injectables administered; staff are trained in sterile procedures so as to avoid contamination, re-use of needles, and infections. Plus, in the rare case of an allergic reaction, staff and physicians are trained in resuscitative measures and have emergency drugs available. Not too many spas, peoples’ homes, or hotel rooms have the same standards for cleanliness and emergency care that a doctor’s office does!

DIY Botox Parties

Click here for video

And the products obtained must come from the US where the FDA maintains safety levels not so strictly adhered to in other countries Importation of cosmetic injectables can be a felony, subject to one year in prison and $100,000 in fines. Recently 5 physicians, a nurse and a practice manager in New York pled guilty to such charges. Therefore patients need to be cautious when injectables are offered at bargain prices, because they may have been obtained through web sites or offshore; they may be counterfeit and there’s no one to assure purity or content! Serious injury or personal harm may result when unknown substances are injected.

Individuals who decide to have their injections in spas may be putting themselves at risk. Even if the spa is overseen by a physician, is he on-site to supervise the injection? In most states the practice of medicine is defined by the diagnosis and treatment of a problem. Is an aesthetician or nurse deciding on their own what injectable is appropriate for you and how much you should get? Or is the physician first seeing you, discussing the options and then deciding, based on your medical history and his exam, what should be done—the preferable route—and is that doctor relaying on alternatives to that injectable? And what kind of physician is doing the injecting or the supervision? Is the physician one who routinely treats such conditions, for example, as would a facial plastic surgeon, plastic surgeon, or dermatologist, whose touch might be more delicate, aesthetic, and precise?

Botox parties at someone’s home are fraught with problems! Some of these parties involve the drinking of alcohol on the premises. Can you truly decide with a clear head if this is what you want to do? Also, before being injected, have you been offered an informed consent form to read and fill out? Did anyone talk with you about risks and possible complications? Did someone go over your medical history to see if you might be allergic to the material to be used? Did someone ask if you are nursing? On immune-suppressant drugs? Have taken aspirin, non-steroidal inflammatory, or herbal drugs recently, that could cause bruising or bleeding? Did someone take any pictures to document what you looked like before so that later the efficacy of the treatment could be assessed?

The DIY or Do It Yourself injections recently seen on the internet are quite simply one of the most bizarre, unsafe and unwise acts I have ever witnessed. Will heart surgery be next? Number one, you want someone with experience to do your injection; someone who’s done it hundreds of times, someone who knows the underlying anatomy and who knows how to avoid problems. Since you can’t yet get a medical degree or residency training over the internet, and you probably don’t have the time for 4 years of medical school and 4 to 6 of additional residency training, you might want to visit your facial plastic surgeon instead. Even with a doctor with an experienced hand there can be problems, albeit small. Bruising, bleeding, asymmetry, migration to unwanted areas are all possible. Who is going to pick you up off the floor when you pass out? Plus, ever try to do something in a mirror, where left to right are transposed? It’s difficult.

What is exciting now are all the FDA approved injectables that we now have (such as Botox, Dysport, Restylane, Sculptra, Perlane, Juvederm, Radiesse, etc.), giving facial plastic surgeons, and patients many choices to individualize the right treatment for them. It’s just wise to have the right physician examining and guiding you to the optimal result!

Russell W. H. Kridel, MD, FACS

Houston, Texas


For more information, Dr. Kridel is featured in this article talking on the same topic of DIY injectables and risks on

Aesthetic Medicine News – Consumer Alert:  Safety Issues Associated with Botulinum Toxin Cosmetic Injectables.