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Check out real patient feedback on many cosmetic procedures. Welcome to the exciting, revitalizing world of DeSpain Cayce Dermatology Center and Medical Spa! We are delighted to serve as your guides to radiant health and beauty. We understand that there is much to explore in our offerings, and so we have taken special care to put together a comprehensive overview of our cosmetic skin services and products. This publication includes an introduction to our medical and cosmetic practice, an explanation of how our team members work together, a glossary of our services, and detailed information on some of our most popular and newest services. We ve also included testimonials from our patients because we know the true measure of our success is our patients experiences, and we want you to hear from them. We hope the information presented here will begin to familiarize you with the potential of our services. Still, we expect you to have additional questions and we want to be able to answer those and address your specific concerns. That s why at DeSpain Cayce Dermatology Center, we offer complimentary consultations. These consultations include evaluations from trained skin care professionals who create customized plans for achieving patients goals. We invite patients who are considering procedures, as well as patients who want a customized skin care regimen using scientifically proven products, to call our office at 573-446-5166 to schedule an appointment. More information about our advanced medical and cosmetic dermatology services and products, as well as our team, is also available on our website, www.despaincaycederm.com. We look forward to serving you as you discover and enjoy the many benefits of caring for your skin. & Sincerely, Dr. John DeSpain and Dr. Kimberly Cayce Photo By L.G. Patterson 2 beautiful Dermatologists turning skin care into skin beauty.

contents Produced by Inside Columbia Custom Publishing, 2012. 573-442-1430, www.insidecolumbia.net About The Practice...4 Meet The Staff...7 Glossary Of Services...8 Demystifying Botox...10 The Skinny On Coolsculpting...12 Introducing Ultherapy...14 Patient Testimonials...15 www.despaincaycederm.com beautiful 3

About The Practice when it comes to cosmetic skin care services, consumers have an abundance of exciting new options. Helping them make the most of the offerings is fun and fulfilling work for the doctors and staff at DeSpain Cayce Dermatology Center and Medical Spa. We re here to answer questions and to offer the highest level of cosmetic dermatological care, says Dr. John DeSpain, who has been in private practice since 1992. It s fun to be able to make people feel better about themselves, adds Dr. Kimberly Cayce, who joined Dr. DeSpain in 2007. We talk about Look good, feel good ; that s the experience we give our patients. The patient experience at DeSpain Cayce Dermatology Center and Medical Spa begins with education. We want to make sure that people make their very best choices, so we educate about options; we don t sell, Dr. DeSpain says. We offer consultations at no charge by appointment, so people can come in and talk to our estheticians and learn about what we offer and receive a free evaluation. Both Dr. DeSpain and Dr. Cayce are board-certified dermatologists, and Dr. DeSpain is also a board-certified dermatopathologist. Dr. DeSpain began his career on the faculty at MU before entering private practice. Dr. Cayce finished her M.D. in 2002, and had five years of postgraduate training before joining Dr. DeSpain. She became a full partner with him in 2010. There are two sides to their practice: medical dermatology for patients facing skin cancer, eczema, acne and other skinrelated medical concerns and cosmetic dermatology for patients looking to treat age spots, lift sagging skin, remove an unwanted tattoo or otherwise improve their skin s appearance. The estheticians who perform some of the cosmetic procedures at DeSpain Cayce Dermatology Center and Medical Spa have received advanced training and certification in the dermatology field, and even the simplest cosmetic cases receive oversight from at least one of the doctors, a point of pride for the practice. If patients are going to take information or advice from anyone, shouldn t it be the skin care experts, the dermatologists? asks Dr. Cayce. The commitment to education also ensures patients have realistic expectations, something that s impressed office administrator Wendy Willingham. I ve stayed as long as I have because I believe in everything we do, says Willingham, who is approaching 13 years with the practice. We re not going to recommend something if someone doesn t need it, visit us online! and we re honest with expectations. We will only do something if someone is a good candidate and fully understands the benefits and limitations. I feel like we respect our patients. Another point of pride at DeSpain Cayce Dermatology Center and Medical Spa is the comprehensive menu of services. We re unique because we have a good blend of offerings that, collectively, can change a lot of things for people, Dr. DeSpain says. And that menu is continually evolving to keep up with advancing technologies. Today s offerings include Photo By Casey Buckman Photography; Opposite Page: Photos By L.G. Patterson 4 beautiful Dermatologists turning skin care into skin beauty.

many new injectables for smoothing wrinkles, and such technologies as CoolSculpting, a noninvasive one- to three-hour procedure that eliminates stubborn fat cells, and Ultherapy, an ultrasound procedure that delivers noticeable skin lifting and toning results without the downtime or risks of a surgical facelift. The office also offers a complete line of skin care products and mineral makeup to complement the cosmetic services. Remaining on the cutting-edge requires continuous education for the doctors and staff. Offering new technologies and products requires tremendous investments of time to ensure results will match the manufacturer s claims. As services have expanded, so, too, have staff and space. The practice has grown from Dr. DeSpain, a nurse and a receptionist in a 1,400-square-foot office in 1992, to more than a dozen staff members, including patient service coordinators, clinical assistants, nurses and estheticians, who serve patients in a beautiful, 4,000 square-foot facility built in 2006 in The Village of Cherry Hill. Dr. DeSpain consulted with two medical architects and hired a professional interior designer to create a welcoming and accommodating space. We have lots of windows and excellent lighting, comfortable furnishings and decor, and bubbly, pleasant staff who brighten the place up, too, Dr. DeSpain says. It s not just about the bricks and mortar; it s the overall environment we create. And because nothing can drag down the environment in a doctor s office like long waits, the doctors and staff at DeSpain Cayce Dermatology Center and Medical Spa work a realistic schedule. Seeing our patients in a prompt manner is something else we pride ourselves on, Dr. Cayce says. We respect patients time. Although emergencies and unexpected issues can occur in a medical office, the disciplined staff works hard to stay on track, while always giving their full attention to the patient in front of them. Our first priority is listening to our patients needs, concerns and desired outcomes, Dr. Cayce says. Adds Dr. DeSpain, Listening and caring are the core values of our practice, and they help us provide the best possible outcomes for our patients. That approach to patient care has garnered strong loyalty from patients. Testimonials on the office s website, www.despaincaycederm.com, highlight the helpfulness of the staff and the patients excellent results, as well as the doctors commitment to community leadership. Dr. DeSpain and Dr. Cayce are each involved in several local organizations, ranging from such professional organizations as the Missouri State Dermatological Society and the Boone County Medical Society to service organizations such as The practice has grown from Dr. DeSpain, a nurse and a receptionist in a 1,400-squarefoot office in 1992, to more than a dozen staff members, including patient service coordinators, clinical assistants, nurses and estheticians, who serve patients in a beautiful, 4,000 square-foot facility built in 2006. Heart of America United Way, Central Missouri Food Bank, Columbia Sunrise Southwest Rotary Club, RAIN and more. The office is also a committed supporter of the arts and underwrites several community events. The doctors also find outreach opportunities related to their area of expertise. For example, DeSpain Cayce Dermatology Center and Medical Spa is an underwriter for the Sunsense UV index and tips reported on KOMU, and the doctors have made trips to Jefferson City to work with state legislators to promote regulations limiting minors access to tanning beds. All of these are ways for us to get involved and to benefit our patients and our community, from supporting our patients passion for the arts to saving a teen from unnecessary skin damage, Dr. DeSpain says. All of this makes our work that much more worthwhile. Meet The Dermatologists Dr. John DeSpain and Dr. Kimberly Cayce are both board-certified dermatologists. They administer direct care to all of the medical patients and to all of the cosmetic patients whose procedures are more aggressive or invasive. The doctors also meet every patient and review all treatment plans, including those involving the simplest treatments. www.despaincaycederm.com beautiful 5

Meet The Staff most people who hear the tale of Cinderella put themselves in Cinderella s place and dream of how it would feel to receive such a marvelous transformation. Those who imagine instead how much fun it would be to be the fairy godmother, waving a wand and creating unbelievable results, find working at DeSpain Cayce Dermatology Center and Medical Spa to be a real dream job. Of course, the staff does not have a fairy s magic; their gift for helping people look and feel their best depends on high levels of training, careful listening to patients and effective collaborations with the dermatologists. A great practice depends on a great staff, says Dr. John DeSpain. Our staff extends our commitment to providing the best in care, from patients initial phone calls to helping them make their best choices and monitoring their progress. We choose team members who impress us with their professionalism and sensitivity. While the doctors at DeSpain Cayce Dermatology Center and Medical Spa are proud of the advanced procedures and equipment they have that enhance patient care, they realize that their most exceptional asset is their friendly, knowledgeable staff. Being at the forefront of patient care is about more than the newest equipment, Dr. DeSpain says. It s about who uses the equipment, their clinical judgment and how they interact with the patients. Out staff is trained to excel on each of these points so our patients receive the highest quality of care. the patient service coordinators This group includes a skilled team of half a dozen professionals including Wendy Willingham, who has been with the practice going on 13 years and Julie McDonald who has been with the practice for nine years. As the office administrator, Wendy serves behind the scenes working on patient accounts and keeping the paperwork moving, while Julie, the cosmetic service coordinator, is often the first person to extend a welcome to cosmetic patients wanting to set up an appointment or address questions about the office s services and product lines. Photos By L.G. Patterson the clinical staff The estheticians and nurses are the trained skin care professionals who competently support, and in some cases administer, specific treatment regimens under the supervision of the doctors. Initial patient consultations are generally with the clinical staff, who are familiar with all the offered procedures having administered the simpler ones and having assisted the dermatologists with the others. The estheticians and nurses have received advanced training for each piece of equipment they operate. We don t have any staff members who learn from another staff member alone; they learn from the trainer themselves, so there s no dilution of the knowledge, Dr. DeSpain says. www.despaincaycederm.com beautiful 7

Spa Services Following is our current menu of services at DeSpain Cayce Dermatology Center and Medical Spa; some are physician-administered and others are offered by our esthetics team. As technologies evolve, you can expect our offerings to expand! A customized treatment plan will be tailored to your particular needs. Smooth Wrinkles Botox is a prescription medicine that is injected by our physicians into facial muscles to temporarily reduce moderate to severe frown lines. It works by blocking nerve impulses to the injected muscles, reducing the muscle activity that caused the lines to form. Repeated at threeto four-month intervals. Restore Lost Volume Facial lines and laxity result from lost volume and soft tissue quality. We have various products with unique characteristics to fill fine lines (or restore volume), and in some cases these products act as collagen-stimulators to increase the patient s own production of collagen. These physician-administered procedures include: Juvaderm An injectable gel (called hyaluronic acid) especially suited to smooth out parentheses lines around the nose and mouth; lasts approximately 6-12 months. Radiesse A filler that provides replenishment of lost volume often used a bit deeper in tissue; results last a year or longer. Sculptra A series of injectable treatments that gradually restore volume over the course of many months. The results emerge gradually for a subtle but impressive effect; can last up to 25 months. Rejuvenation and Repair Here are the treatments we offer to reverse sun- and agedamaged skin: Facials are tailored to each patient s skin. Benefits include hydration, exfoliation and detoxification. For example, clarifying facial treatments focus on soothing irritated skin, while rejuvenating facial treatments focus on deep pore cleansing to even out skin tone and pigmentation. Microdermabrasion is a skin resurfacing technique that is noninvasive, produces virtually no discomfort, requires no topical or local anesthesia and involves no downtime making it a lunchtime treatment known to return an enhanced glow to the complexion and firmness to the skin. Chemical Peels use ingredients such as glycolic acid, salicyclic acid, lactic acid, TCA, or phenol, and are useful to recondition the skin and stimulate skin renewal for treatment of fine lines, skin discoloration, age spots, dull skin texture and mild acne scars. Intense Pulsed Light (IPL) delivers noninvasive light that can be customized for different skin tones and aging conditions. For several weeks following a treatment, signs of sun damage and age spots fade and flake off, clearing the complexion and leaving behind younger looking skin. We use a technology known as LimeLight TM to provide this treatment series. Laser Skin Toning uses noninvasive laser technology to treat fine lines, large pores, uneven skin texture, diffuse redness and scars. These methods improve skin tone, pigmentation and texture through a procedure involving a gentle warming of the skin resulting in collagen stimulation and tissue repair without damage to the skin surface; hence, there is no downtime. Ablative Skin Resurfacing techniques (We use Pearl and Pearl Fractional technology.) combine the impact of resurfacing lasers with the relative gentleness and safety of fractional procedures to treat aging and sun-damaged skin. Photo By L.G. Patterson 8 beautiful Dermatologists turning skin care into skin beauty.

Results are more dramatic than the above options and are noticeable a few days after the procedure when the superficial tissue has peeled off, revealing fresh, bright, healthy skin underneath. Tighten and Sculpt Without Surgery CoolSculpting is noninvasive, permanent fat reduction that uses a technology called Cryolipolysis to target, cool and eliminate fat cells without damage to other tissue. There is no downtime involved, and results begin to show as quickly as two months after the treatment, with the most dramatic results after four months. The goal is for toning and better fitting clothing; this is not a replacement for a healthy lifestyle. Ultherapy lifts, tightens and tones loose, lax skin without surgery! The procedure uses ultrasound to strengthen skin from the inside out. After just one treatment, the skin will have a more refreshed, uplifted appearance, with results appearing gradually over three to four months after the procedure. Treat Unsightly Veins Sclerotherapy treats unsightly veins through injection of a solution that causes the vein to constrict and, in time, disintegrate, resulting in the vein s appearance being greatly reduced or eliminated. The number of treatments varies. Sclerotherapy tends to be more effective than laser treatments for most spider veins on the legs, while laser is the best treatment for all facial blood vessel growths and some leg veins. Laser Treatments, including Cutera CoolGlide, deliver pulses of light energy that cause the blood within the vein to coagulate, eventually destroying the vessel, which is later reabsorbed by the body. Blood flow will then be redirected to veins deeper below the skin s surface, where it should be. Small facial veins and some leg spider veins can be treated with excellent results. Patients with deep vein disease are referred to a specialist to address these issues, as these are not cosmetic in nature. Reduce Unwanted Hair Laser Hair Removal, using Lumenis LightSheer and Cutera Prowave lasers, provides permanent reduction of unwanted hair. Treatments are spaced one to two months apart and work best on dark hair on lighter colored skin. A course of treatment could last eight months or more. Laser Tattoo Removal. Astanza Trinity is the laser offering the best wavelengths for most pigments. Treatments take only a few minutes and are normally spaced four to six weeks apart. A short pulse of energy breaks up the pigment into small enough pieces for the body s immune system to flush away the ink, causing the tattoo to fade. Acne Scarring A variety of techniques can be used, often in combination, to address acne scars once the complexion is improved. These include chemical peels or microdermabrasion, TCA cross procedure and punch excisions, subcision, and in some cases, laser resurfacing or laser skin toning, as discussed above. Simple Procedures for Skin Lesions and Growths Cryotherapy is used to freeze off unwanted tags or keratosis and give a great result for the properly selected condition. Excision/Removal of Moles. Dermatologists offer the best options to remove skin lesions or growths in a comfortable office setting. Products: Maintain Those Great Results! SkinCeuticals combine prevention, protection and correction the three fundamental elements for maintaining and improving skin health into a skin care line backed by science. This company carries the most effective combination of products on the market; you ll see results. Jane Iredale : Known as The Skin Care Makeup, the Jane Iredale line is so safe and beneficial to use that it is recommended by plastic surgeons and dermatologists throughout the world. Our esthetics team is specially trained and certified to skillfully match and apply this mineral-based makeup for all skin types and patients of all ages. Renova has been scientifically proven to increase collagen production, exfoliate the skin surface, and decrease proliferation of atypical skin cells. Thus, you can see improvement in fine lines and wrinkles, a reduction in brown spots and uneven skin tone and texture, as well as a reduction in precancerous lesions. Available in our office or area pharmacies by presctiption. Latisse is the first and only effective prescription treatment approved by the FDA for inadequate or insufficient eyelashes; it grows them longer, fuller and darker. It s a bedtime treatment applied to the base of the upper eyelashes. Clarisonic ultrasonic cleansing brush uses sonic technology to make skin healthier, smoother, more radiant and more beautiful. The sonic micro-vibrations of the Skin Cleansing System gently loosen and remove more dirt and makeup than manual cleansing. Remember, we offer free consultations with our estheticians to help you make the best decisions regarding your skin care! The number to call is 573-446-5166. www.despaincaycederm.com beautiful 9

Demystifying Botox cathy thought and thought about seeing what Botox could do for her. She d long been discontented with the deep scowl lines between her brows, and she d seen her neighbor get beautiful results from Botox. Finally, Cathy asked her longtime dermatologist, Dr. John DeSpain, if Botox could give her the results she wanted. Confident she d be pleased, Dr. DeSpain recommended the procedure. I started with just between the brows, Cathy says, and I really liked the results. I liked it so much that I went ahead and had the rest of my forehead done. I have bangs, but whenever I pulled them back, I just hated it; I hated those lines. And the Botox pulled everything up and made my eyes brighter. It s just amazing what it does. Dr. DeSpain has heard similar comments from countless patients. Many of my patients come seeking solutions because even when at rest, they sometimes look to be frowning or upset, he says. Botox smoothes those wrinkles and lines, so patients look happier and therefore feel happier, too. What is Botox? Botox (onabotulinumtoxina) is a specific brand of a prescription medicine that uses very dilute injectable forms of the botulinum toxin. This toxin in its purified medical form is ideal for treating lines due to muscle movement and contraction, such as wrinkles between the brows, because it blocks the nerve impulses that tell those muscles to contract. Without those signals, the muscles remain relaxed, and the skin above remains smooth. Botox is used to reduce lines around the mouth, shape a patient s smile, relax crow s feet and improve eyebrow height and shape. We think of it when the unwanted lines are due to muscle movement, Dr. DeSpain says. Properly administered, it will reduce lines at rest but still allow desired facial expressions. There are other botulinum toxin products available, but patients at DeSpain Cayce Dermatology Center and Medical Spa receive only brand-name Botox Cosmetic direct from the manufacturer. It is appropriate for the patient to ask to see the vial, Dr. DeSpain says. In skilled hands, the true Botox drug, given at appropriate dosing in appropriate areas has extremely low risk of serious side effects. Patients can request full product information, including Boxed Warning and Medication Guide, from the DeSpain Cayce doctors, who will also discuss the potential risks. Learn more at www.botoxcosmetic.com Understanding FDA Approval The FDA approved Botox in 2002, specifically for the treatment of moderate to severe frown lines between the brows. Since then, Botox has gained acceptance for treating many other kinds of unwanted wrinkles. That can be confusing for patients who don t know that the FDA regulates products but not their uses. The reality is, once a drug gains FDA approval, it may be used off-label, meaning health care providers can prescribe the drug for uses besides those in the FDA indication. Such off-label prescribing is entirely legal and common in medical practices. While doctors are free to prescribe off-label, drug companies are not free to market off-label use; consequently, the website for Botox, www. BotoxCosmetic.com, covers only its use for treating moderate to severe frown lines between the brows. Facial Fillers: Another Anti-Aging Solution Facial fillers are another effective, nonsurgical method for facial rejuvenation. Fillers are best to restore volume, Dr. DeSpain says. In some cases especially, but not only, around the mouth and mid-face the lines are due to tissue laxity. Fillers restore this defect and in some cases stimulate new tissue in their place. Patients often benefit from fillers in conjunction with Botox. Common fillers used at DeSpain Cayce Dermatology Center and Medical Spa are Juvaderm, Radiesse and Sculptra. All of these are physician-administered products. Opposite Paeg: Patient Photos Courtesy of DeSpain Cayce Dermatology Center & Medical Spa 10 beautiful Dermatologists turning skin care into skin beauty.

Frown lines Relax lines caused by frowning crows feet Reduce lines from the outer corner of the eye glabellar lines Smooth vertical lines bunny lines Smooth horizontal lines on the nose eyebrow lift Relax the muscles that pull the brow line down Dumpling/apple chin Reduce the appearance of an apple chin top lip lines Smooth lines on the upper lip neck lines Remove banding in the neck marionette lines Achieve a smoother smile by reducing verticle lines hyperhidrosis Dramatically reduce sweating in the armpit Despain Cayce patients frown lines glabellar lines before after before after What Is The Patient Experience Like? At DeSpain Cayce Dermatology Center and Medical Spa, patients first consult with the practice s trained estheticians, who visit with them, identify treatment goals and ensure those goals are consistent with what Botox can do. One of the doctors also meets with each patient to review the treatment plan. Only a doctor administers Botox at DeSpain Cayce. (This is not the case at all practices.) The doctor s first step is to clean the treatment areas with alcohol. Next comes an application of ice. Then the doctor, using a needle so tiny that the prick is hardly felt, injects the drug into the targeted muscles. The injections are very quick and relatively painless, Cathy says. On average, five to 10 areas receive treatment per session. There is little, if any, bleeding and only a very slight risk of bruising. The injections take less than a minute and require no recovery. How Quickly Do Patients See Results? Within 48 to 72 hours, patients may notice a smoothing of treated areas. Full results are seen in a few days and last, on average, three months, depending upon dose and patient response. Cathy has loved her results so much that she s been faithful with maintenance. It just makes me feel better, she says. I m not trying to look 20 again. I m just enhancing. It makes me look better. The first time I ever did it, Cathy adds, was because I had a reunion coming up. Now I do it for me. www.despaincaycederm.com beautiful 11

The Skinny On CoolSculpting no matter how much he rode his bike on the Katy Trail, Chris Kellogg just couldn t seem to burn off the fat he had collected on his lower abdomen. He d lost around 20 pounds over six months through his increased activity. His legs were in great shape, and his heart rate was excellent. But that lower abdomen fat was being stubborn. I biked 180 miles in one month, and it still wasn t enough to get rid of that belly fat! Kellogg says. The Cool Solution It s a common complaint: Despite a healthy diet and lifestyle, there are lumps, bumps and bulges that just won t go. Men and women alike face the frustrating truth of it every day: A muffin top. Love handles. Back fat. Not much, but just enough to show through a snug-fitting T-shirt or blouse. These small areas of fat don t seem to warrant a surgical procedure. But it s tempting. What else is a person to do? Kellogg found his solution at DeSpain Cayce Dermatology Center and Medical Spa: CoolSculpting, a revolutionary, noninvasive procedure to trim fat from a person s frame. Nobody likes surgery, and this was a great noninvasive way to give that more sculpted, firmer look that I just couldn t seem to get on my own, Kellogg says. It was really quick and simple, and I literally got up and went right back to work. Despain Cayce patients CoolSculpting: abdomen before CoolSculpting: back before after after The Cool Science A safe and permanent removal of unwanted fat cells without knives? The doctors at DeSpain Cayce know it sounds too good to be true. As skeptical physicians and scientists, it took us a year of research to be convinced that it was possible, says Dr. Kimberly Cayce, and we ve been rewarded with patients who couldn t be more pleased with the CoolSculpting technology. The revolutionary CoolSculpting procedure uses a precisely controlled cooling method called Cryolipolysis to target, cool and eliminate fat cells without damage to neighboring tissue. First, the cooled fat cells crystallize. Next, these crystallized fat cells gradually die off and are naturally eliminated from the body. Finally, in the weeks and months following treatment, the remaining fat cells condense, resulting in a thinner layer of fat. The Cryolipolysis method received FDA-approval in the U.S. in September 2010 for permanent noninvasive fat reduction: It was the first noninvasive procedure to receive this indication. The Cool Candidate Kellogg was an ideal candidate for CoolSculpting because he was relatively fit but struggling with an area of fat not easily reduced through diet and exercise. Ideal candidates are seeking spot reduction for specific areas of fat but want to avoid a surgical procedure, Dr. Cayce says. The CoolSculpting procedure is not intended for weight loss or obesity, and it is not a substitute for invasive methods such as liposuction. Learn more at www.coolsculpting.com Patient Photos Courtesy of DeSpain Cayce Dermatology Center & Medical Spa; Opposite Page: Graphic Provided By CoolSculpting 12 beautiful Dermatologists turning skin care into skin beauty.

In general, CoolSculpting is a good option for someone within 25 pounds of ideal body weight, whose weight is stable, who is already leading a healthy lifestyle, and who has a discrete bulge of at least an inch of fat to pinch. The Cool Experience The first step for CoolSculpting patients at DeSpain Cayce Dermatology Center and Medical Spa is meeting with the office s trained estheticians to select the areas to be treated. One of the doctors will also meet with the patient and review the treatment plan. Kellogg was highly impressed with the education he received from staff. The way they described the process, and what I was going to experience in the process, just made so much sense, he says. And for somebody like me, being wellprepared is always better. I like to know what s going on, what s happening, the end results, how long it will take to see results I like to know what to expect and they did an incredible job explaining all of that. Kellogg learned that the actual procedure was nothing to be nervous about. Patients sit or lie while the clinician positions the device. The device then draws the bulge up between two cooling panels. The sensation is a firm pull and pressure, enough of a pull to ensure the selected tissue will be cooled most efficiently. At first, it was like, Wow, that s really sucking the fat up there! Kellogg reports. And then about the time I felt the suction and the suction was becoming uncomfortable, then the area was being cooled so quickly that I didn t really feel the discomfort. So that initial discomfort that was there quickly vanished as the CoolSculpting did what it had to do. I was tweeting on my phone at the time and writing emails for work, he continues, so it didn t seem like a lot was going on. The procedure takes an hour or so, depending on the patient s needs, and then the patient is free to go and return to regular activities. The Cool Results CoolSculpting results may begin to be noticeable as soon as three weeks after, with the most dramatic results coming after two months. And then the body continues to flush fat cells for up to six months. As long as patients maintain their weight with normal diet and exercise, the long-term results should be stable. It s been a year since Kellogg had the CoolSculpting procedure, and he s still more than satisfied with the results. It really was very effective, he says. The area I had treated is much trimmer looking, much more sculpted. It was a great experience; I can t rave enough about it. CoolSclupting is a registered trademark and the CoolSculpting logo and the Snowflake design are trademarks of ZELTIQ Aesthetics, Inc. 2012. All rights reserved. www.despaincaycederm.com beautiful 13

Introducing Ultherapy It takes years for gravity to pull skin down into a droop or sag, but it takes just one visit to DeSpain Cayce Dermatology Center and Medical Spa to restore skin to its rightful position with no cutting required! Patients are ecstatic, as are we, with the results we ve seen from a simple ultrasound device that delivers highly effective skin tightening, toning and lifting results, all noninvasively! says Dr. Kimberly Cayce. What is Ultherapy? Ultherapy uses ultrasound and the body s own natural healing process to undo the effects of time and gravity on the face and neck. The FDA-cleared device stimulates the deep, structural skin tissues without disturbing the skin s surface. Unlike lasers, which penetrate the skin from outside-in, Ultherapy actually works from the inside-out to lift and tighten skin noninvasively, Dr. Cayce explains. Ultherapy is like an ultrasound imaging procedure that expectant mothers receive in that both use a smooth hand piece and project an image on a screen. With Ultherapy, however, the hand piece also delivers tiny deposits of focused ultrasound energy into the skin to the same foundational layer addressed in a surgical facelift. Your skin s response is to stimulate the growth of fresh, new collagen, Dr. Cayce says. The result is a tightening and gradual lifting of the skin back to a more youthful position. Is It Right for Me? A good candidate for Ultherapy has skin that has noticeably relaxed. A lowered eyebrow line or sagging skin on the eyelids, for instance, is often the first sign of maturing skin. While Ultherapy is not a replacement for a surgical facelift, there are many people who want some lifting but are not ready for surgery, either mentally, financially or logistically, Dr. Cayce says. There are also younger people who want to stay ahead of the game, as well as those looking to prolong the effects of cosmetic surgery. What Does It Feel Like? Comfort levels vary from patient to patient and can depend on the area being treated. The sensation results from the focused ultrasound energy. It is noticeable just while the energy is being delivered, and patients typically leave comfortable and excited about the benefits to come, Dr. Cayce says. You are able to return to your normal activities right away. Your skin may appear flushed immediately after the treatment, but any redness should disappear within a few hours. Your physician will review other potential post-procedural effects with you. What Are the Results? Patients may enjoy some initial effect, but the ultimate lifting and toning takes place over two to three months, as tired collagen is replaced with new, more elastic collagen. Further improvements can appear up to six months following a procedure, and patients will still have fresh young collagen after a year s time, but skin will continue to age. Future touch-ups can help keep pace with aging s effects. Learn more at www.ultherapy.com 14 beautiful Dermatologists turning skin care into skin beauty. patient #1 before 180 days post treatment patient #2 before 180 days post treatment Photos By Ultherapy; Opposite Page: Photos By L.G. Patterson

Patient Testimonials barb glenn I have been a patient of John DeSpain s since moving to Columbia 14 years ago. Dr. DeSpain, Dr. Cayce and their staff have treated our family for many things over the years ranging from acute acne, severe poison ivy, and deer ticks to skin cancer. Oh, I almost forgot I have also had some cosmetic procedures from microderms and peels to fillers, just to name a few. As time goes on it is nice to be able to maybe stop the clock for a minute or two now and again, and DeSpain Cayce are always there to help. Margaret Duffy and Esther Thorson As University researchers and professors, we re called on to present our work and to collaborate in venues around the world from New York to Seattle to Shanghai to Rome. Extensive travel, consulting, teaching and tight deadlines are part of our everyday lives so it s important that we look and feel our best. We turn to Dr. DeSpain and his team of top medical professionals because they have the highest professional standards. DeSpain s work is based on research, cutting edge innovations, and a laser focus on what is safe, healthy and natural. DeSpain Cayce Medical Spa is the go-to place for top quality treatment and the office is warm, friendly, and supportive all done with charm and humor. jane bell Dr. DeSpain has been helping me for many years. I have turned to him for a variety of skin conditions and help making decisions concerning skin quality and treatment. It is a comfort that I am able to turn to him with questions about aging and how to approach it with a sensible attitude. There are no magic bullets to allow us to remain looking young forever, but Dr DeSpain s advice is always to the point. He allows his patients to make decisions, but gives clear and concise guidelines to help us through the process. Perhaps his most important attribute is his willingness to serve each patient s needs by getting to know them and their goals. Mary Orscheln I have been going to DeSpain Cayce Dermatology for over 18 years. I have the utmost confidence in their knowledge and expertise. I really enjoy the staff at DeSpain Cayce Dermatology, as they are always friendly and professional. I love that Dr. DeSpain and Dr. Cayce have so many state-of-theart alternatives for less invasive procedures to protect the youth we all long to enjoy. This is one of the few doctor appointments that I really look forward to keeping! amy monahan I am always amazed at the level of warmth and professionalism I experience from the staff and the physicians at DeSpain Cayce Dermatology. My family and I have received excellent treatment and care from both Dr. Cayce and Dr. DeSpain. When Dr. DeSpain removed a basal cell cancer from my nose, I went running to the plastic surgeon in fear because there was a very terrifying looking hole on the right side of my nose. The plastic surgeon remarked that it was the nicest looking removal he had seen and asked if he could take pictures of this and the healing process to show his patients! The result was beautiful; no scar to be seen. www.despaincaycederm.com beautiful 15

The Village of Cherry Hill 2011 Corona Road #207 Columbia, MO 65203 573-234-1000 (medical appointments) 573-446-5166 (cosmetic dermatology services) Dermatologists turning skin care into skin beauty.