Because your skin is your most visible organ, you want it to look its best.  Dermatology, while a serious medical specialty that deals with diseases of the skin, has many cosmetic aspects to which Dr. Metcalf is sensitive.  The subspecialty of cosmetic dermatology addresses these issues, with a special focus on aging skin.  Modern treatments are available to improve the signs of aging on the skin. 

After providing an in-depth assessment of your cosmetic needs and concerns, Dr. Metcalf will create a customized treatment plan for you.  Dr. Metcalf has had training in cosmetic procedures both during her dermatology residency and while attending national cosmetic conferences.  The cosmetic procedures or products she and her aesthetician Belinda Hammergren currently offer include:

Cosmetic Procedures

Laser Procedures


Cosmetic Procedures
Sclerotherapy is the injection of a salt solution into unsightly superficial veins, such as varicose and spider veins of the legs.  The solution causes destruction and subsequent reabsorption of the vein by the body.  The procedure causes minimal pain and generally all that is felt is the stinging from the salt solution.  Possible side effects include bruising and hyperpigmentation (dark spots) that may or may not resolve.   Less common side effects will be discussed by Dr. Metcalf at your visit.  Dr. Metcalf only treats the small and medium sized veins of the legs and recommends that you wear compression stockings or ACE bandage wraps for several days following your procedure so as to maximize the effect of the treatment, while minimizing the side effects.   Usually several sessions, 3-6 weeks apart, are required to eliminate the veins.

Botulinum toxin injections are commonly used to improve the wrinkles caused by muscle movement.  This treatment does not help wrinkles that are present at rest (without facial muscle movement).  Because years of facial muscle movement (frowning, laughing, smiling) causes wrinkles to form, initiating Botox treatments at a relatively early age (thirty) may help to reduce wrinkling over time when used in conjunction with good sun protection habits.  The almost painless procedure consists of injections of the medicine with a tiny needle into the muscle that causes the wrinkle.  An effect is seen within a few days and usually lasts 3 to 6 months.  Potential side effects include bruising, temporary headache, and rarely, a reversible drooping of the eyelid when certain areas are treated.

Chemical Peels
Dr. Metcalf performs several different chemical peels, including very superficial, superficial, and medium depth peels.  Chemical peels are most often used to improve uneven/blotchy pigmentation, acne lesions, and precancerous skin lesions (actinic keratoses).  They may also improve skin texture, very fine wrinkling, and superficial acne scarring depending on the depth of the peel performed.  The amount of down time also varies depending on the depth of the peel.

Juvederm Ultra® and Juvederm Ultra Plus® are FDA-approved hyaluronic acid dermal fillers used to restore volume and contour of the lips, facial folds, and wrinkles. The result usually lasts 6 to 12 months.  Hyaluronic acid is a naturally occurring substance already found in the skin that functions to provide volume and fullness by absorbing water.  It is found in diminished quantities in aged skin. 

RADIESSE dermal filler is establishing itself as the dermal filler of choice for total facial rejuvenation. It is made of calcium-based microspheres, a biocompatible substance that's identical to what's naturally found in the body, resulting in a very low risk of allergic reaction.   Unlike other dermal fillers, it also stimulates your body to produce your own new collagen, so results tend to be longer-lasting, usually one year or more.

RADIESSE is used to correct folds, wrinkles, and volume loss of the face, including the smile lines, cheeks, jaw lines, and chin.  Additionally, it can be injected into the backs of the hands, adding volume that creates a more youthful appearance.

The "HydraFacial" treatment is the newest advance in non-laser skin resurfacing and microdermabrasion. HydraFacial is the only hydradermabrasion procedure that combines cleansing, exfoliation, extraction, hydration and antioxidant protection simultaneously, resulting in clearer, more beautiful skin with no discomfort or downtime. The treatment is soothing, moisturizing, non-invasive and non-irritating. The HydraFacial treatment improves the appearance of fine lines, wrinkles, congested and enlarged pores, oily or acne-prone skin, hyperpigmentation and brown spots with virtually no downtime.

Permanent Makeup
Belinda Hammergren, Dr. Metcalf's medical aesthetician, is highly trained to perform micropigmentation of the eyebrows, eyeliner, and lips. 

Obagi Medical Products
Obagi Medical is one of the leading physician-dispensed, prescription-strength skin care systems designed to correct the signs of aging and enhance the health and beauty of your skin.  What can an Obagi system do for you?

  • Correct hyperpigmentation (discoloration)-evening out skin tone and enhancing color uniformity-by regulating the production of the cells responsible for pigment in your skin
  • Promote skin cell turnover through gentle exfoliation to expose more glowing, healthy skin
  • Prevent future skin cell damage by neutralizing free radicals and protecting the skin from UVA (aging) rays and UVB (burning) rays
  • Increase collagen and elastin for firmer, more resilient looking skin
  • Significantly reduce acne breakouts

    Laser Treatments
    Pigmented Skin Lesions
    The Q-switched Nd:Yag laser can be used to treat pigmented lesions including large freckles, lentigines (sun spots), and tattoos.

    Hair Reduction
    Significant reduction of unwanted body and facial hair can be achieved with laser therapy (Alexandrite for lighter skin tones and long pulsed Nd:Yag for darker skin tones).  These lasers target melanin pigment within hair follicles, therefore only pigmented hairs can be treated.  Because not all hairs are in the actively growing phase at once, four to six treatments are typically needed. 

    Vascular Lesions
    Facial spider veins, port wine stains (vascular birthmarks), red scars, and sometimes varicose veins of the lower extremities can be treated using either the pulsed dye laser or the long pulsed Nd:Yag laser, depending on the lesion.

    Fractionated CO2 Laser Resurfacing
    Fractional laser resurfacing is used to improve wrinkles, sun damage, acne scars, and uneven skin tone.  Because fractional laser treatments only treat a fraction of the skin’s surface at a time, healing is faster than previous resurfacing procedures.  By creating microscopic wounds on the skin’s surface, collagen production is stimulated.  Collagen formation helps diminish wrinkles and plumps acne scars. The number of treatments needed depends on the goals of the treatment.  For fine lines, uneven skin tone, and sun damage, one ablative fractional resurfacing treatment should offer improvement.  For deeper lines and acne scars, several treatments may be needed.  A second treatment can be performed as early as 8 weeks following the first procedure.
    Unlike BOTOX and the dermal fillers such as Juvederm and Radiesse above, Fractionated CO2 resurfacing provides near-permanent results, changed only by subsequent sun damage and aging.

    During your consultation, Dr. Metcalf or her aesthetician Belinda Hammergren will discuss the risks, benefits, and alternatives to these procedures.









    To schedule an appointment,
    call 405-372-7575