Accreditation distinguishes our surgical center from many other outpatient surgical facilities by providing a safe work environment with the highest quality of care provided to our patients. Not all ambulatory health care organizations seek accreditation and not all undergoing the on-site survey are granted accreditation.
Any ambulatory health care organization seeking accreditation by AAAHC must undergo an extensive self-assessment and on-site survey by AAAHC. The onsite surveyors are volunteer physicians, nurses, and administrators who are actively involved in ambulatory health care. The survey is consultative and educational, presenting best practices to help an organization improve its care and services.
This milestone is important in the continuing growth and success of our health care organization. Accreditation shows our commitment to providing the highest levels of quality patient care and applying the same high level of conduct in our business practices. Accreditation by AAAHC is proof of this commitment, and signifies that we have met the rigorous standards of a nationally recognized third party.

Botox®,  Juvederm®,  Dysort®, Restylane®, Radiesse®,  Perlane®, Sculptra®, Xeomin®, Belotero, are all considered cosmetic injectables.  Years ago, Collegen was the only treatment offered to help “fill in” an aging face.  Today three main companies, Allergan, Medicis and Merz offer products to improve wrinkles and loose skin with the goal of facial rejuvenation.  It may be difficult to understand which product is right for you.

The first thing to understand is neurotoxins and dermal fillers are not the same and in fact, they each treat different issues.  In simple terms, neurotoxins stop the muscle’s ability to furrow while dermal fillers “fill in” areas that have lost volume or naturally leave hollows on the face.

Neurotoxins: Prescription medication injected into the muscle which blocks the signal from the nerve to the muscles ultimately resulting in a reduction of muscle activity and temporarily preventing contraction of the muscles that cause dynamic facial lines.  This decrease in muscle activity can be expected to last 3 to 4 months.

Neurotoxins on the market today are Dysport®, Botox® and Xeomin®

Dermal Fillers: Prescription medications injected into the facial dermis to replace lost volume and help restore youthful contours and smooth away moderate to severe facial wrinkles and folds.

The two most common dermal fillers are Hyaluronic Acid (HA) and calcium based filler.

Hyaluronic acid is a natural substance found in your body. When injected into the dermis it acts like an inflated cushion to support facial structures and tissues that may have lost volume or elasticity due to normal aging.  It also brings water to the surface of the skin to help keep it looking fresh and supple.  HA fillers can be dissolved with an enzyme if necessary.

Juvederm®, Perlane® and Restylane® are best used for nasal labial folds or “parenthesis” and marionette lines.

Juvederm and Restylane are FDA approved for lip enhancement

Belotero is injected superficially to treat fine lines, common areas include lip lines and tear troughs.

Calcium based fillers such as Radiesse® are injected in the deep dermis providing lift and stimulating your own natural collagen to grow.  This collagen growth can continue for several months, and many patients correction can last for a year or more.

Common areas of treatment are nasal labial folds, marionette lines and cheek enhancement.

Whether you are looking to “fill in” with dermal filler or “stop” with a neurotoxin, we highly recommend a thorough consultation with a physician before the actual treatment.  A consultation with Dr. David Magilke will help you understand and decide what treatment is best for you.  Allow only certified professionals to administer your cosmetic injectables!

Rhinoplasty, or a “nose job,” is not performed exclusively for aesthetic purposes, as it could help improve breathing by restructuring nasal passages.  In 1999, researchers from the University of Illinois reported an improvement rate of nearly 100 percent in breathing among rhinoplasty patients. Some patients who turned to rhinoplasty have even tried other methods of allowing more air, to no avail.

For Dr. Lawrence Reed, assistant professor at Cornell University’s plastic surgery program, the so-called “nose job” has shifted its focus over the past three decades. Rhinoplasty today is now more likely done by repositioning the nose, than removing excess cartilage. Reed argued that the latter procedure only restricted airflow even more during normal breathing.

There are a lot of things your nose has that your mouth doesn’t. For one, the nose has its own filtration system, in the form of nasal hair or cilia, that mechanically block off particles suspended in ingested air. This is how people are able to inhale clean air, in spite of being in an extremely dusty environment.

In a Japanese study, it was found that breathing through the nose improves gaseous exchange including carbon dioxide content in the alveoli by as much as seven percent. The alveoli are the miniscule structure within the lungs that are tasked with handling the exchange of gases between the atmosphere and the bloodstream. . In the study, the alveoli produced a partial pressure of 43.7 mm Hg of carbon dioxide in nasal breathing compared with the 40.6 mm Hg in oral breathing.

Carbon dioxide levels that go below 35 mm Hg may put you at risk of hypocapnia. This is a state of reduced carbon dioxide in the blood which leads to oxygen starvation. MRI images illustrate decreased activity across the brain due to the lack of carbon dioxide in the system.

Plastic surgeons believe that runner’s face is also common among people who spend most of their time outdoors. A closer look at this condition reveals that the gaunt look is not caused by the exercise, but by loss of facial fat, and excessive exposure to sunlight. Thus, patients with sagging faces can be a concern for any Portland plastic surgeon.

The American Society for Aesthetic Plastic Surgery (ASAPS) noted how this condition can result from free-radical damage on skin. When not hindered by any kind of ultraviolet radiation protection, sunlight bombarding the skind can cause healthy cells to split, resulting in the creation of free radicals. These unstable cells can steal precious energy from healthy cells, which may result in wrinkles and other afflictions.

Even if exposure to sunlight is healthy at the wee hours of the morning, surgeons say the skin will still take some damage from the exposure. One plastic surgeon even remarked this as “a downside of running”. Especially when unprotected, runners often get sunburns on their faces, increasing skin cancer risk.

However, you must never trade the benefits of running for timeless beauty. If you must run in the daylight hours,, never forget to put on sunblock with a Solar Protection Factor (SPF) of at least 30.  It’s also advisable to lose no more than two pounds a week so that the skin has enough time to adjust to the reduction in cutaneous fat. Likewise, formulate your diet to include food rich in lycopene and carotenoids.

In fact, it’s not just running you need to be concerned with. Runner’s face can also occur from  brisk walking, biking, mountain climbing, and other activities. Have your sunblock handy if you are the outdoorsy type.

With this change, we saw the need to add treatment days and expand hours to meet the needs of Dr. David Magilke’s current patients and the ones joining us from Dr. Lee Robinson’s office.

We are fortunate to add Kathy Hodge, RN, to our team.  She will provide consulting and administering injectables and laser treatments on Wednesdays, Thursdays, and Fridays.  Kathy’s past experience as an EMT, trauma surgical nurse and cosmetic injector from Dr. Robinson’s busy office make her the best choice for your injectable needs.

Recent studies show that RN’s can be superior injectors due to their desire and ability to “follow doctor’s orders”.  RN’s tend to spend more time with the patient listening, sympathizing and evaluating the patients needs.  Some like to say female RN’s make better injectors because they have a “woman’s touch”.

We at Portland Face Doctor are happy to now offer Friday’s for laser treatments , injectables, chemical peels, and skin rejuvenation consultations. Julie, Dr. Magilke’s Medical Aesthetician  and Kathy work as a team to provide you with “pre-weekend” treatments.  Take advantage of a Friday afternoon appointment to have the treatment you’ve wanted, but did not have the downtime for!  Just think, treatment on Friday afternoon, recover over the weekend and back to work on Monday.

Ask yourself, “would I take a prescription medication without consulting with a doctor?”  The same question should be asked when deciding to have prescription grade medications injected into your face.

We believe you deserve, experience, quality care, compassion and consistent treatment follow up when choosing the practice to administer prescription medications and treatments.

A new addition to our surgical lasers is the Sciton Erbium Laser used for deep skin resurfacing.  The beauty of this laser is the control that Dr. Magilke has with the depth settings and energy levels.   Each laser resurfacing procedure is personalized to fit the patient’s skin needs whether it is deep wrinkles, poor skin texture, actinic keratoses, scars or sun damage.   Downtime is dependent on the depth of the treatment.  Usually 1 skin resurfacing treatment is needed for excellent result. If downtime is an issue, you may opt to have 2 to 3 less invasive treatments that will have you back to work sooner than the recovery time needed for the deep laser peel.

The Skin Resurfacing Laser Peel may be combined with all surgical procedures provided by Dr. David Magilke, except a rhinoplasty.  The splint needed with a rhinoplasty surgery prohibits the ability for the laser to treat the skin under the splint.  Some patients choose to schedule the resurfacing post surgery.

Skin resurfacing without surgery is performed in the Operating Room under IV sedation to provide maximum patient comfort.

Complete healing will depend largely on the depth of the treatment.  Healing time for shallow treatments is typically 3 to 4 days to resume normal activities. Dr. Magilke will discuss with you the recovery time needed for deeper peels and desired expectations.

Skin resurfacing with the Sciton Erbium laser stimulates the growth of new collagen, which improves the skin’s thickness and resilience.  The skin surface will also re-grow with fresh, healthy cells, which will give your skin a younger rejuvenated fresh appearance.

If you are interested in hearing more about laser skin resurfacing and how it can turn back the clock, call and schedule a consultation with Dr. Magilke, 503-297-6511.

While a few character lines and wrinkles make you appear rustic and trust worthy, looking mad or concerned all the time can be a hindrance.  Who wants to approach a salesman or boss that looks cross?  A resting frown-line really can change the way the world views you – and not always in a good way.

Women have grown up with the awareness that a few beauty secrets can really make a difference in your appearance – whether it is cosmetic surgery, laser procedures or just a small amount of lipstick.  Men often discover cosmetic enhancements later in life – and often are brought into the clinic for the first time by their wives, girlfriends or partners.  However, once the improvement is achieved, men enjoy the benefits of looking friendly, energetic and attractive just as much as women.  And while they might not share their “beauty secrets” in the locker room or on the golf course, most view their treatments as a worthwhile competitive advantage in an ever more competitive social and economic climate.  Maybe a good haircut and a little BOTOX Cosmetic are the new keys to a man’s success!

Ok, I give up.  BOTOX Cosmetic is truly like hair dye. 

And yes, that makes part of my job the equivalent to working as a hair stylist.  The argument goes like this.

1. BOTOX Cosmetic and hair dye are not permanent, so you can always change the way you do it to get the look you want.  If you hate it, you can stop doing it with no long term affects.
2. If it is done right by a skilled professional it looks natural and no one has to know you are doing it.  However, you can also brag to your girlfriends and celebrate your new look.
3. If you keep up a regular schedule, the roots/wrinkles never return – so book your next appointment before you leave.
4. It really is the most reliable and affordable options to seriously take years off your appearance.
5. It is one of the most common beauty secrets among women, and a growing procedure among men.  How many natural blonds with no wrinkles do you know?

The good news is most women love their hair stylist, and that feeling seems to transfer to the doctor providing their BOTOX Cosmetic treatments.   Providing BOTOX Cosmetic treatments between surgeries is rewarding.  It is good to be loved!

(As a side note, Dysport and BOTOX Cosmetic are used interchangeably in our clinic.  Both work very well for smoothing out wrinkles and lines.  I liken the choice to deciding between Diet Coke and Diet Pepsi.  Cheers.)

People visit our clinic to look better – rested, relaxed, happy, youthful.  Relaxing muscles with BOTOX Cosmetic or Dyport gets rid of frown lines, forehead creases, crowsfeet creases around the eyes and even lines around the mouth.  The injections are almost painless and give reliable results if performed by a well trained practitioner.  In our clinic I perform all the injections.  As a surgeon I am confident that I know the anatomy – and it is fun to take credit for something that brings patients joy.   These are the number one cosmetic procedures in the world for a reason.

The Academy Awards is near to our hearts at Portland Laser & Cosmetic Surgery Center.  Last year Restrepo was up for an award for the best documentary of 2010.  The film was by Sebastian Junger and featured a troop of solders in Afganistan.  Misha Pemble-Belkin was one of the main soldiers featured, and is the son-in-law of Karen McConnell – our own patient care coordinator.  It was very exciting in the office, as Misha and Amanda (Karen’s daughter) got to attend the awards and the after parties.  What a great experience for a young couple from Oregon to walk the red carpet and socialize with celebrities.  This year Sebastian Junger was speaking in Portland at the Schnitzer concert hall the week before the awards, and I personally got to meet him.  He is truly an amazing man with a passion for helping those affected by war.

Dr. Magilke, Karen and Sebastian Junger

It is interesting to reflect that many of the advances in plastic surgery were the result of wars.  When faced with devastating injuries, surgeons developed new techniques to restore form and function to the young victims.  Many of these same techniques were the principle on which modern cosmetic procedures were developed.  We really do owe so much to those that serve in times of war.  Hopefully we will always let the veterans in our lives know our gratitude.