As we age, our faces begin to show the effects of gravity and sun exposure. Years of facial muscle movements like smiling, chewing and squinting result in creases in our skin much like folding a piece of paper repeatedly along the same line does. Collagen which keeps our skin looking youthful and plumped up begins to break down causing laugh lines, smile lines, crow's feet or facial creases over the areas where muscle movements occur. Soft tissue fillers, most commonly collagen and fat, can help fill in these lines and creases thereby restoring the face of a patient to a smoother and more youthful appearance. When injected beneath the skin, fillers plump up creased and sunken areas of the face. They can also add fullness to sullen and sunken cheeks and lips thereby correcting the lines of thinning lips and old age. Fillers also smooth out the step-offs that can occur between the lower eyelids and cheeks over time. Soft tissue fillers in conjunction with other plastic surgery procedures like laser skin resurfacing or chemical peels or eyelid surgeries and face lifts benefit patients. The most important fact to remember about injectable fillers is that the results are not permanent. The body eventually metabolizes injected materials. In some individuals, the effects of injected fillers last only a few months, while in others the results remain indefinitely. Researchers believe that age, genetic make up and skin quality may all play a role in the staying power of injected materials. Collagen is a naturally occurring element that supports various parts of the human body: skin, joints, bones and ligaments. A doctor injects collagen using a fine needle inserted to several points along the edge of the treatment site. Some physicians administer some local anesthesia so that the injections are not painful.

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Concierge medicine goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. By any name, concierge medicine is the solution for doctors trying to maintain their integrity and independence in today’s difficult healthcare environment. Concierge medicine is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most concierge physicians continue to receive reimbursements from health plans and private pay clients. Concierge medicine is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design. The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all concierge medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged.