Anti Aging

Stop the Drop BEFORE it Happens.

As dermatology advances provide more and more options to reverse some of the effects of aging, those same options are now being wisely used to prevent aging effects. The key element in retaining vital and youthful skin is collagen – both levels and quality. Good quality collagen, in abundant amounts, translates to skin integrity, smoothness and volume, all hallmarks of youth and health.

Collagen Starts Off Running and Slows to a Crawl

Savvy patients realize the key to looking youthful for as long as possible means taking steps to PREVENT the noticeable progression of aging from collagen loss and related volume loss.

Collagen production in your skin slows very early – in fact, neo-collagen production takes a dive in your 20’s! What’s going on “beneath” is often not seen until there is substantial collagen loss.

Treating once you SEE sagging demands a fairly rigorous “catch up” program. Just as you’d not skip maintaining your car until you had an obvious problem, maintaining collagen levels all along is a smart investment in how you will look long-term.

Dr. Nissan Pilest has a high experience level you won’t easily find elsewhere. He has been a trainer and speaker for Allergan injectables, Restylane products and the ever-expanding new range of technologies since their inception. If you want to find out what works, what doesn’t and how to choose the best possible solutions for your concerns, you’ll get the answers here.



Thermage as a Preventive Measure

Thermage’s noninvasive application of radio frequency energy works on two levels

• Tightens Existing Collagen
• Activates New Collagen Production

Collagen that has begun to weaken gets a heat boost that shrinks and tightens. “Lazy” fibroblasts (collagen-making cells) get a wake-up call and go back to work. Over a 6 month period, those new collagen strands provide a tighter skin wrapping.

Periodic re-treatment can keep the positive prevention cycle active, which keeps you looking more like the version of yourself you prefer.

As Dermatology colleague Brandith Irwin notes, “… it helps to prevent sagging over the next year or two. Preserving what you have is still a benefit.”

Collagen Creation Options


  • Thermage heats tissue on the face, eyelids and body to tighten loose collagen strands and spur the development of new, tight, younger collagen.
  • Pelleve uses a gentle heating wand to boost skin temperature to the level of repair. A series treatment, Pelleve is the highest comfort procedure.
  • Microneedling utilizes tiny needle bundles to activate the skin’s response. Microneedling is usually combined with Platelet Rich Plasma to bolster response.
  • RF Microneedling (intensif), though used more for more obvious skin damage or scarring, adds Radio Frequency heat.
  • Aqua Gold delivers a cocktail of skin nourishing serums (and sometimes Botox) to smooth the skin and trigger collagen response (though on a gentle level).
  • Fraxel is an ideal 2-for-1 treatment in that it not only advances collagen build, but smooths the skin and with the Thulium laser, can reduce discoloration and actinic keratoses.
  • Fraxel Repair (CO2 Laser) is the granddaddy of resurfacing and collagen build. High energy levels may mean downtime and a need for managed pain control but the outcomes are dramatic.
  • Sculptra is a bio stimulator and induces new collagen in the skin – an ideal global option for facial recontouring.


We love our patients at Total Dermatology! Read what our satisfied patients have to say about their experiences with Dr. Pilest and our team.

read more

*Individual Results May Vary

Lifting Options

  • Nova Threads are absorbable suture threads placed in the skin to reposition tissue.
  • Silhouette Instalift elevates mid face skin and is often combined with Nova Thread.
  • Voluma and Restylane products such as Defyne or Restylane Lyft provide lift through volume with fillers.

Prevention Plus

More goes into an effective prevention and maintenance program than singular procedures. In addition to heat induction to maintain collagen generation, you also need to protect and nourish your skin.

1. Photoprotection is a key element. Sunscreens and sunblocks go a long way in preventing UV damage that causes wrinkling, loss of elasticity and skin discoloration.
2. Nourishment to the skin involves sticking to a healthy diet and using appropriate products that can keep your skin supple, clear, smooth and translucent. A well-stocked skincare arsenal will include a retinoid or retinol, products with Vitamin C and products with epidermal growth factors.

Take the First Step – Request A Consultation

Schedule your consultation with board-certified dermatologist Dr. Nissan Pilest at Total Dermatology in Irvine, CA today by calling (949) 727-3800

*Individual Results May Vary