10870 Brockway Road
Truckee, CA 96161
Call for an appointment:
Mon/Tues: 9am - 5pm
Wed/Thurs/Fri: 8am - 4pm
Closed Daily: 12pm -1pm Lunch
Dr. Dianne Kamenetsky, MD / Dr. J. Hibler, DO
Medical Services Provided:
• Skin cancer screening and treatment
• Acne evaluation and treatment
• Skin, hair and nail disease evaluation, treatment and education
• Blue Light Photodynamic Therapy treats acne and sun-damaged skin.
Cosmetic Services Provided:
Free with our Nurse Practitioner, Simone Jensen. Explore your options for improving your skin.
A wonderful way to treat someone special. You may purchase gift certificates in any denomination for cosmetic products or services by calling us at 530-550-0440 or emailing us at email@example.com.
You may want to consider Botox if you have noticed any of the following:
- Deep lines between your eyebrows
- People often ask you if you are angry
- Crow's feet around your eyes when you smile
- Fine wrinkles around your lips
- Excessive sweating (hyperhidrosis), of the axillae (armpits), palms and/or soles
What is Botox?
Botox is a purified botulinum toxin, which is used to relax the muscles in the face. Wrinkles result from the repeated contraction of facial muscles, which cause creases in the overlying skin and breakdown of collagen. By relaxing the muscles which are causing the creases, the creases will begin to soften and possibly disappear with time. The muscles which have become overactive will become weaker and habitual frowning, squinting, etc. may become less habitual.
We do not treat our patients with Botox leaving them without expression. You can still smile, look surprised, show enthusiasm, cry and even look angry if you feel the need. Mostly, you will notice that people say you look “rested”.
Botox has an excellent safety record and has been FDA approved for medical conditions in 1989. It was FDA approved for cosmetic use in 2002.
One of the most common uses for Botox is to improve glabellar furrows. These are one or two grooves between the eyebrows which can become permanent from overactive frowning muscles that result in an “angry” appearance.
Botox can also be used to treat wrinkles on the forehead, around the eyes and/or lips. Skilled use of Botox can be used to shape the eyebrows and or treat asymmetry of the face.
Axillae (armpits), palms and soles are common areas treated with Botox for excessive sweat production.
How is it done?
A very fine needle is used to inject the Botox into the targeted muscles. We offer ice packs to be applied prior to injections for a numbing effect and afterwards to help prevent bruising from the injection. Facial treatments take only about 5 minutes to complete.
How long will it last?
The results appear in 3-7 days and usually last 3-4 months. Treatment of hyperhydrosis (sweating) usually causes reduced sweating for 4-6 months and possibly up to 1 year. Treatment may be repeated as needed.
Bruising may occur as with any injection. Please avoid taking aspirin, ibuprofen, or other non-steroid anti-inflammatory medications, vitamin E, fish oil and/or blood thinners in the week prior to treatment to decrease your risk for bruising. If you are taking a prescription blood thinner, please check with your doctor before discontinuing use.
Botox treatments are not advised if:
- You are pregnant or nursing
- You have any neurological disease or a disease called myasthenia gravis
- You are currently taking an aminoglycoside antibiotic, clindamycin or penicillamine
Juvederm XC & Juvederm Voluma XC
Used for facial rejuvenation and augmentation to correct various severities of lines, wrinkles, and folds and to restore facial volume.
You may want to consider a filler if you:
- have facial folds or wrinkles, shallow acne scars and/or loss of facial volume
- want to enhance facial contours or a specific facial feature such as lips or cheeks
Consider a complimentary cosmetic consult if you have never had a filler before. At the time of your treatment, we will discuss which filler is best for your desired look.
What is a filler?
We use the following fillers: Juvederm® XC and Juvederm Voluma® XC.
These are all hyaluronic acid fillers. Hyaluronic acid is a naturally occurring substance found in the body. Injecting these products under the skin creates volume and fullness, and enhances the moisture content of the skin. The result is softening of lines, wrinkles and folds. Lost volume is restored. Allergy testing is not needed prior to using these fillers.
Although the face is most commonly treated, we can also treat the backs of the hands to hide tendons and veins to make them appear more youthful.
Juvederm® XC Filler
Nasolabial foldstreated withJUVEDERM®
Ultra Plus XC Nasolabial foldstreated withJUVEDERM®
Ultra Plus XC Marionette linestreated withJUVEDERM®
Ultra Plus XC
Juvederm Voluma® XC Filler
The first and only FDA-approved filler to correct age-related volume loss in the midface. With optimal treatment, natural-looking results last up to 2 years.
To learn more about Juvederm Voluma® XC, click the link below:
BeforeAfter 1 month
BeforeAfter 1 month
Individual results may vary.
How long will it take?
We apply a topical numbing cream for most injections, which is left on for approximately 30 minutes. The fillers are injected with a series of injections to achieve the desired results. Ice packs are provided to help alleviate swelling and discomfort. Expect to be in the office for at least one hour for facial injections.
How long does it last?
Juvederm® XC usually lasts about 6 to eight months. It may be helpful to have a touch up treatment in 4 months to increase the longevity. Juvederm® Voluma XC can last up to 2 years.
Bruising and swelling can occur which may last up to one week or more. Please do not schedule any important social events for one week after the treatment. Please avoid taking aspirin, ibuprofen, or other non-steroid anti-inflammatory medications, vitamin E, fish oil and/or blood thinners in the week prior to treatment to decrease bruising. If you are taking a prescription blood thinner, please check with your doctor before discontinuing use.
Fraxel Laser re:store
Fraxel re:store laser treatment is a safe, non-invasive laser skin treatment that treats sun damage, wrinkles, acne scars and increased pigmentation.
What is Fraxel re:store?
The Fraxel re:store laser treatment is cleared by the FDA for wrinkles, fine lines around the eyes, age spots/sun spots, acne scars, surgical scars, irregular texture and actinic keratoses (precancerous lesions).
With age and sun damage, your collagen and elastin fibers break down faster than your body can rebuild them. As a result, you skin may start to sag and show damage such as wrinkles, lines, irregular texture and dark spots.
The Fraxel re:store laser uses a fractional technology, which allows the skin to heal quickly. Fraxel re:store produces thousands of tiny but deep columns of laser treatment into the dermis of your skin, creating tiny wounds known as microthermal treatment zones (MTZ’s). This triggers your body’s natural response system to heal those wounds which remodels the collagen and elastin leaving you with tighter, fresher, more youthful-looking skin. Because the treatment is so precise, only a fraction of the skin is treated, leaving the surrounding tissue intact. This allows the quick healing with minimal downtime.
Fraxel re:store can be used to treat all areas of the skin, including face, neck, hands, and body. Commonly treated areas are the entire face, perioral (around the mouth), periorbital (around the eyes), upper/lower eyelids, hands, neck and the chest.
Prepare to spend at least 2 hours with us for a facial treatment. We use a topical numbing agent to make the treatment more comfortable. Treatment times range from 5 minutes for small scars to 45 minutes for the entire face. We can prescribe some oral pain medication. If you choose this option, you will need a ride home.
We typically recommend that you undergo between 3-5 treatments with 2-4 weeks between treatments. For optimal results, it is important to keep your appointments within this time frame. The more treatments, the better the results!
After the laser treatment is done, you will experience a mild sunburn sensation for one to two hours. With this laser treatment, you will have what we call “social downtime” due to swelling and redness. Swelling and redness will vary depending upon your skin and treatment. The swelling and redness begins to subside approximately 2-3 days after your treatment. Your skin will have a slight pinkish tone for five to seven days, which is a normal sign of healing. You may apply makeup or shave soon after treatment. You may experience a bronze appearance to your skin for 3- 14 days and some flaking as your skin naturally exfoliates.
With Fraxel laser treatments you are turning back the clock on aging. You will see improvement for 2-3 months after your treatment series, due to the re-growth of collagen and elastin.
If you take prescription pain medications, you will need a ride home after the treatment.
Keep appointments 2-4 weeks apart for optimum results.
Please let us know if you tend to get cold sores. We can prescribe medication to prevent a cold sore flare after treatments.
Please avoid extreme sun exposure after treatments to improve your results. Your skin will be more sensitive to the sun during the healing phase and for several months after the treatment(s). Wear a UVA/UVB blocking sunscreen with an SPF of 15 and apply twice daily. Apply a moisturizing sun block with zinc oxide and an SPF of at least 30 if sun exposure is unavoidable. For extra protection from the sun, seek shade and use wide brimmed hats.
Accutane is a prescription medication used to treat acne and other skin diseases. This drug may impair the ability of skin to heal following laser treatments or surgery for a variable amount of time, even after you have stopped taking it. Please let us know if you have taken this drug as you need to allow your skin adequate time (at least 6 months) to recover from Accutane before undergoing laser skin treatment.
Iridex Varilite Laser
Iridex Varilite laser treats small red blood vessels and brown spots from sun damage. It can improve redness from rosacea and lighten reddish scars also.
What is the Iridex Varilite Laser?
This laser produces 2 wavelengths of light to treat small blood vessels and brown spots on the skin safely and easily. The laser utilizes heat energy to vaporize and destroy the targeted cells. The body, through the natural healing process, will either eliminate these cells through re-absorption or extrusion (pushing out to the surface).
This laser is primarily used to treat the face, but can also be used on other parts of the body.
We will apply a topical numbing agent for about 15-20 minutes prior to the treatment. The laser feels like a hot pin-pricking sensation and ceases when the laser is stopped. You will wear safety goggles during the procedure. The treatment will take anywhere from 15 minutes to 1 hour depending on how large an area is being treated. You may have some redness from the laser which usually goes away in 2-4 hours. Some mild swelling may also be experienced and may last 1-2 days (more likely to be seen with a more involved treatment). Pigmented spots will turn darker during treatment and will remain visible until the superficial crust, which forms only over the treated spots, falls off naturally 5 to 10 days after the treatment.
The vessels may completely be eliminated or may get smaller. Pigmented lesions may go away entirely or get lighter. Often more than one treatment is necessary, with maintenance follow up visits 1-2 times a year or more frequently if needed. Using sunscreen daily with zinc (SPF of 15 for daily use, SPF of 30 when you are out in the sun) and reapplying every two hours when you are in the sun, will help to maintain your results.
The benefits of this laser treatment are excellent and consistent, with minimal to no discoloration, swelling or complications. This is a simple treatment requiring minimal care before and after.
Treated areas will be slightly red and swollen for a day or two following the procedure. Treated brown spots will be darker for a few days, then peel off. Treated red spots will be slightly scaly for a few days. Although you will be able to continue your daily activites, you may want to plan this around important social events.
If you have small children, please arrange for child care as they cannot be present in the room while the laser treatment is being performed.
Lightsheer Hair Removal Laser
The “gold standard” in hair removal.
Spider veins of the legs are unattractive and embarrassing to many people. The treatment and eradication by sclerotherapy is simple, effective and safe.
What is sclerotherapy?
Sclerotherapy works by injecting an irritating solution into the affected vessels with a tiny needle. The solution irritates the blood vessel lining, making the blood vessel walls stick together and prevents blood from getting through. The vessel then eventually becomes absorbed by your body.
Each treatment session lasts approximately one hour and can be repeated monthly if necessary until desired results are achieved. The number of treatments needed varies with the number of areas that need to be injected and the response to each injection. Bruising and swelling is expected for a few weeks after the treatment. The vessels will slowly fade away over a period of months. It is important to recognize that sclerotherapy does not prevent new spider veins and recurrences can occur over 1-5 years. These can be treated as they occur.
Please do not shave your legs or apply lotion on the day of the treatment.
Wear shorts under a jogging suit to your appointment. If you forget, we can provide you with a pair of disposable shorts to wear during the treatment.
Support stockings should be worn continuously for the first 72 hours and during the day for at least 3 weeks. This is strongly recommended when larger vessels are treated. Long term use of support hose may prevent formation of new small veins. Please purchase stockings prior to your procedure. We carry a limited selection of sizes in our office.
Strenuous activity and standing for prolonged periods of time should be avoided for the first 72 hours after treatment.
Some types of vessels do not respond to treatment. Larger vessels often require treatment by a vascular surgeon.