Dr. Janelle Vega, MD

Dr. Vega emphasizes that the sun is responsible for up to 80-90% of skin aging and sun damage is cumulative, leading to thinning skin, brown spots, easy bruising, and crepey skin over time. She believes prevention is the best medicine and strongly recommends enjoying the sun responsibly. Daily SPF is considered the single most evidence-backed thing you can do for your skin, preventing collagen breakdown, pigment issues, fine lines, and most importantly, reducing the risk of skin cancer, including melanoma. Cosmetic benefits are a positive side effect, but prevention is the primary purpose. She recommends applying broad-spectrum SPF 30 or higher every morning, reapplying every two hours outdoors (sooner with sweat or water), and specifically covering neglected areas like the back of the neck, ears, and hairline, where she often observes advanced photodamage and precancerous lesions. She notes that applying sunscreen takes only 15 seconds and costs almost nothing. For those prone to redness or melasma, mineral sunscreen is recommended. Practical tips include using a stick sunscreen for reapplication over makeup, wearing wraparound sunglasses (as eyelids are common sites for skin cancer and crepey texture), and using a visor or wide-brimmed hat for driving and midday outdoor activities. She also recommends UV-filtering window tint, as UVA radiation passes through untreated glass, leading to more photoaging on the driver's side of the face.

Dr. Vega emphasizes that achieving a sharper jawline is rarely about adding volume directly to the jaw. Instead, it involves rebuilding structure, often by placing product deep on the bone along the mandibular border for some patients. Balancing the chin in profile is crucial to ensure a continuous line from ear to chin and a clean transition into the neck. When done correctly, results are subtle; others might just assume you've been sleeping better, without identifying what was treated. Results are visible on the same day and fully settled at two weeks.

Sculptra is a collagen stimulator, not a traditional filler, that rebuilds facial structure gradually over weeks to months. This gradual process makes it difficult for others to identify that a cosmetic procedure has been performed. Dr. Vega uses Sculptra yearly to help maintain facial structure. It's important to note that Sculptra's apparent ineffectiveness can be due to significant weight loss changing the facial structure it was meant to support. Active weight loss, particularly with GLP-1 medications, removes facial fat, which can counteract the structural support Sculptra provides. The product continues to work, but it's 'working against a moving target.' As a benchmark, if you're losing weight and your face looks the same or better (not worse), you're on the right track. Dr. Vega's general rule for Sculptra dosage in the context of weight loss is approximately 1 vial for every 10 lbs lost, intended to maintain current facial volume rather than add new volume.

Dr. Vega considers neuromodulators the most reliable method for preventing expression lines. They work by softening these lines before they become permanently etched into the skin. She uses neuromodulators on both the face and neck.

Dr. Vega performs yearly radiofrequency treatments for skin tightening and remodeling, which work from the inside out. Patients can expect slow, steady, and beautifully natural-looking results.

Dr. Vega offers laser resurfacing, which she considers the single biggest quality upgrade for your skin. It is effective for improving skin texture, tone, fine lines, and scarring.

Dr. Vega uses pigment lasers, including Pico, BBL, and IPL, to treat sun damage, brown spots, and redness. She finds them particularly valuable for patients living in Miami due to the prevalence of sun damage.

Dr. Vega emphasizes that every treatment plan is customized to the individual patient. She warns against treatments that promise to replace multiple advanced procedures for a very low cost, stating that the skill of the practitioner and the quality of the device used are more critical factors than the treatment name. She advises that what is appropriate for her patients may not be right for others, and always recommends consulting a board-certified dermatologist.

Dr. Vega believes the true measure of aesthetic treatment success is observing a patient's aging process over a significant period, through various life events. Her philosophy is to achieve the art of aging well, rather than creating the illusion of not aging at all. She prefers patients to look age-appropriate and maintain their natural appearance, ensuring they still look entirely like themselves. This approach involves consistent, intentional, medically guided aesthetic care over many years, typically resulting in a quiet transformation rather than a dramatic one. Facial balancing, skin texture correction, and overall aesthetic improvement require time, maintenance, and trust, with the approach varying for each individual. Improvements are attributed to changes in skin quality and structural support, not solely to individual products or syringes. Excellent and consistent photography is essential for effectively tracking a patient's aesthetic journey over time.

Dr. Vega emphasizes that consistent skincare, even if imperfect (e.g., 90% adherence), will always outperform a perfect routine that is not maintained. She advises that a minimal routine consisting of a wipe and one good cream is always better than falling asleep with a full face of makeup, which can lead to clogged pores, irritation, and a compromised skin barrier. While this minimal routine is not her 'gold standard,' she personally uses it on nights when she is exhausted. She recommends this simplified nighttime routine (wipe, one good cream, lights out) for those nights when you're just too tired for a full regimen.