Acne is an outbreak on the skin which is due to the blockage and subsequent infection of the skin's pores or follicles. It may also affect the sebaceous glands from over-production of oil. Acne can be non-inflammatory, inflammatory or a combination of both. Non-inflammatory acne consists of whiteheads and blackheads whereas papules, pustules, nodules and cysts are all characteristics of inflammatory acne. Acne is most common on the face, neck and back but can be present on the upper extremities. Acne is estimated to affect 75% of all teenagers and young adults. Although not as common, acne can also affect adults in their 30s and 40s.

Our state-of-the-art acne reduction treatment consists of a laser treatment from the Emax system powered by elôs, a Syneron technology. elôs offers the safest, most effective non-ablative medical technology available for treating acne. The combined energies of natural photodynamic therapy (blue spectrum), infrared light and radiofrequency enable highly selective targeting of the sebaceous glands and acne bacteria. Infrared and RF energies reduce sebaceous gland activity while blue light destroys acne. These two gentle pulses of targeted elôs energies mean better results and higher levels of safety and comfort. We also use FDA approved prescription strength Obagi CLENZIderm M.D. acne treatment products in combination with elôs for patients with more difficult acne. Obagi CLENZIderm M.D. has been proven in clinical trials to outperform all other benzoyl peroxide products and to provide an effective treatment for acne in as little as two weeks.

Treatments are done twice a week for 4-6 weeks. After your initial series of treatments, a maintenance program is recommended to maintain your results.

Elôs laser treatments take approximately 15 - 30 minutes.

You may note the sensation of a “hot pinch” or “snapping” feeling. This lasts for a fraction of a second, followed by a feeling of warmth or a tingling sensation for a short time afterward. Although we do make a topical anesthetic available to our patients, most do not feel the need to use it.

Every patient responds differently but most patients report that they notice improvement as early as three weeks after beginning the treatment series.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

We use the Matrix Heating system, a laser treatment powered by elôs to treat fine lines in addition to superficial and deep wrinkles. We effectively reduce and eliminate fine lines and wrinkles on the surface and penetrate deep into the skin to treat more prominent wrinkles. Through elôs, the intersection of RF current and light energies (the Matrix) creates a focused energy at a precise depth for stimulating collagen production and rejuvenating the skin. This enhanced collagen production produces a firming effect in lax skin.

Wrinkle reduction is one of the three treatments included in facial renewal. In addition to reducing fine lines and wrinkles, facial renewal targets color correction (skin rejuvenation) and skin tightening for the face and neck. When wrinkle reduction is the focus of treatment, the overall treatment period is longer.

Our skin rejuvenation treatment includes the patented prescription strength Obagi skin care line as stand alone products or in combination with elôs technology. Obagi skin care products are clinically proven to reduce hyperpigmentation and effects of sun damage, make skin more radiant, stimulate the production of collagen for reducing fine lines and wrinkles and produce an even skin tone with improved skin balance and structure.

Elôs treatment is very safe. The safety of this technology is well documented. Similar applications using electricity and lights have been used in medical, surgical and aesthetic treatments for decades without any adverse effects.

Most patients find the treatments gentle and not unpleasant. The Matrix IR treatment head has a built-in cooling treatment tip that helps to insure the patient's comfort. If you feel the need for numbing medication, we provide topical anesthetic cream and external cooling to increase your comfort level.

Wrinkle Reduction Treatments are every three weeks for a total of fifteen weeks. Maintenance sessions are recommended following initial treatment. The average treatment takes less than 30 minutes. If your wrinkle reduction treatment is part of the full facial renewal, the time to complete each session is 40-60 minutes with an additional 15-30 minutes for treating your neck.

Most people see a gradual and continual improvement over the course of their treatments. You will notice a steady improvement with each treatment.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

Radiesse is an injectable filler for the face and hands that restores a youthful looking skin in about an hour. Radiesse reduces facial wrinkles and pronouced nasolabial folds that contribute to an aged appearance.

Generally, Radiesse is effective for about a year.

Your Radiesse treatment takes less than an hour. It is an ideal lunch time procedure as there is no downtime and side effects are rare.

Radiesse actually stimulates your own body's production of collagen in areas where the injections are given. Collagen keeps your skin young looking by contributing to its strength and elasticity. With aging, a reduction of collagen is associated with the development of wrinkles.

BOTOX® Cosmetic is the purified protein produced by the Clostridium botulinum bacterium. Tiny amounts of BOTOX are injected into specific facial muscles responsible for frown lines, forehead lines and crow's feet. The result is a significant reduction in fine lines and wrinkles in injected facial areas for up to four months.

People who have brow wrinkles, crow’s feet and facial forehead lines may be good candidates for BOTOX. Patients who should not receive BOTOX include those with a history of muscular and nervous disorders, allergies to any botulinum toxin product, asthma or emphysema, swallowing problems, facial weaknesses, eyelid drooping or bleeding problems. Other conditions where BOTOX should be avoided include a recent antibiotic injection, impending surgery, during pregnancy and while breast feeding. BOTOX should be not be used in those who have received another botulinum toxin product in the last four months or in people taking over-the-counter and prescribed muscle relaxants, allergy, cold and sleep medications.

During 2005, over 3.3 million BOTOX® Cosmetic procedures were performed. In BOTOX clinical trials, approximately 90% of men and women reported a significant improvement one month following treatment.

Since 2002, BOTOX has been FDA approved for the treatment of frown lines in people between the ages of 18 and 65. This approval followed extensive clinical trials for safety and effectiveness. Prior to using BOTOX, a health screening is essential for determining medications and medical history that would make BOTOX use unsafe. This screening and the actual BOTOX treatment should only be provided by a skilled and trained medical professional

Expect a consultation by a medical professional to obtain health information, verify your suitability for BOTOX, and determine your goals for treatment and the exact muscles to be injected. Although BOTOX injections are not painful, you may receive a topical anesthetic to increase your comfort during treatment. Several tiny injections of BOTOX® Cosmetic will be given in facial muscles associated with your lines and wrinkles that are part of your treatment plan. Immediately following your treatment, you can resume your normal activities. A marked improvement is generally seen within days but may continue as long as a month. Treatments can last up to 4 months.

Side effects with BOTOX® Cosmetic are uncommon but some are serious with potential life threatening consequences. Problems affecting breathing, speaking or swallowing are a medical emergency and should be treated by calling 911 to activate the EMS. Such problems may occur hours to weeks following an infection of BOTOX® Cosmetic. Less serious side effects that are temporary and minor include pain at the site of injections, fatigue, headaches, neck pain, visual problems, dry mouth and allergic reactions. Rarely, the injected Botox solution can migrate from the treatment site and affect other areas of the face. This can result in unwanted “drooping” which resolves over time.

Cellulite is a dimpled appearance of the skin which is predominantly on the abdomen, thighs and buttocks of women.

More than 80% of women over the age of 20, regardless of their weight or size, are affected by cellulite.

VelaShape is the first non-surgical, non-invasive, no down time cellulite reduction system that is FDA approved. It is completely safe and has been proven effective in reducing the appearance of cellulite and re-contouring the body. VelaShape is a medical device that reduces the appearance of cellulite through a new technology called elos, short for electro-optical synergy. This breakthrough technology combines four kind of energy, working together at the same time. VelaShape can reduce the appearance of cellulite and re-contour problem areas of the body. Best of all, VelaShape is a completely non-invasive treatment option that is highly effective.

VelaShape can work for you. The best candidates are women who are in good health and practice good health habits. You must be prepared to commit to the full regimen of two treatments a week for 6-8 weeks, as well as a follow up maintenance program.

VelaShape is not a weight loss tool. However, many patients look and feel as though they've lost weight because their bodies are better proportioned and more contoured than before.

Some patients report skin tightening, improved circulation, decreased muscle aches and pains and overall better health.

A healthy lifestyle will support and maintain the improvements made by the VelaShape. Prior to each treatment, please remove all body oils, shave body hair over targeted areas or use a body scrub to ensure clean skin.

You will feel a deep, soothing heat in the targeted area. Patients have compared the feeling of the treatment to the sensation of finishing an intense workout or a deep tissue massage.

Treatment Schedule Initial number of treatments is 12-16. Treatments are 2 x per week with a maintenance treatment every 1-2 months or as needed. The duration of each treatment session is 45 minutes to 1 hour.

Call to arrange a free consultation. Any other questions that you have about VelaShape will be answered at that time.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

Facial Renewal is an innovative FDA approved non-surgical treatment that uses 3 applications of elôs technology in a single visit for color correction, skin tightening and wrinkle reduction.

These three elôs technologies combine and direct Bi-Polar Radio Frequency and Laser/Light energy to precise treatment areas that improve superficial and deeper layers of the skin. The three treatments include color correction, skin tightening and wrinkle reduction.

All three treatments are provided in a single office visit with a total of three - five office visits required for full facial renewal.

The time to complete each session consisting of three treatments is 40-60 minutes. An additional 15-30 minutes is required for treating the neck. Three - five sessions are spaced three to four weeks apart. One maintenance session is recommended every six months.

Although the procedure is well tolerated with little complaints of pain, we provide a topical anesthetic cream to increase your comfort. Most patients are able to resume normal activities immediately following their treatment.

These treatments are FDA approved and considered safe and effective for most skin types and colors.

Although you will notice some improvements immediately after your first session, you will continue to experience a gradual improvement throughout and following the treatment period.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

Elôs (electro-optical synergy) uses a unique combination of radio-frequency and light to isolate the treatment area and leave the surrounding skin free from potentially harmful side effects. Using gentle pulses of two targeted energies means better results with lower overall energy output. This assures the highest level of safety and comfort. elos uses Vortex Heating to target and damage the hair follicle. The Vortex is created when the RF current, the destructive energy, encircles and heats the hair follicle. This damages the follicle itself and not just the hair shaft. Treatment with elos technology also brings you healthier-looking skin with no downtime, no pain and without other invasive procedures.

Because this unique elôs technology uses two energy sources combined, Radio-Frequency and Light, lower, safer energy levels are necessary to get superior, reliable results. elos requires lower overall energy levels for superior results and maximum safety. Most people experience no side effects at all, though a few exhibit some short-term local reddening of the surrounding skin. Treatments require no patient downtime.

Elôs is a proprietary technology of Syneron Medical Ltd, located in Israel. Syneron operates wholly owned sales, service and support subsidiaries in North America (Syneron Inc., in Toronto, Canada) and Europe (Syneron GmbH, in Grunwald, Germany). Syneron develops, manufactures and markets medical devices for a wide array of medical aesthetic applications.

Elôs uses a method of hair removal that involves targeting and damaging the hair follicle rather than just the hair shaft. Over a series of several treatments, this is highly effective in permanent destruction of the hair follicle, preventing re-growth of hair. However, in certain cases, a patient may experience some recurrence and require additional treatments. That is why we offer half price treatments for one year after concluding the initial four treatment sessions.

Elôs Hair Removal is Color Blind Hair Removal. The RF of elôs technology (RF and Light) means safe hair removal of all colors (including white, gray, red and blonde)-from all skin types, including tanned skin.

Treatment with elôs produces a slight tingling feeling, and on the most sensitive areas of the skin, patients may only feel a quick, light pinch. JVAI routinely applies a topical anesthetic (numbing cream) 30 minutes prior to the procedure to assure the comfort of our patients. Additionally we use SynerCoolâ„¢ during the procedure. This cold air skin cooling at -32°C significantly improves patient comfort during aesthetic procedures and reduces redness.

elôs hair removal treatments are done in our office. Prior to treatment you will receive a comprehensive skin assessment and medical skin evaluation. This evaluation determines unique characteristics and requirements for your skin type, hair qualities and areas of treatment. Thirty minutes prior to each treatment, we will apply a topical anesthetic (numbing cream) to the skin being treated. Once the procedure begins, the treatment area is covered with a very thin layer of non-gel, aqueous RF conductive medium. This conducts the RF current into your skin efficiently. The hand piece of elôs device is dynamically cooled to help protect your skin. Once the RF conductive medium has been applied, then the body part is treated with a gentle pulse of light and Radio-Frequency energy. Each treatment takes about 30 minutes. There is no downtime and no pain and patients can resume their normal activities immediately following the treatment.

Six to eight treatments are generally performed every 8-12 weeks for arms, legs and back with maintenance treatments once or twice per year. Four to six treatments are needed for facial hair removal with an additional four maintenance treatments per year. A total of six bikini and axillary hair removal treatments are needed and spaced every 4-8 weeks with maintenance once or twice per year. Treatments are dependent on individual factors that are discussed with you during your initial consultation.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

Skin rejuvenation refers to color correction that reduces or eliminates imperfections on the skin such as brown spots, red blotches and rough texture. The goal is to create a smooth, even skin tone and texture.

We use the elôs laser system to direct gentle light and electrical energies to problem areas on the skin. elôs restores the skin to a more even, balanced and youthful state. Through elôs technology, we are able to reduce and eliminate brown spots from sun damage and aging, red blotchiness from spider veins or Rosacea and rough skin texture.

Our skin rejuvenation treatment includes two medical grade advanced skincare product lines available by prescription. We use FDA approved Obagi skincare as stand alone products or in combination with elôs technology. Obagi skin care products are clinically proven to reduce hyperpigmentation and effects of sun damage, make skin more radiant, stimulate the production of collagen for reducing fine lines and wrinkles and produce an even skin tone with improved skin balance and structure. We also use Biopelle AFA daily skin rejuvenation products. These offer an ideal stand alone rejuvenation skincare program or compliment for our AFA In-Office Facial Chemical Peels.

Elôs treatment is very safe. The safety of this technology is well documented. Similar applications using electricity and lights have been used in medical, surgical and aesthetic treatments for decades without any adverse effects.

Most patients tell us that they do not feel anything. If you are uncomfortable, topical anesthetic cream and external cooling can be used to increase your comfort level.

Most people see a gradual and continual improvement over the course of their treatments. Just as it took years to produce damage to your skin, it will take some time to repair that damage. You will notice a steady improvement with each treatment.

Three - five sessions are spaced three to four weeks apart. One maintenance session is recommended every six months. The time to complete each session is 40-60 minutes but may be longer if additional treatments are provided.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

Spider veins are a common, mild and medically insignificant variation of varicose veins. They are thin thread-like veins that lie close to the skin's surface. Spider veins are bright red to blue in color. They can be found on the legs and feet as well as other areas of the body such as the face, neck and dacolletage. Smaller spider veins typically seen on the nose, chin, cheeks and dacolletage are commonly due to rosacea and sun damage. Larger spider veins are commonly seen on the temples and at the edge of the jaw line. Typically, none of these veins cause pain and are usually treated for cosmetic reasons only.

Spider veins are thread-like veins close to the surface of the skin. Varicose veins are gnarled, enlarged veins which commonly are found on the feet and legs. Unlike spider veins which are only a cosmetic concern, varicose veins can be a sign of underlying venous disease. Spider veins have no associated symptoms. Varicose veins on the other hand, can cause symptoms that may include leg pain, heaviness and aching. Spider veins need to be evaluated at a medical esthetics office. Varicose veins should be evaluated by a vein treatment specialist.

Many factors may play a role in the development of spider veins. Heredity and trauma can influence the occurrence of spider veins. Hormonal influences during pregnancy are another contributing factor. Spider veins increase in incidence with advancing age.

Today, many providers treat spider veins with a laser, sclerotherapy, or a combination of both. Sclerotherapy is a rather simple procedure of injecting spider veins with an agent that causes them to collapse. Lasers are a safe and highly effective treatment for those veins too small to inject. Laser treatment offers an alternative non-invasive approach to vascular treatment.

We perform laser and sclerotherapy for the treatment of spider veins at the Joyce Vein & Aesthetics Institute. This is an office procedure and no hospitalization is required. Each treatment may be 30-60 minutes.

After treatment, spider veins are no longer visible. Although there is no scarring from the treatment, lasers and sclerotherapy may cause some temporary brownish splotches which fade in a few months.

Most patients require one to three treatments. A consultation is needed to evaluate each patient's situation and to formulate an appropriate plan.

Women of any age may be good candidates for sclerotherapy, but most are in the 30-60 age range. Spider veins related to pregnancy will usually disappear spontaneously a few months after the birth of the baby. Make an appointment with our clinician to evaluate your suitability for spider vein treatment.

There are no side effects that will limit your activities after treatment. You can return to work or your daily schedule immediately following treatments.

When valves in the veins become incompetent, high-pressure blood from the deep system flows towards the skin and produces high blood pressure of the surface veins. Distention of the veins over time produces varicose veins. It also increases the pressure in the smaller veins causing these to stretch and become very prominent. When these are just under the skin, they are known as spider veins. The increase pressure causes the small veins to leak fluid into the surrounding tissues resulting in swelling or edema followed by discoloration. The high pressure is also transmitted to the smallest veins that lie near the capillary beds. This makes it difficult for blood to flow across the smallest vessels or capillaries, thus disrupting the exchange of nutrients and wastes in this area. The tissues of the leg respond by thickening of the skin and finally by ulceration. A serious consequence of this type of vascular disease is Infection of the skin or cellulitis.

Most ulcers of the lower legs and serious venous disease are caused by incompetence of perforator veins in the calf. These incompetent veins generally occur on the inside of the ankle. Ultrasound scans performed at our facility almost always show incompetent perforator veins lying beneath the leg ulcer. The answer to chronic venous insufficiency with all its related symptoms is to remove the dysfunctional perforator veins. Dr. Joyce began was a leader in using the SEPS procedure to treat perforator disease in 1998. Approximately 94% of leg ulcers were completely healed with SEPS. Over the past several years, Dr. Joyce has pioneered the use of laser ablation and VNUS radiofrequency closure to treat incompetent venous perforators in the office setting. These less invasive office procedures have proved to be highly effective and well tolerated. These new technologies can be performed under local anesthesia within our office setting. They have now replaced the SEPS operation for the treatment of perforator disease. Post-operatively, over 99% of leg ulcers treated with these methods heal completely within several months.

Spider veins appear just under the skin. They are caused by abnormal venous blood flow resulting in an increased pressure in these smaller veins, causing them to stretch and become prominent.

Spider veins may be one of the first signs of venous disease.

Treatment of spider veins with a 940 nm pulsed diode laser is an extremely efficient way of removing these unsightly veins. The laser actually passes directly through the skin and spider vein wall to vaporize the blood within the spider vein. This destroys the internal vessel wall, which leads to obliteration of the spider vein. The spider veins turn red and gradually disappear over the next 2-3 weeks. The treatment is well tolerated and results in minimum scarring and discoloration. Saline injections also destroy the internal vessel wall but have a much higher chance of leaving permanent discoloration.

When the valves in the veins cease to function, gravity can reverse the vein flow and move the blood back towards the feet when the leg is at rest. This restricts venous drainage and results in increased blood pressure in the surface veins of the leg. Over time, this causes the veins to distend, producing varicose veins and leads to more serious venous disease.

For the most part, varicose veins are not dangerous. However, large varicose veins can lead to very slow blood movement through the dilated vessel. Blood has a natural tendency to clot when it is moving very slowly, making it more likely for blood clots to form and lodge within the vein. This condition is called thrombophlebitis or simply phlebitis. If present only in the superficial veins under the skin, it is not dangerous and usually will respond to moist heat and elevation. If the clot extends into the deep venous system, it is considered dangerous and therapy with blood thinning medications is recommended.

There are many reasons why veins dilate and become incompetent. Age is a primary factor. As we become older, the elastic walls of the veins slowly wear out and are damaged by overstretching. Veins are also dilated by certain occupations that require standing for prolonged periods producing venous stasis. Nurses, auto mechanics, store personnel and waitresses are examples. In women, pregnancy plays a major role. The increased pressure in the lower abdomen during pregnancy makes it difficult for the veins of the legs to drain and creates back pressure in the leg veins. This back pressure dilates the veins and is responsible for the varicose veins that are often seen during and after pregnancy.

Vein stripping is an outdated surgical treatment for chronic venous insufficiency. Patients present with symptoms of the leg that may include swelling, pain, prominent varicose veins and skin discoloration which can eventually produce ulceration. Vein stripping almost always involves removal of the greater saphenous vein which lies along the inside of the thigh and lower leg. The vein stripping procedure is associated with a long and painful convalescence. An incision is made in the groin to tie off and divide the top of the vein. A vein stripper is then inserted into the vein. It is generally pushed through the vein above the knee and brought through the skin by a second incision. A small stripping device is then connected to the stripper and it is pulled back through the leg tearing the vein out with it. Pressure is then applied to the leg to reduce bleeding. This procedure is uncomfortable for the patient postoperatively and may result in bruising under the skin that can take months to completely resolve.

Yes. At JVAI we utilize endoluminal laser ablation of the saphenous vein or ELAS. In this procedure a small diameter laser filament is inserted into the vein through a needle puncture. This is done right in our office with minimal anesthesia. The laser filament is connected to a laser system that closes off the greater saphenous vein from the inside. There is very little trauma to the leg and almost no bruising. Postoperative discomfort is minimal. Patient satisfaction is high. In fact, patients who have had vein stripping of the other leg have stated that they wish they had waited until this laser technology was available before having their previous procedure.

The heart pumps blood into the arterial system. It travels to the legs under pressure through a system of arteries that becomes smaller and smaller as it progresses towards the tissues. Oxygen and nutrient transfer and waste removal is carried out through the smallest arteries called capillaries. The blood is then returned through tiny veins that become progressively larger as they move away from the tissue and drain towards the heart. The heart does not pump blood out of the legs. Blood is moved through the veins by contraction of the muscles around them. As each vein is compressed, the blood moves in one direction towards the heart. This one-way flow is maintained by valves located at intervals along the vein. The valves only allow the blood to flow one way, back towards the heart for re-circulation.

Venous disease, also called chronic venous insufficiency, is a chronic disease that produces symptoms in the patient's legs that may include swelling, pain, prominent varicose veins, skin discoloration, ulceration and infection.

Patients with venous disease of the legs have specific complaints and symptoms that may include: <ul> <li> Tired, aching legs, usually best in the morning and worse during the day especially after prolonged standing or sitting.</li> <li> Intolerance to exercise</li> <li> Leg discoloration, thickening and ulcers that are difficult to heal.</li> <li> Spider veins, varicose veins and leg swelling from venous stasis.</li> </ul>

Most of the vein problems are due to increased pressure in the venous system. This is actually high blood pressure of the veins located under the skin. This increased pressure is caused by malfunction of the valves that lie within the veins, causing the veins to dilate. When the veins become dilated, the valves, which are attached to the sidewalls, are pulled apart. They no longer are able to maintain one-way flow and prevent blood from draining back toward the feet. These leaking veins are called incompetent.

Patients come from all parts of the country to benefit from Dr. Joyce's superior knowledge and experience in performing vein treatment procedures. Dr. Joyce is an innovator - always on the cutting edge of medical advancements that offer his patients the best possible outcome while affording them safety, comfort, convenience and affordable care. Almost a decade ago, Dr. Joyce became increasingly aware of numerous patients with a poor quality of life who suffered from misdiagnosis and mismanagement of venous disease. This prompted him to shift his focus from the practice of open heart and trauma medicine to vein treatment. In an attempt to explore the best treatment options for venous disease, he was one the first physicians to meet and train with the developers of the SEPS Procedure when it was just becoming known. At that time, Dr. Joyce had approximately 30 patients with chronic venous insufficiency with unhealed leg ulcers. He contacted them, performed a specialized ultrasound exam and determined that most were good candidates for the SEPS Procedure. Post-operatively, over 94% of those patient's ulcers healed completely within several months. Over time, Dr. Joyce became a leader in performing the SEPS procedure. He is credited with the highest volume of SEPS surgeries in Florida and one of the two highest volumes in the entire country. In spite of that success, his interest in continually improving the quality of his services prompted him to pioneer two new technologies, laser ablation and VNUS radiofrequency closure for treating incompetent venous perforators in the office setting. He has found that most patients can benefit from these less invasive office procedures as an alternative to SEPS procedures that have proved to be highly effective and well tolerated.