The document discusses cosmetic dermatology and skin aging. It covers the anatomy of skin, the causes of intrinsic and extrinsic aging, clinical signs of aging and photodamaged skin. It also summarizes treatments for photodamage including chemical peels, fillers, botulinum toxin, lasers and the importance of sun protection and lifestyle factors in skin health.

1. Cosmetic Dermatology in Primary Care

13. Photodamaged Skin

20. Protect

29. Sunscreen

32. Peels

35. Types of Peels

51. Collagen Lip Augmentation

53. Juvederm

54. Juvederm before

55. Juvederm after

57. Marionette before

58. After 3 months

59. Nasolabial before

60. After 3 months

61. Cheeks before

62. After 3 months

64. Before Sculptra

65. Sculptra after 3 treatments

66. Lasers

77. Before

78. After 2 months

80. Before After 8 treatments

82. Ablative & Non-Ablative Skin Resurfacing CONFIDENTIAL Palomar Medical Technologies, Inc.

83. Mechanism of Light-induced Skin Rejuvenation Light absorption by tissue water Inflammatory response Release of inflammatory mediators into dermal interstitium Stimulation of fibroblast activity Increase of collagen production and proliferation of keratynocytes Limited thermal damage CONFIDENTIAL Palomar Medical Technologies, Inc.

85. Lux1540 Fractional ™ Laser for Texture, Wrinkles and Acne Scars CONFIDENTIAL Palomar Medical Technologies, Inc.

86. Lux 1540 Fractional Photos courtesy of Dr. Dwight Scarborough Pre Tx 1 Immediately After Tx 1 1 Week after Tx 1 8 Weeks after Tx 1

87. 6 weeks post tx #2 @50 MJ Pre-TX Aesthetica Cosmetic & Laser Center David B. Vasily, M.D. Lux1540 Fractional™ CONFIDENTIAL Palomar Medical Technologies, Inc.

88. Tiffani Hamilton, MD Lux 1540 Fractional ™ PreTx 1 PostTx 2

89. Lux 1540 Fractional™ PreTx 1 3 WeeksPost 2 tx CONFIDENTIAL Palomar Medical Technologies, Inc

90. Lux 1540 Fractional™ Stan Kovak MD-2 Weeks Post 4 TXs Post 4 Treatments w/o Botox

91. Lux 1540 Fractional™ 2 weeks Post 1 st Treatment Pre-Treatment CONFIDENTIAL Palomar Medical Technologies, Inc. Post-Treatment

93. Thermage before After 3 months

94. Titan before & after

95. Titan before & after

98. Stop Smoking!