Possible Delays

We regret that Stephanie Jeffrey has accepted a position at Virginia Adult and Pediatric Allergy and Asthma effective March 21, 2008.  This change has caused significant delays in patient appointments and we request your patience during the month of April, while we reorganize to ensure continuity of care for her established patients.  Feel free to ask the receptionist if we are running behind.

AAOA Fellowship

At its September 2007 annual meeting, the American Academy of Otolaryngic Allergy granted fellowship status to Dr. Michael Armstrong.  The academy is the primary educational and research organization for otolaryngologists (ear, nose and throat specialists) dedicated to the quality care of patients with allergic diseases.  All otolaryngologists are trained in the diagnosis and treatment of allergic diseases of the ears, nose, sinuses, larynx and trachea, as well as immunologic diseases of the ears, salivary gland, thyroid and lymphatic system.   

The American Board of Otolaryngology is an ABMS-accredited examination that includes in its annual examination questions relating to allergy and immunology of the head and neck.   Fellowship status in Otolaryngic Allergy requires additional post-residency continuing education over a five-year course of prescribed study.  The application further requires the submission of personal case reports for peer review and culminates in a five-hour written and oral examination that is similar in scope and content to medical board examinations. Training and examination in otolaryngic allergy includes the study of immunology, skin testing and immunotherapy, food allergies, nasal allergies and asthma.   Fellowship in the American Academy of Otolaryngic Allergy is your assurance that Dr. Armstrong cares enough to provide you with the very best care for your nose and sinuses. 

Our nurse practitioner, Stephanie Jeffrey, also has years of experience in allergy and asthma management.  She has trained not only with Dr. Armstrong but also with several general allergists in the community.  We offer skin testing and immunotherapy for patients with nasal allergy.  For the convenience of small children who require surgery, skin testing is often offered under anesthesia. Sublingual allergy drops are available for those who do not have time to come to the office for weekly injections or for those who prefer treatment without needles. For your safety, all allergy testing and services are provided under direct physician supervision.  If you have any concerns about sinusitis, nasal allergy or asthma, please discuss this at your next office visit. 

Botox and Fillers

Need a lift, or just want to get pumped up?

On September 19, 2007 at the American Academy of Facial Plastic and Reconstructive Surgery in Washington, DC, an entire afternoon course was devoted to minimally invasive procedures such as injectable techniques to replace lost facial volume due to aging.  For many years, the concept of a facelift has been to remove skin and pull the soft tissues upward and backward toward the ears.  Eyelid surgery has frequently involved removal of bulging fat pads. 

In recent years, cosmetic surgeons have recognized that loss of volume is a significant component of facial aging.  Silicone injections were discontinued because of complications.  Collagen injections were popular for many years to replace lost volume in the lips and creases, but collagen required skin testing to exclude allergy and rarely lasted longer than three months, requiring frequent re-injection. The availability of Restylane in recent years has more than doubled the durability of facial injections and has rejuvenated the use of injectable fillers in the face.  Until recently, long term fillers have not been available in the United States. 

Two products that have been widely used in Europe and Canada are now available under the trade names Radiesse and Sculptra.  These products have recently become available in the United States and are rapidly gaining popularity.  Both have durability greater than one year.  Sensitivity to these products is extremely rare and none of these requires pretreatment skin testing.  Risks of injection include momentary discomfort and potential for bruising and a small possibility of visibility, lumpiness or other disappointment in the cosmetic result. 

The most permanent filler available is your own fat.  The recent availability of smaller and better designed liposuction and injection cannulae has improved our ability to transfer fat from the thighs or abdomen up to the face.  Techniques now allow very delicate injections within and around the eyelids, cheeks, lips and mouth creases. The smaller more delicate injections have significantly increased precision, smoothness and success rates.  Smaller fat grafts receive a new blood supply more quickly and are more likely to survive permanently. 

Although there is some resorption with any type of tissue graft, fat that survives for 3-4 months is likely to survive permanently.  For many patients, these fat grafts can provide dramatic rejuvenation that is more attractive and much less invasive than traditional facelift procedures.  If you look back at some old photos of your younger days, you probably will not see a gaunt, wind-blown face with hollowed out eyes.  Most likely you will see full, rounded cheeks and a softness of facial features.  Autologous fat grafting may be the single best treatment to restore this appearance.  If you would like to discuss this procedure or have any concerns about the appearance of your face or neck, please discuss this with your provider at the next office visit. 

Back to Top >>