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Dr. Romano’s “Exquisite Care”
Medical Spa

Injectables and Fillers

Thermage -
Radiofrequency energy
non-invasive skin tightening.

Medical Grade Skin Care
Prescription Strength Skincare Products
Wrinkles & Loose Skin
Skin Textural Irregularities
Stretch Marks
Sensitive Skin

Anti - Aging-
Reversing  external and internal
consequences of age.

Skin Maintenance
Postoperative Skin Care

Stretch Marks

In my office, the spectrum of providing skin care and educating patients are collectively referred to as Skin Fitness. This is a highly customized program, as it needs to be, to address several related factors.

First, a detailed conversation about your impressions of your present skin condition and expectations set the foundation of what we want to achieve together. Next, a careful history is taken that assembles all of your past skin treatments, services, products and results you have obtained from these. Following this, a very thorough skin exam that addresses all aspects of your skin condition and skin health is performed and documented. All this information is then integrated with a discussion of your lifestyle, exercise habits, outdoor activities, work environment and tolerance levels to formulate that special custom program to give you the results you want. In summary, we combine your expectations, history, exam, and lifestyle to formulate your custom Skin Fitness program.

Men have special needs in skin care especially as these may relate to your work and lifestyle. Men generally have larger pores, facial hair that may challenge skin care, and daily shaving that creates its own problems and needs. We understand and address the needs of men.
Your skin care program is designed to give you results in a safe and predictable way. It is designed to delay or prevent the need for plastic surgery and preserve the results of any procedure you may have.


Stretch marks are medically referred to as striae distensae. They were first described in pregnant women in 1773, and the first microscopic description was published in the medical literature in 1889. The site of striae development varies somewhat with the causative factors and gender but usually follows our skin fold and cleavage lines. Irrespective of cause or location on the body, a consensus exists on the clinical course of striae. First, a raised red papular eruption is seen. Next, striae rubrae develop and are the early characteristic flat, pink lesions. Over time, the lesions mature, widen, lengthen, and change to a purplish color. The final stage, striae albae are the white, depressed, well-circumscribed lesions that gradually become more flesh colored or white with time. We treat all stages of stretch marks in my practice.


In your examination there may exist any degree of stretch mark development, color, and distribution. They will exist in different areas and are not necessarily related to stretching of skin. Stretch marks represent collagen type (“scar”) tissue that is interspersed between normal skin. For this reason they cannot always be removed, but usually can be shrunk or changed from red to flesh colored. Program Basics and Overview
This is the basic outline for treatment of stretch marks. It relies on the principles of exfoliating aggressively the upper skin cell layers then application of topical products that cause contraction and narrowing of stretch marks, and improvement of color. Your improvement will depend on the degree and location of stretch marks and your monitored degree of improvement on the program.

  1. Start:
    1. Microdermabrasion treatment. This is to mostly to exfoliate and prepare the skin and scar for better penetration of products.
    2. Ultrasound treatment. This is done at the same time to further enhance penetration of products.
    3. Product recommendations. This depends on the nature of your stretch marks but these are products for decreasing inflammation and enhancing quick healing if your stretch marks are early and red. If stretch marks are mature, we choose products that contract and tighten to fade and narrow the stretch marks.
  2. 4 weeks:
    1. Second Microdermabrasion in combination with Ultrasound Treatment to further increase the effects described above.
    2. Intensify the products home program. This is done according to your degree of improvement and usually involves stronger product or more products on the areas. This is where we often add Retin-A.
  3. 8 weeks:
    1. Third Microdermabrasion in combination with Ultrasound Treatment
    2. Adjust and continue products.
  4. Maintenance:
    1. Products
    2. Treatments as indicated according to your degree of improvement.









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Botox , Cellulite / Fat Reduction, Injectable Fillers,
Skin Peels / Facials, Microdermabrasion, Laser Hair Removal, Laser Skin Resurfacing Laser Vein Treatment

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Dr. James Romano, M.D.
San Francisco Plastic & Reconstructive Surgery
1650 Jackson St., Suite 101, San Francisco CA 94109