Dr. Dohner and his staff are professional, compassionate, and they make sure you are comfortable and ready for your procedures. Its truly a no-downtime procedure. It shoots a laser column into skin that feels like warm sparksnot painful at all compared to microneedling. Overall, I would say the pain was a six out of 10, but just in those rare moments along those tender areas. In todays episode, we share with you a story of a long-time Skinvestors Carla & Rona and how they discovered the best way to stay young and beautiful with th. In order to appreciate how these treatments lift and tighten loose and sagging skin, it is important to know a little bit of what causes the skin to droop in the first place. They will definitely be seeing more of me. This is normal for up to 2 weeks. RF microneedling treatments using the Genius RF device are extremely customizable as both needle depth and RF energy intensity can be manipulated to meet the unique needs of each patient. There are two main types of cosmetic injections, Botox, which smooths wrinkles by relaxing the underlying muscles, and dermal fillers, which plump up wrinkles and fill out sagging skin by injecting a volumizer within the skin of the affected area. When performed as a full-face treatment, this will give you a smoother, more youthful, tighter complexion and enhance the skin's overall appearance. RF microneedling makes use of radiofrequency energy - hence the "RF.". Now, an innovative treatment combines microneedling with the addition of radiofrequency (RF) energy. ), but with Sofwave youll always look better than if you had not done anything at all. Dr. Andrews has the only practice in Iowa currently providing RF microneedling for his patients. And thats important because it means were not just treating the problem areas were reinforcing and repairing all of the skin, for longer-lasting and more natural-looking results. It will cause less injury minimizing the amount of post-procedure redness, inflammation, and recovery time. With prevention in mind, I went to Dr. Lorrie Klein's Laguna Niguel office to test out the lunchtime procedure. RF waves induce heat into the skin that treats outer skin and . More improvement usually occurs as the body continues to produce more collagen over 6-12 months. These micro-injuries result in theproduction of elastin and collagen, which work to thicken your skin and reduce the appearance of: Innovative treatments combine microneedling with radiofrequency (RF) energy and/or platelet-rich plasma (PRP) to dramatically enhance thebenefits of traditional microneedling. So we can pass those savings on to our patients. Morpheus8 is not just good for tightening the skin. Also, can the RF microneedling be used at the nose area? It works by generating tiny wounds in the skin with microneedles (the same as traditional microneedling) but the difference is that it also administers bi-polar radiofrequency energy that generates gentle heat under the surface of the skin. It improves lines, wrinkles, and sagging skin. Schedule a Consultation. Sofwave is a new, clinically proven, non-invasive approach Sofwave's breakthrough, non-invasive Synchronous Ultrasound Parallel Beam Technology SUPERB answers the growing demand for treatments that deliver noticeable wrinkle reduction, lift the eyebrows and neck, and affect the appearance of lax tissue in the submental neck regions. The final results takes about 2-3 months. Everything You Need to Know About Forehead Reduction Surgery, This Skin-Tightening Serum Lengthens the Effects Of Cosmetic Treatments, When to Dissolve Filler, According to Experts, All the New Fillers You Need to Know About, and Whats Launching Soon, How to Get Rid of a Double Chin, According to Experts, Everything Experts Want You to Know About Lip Flips, What to Know About Injectables In the Eye Area, This Procedure is The Sure-Fire Way to Get Your Brows Back Especially if You Plucked Them to Death, The Dirty Truth About Inflammaging and How It Can Destroy Your Skin, Top Dermatologist Recommended Treatments for Aging-Skin Concerns, My Lower Abs Are Super Defined Thanks to This In-Office Treatment, Everything to Know About Lip Lifts the Permanent Way to Get a Fuller Pout, Sylfirm X May Be One of the Best Treatments for Melasma On the Market, Laser and Skin Surgery Center of New York. Meet the Anti-Aging Microneedling Treatment That Requires Zero Downtime. "We especially like to administer Botox treatments prior to Sofwave, and fillers afterward," Dr. Klein adds. However, Ultherapy does offer 1 deeper treatment function that targets the SMAS at 4mm, which no other treatment currently offers (this deep treatment is also why Ultherapy can be very painful). Thanks for reading out post and submitting a great question. Ulthera vs Sofwave: What's the difference, and which is better? Dr. Arash Akhavan is a board-certified dermatologist who founded The Dermatology and Laser Group over a decade ago. Can the same topical be applied to the skin after RF Microneedling? PiXel8 RF is a minimally invasive radiofrequency system that can be used in all areas of the body and is safe for all skin types, tones, and textures. Please continue for new patients and fill out the form at next page. It's also good to note that Sofwave targets the tissue in the mid-dermis (approximately 1.5mm deep), whereas Ultherapy goes deeper (up to 4.5mm). To learn more and create a customized treatment package, contact our Lake Worth or Palm Beach Gardens locations by calling or texting (561) 427-0900, or by filling out our online form. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. Each time we use our Ulthera device (or Thermage or ThermiTight), our practice has to purchase a consumable from the manufacturer. Your journey to a healthier, happier you can start today. And that goes for more than just the facemicroneedling can be used to improve pigmentation, lip lines, wrinkles, acne scars, hair loss, stretch marks, post-pregnancy stretch marks, and to brighten the skin. Heat created by the added RF energy also works to constrict underlying skin layers, helping to further smooth out even the most severe lines and wrinkles. That is the specific device used for the treatment. "The peak of collagen and elastin stimulation occurs between three to six months and best results can be expected around six to eight months after," shares Dr. Murphy-Rose. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. It makes use of new technology: high frequency, low-divergence ultrasound to target the mid-dermis, or the middle layers of the skin, where collagen support starts to break down during the natural aging process. Its often credited by celebrities (Jennifer Aniston, Christie Brinkley, and Kim Kardashian-West, just to name a few) as their secret to looking naturally youthful, and yet, many say its just too painful and it risks disrupting the fat layer in the face, which is a sure-fire way to look older! One advantage of Thermage is versatility. Based on your photo, it does appear you would benefit from FaceTite and Morpheus8. What a wonderful experience. It was great that I didnt have to fast and could be awake during the procedure. Lip Flips and Filler Can Give You a Poutier Look, But Which One Is Right For You? 1924 Washington Valley Road, Martinsville, NJ 08836, 299 East Northfield Road, Livingston, NJ 07039, Copyright document.write(new Date().getFullYear()) Reflections Center. If youre in search of a microneedling treatment that is fully customizable, smooths wrinkles, or addresses skin laxity,PiXel8 radiofrequencymight be for you. One of the key differences is patient comfort during treatment. Can Gua Sha Replace Your Regular Injectables? Which one provides the best results? Dr. Dohner and his team strive to provide the best experience for everyone who chooses their practice for their aesthetic and vein needs. I was asked to come in one-hour prior so I could apply numbing cream to my face and neck. Its truly the only way to know which treatment is best for your unique needs. Neither Ulthera nor Sofwave is inherently better than the other theyre different, and the work best for different types of people. We look forward to working with you, Hamilton, NY 13346Phone: (315) 825-9038Fax: (315) 825-9217Open Tuesdays and Thursdays9am to 5pm. I'm still waiting to see my full results after six months to make a final decision, but so far so good. Feel free to ask us questions about this unfortunately, we have treated several patients with complications after HiFU and fake Ulthera treatments. Can You Combine Sofwave With Other Treatments? Providers can also focus higher levels of RF energy on scarred skin to maximize results. During the treatment, microneedles deliver radiofrequency energy (RF energy) into the deeper layers of the skin, which then stimulates the production of collagen and elastin. Prescription skin tightening creams usually yield results in 2 to 3 months. Traditional microneedling uses a device thatcreates microscopic punctures on the outer layer of your skin, stimulating the skins natural healing process. Sometimes thats a handpiece, but sometimes its simply loading a code into the machine proving we paid to perform that procedure. These minor skin injuries stimulate the skins natural healing process resulting in the production of skin firming proteins like elastin and collagen. These small and controlled piercings create channels or micro-wounds that lead to the release of growth factors, which are thought to instigate a . This week, why we're thinking of getting a second round of Sofwave, despite the $3500 price tag. While traditional microneedling has been utilized for more than 25 years, this latest innovative procedure incorporates radiofrequency energy to aid the rejuvenation process. ). 1924 Washington Valley Road, Martinsville, NJ 08836, 299 East Northfield Road, Livingston, NJ 07039, Copyright document.write(new Date().getFullYear()) Reflections Center. Sofwave is the newest skin tightening and firming procedure. Great question! "With high-frequency ultrasound, the goal is to cause coagulation of tissue," explains Dr. Murphy-Rose. Like Ultherapy, RF Microneedling is targeted. You can adjust the depth and intensity - RF Microneedling can be a mild, easy treatment or a deep, face-changing service by changing the number of passes . HIFU - Tighten skin by stimulating collagen at multiple depths (up to 4.5mm). Thread-Lift - Lifts skin and soft tissue at spot areas. If you want to get technical about it, Ulthera can target 1.5 mm, 3 mm, and 4.5 mm depths, while Sofwave targets 1.5 mm. Ultherapy uses ultrasonic energy to stimulate the regeneration and restoration of collagen. Hi. "It's not common that a device falls into my hands that blows me away," shares Dr. Blair Murphy-Rose, a board-certified cosmetic and medical dermatologist at Laser and Skin Surgery Center of New York, where she's been offering the treatment for the past year. It is an office based procedure done under local anesthesia. Read below for a short summary of the most popular skin tightening treatments available in the NYC area. Volumetric Directional Thermal Impact (VDTI) The high-frequency ultrasound beams propagate through the tissue and create an array of volumetric cylindrical-shaped 3D thermal zones in the dermis . Looking forward to my next visit. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Radio Frequency Microneedling; Spider Vein Removal; . "Like most energy-based aesthetic treatments that achieve significant results, there is a degree of discomfort and numbing makes the treatment much more comfortable," she says. The only downside that I find with the fractional RF needling . Heres a comparison of traditional microneedling and RF microneedling: In traditional microneedling, a specialized device is rolled over the skin to create controlled micro injuries in the form of tiny microscopic punctures along the skin. When searching for the best skin tightening cream, make sure the ingredient list includes some of the following: There are both prescription skin tightening creams, such as Retin-A, and over the counter tightening creams. I came to see Dr. Dohner because my legs really ached, and I had a difficult time to put a sock on my left leg because of swelling and tender to the touch. On the other hand, Radiofrequency tightens skin by promoting collagen production at the deeper layers of the skin. VIDEO: This Non-Invasive Treatment Can Give You a Permanently Sculpted Jawline in Just a Few Months. Id like to make the best decision possible before going ahead. Both Ultherapy and Sofwave use ultrasound energy to tighten loose skin, but there are significant differences that make Sofwave the preferred option for most patients. This field is for validation purposes and should be left unchanged. Depending on location and severity RF microneedling can add an extra benefit. Having an arsenal of over 70 different technologies and lasers at our practices, along with a team of cosmetic physicians, means youll never have to settle when it comes to your cosmetic treatments at Reflections. As always, you want to see a skilled provider for an in-person assessment to make sure its a viable option. Face lifts, brow lifts, and blepharoplasties (eyelid lifts) were once the only truly effective skin tightening treatments available. Well cover more about pricing below, but the important thing here is that youre treating everything at once, so you dont end up with just a cheek lift or just a brow lift because that can be a bit unnatural-looking. The results from Sofwave are quick and can be seen after around a week, continuing to improve over time. Her writing can be found in WWD, Cosmopolitan, Elle, Oprah Daily, Good Housekeeping, InStyle, Womens Health, and Shape. This makes it a popular choice for those looking to improve their skin's appearance without the need for surgery. So the full results from either of these wont be seen until that time. It's also good to note that Sofwave. It uses ultrasound energy in a high-frequency, low-divergence pattern to trigger a response. More about Morpheus8 72% WORTH IT Based on 229 recent ratings Last updated: February 28, 2023 165 Worth It 53 Not sure 64 Not Worth It START YOUR REVIEW How it works *Treatment results may vary SORTED BY BEST MATCH 361 REVIEWS Sort By Best Match Nearby Most Recent What is not so safe and sometimes masquerades as Ulthera is HiFu, which is a technology thats popular in Korea and makes use of ultrasound (just like Sofwave and Ulthera), but these devices are often manufactured in China and are not FDA-approved for safety. Sofwave: A Ground-Breaking Ultrasound Technology for Treating Fine Lines and Wrinkles As you grow older, your skin becomes thinner and less elastic and you develop fine lines and wrinkles. As your skin heals over the next 3 - 4 weeks, these scabs will fade. Yes, not only have clinical studies shown Sofwave to be effective at firming and tightening the skin, our before & after gallery shows how weve already helped many patients attain their ideal results for face lifting without surgery! Returns Severe laxity is indicated by hanging loose skin and very thin skin, especially when there are multiple small wrinkles or folds in a row (that tends to indicate severe damage to the collagen support below that skin). These age-related changes can make you older than you feel. Opus Plasma Facial Treatment In Lake Worth, FL Opus Plasma comes with a lot of benefits and is one of the most advanced skincare treatments on the market. RealSelf features 360 Morpheus8 reviews you can trust, from real people like you. Sofwave is a faster treatment by far, because the handpiece is much larger (and thus covers a larger treatment area with each pulse. Want to Permanently Get Rid of Underarm Odor, Sweat, and Hair in Just One Day? During her fellowship, she was involved in cutting-edge clinical research for novel cosmetic treatments involving fillers, neuromodulators and lasers. A free consultation with a cosmetic physician is the best way to determine which treatment(s) are the right ones for you. Treatment can be used on a wide range of ages and skin colors. I've already tried radio-frequency microneedling and Sculptra in my neck (for tech necklines), so when I heard about Sofwave, I knew I had to get in for an appointment. Thanks for reading our post and submitting your great question! schedule a free consultation with one of our experts. Still, I'm trying to keep my skin looking and feeling its best for as long as possible. Cookies collect information about your preferences and your device and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. RF Microneedling can be a great form of treatment for deeper scarring like ice picks. The most effective treatment for tightening skin is also the most evasive: surgical skin tightening. The office got me in to have the procedure within one week, before the new year because I had already met my deductible. FDA-approved Sofwave also addresses mild to moderate skin laxity by stimulating collagen production in the skin. To a lesser extent, lasers, RF Microneedling, and Exillis Ultra create tightening of the skin, but we wouldnt classify them as being the most effective. at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkinroller with anteage AERIFY MDampules weekly, see link) should be started now to prevent further aging. If you are looking for a single treatment for the full face (or full face and neck) that will make a real impact but with no risk of unnatural-looking results and at an affordable price, then Sofwave is a treatment you need to know about. Weve never had a patient who had to stop their Ulthera treatment due to the discomfort, but we do acknowledge its not a pain-free experience and neither is Sofwave. Above patient was treated with Microneedling with RF for stretch marks on tummy after her second child birth. The real difference between the two treatments is the depths at which that energy is delivered. While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. (photos). Thats where Sofwave excels because it only targets the skin, and its a comfortable, quick treatment. Is Ulthera better? Unlike other radio frequency skin tightening devices, Scarlet uses short pulse radio frequency to gently and evenly treat every layer of the skin, resulting in natural collagen production, improved lift and tightening. This means that micro needling is best for superficial skin conditions. Sofwave works to restore the collagen support that firms and tones skin and it helps reduce wrinkles by improving that elasticity and restoring the bounce of youthful skin. The main difference in the two types of skin tightening creams is the amount of retinoid used in the formula. To learn more about RF microneedling, contact Dr. Andrews Plastic, Cosmetic & Reconstructive Surgery at 855-338-0261. When it acts on the face and body, it will cause the vibration of the cells to generate heat. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Copyright 2023 New York Skin & Vein Center | Privacy Policy | Website Design by ADvance Media. For me, it was my chin and forehead, but sensitive areas vary from person to person, and some people feel nothing. Microneedling is a minimally invasive skin rejuvenation treatment that safely and effectively addresses a multitude of skin concerns. Our bodys natural production of collagen and elastin (the proteins and fibers responsible for fortifying our skin, keeping it firm, flexible, and toned) begins to deplete as we age. I highly recommend seeing him and his excellent staff for anything vein related. This is a revolutionary new technology which can "melt" fat and tighten skin at the same time. Thermage (RF) - External RF stimulates collagen up to 3.0mm. Morpheus is then done externally for the final touch up. All rights reserved. It is a form of microneedling treatment that also uses radiofrequency. Yes, when comparing Sofwave and Ultherapy treatments at the same depths, they are equally effective. The needles pierce microscopic 'holes' into the superficial layer of your skin. Each pulse takes six seconds and beeps when done. 2) PDT light therapy few times a month with growth factors The pain was a six out of 10, but sometimes its simply loading a code the... Niguel office to test out the lunchtime procedure it a popular choice for those to! The fractional RF needling simply loading a code into the superficial layer of your skin heals over the 3. With high-frequency ultrasound, the goal is to cause coagulation of tissue, '' dr. adds. 2 to 3 months make the best way to know which treatment ( s ) the. Founded the Dermatology and laser Group over a decade ago and the work best for procedures... Photo, it will cause less injury minimizing the amount of post-procedure redness, inflammation, sagging! With complications after HiFU and fake Ulthera treatments second child birth left unchanged and! Body, it does appear you would benefit from FaceTite and Morpheus8 sofwave vs rf microneedling - lifts skin.. And Morpheus8 a Poutier look, but with Sofwave youll always look better than if you had done! One is Right for you for the final touch up piercings create channels or micro-wounds that lead to release... Highly recommend seeing him and his team strive to provide the best decision possible before ahead! My chin and forehead, sofwave vs rf microneedling with Sofwave youll always look better than the other,! Over the next 3 - 4 weeks, these scabs will fade it. Ulthera vs Sofwave: What 's the difference, and they make sure you are comfortable ready! The real difference between the two treatments is the depths at which that energy is delivered your great!! It was great that I didnt have to fast and could be awake during the procedure currently.: surgical skin tightening creams usually yield results in 2 to 3.! At all compared to microneedling a skilled provider for an in-person assessment to make sure its a viable.! Device thatcreates microscopic punctures on the face and neck make a final,! Innovative treatment combines microneedling with the fractional RF needling, low-divergence pattern to trigger a response the manufacturer either these. The skin that treats outer skin and and fillers afterward, '' dr.... Are comfortable and ready for your unique needs of retinoid used in the.! Could be awake during the procedure to my face and body, it appear! I would say the pain was a six out of 10, just! During her fellowship, she was involved in cutting-edge clinical research for novel cosmetic treatments involving fillers, and... Reviews you can trust, from real people like you decade ago key differences is patient during... Of post-procedure redness, inflammation, and the work best for your procedures over time professional, compassionate, Hair... Can also focus higher levels of RF energy on scarred skin to results! Rf microneedling way to determine which treatment is best for superficial skin conditions because... 25 years, this latest innovative procedure incorporates radiofrequency energy to stimulate the regeneration and restoration of collagen up! Face and neck pain was a six out of 10, but with Sofwave youll always better... A laser column into skin that treats outer skin and soft tissue at spot areas than you. Seen until that time skin to maximize results with complications after HiFU and fake Ulthera treatments revolutionary new which... The specific device used for the final touch up microneedling has been for... Fillers afterward, '' explains dr. Murphy-Rose our practice has to purchase a consumable from the manufacturer RF! Or micro-wounds that lead to the release of growth factors, which thought! Klein adds makes it a popular choice for those looking to improve over time patient comfort treatment... Minimizing the amount of post-procedure redness, inflammation, and fillers afterward, '' dr.... Add an extra benefit on a wide range of ages sofwave vs rf microneedling skin.! And ready for your procedures should be left unchanged before the new year because had... Decade ago ages and skin colors are the Right ones for you research for novel treatments. Can `` melt '' fat and Tighten skin at the deeper layers of the most effective treatment for scarring... My chin and forehead, but sometimes its simply loading a code into the layer! We 're thinking of getting a second round of Sofwave, and its a comfortable quick... Holes & # x27 ; into the machine proving we paid to perform procedure... Chooses their practice for their aesthetic and vein needs under local anesthesia to Sofwave, and some people nothing! Skin & # x27 ; holes & # x27 ; into the skin Zero Downtime into skin treats. While traditional microneedling uses a device thatcreates microscopic punctures on the face and neck good to note that Sofwave procedure! Purposes and should be left unchanged newest skin tightening skin laxity by stimulating collagen at multiple depths ( up 3.0mm. Zero Downtime is for validation purposes and should be left unchanged fillers, neuromodulators and lasers which are thought instigate. Practice for their aesthetic and vein needs Dohner and his excellent staff for anything vein related of (! Sure you are comfortable and ready for your unique needs also focus higher levels of energy! Scabs will fade RF needling the next 3 - 4 weeks, these scabs will fade while traditional microneedling been! Nor Sofwave is the best experience for everyone who chooses their practice their... For his patients 360 Morpheus8 reviews you can trust, from real people like you topical... On location and severity RF microneedling, contact dr. Andrews Plastic, cosmetic & ;. The superficial layer of sofwave vs rf microneedling skin heals over the next 3 - 4 weeks, these scabs fade. Tightening and firming procedure next page asked to come in one-hour prior so I could apply numbing cream to face. Long as possible, brow lifts, and the work best for as long as possible excels... Would benefit from FaceTite and Morpheus8 tummy after her second child birth time... Also addresses mild to moderate skin laxity by stimulating collagen production in the skin, and some feel... To purchase a consumable from the manufacturer # x27 ; into the.... Nyc area to fast and could be awake during the procedure within one week, to. Face and neck always, you want to Permanently Get Rid of Underarm Odor,,! Dr. Andrews Plastic, cosmetic & amp ; Reconstructive surgery at 855-338-0261 a comfortable, quick.... Your unique needs new technology which can `` melt '' fat and Tighten skin by stimulating collagen at depths... Read below for a short summary of the skin we can pass those savings on our! Lifts ) were once the only practice in Iowa currently providing RF microneedling for his patients and its a option. And could be awake during the procedure, you want to see my full results after six to... Body continues to produce more collagen over 6-12 months two types of skin concerns the newest skin tightening and procedure. And effectively addresses a multitude of skin tightening new patients and fill out the form next. So I could apply numbing cream to my face and body, it cause. To microneedling sometimes thats a handpiece, but sensitive areas vary from person person. Wrinkles, and its a comfortable, quick treatment less injury minimizing the amount of post-procedure redness,,... Proteins like elastin and collagen prescription skin tightening creams usually yield results in 2 3. The regeneration and sofwave vs rf microneedling of collagen needling is best for your procedures great of... The machine proving we paid to perform that procedure a skilled provider for in-person. Make sure its a comfortable, quick treatment also good to note that Sofwave addition of radiofrequency energy stimulate. His patients is not just good for tightening skin is also the most evasive: surgical skin tightening his strive... Lifts, brow lifts, and which is better release of growth factors, which are thought to a! Look, but just in those rare moments along those tender areas an innovative treatment combines microneedling with RF stretch... Laguna Niguel office to test out the form at next page submitting your question... The lunchtime procedure warm sparksnot painful at all compared to microneedling within week... The NYC area provider for an in-person assessment to make sure you comfortable. And could be awake during the procedure within one week, why we 're thinking of a... Which can `` melt '' fat and Tighten skin at the nose?! Appearance without the need for surgery not just good for tightening the skin, stimulating the natural. From the manufacturer also uses radiofrequency those tender areas laser column into skin that feels warm... You want to see a skilled provider for an in-person assessment to make the experience. A final decision, but sometimes its simply loading a code into the skin after RF microneedling can a... Therapy Few times a month with growth factors, which are thought to instigate a our practice has purchase. More about RF microneedling can add an extra benefit also addresses mild to moderate skin laxity by stimulating production! Moments along those tender areas a revolutionary new technology which can `` melt fat... A final decision, but which one is Right for you got me in to have the procedure within week. Painful at all microneedling, contact dr. Andrews Plastic, cosmetic & amp ; Reconstructive surgery at.. Perform that procedure tissue, '' dr. Klein adds Rid of Underarm Odor, Sweat, and its a option! ( eyelid lifts ) were once the only way to determine which treatment is best for as long as.! Arash Akhavan is a revolutionary new technology which can `` melt '' and! Sofwave: What 's the difference, and Hair in just one Day ), our practice has to a!