THIRD QUARTER 2000, VOLUME 14, NO 3

Various procedures for skin rejuvenation and which one is best for you

IN THIS ISSUE

Fun in the sun with protection and care

Various procedures for skin rejuvenation and which one is best for you

Ask the surgeon

Lip augmentation found to be a trendy new procedure

With so many choices available for helping your skin to achieve a youthful, healthy appearance, it may be easy to be confused. What procedure is right for my skin type? What is the most effective, permanent treatment for my skin? The following information provides key facts about the procedures available to you.

Chemical peels

Chemical peels are used to improve the appearance of the skin by removing the outermost layers so that new, regenerated skin can appear. Depending upon the type and strength of chemical used, peels vary in intensity and depth. Your facial plastic surgeon may choose to use a combination of chemicals to tailor the treatment specifically to your skin type and its needs.

Dermabrasion

Standard dermabrasion is a procedure where a rotating brush mechanically sands the top layers of the skin to treat deep scars, severe sun damage, or uneven skin color. The underlying dermal layer is exposed and promotes the production of collagen. The process takes from minutes to hours depending on the extent and may use a local anesthetic and sedative. A gentler variation is called micro-dermabrasion; this process uses microscopic crystals made of aluminum oxide that pass over the skin to buff superficial skin irregularities. This procedure can rejuvenate any skin type and can be used in combination with other cosmetic procedures .

Fillers

As we age, facial expressions such as squinting, frowning, and smiling produce creases in our face. Soft tissue fillers may be used to plump up the skin and give it a smoother and more pleasing appearance. Filler substances include collagen, autologous fat, and polymer implants; they are either injected under the skin or surgically placed.

Another treatment to improve wrinkles associated with facial expressions is Botulinum Toxin, or Botox. The Botox injection relaxes the facial muscles so they cannot contract or cause wrinkles. Botox does not improve wrinkles due to aging or sun-damaged skin since these conditions are unrelated to facial muscle contractions. However, Botox is an effective, unobtrusive method to treat expression lines that lasts from three to six months.

Laser Resurfacing

Lasers work by producing an intense beam of bright light that removes layers of the skin. The intensity of the laser treatment depends on the purpose for resurfacing and the desired outcome by the patient and physician. The laser is an attractive option because the procedure is relatively bloodless, uses a precise instrument, and can be used in combination with other rejuvenating procedures. There are three different lasers currently available: the carbon dioxide (CO2) laser, the Erbium: YAG laser, and the cool touch laser.

The CO2 laser is used for deep wrinkles and skin imperfections. It is the most powerful of the three lasers. The YAG laser is gentler and may be used for providing a smooth texture. The Cool Touch laser is a new procedure that treats fine lines and wrinkles without burning of the skin. The procedure may take one to two hours (depending on area and extensiveness) and may include a topical anesthetic with mild sedation, or a monitored intravenous sedation. There is little discomfort both during the procedure and throughout the recovery phase. Following treatment, the areas are kept moist with ointment or surgical bandages for the first few days. The resurfaced area must be protected from the sun.

If you are looking for a more youthful appearance and are considering skin rejuvenation, make an appointment to see your facial plastic surgeon. He or she will be able to tell you what procedure or combination of procedures is best for your skin.

Types of peels

AHA Peels
A mild chemical solution, alphahydroxy acid (AHA) includes glycolic, lactic, or fruit acids that lightly peel the skin. The purpose is to smooth rough, dry skin. The AHA peel is performed in the doctor’s office, takes 10 to 15 minutes, and can be repeated weekly. There may be temporary reddening or dryness, but patients usually resume normal activities right away.

TCA Chemical Peel
Trichloroacetic acid (TCA) is applied to the skin and penetrates into the dermis, the second layer of the skin. This peel treats moderate sun damage, fine lines, weathered skin, and pigment problems. The chemical application takes 10 to 15 minutes with a sedative; recovery involves moderate discomfort and mild swelling for about a week. The TCA peel is often repeated over a period of weeks and effects smoother, fresher looking skin.

Phenol Chemical Peel
For extensive, coarse wrinkling, marked discoloration, or scarring, a phenol chemical peel may be used. The phenol peel is the strongest of the chemical solutions and causes a deep peel. The carbolic acid is applied in a one to two hour procedure, with the patient sedated. The convalescence is uncomfortable, with the treated area being red for two weeks. The phenol peel results in permanently lighter, more even, and tighter skin.