SKIN CARE AND REJUVENATION

Younger, healthy skin is an important part of facial rejuvenation.

Plastic surgery operations such as face-lifts are only one part of recapturing a more youthful appearance. The surface of the skin needs to be refreshed, removing fine wrinkles, discoloration and age spots. The right combination of treatments and products will leave the skin looking and feeling smoother, softer, and younger.

Skin products and a skin care program by one of our aestheticians (skin specialists) can be provided on request. We offer medical grade product lines available only in physicians' offices. These products contain various alph-hydroxy acids such as glycolic or lactic acid. Newer products use Vitamin C or A based acids. Examples of some of these companies include: MD Forte, C-Esta, Jan Marini, Renova, Retin-A and Neostrata. These product lines include various combinations of cleansers, exfoliants, sun screens and mild acids to improve your skin. Our aesthetician can perform facials and provide a customized skin care program to let you obtain the best possible result.

Glycolic peels are very light chemical peels done in the office by our skin specialist. Generally a series of six peels is recommended. We suggest follow-up peels every other month to maintain the best results. Skin care products are used in between. These peels leave the skin with the appearance of a sunburn for 2-4 days but does not restrict your normal activities.

Chemical peels in our office generally refer to TCA peels (trichloroacetic acid). These are stronger and deeper than the glycolic peels performed by our aesthetician. The results are quicker and more effective for deeper lines. Small areas can be treated without any anesthesia although larger peels may require local or mild sedation. The superficial skin peels off in 3-5 days leaving light red or pink skin which slowly returns to normal over several weeks. These peels are done by the physicians and will usually require some time off from work for recovery.

Laser peels are used for deeper wrinkles and skin which show greater signs of sun damage and aging. Lighter peels are done with Erbium lasers, however most of the patients requiring skin rejuvenation are best treated with CO2 lasers. See the section on laser peels for more detailed information.

Wrinkle fillers can be used to fill deeper lines, folds and creases of the skin. Examples include: collagen, fat, gortex, and newer products such as softform, autologen, alloderm and dermalogen.

Collagen is the most widely know and used product. It is a substance made from cow (bovine) protein. It comes from the company as Zyplast or Zyderm and lasts approximately 2-4 months. Allergies are unusual but occur in about every 3000 patients and therefore skin testing is required prior to a treatment program. Benefits include it's simplicity of use.

Fat injections use the patient's own fat. There are no allergies or "rejection" problems with this method. Fat may be more permanent although this seems to vary from site to site. With each treatment, the body will generally retain a portion of the improvement and with time the results becomes longer lasting. Each treatment is more involved than collagen as we need to obtain fat from a body site under local anesthesia and then prepare the fat cells prior to use.

Gortex is a synthetic material, which has many medical uses which most recently includes facial plastic surgery. It comes in strands and sheets which can be cut and contoured. It is well accepted by the body with little rejection problem. It is soft with the consistency of foam rubber. It is placed under wrinkles and depressions to raise the skin. Corrections are permanent.

Softform is a synthetic product similar to gortex with similar characteristics.

Autologen is a human collagen implant material made from your own skin. The patients skin may be removed during a cosmetic procedure such as a facelift. It's then sent to the company which processes the tissue and stores it for later use. Tissue can also be obtained at a previous incision site such as a C-section scar. The collagen can be stored for up to one year.

Alloderm is preserved human skin (dermis) which has been medically processed so that it is accepted by the patient's body without rejection. Over time it is replaced by the body's own collagen providing a "natural" permanent result. This product is implanted under the skin with a similar method used for gortex.

Dermalogen is an injectable human substance obtained from donor tissue and processed by a patented method to provide a product similar to dermis (the second layer of the skin). Dermalogen may require two to three treatments over a three-month period followed by less frequent treatments. This product provides another alternative to collagen injections.

Botox is not a filler but is actually a medication that can temporarily weakens muscles which cause wrinkles. It is most commonly used for frown lines, and smile lines (crow's feet). It is frequently used on the forehead and neck. Treatments last 3-8 months but often two or three sessions are needed early on to get a good baseline result similar to the use of collagen. After that touch ups will require less medication are longer intervals. Botox comes from Botulinum Toxin Type A, a neuromuscular blocking agent that has been FDA approved since l989 for the treatment of crossed-eyes, tics, spasms, and other medical conditions. The cosmetic use is not FDA approved, however it has been used widely since about 1990 with excellent results and few complications. The results can be dramatic and may provide the only alternative to surgery for many wrinkles and folds.