Smooth, fresh facial skin - it's the promise of countless beauty products and salon services. However, no product on the market is able to match the results that can be achieved in your plastic surgeon's office.
Today, there are a variety of options available for people seeking smooth, healthy-looking facial skin. Some treatments work best for fine lines, blemishes and sun damage; other procedures are better suited for wrinkles, scars and deeper imperfections. Many treatments require little or no "down time" for recovery or healing.
Your board-certified plastic surgeon is a skin-care expert who has training and experience with a variety of skin-revitalizing and resurfacing treatments. It could be that a combination of techniques rather than one single method will give you the best results. Your face is the most visible part of your body; it's important to find a qualified doctor who can offer you options and choices.
In this brochure, you will find basic information about skin revitalizing treatments, such as specially formulated creams, Retin-A®, microdermabrasion and light chemical peels. You will also learn about skin resurfacing with deeper chemical peel and dermabrasion. However, the best way to get complete answers to specific questions that relate to your needs is to have a personal consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
What types of conditions can be treated?
Men and women of all ages may benefit from skin-revitalizing treatments or resurfacing procedures. Your skin type or characteristics may make you a better candidate for one method rather than another. However, your surgeon can offer treatment options for any of the following conditions:
- wrinkled or sun-damaged skin
- vertical wrinkles around the mouth that cause "lipstick bleed"
- brown spots or blotches
- superficial blemishes
- facial scars caused by chicken pox or acne
- uneven pigmentation
- skin growths
- enlarged or oily pores
You should be extra cautious in selecting a skin treatment if any of the following applies to you:
- you are prone to abnormal scarring
- you frequently develop allergic rashes or other skin reactions
- you frequently get fever blisters or cold sores
- you are pregnant or nursing a baby
- you have been treated with Accutane®, (isotretinoin) within the past 12 months
What should I expect from the consultation?
A personal consultation is the first step for every patient considering skin treatment. During this meeting, your surgeon will assess your physical health and discuss your specific cosmetic goals.
You should arrive at the consultation prepared to provide complete information about:
- previous facial injuries, surgical procedures or facial-skin treatments
- skin conditions, including acne and allergies, that have been previously diagnosed or treated
- medications you are taking or have taken previously, including dietary and herbal supplements
During your physical examination, your plastic surgeon will evaluate your skin type and the severity of any sun damage, uneven pigmentation and surface imperfections. Your surgeon's observations will help determine which treatments or procedures can offer you the greatest benefit.
Many people elect to have a skin treatment or resurfacing procedure in conjunction with other rejuvenating surgical procedures, such as a facelift, browlift or eyelid surgery.
What should I know about the safety of skin revitalizing and resurfacing?
Each year, thousands of men and women undergo an array of skin treatments and experience no major complications. However, it is important for you to be informed of the risks as well as the benefits of the procedure you choose.
One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications associated with your procedure.
By carefully following your doctor's instructions - before and after your treatment - you can do your part to minimize some of the risks.
How do skin-revitalizing treatments work?
Skin-revitalizing treatments are best suited for individuals who seek a refreshed complexion without the recovery time associated with more extensive skin-resurfacing procedures.
You may choose a topical treatment, which will become a part of your skin-care regimen at home, or a gentle revitalizing treatment that is performed in your doctor's office. Sometimes, a nurse or a trained esthetician, acting under the direction of your plastic surgeon, will perform the revitalizing treatment or instruct you in the use of a topical cream, lotion or gel.
No anesthesia is needed for the revitalizing treatments described below and all have the same goal: smoother, fresher-looking facial skin. However, they work in different ways.
Topical treatments for home use
Glycolic acid creams and lotions are used to soften imperfections of the facial skin. These prescription-strength formulations can help slough away dry, sun-damaged skin cells. The mild acid may be blended with bleaching chemicals to help correct areas of uneven pigmentation. In most cases, the preparation is used twice daily. Your doctor may adjust the strength of the formula or the frequency of its use after evaluating your skin's condition in follow-up visits.
Retin-A® is a prescription-strength cream or gel that is applied to the face nightly as part of your skin-care routine. Although it has been used as an acne treatment for decades, Retin-A® can also be used to treat fine wrinkles or uneven pigmentation caused by sun damage. At periodic follow-up visits, your doctor may adjust your Retin-A® prescription. However, to maintain your smoother complexion, its use must be continued.
Gentle revitalizing treatments performed in your doctor's office
Glycolic acid peels involve the application of a prescription-strength solution that penetrates only the topmost layers of the facial skin. It is intended to give your skin a fresher, healthier appearance and a radiant glow. A single peel treatment may provide good results for some patients; others may opt for repeated treatments to improve their skin's overall texture. For many patients, glycolic acid peels can reduce the visible effects of aging and sun damage, including fine wrinkling and brown spots. Your plastic surgeon may recommend products that you can use at home to maintain your results.
Microdermabrasion is a skin-revitalizing treatment that freshens the skin and reduces surface imperfections, including age spots and sun-damaged areas. The technique uses a pen-like instrument that directs a stream of mildly abrasive crystals and gentle suction to areas where improvement is needed.
How will I look and feel after a revitalizing treatment?
After a revitalizing treatment you may experience some mild irritation or tingling. However, these sensations are short-lived and usually will not interfere with your work or plans for the hours after your treatment. One of the benefits of skin-revitalizing treatments is that they require little or no "down time" for healing or recovery.
What should I know about my results?
To maintain the smoother, more-refreshed appearance that can be gained from micro-dermabrasion, glycolic acid peels, Retin-A®, or glycolic acid creams, treatments must be repeated. However, most people find that maintaining their new look is easier than expected.
How long will I continue to see my plastic surgeon?
If you have decided to continue with a regular program of glycolic acid peels, microdermabrasion or treatments with glycolic acid or Retin-A®, you will visit your doctor's office according to the schedule prescribed for you.
How do the more extensive skin-resurfacing procedures work?
Deeper chemical peels and dermabrasion are procedures best suited for individuals who have acne scars, moderate to severe sun damage or deeper imperfections of the skin. Your skin-resurfacing procedure will likely be performed in your doctor's office or an outpatient center. However, for extensive or multiple procedures, your surgeon may discuss brief hospitalization as another option.
For deeper chemical peels or dermabrasion, sedation may be used before and during the procedure to keep you relaxed and comfortable.
Chemical peel involves the application of a chemical solution to either the entire face of to specific areas - such as the regions around the eyes and mouth. It works by removing the damaged outer layers of skin, allowing a new, healthier-looking layer to emerge. The types of chemical peels most commonly used for medium to deep treatments are:
- Tricholoroacetic acid (TCA) peel - Often used for treating blemishes, pigment changes and wrinkles, this type of peel can be used on any part of the body. TCA is often recommended for people with darker complexions because TCA has less of a bleaching effect on the skin than stronger peeling solutions.
- Phenol Peel - The strongest of the chemical peels, phenol is used for skin that is particularly rough, blotchy or sun-damaged. Phenol helps reduce the appearance of deeper wrinkles, especially the vertical lines that often form around the mouth.
Dermabrasion is a technique that uses a high-speed rotary wheel to resurface the skin by removing its upper layers. This resurfacing method is most often used for the treatment of facial scars, such as those caused by acne. The technique can be applied to either a small area or to the entire face. Often, it is used to help reduce the appearance of vertical lines and wrinkles around the mouth.
Are there other skin-resurfacing options?
Another resurfacing technique uses a laser to vaporize the skin's outer layers. Like other resurfacing methods, the laser is effective in treating wrinkles, blotchiness or age spots, and scars from acne or other causes. Your surgeon can help you determine which resurfacing treatment is the best choice for you.
What can I do to prepare for my skin-resurfacing procedure?
If you are having a chemical peel or dermabrasion, your plastic surgeon will provide you with specific instructions for the days immediately before and after your treatment. A number of points may be covered, including:
- avoiding certain medications that may complicate recovery
- stopping smoking for a period of time before and after your treatment
- following a program to prepare the skin. (For example, before a chemical peel or, less often, dermabrasion, you may be instructed to apply a pre-treatment cream or gel to your skin for a few weeks. You may also be given certain oral medications that you should begin taking prior to your treatment.)
How will I look and feel right after skin resurfacing?
After a deeper chemical peel or dermabrasion, your treated skin will appear red and swollen. Any discomfort you may feel can be relieved by medication prescribed by your surgeon. The affected area will be covered with petroleum jelly or other protective ointment. In some cases, waterproof adhesive tape or a bandage may be applied.
The speed of your healing after a chemical peel or dermabrasion will depend upon the extent of your procedure. However, you can expect that your recovery will follow this general time line:
The first few weeks
After four weeks
- Your new skin will begin to form and may be bright pink or red. The color is a positive sign that the healing process is progressing.
- You may apply makeup (after two weeks) to minimize the redness as your face continues to heal.
- You may return to work and gradually resume your normal activities.
- You may resume exercise or more strenuous activity (bending and lifting)
- You may resume your skin-care routine as your physician directs.
It's important to remember that the redness associated with dermabrasion or deeper chemical peels will fade gradually. Although the color will diminish with every passing week, some pinkness may remain for up to six months.
Following your resurfacing procedure, it's important to protect your skin from the sun until all the pinkness is gone. If you must be in the sun, apply a strong sunblock with an SPF of 30 or higher and shade your face with a wide-brimmed hat. This is particularly important if you have had a phenol peel, which eliminates your skin's ability to tan. If the skin around your eyes has been treated, you should wear good-quality sunglasses with UVA/UVB filters when outdoors.
What should I know about my results?
It may take several months to fully appreciate your new look after a deep chemical peel or dermabrasion. However, the improvement you'll notice can be dramatic, long-lasting and well worth the wait.
You can help to maintain your fresher appearance by using sun protection and following a skin-care regimen recommended by your surgeon.
Your face will continue to age in the months and years following your treatment. It's important to understand that no skin-resurfacing treatment can eliminate excess fat or sagging skin on the face or neck. If you would like to consider facelift surgery for a tighter, smoother facial contour, your plastic surgeon can help you decide if this procedure is right for you.
How long will I continue to see my plastic surgeon?
After a deep chemical peel or dermabrasion, you will return to your plastic surgeon's office for post-treatment follow-up visits so that your healing and progress can be evaluated.
CHOOSING A QUALIFIED SURGEON
No matter what type of plastic surgery you're considering, one of the most important factors in its success is the surgeon you choose. Although it may seem hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.
It's advisable to consider the following points before scheduling a consultation:
Find out if your doctor is certified by the American Board of Plastic Surgery (ABPS). Surgeons with this certification have completed a minimum of five years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgement. After training, a surgeon must pass comprehensive oral and written exams before being granted certification. The two organizations that have prepared this brochure, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, require their members to be certified by the American Board of Plastic Surgery.
Ask about the surgeon's hospital privileges
Even if you are planning to have your surgery in your doctor's office or at a surgery center, it is important to find out if your surgeon has operating privileges in an accredited hospital for the same procedure that you would like to have performed. Before granting privileges, hospital review committees evaluate a surgeon's training and competency for specific procedures.