Clear, unwrinkled skin is a sign of youthful vitality and beauty. Skin that is sagging, scarred, wrinkled, or sun-damaged can make individuals look older than they feel.
Fortunately, we now have the cosmetic technology and procedures to correct or improve a host of facial imperfections. From sun damage and acne scars to birthmarks and wrinkles, a well-trained and experienced cosmetic surgeon can almost always help you achieve a more youthful and aesthetically pleasing appearance.
When counseling patients for the first time, I always tell them it’s never too early or too late to begin practicing good skin care. Most of what people believe to be the result of aging -- wrinkling, sagging, brown spots, etc. -- is actually caused by exposure to the sun. To keep the skin looking youthful, or to help make it look youthful again, the best medical advice is to protect your skin from exposure to the sun. Establishing a daily skin-care regimen, which may include the use of cosmeceuticals (pharmaceutical products for cosmetic use), is also essential before and after any cosmetic procedure or surgery is performed.
The problems most patients want addressed usually fall under one of two broad categories, 1) sagging skin or 2) wrinkles. Excessively sagging skin, particularly around the jowls, neck, forehead, or beneath the eyes, is often best treated with traditional aesthetic surgical procedures -- a face lift, brow lift or eye lift. There are laser procedures that also provide lifting effects, which will be discussed later in this article.
Wrinkles can be caused by facial muscle movement, natural aging, and/or sun exposure. Frown lines between the eyebrows, crow’s feet at the corners of the eyes, and furrows across the forehead are all lines of expression (movement-associated lines). They are actually creases in the skin caused by making the same expression thousands of times. These types of wrinkles can be treated with injections of Botox, a purified protein toxin.
Botox works by blocking the nerve impulse from reaching the muscle that makes the expression line. Using a tiny needle, a very small drop of Botox is injected directly into the muscle. The muscle weakens, and the skin overlying the muscle relaxes. The wrinkle in the skin gradually softens and disappears. The effects of a Botox injection slowly wear off in three to six months, whereupon another injection is required to achieve continued results. The advantages of Botox include its highly effective and safety profile -- having been used in opthalmology for over 10 years and in wrinkle therapy for over six years. It is an in-office procedure that can easily be done during a patient�s lunch hour, after which time he or she can immediately return to work. There is no recuperation period required.
Deeper wrinkles, pock marks, or acne scars are often treated with filler substances -- such as collagen, fat, or hyaluronic acid gel. The filler is injected directly into the involved skin using extremely fine needles, plumping up the wrinkle or depressed scar. The procedure is done in-office and requires no anesthesia. Results are immediate, and no recuperation period is needed. However, over a period of three to six months, the body absorbs the filler material, thereby requiring reinjection to maintain the desired effect.
Laser resurfacing offers a much more long-term solution than filler substances for scars and wrinkles. Typically, a CO2 or erbium laser (or a combination of the two) is used.
The laser may well be the world’s most precise tool. A full facial laser resurfacing procedure performed by a highly skilled and experienced laser surgeon often yields dramatic results. The layers of skin that are responsible for wrinkles, roughened surface texture, and blotchy coloration are literally vaporized. The body’s natural healing process then begins to form new skin undamaged by sun exposure. Intensive laser resurfacing also has a unique rejuvenating effect called collagen tightening, which results in a non-surgical lift. This is due to shrinkage of collagen fibers by exposure to the laser light. As a result, the skin surface is tightened, which creates a more youthful appearance.
For all its potential benefits, laser resurfacing is not without its drawbacks. Postoperative recovery takes a week to 10 days, during which time the skin is tender and swollen, appearing as an open wound. The treated area remains red for several weeks, often requiring application of camouflage makeup. Complete recovery can take up to a year or more.
Thermescent laser skin treatment is a recently introduced option that can achieve collagen-tightening effects without producing an open wound. The procedure is performed with a 1.32 um Nd:YAG laser that emits light energy penetrating to the skin layer containing collagen fibers and stimulating collagen remodeling. What little redness the procedure creates usually fades within a few hours. An observable improvement in skin texture continues for several weeks after a series of thermescent laser skin treatments. Results are slow and progressive, making for gradual, natural-appearing rejuvenation.
Microdermabrasion is another procedure that can improve skin texture and coloration without pain or recuperation downtime. Using a wand-like handpiece, very fine crystals are propelled against the skin at high velocity and immediately vacuumed away. The procedure removes dead surface skin cells, enhancing the look and texture of the skin. Microdermabrasion is very good for improving irregular blotchy pigmentation and scaly skin. It may also help the appearance of fine wrinkling and shallow acne scars.
No one cosmetic procedure or technique is right for every patient and every cosmetic condition. It’s important to understand the cosmetic treatment options that are available to you. Also, there is always the potential for complications with even the most minor surgical procedure. If you’re considering cosmetic treatment, your physician should explain all possible complications to you. A full understanding of the potential risks and benefits will help you make a better and more informed decision for yourself.
