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Understanding Skin Resurfacing
Facial Peels and
Laser Surgery
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In the last half of this century, men and women have had more leisure
time to spend outdoors than in previous generations. Many hours spent on
outside recreation and the prevalence of both summer and winter vacations
have all taken their toll on people's skin. Premature wrinkling is more
common now than ever before. Both men and women seek facial plastic
surgery to reverse the effects of sun damaged skin. Surgery may also
improve the pitted look of acne scars and remove pre-cancerous
skin growths called keratoses. | If you've
wondered how skin resurfacing with lasers, chemical peeling or dermabrasion
could improve the look of your skin, your self-confidence
or your health, you need to know how laser resurfacing, chemical peeling and
dermabrasion are performed and what you can expect from these procedures. No
article can answer all of your concerns, but this one can provide answers to
many common questions about laser resurfacing, chemical peeling and
dermabrasion.
Successful facial plastic surgery is a result of good rapport between patient
and surgeon. Trust, based on realistic expectations and exacting medical
expertise, develops in the consulting stages before surgery. Your surgeon can
answer specific questions about your specific skin problems.
Is Skin Resurfacing For You?
The most basic requirement for any surgery is good health. Other requirements
are more subtle and should be carefully considered in discussions with your
surgeon. Expectations of surgery and of the surgeon must be realistic. Skin
resurfacing procedures cannot produce perfect skin; rather, the goal is to
improve the appearance of the skin as much as possible.
Skin type and color, ethnic background, and age are important factors that
should be discussed prior to surgery. If you have dark skin or problems such as
allergies, previous burns, a history of poor scars, or radiation exposure, you
may need special evaluation to determine if you are a candidate for these
procedures. If you have had episodes of cold sores and blisters around the
mouth, inform your surgeon of this condition.
Before deciding on a skin resurfacing procedure, your facial plastic surgeon
may recommend a skin care regimen prior to the procedure. If you have extensive
damage from aging or injury, more than one procedure may be necessary.
Making The Decision For Skin Resurfacing
Whether you seek laser skin resurfacing, a chemical peel or dermabrasion for
functional or cosmetic reasons, your choice of a qualified facial plastic
surgeon is of paramount importance. The surgeon will examine your skin to
assess factors that could affect the outcome of the surgery and to determine the
proper procedure for your condition. You and your surgeon will explore your
attitudes toward surgery, and discuss realistic expectations and risks.
Trust is built through these discussions, and the agreement between surgeon and
patient is a prerequisite for a successful outcome to the surgery.
After you and your surgeon decide to proceed with laser resurfacing, chemical
peel or dermabrasion, all options for the procedure will be discussed along with
the risks. You will also receive information relating to each procedure. Bear in
mind that neither chemical peel nor dermabrasion can correct sagging skin
or halt the aging process. Furthermore, as some chemical peels lighten skin
color, you must make a commitment to use sunblock. Following a thorough medical
history, your surgeon will advise you as to anesthesia options, the surgical
facility being used, any additional surgery options, and the costs for the
procedure. Your surgeon may also suggest other surgery, either before or
after your resurfacing procedure, in order to enhance your overall
appearance.
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Fresher, Smoother
Skin
Understanding The Surgery
The skin is composed of the epidermis and the dermis. Within the
dermis are two layers, both of which are constructed of collagen, long
fibers that loosen and stretch with age and sun damage. If the
deepest layer, the reticular layer, is damaged, scars result, while the
upper layer of the dermis, the papillary layer, heals from injuries
without scarring. In a chemical peel, the surgeon applies one of several
chemicals to the skin. Glycolic acid is the mildest. TCA, trichloroacetic
acid, can be used in varying strengths for longer-lasting smoothness. The
deepest peel is done with phenol.
Before any peel, the face is first thoroughly cleansed with a solution
to remove oil and to prepare the skin for deepest penetration. As the
chemical is applied, the epidermis is removed, and the chemical
penetrates into the first layer of the dermis.
Dermabrasion is a surgical technique whereby some
deeper scars and wrinkles can be smoothed. The surgeon uses a local
anesthetic and/or a freezing agent to render the skin numb. Then, using a
high speed rotating brush, the surgeon removes the top layer of skin to
the appropriate level for the best results. The size and depth of scars
and the degree of wrinkling determine the length of the surgery.
Laser surgery is used to resurface facial skin with
wrinkles caused by excess sun exposure, "crow's feet," and acne scarring.
The high energy, amplified light waves of carbon dioxide (C02) laser
vaporize the top layer of skin instantly, with no bleeding and minimal
trauma to the surrounding skin. |
What To Expect After The Surgery
Immediately following laser resurfacing, chemical peel or dermabrasion, the
surgeon may apply a dressing to your skin. Swelling and "crusting" of the
skin are normal, and ointments to keep the skin supple will be applied for seven
to ten days following surgery. The redness of skin that persists after the
initial healing phase fades with time. The surgeon often recommends a soft diet,
avoidance of extremes in temperature and any activity that would cause stress to
healing skin. It is imperative that you follow the post-operative instructions
of your surgeon to the letter. Should you experience any increase in redness or
itching in the days after surgery, notify your surgeon immediately.
In one to two weeks after surgery, new skin will emerge that is pinkish,
finer, and free of many wrinkles. But it may take weeks for all the redness
to vanish. Follow-up
care involves using sunblock in order to protect the skin while new pigment is
created. Patients will notice that the skin remains lighter for a long time
after surgery, but that condition will usually subside when the skin's pigment
level has been restored.
Facial plastic surgery makes it possible to correct many facial flaws and
signs of premature aging that can undermine self-confidence.
By changing how you look, cosmetic surgery can help change how you feel about
yourself.
Insurance does not generally cover surgery that is done purely for cosmetic
reasons. Surgery to correct or improve major deformities or accidental skin
injuries may be reimbursable in whole or in part. It is the patient's
responsibility to check with the insurance carrier for information on the degree
of coverage.
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