Peels & Laser Surgery
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 recreations
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.
you've wondered how skin resurfacing with chemical
peeling or dermabrasion could improve the look of
your skin, your self-confidence, or your health, you
need to know how chemical peeling and dermabrasion
are performed and what you can expect from these procedures.
No pamphlet can answer all of your concerns, but this
one can provide answers to many common questions about
chemical peeling and dermabrasion.
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 Resurfacing For You?
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.
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.
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
the Decision For Skin Resurfacing
Whether you seek 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.
you and your surgeon decide to proceed with a 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.
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.
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.
is a surgical technique where by 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.
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 (CO2) laser vaporize the top
layer of skin instantly, with no beeding and minimal
trauma to the surrounding skin.
to Expect After the Surgery
Immediately following a 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 10 days following surgery. The redness
of skin that persists after the initial healing phase
will usually fade in about 4 weeks. 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.
one to two weeks after surgery, new skin will emerge
that is pinkish, finer, and free of many wrinkles.
But it will take several 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.
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
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.
Copyright 2000 American Academy of Facial and Reconstructive