Skin Resurfacing

Skin resurfacing can be performed via multiple modalities.   Dr. Weider offers both chemical peels and laser resurfacing to remove fine lines and wrinkles and rejuvenate the skin. All resurfacing treatments work essentially the same way. First, the outer layers of damaged skin are stripped away. Then, as new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. In general, the more aggressive the resurfacing procedure is, the more prolonged the recovery is likely to be. “Light” resurfacing procedures, such as superficial chemical peels or superficial laser resurfacing, offer shorter recovery times. However, these lighter procedures may need to be repeated multiple times to achieve results comparable to those achieved with more aggressive techniques.

Chemical Peel

Chemical peels, which involve the application of special peeling agents to the skin, remove the outer layers of sun damaged skin.  There are numerous types of peels that have been used successfully.  They range from mild peels that can be done without any type of anesthetic to medium and deep peels that penetrate further into the surface of the skin.  Chemical peels are often effective at treating the following skin conditions:

• Acne scars
• Spots from sun damage
• Fine lines and wrinkles
• Skin pigment irregularities
• Rough skin and scaly patches
• Scars
• Sun-damaged skin

Chemical Peel: How it Works

During a chemical peel, solutions are applied to your face that remove the damaged outer layers of the skin.  This allows for new collagen formation in the remaining, deeper layers of the skin. The end result is smoother, younger appearing skin with more uniform skin tone.  Depending on your individual needs, Dr. Weider will recommend the appropriate type of peel.  At Weider Plastic Surgery, light, medium and deep peels are available. Chemical peels are often combined with other procedures such as face lifts and eyelid lifts for comprehensive facial rejuvenation.

Light Chemical Peels

For those patients within uneven pigmentation or very fine wrinkles, a light chemical peel is often an excellent choice.  This is a superficial peel that removes the outermost layer of skin and leaves you with a healthy glow.  Light chemical peels can be performed without anesthesia with no down time.  The most commonly used light peeling solutions include alphahydroxy acids, glycolic acid, lactic acid and salicylic acid.  These are mild agents, and the peel can be repeated on a weekly basis if needed.  During a light chemical peel:

• Your face is gently cleansed.
• The solution is applied to your skin and left on for five to ten minutes.
• You may feel some tingling or mild stinging.
• The solution is the washed off.

Medium Depth Chemical Peels

If you have deeper wrinkles, more extensive sun damage and uneven skin tones, then a medium depth peel may be the best choice for you. TCA (trichloroacetic acid) will be used to perform the peel.  Unlike a light peel, the medium depth peel will penetrate below the epidermis into the top layers of the dermis.  Typically the procedure and follow up include:

• Cleansing the skin
• Application of the chemical solution, which can cause some stinging or burning
• Neutralizing the chemical solution with cool compresses

Your skin may have a red or brown hue for up to six weeks after the procedure.  At this point, it will be smoother and have a healthy glow with more uniform pigmentation and a fresher appearance

Deep Chemical Peels

Those patients with the deepest wrinkles, the most sun damage and the most uneven pigmentation may opt for a deep chemical peel. Dr. Weider uses phenol to perform deep peels and they are performed with sedation.

While these peels necessitate the longest recovery period, they also provide the most benefit for patients in need of rejuvenation of damaged skin. The typical procedure is as follows:

• Dr. Weider will prescribe a pre-treatment skin regimen to be used for six weeks prior to the peel.  This topical cream prepares the skin for the peel.
• On the day of the peel, you will be given intravenous sedation so that you are comfortable throughout the procedure.
• Your skin will be cleansed.
• The peeling solution will be brushed on and left in place until the peel has reached the proper depth.
• Your skin is then covered with petroleum jelly to soothe and protect it.

Dr. Weider will provide you with oral pain medicine to manage the discomfort from the procedure. You will be instructed in how to care for your skin as crusts develop for the first few days.  You can expect to have swelling for about ten days and a pink hue to the skin for several weeks. In most cases your new smoother, younger appearing skin will last for up to ten years.

Laser Resurfacing

Laser resurfacing is performed with a carbon dioxide laser, an erbium laser or a combination of the two. The laser is used to remove damaged or wrinkled skin. It minimizes the appearance of fine lines on the face especially around the mouth or eyes. It can also treat areas of uneven pigmentation. During the procedure the laser energy vaporizes the upper layers of damaged skin. Once the outer layers of damaged skin are stripped away, new cells form during the healing process creating a smoother, tighter, and younger looking skin surface.

The best candidates for laser resurfacing are fair skinned and have relatively fine wrinkles. Individuals with a history of keloid formation or recent Accutane use may not be appropriate for the procedure. Although laser resurfacing is a safe procedure, as with any procedure, there are risks involved. These include, lightening or darkening of treated skin and scarring.  Although the procedure is relatively quick, the recovery period can take a few weeks. The Erbium laser however has dramatically decreased the amount of time needed to recover from this procedure.

AFTER YOUR TREATMENT

As with medium to deep chemical peels, you are likely to experience some mild swelling and discomfort after laser resurfacing. However, this can be controlled with ice packs and medications prescribed by Dr. Weider. You will likely experience some crusting of the skin, but most patients are free of crusts after about a week. Redness may persist for several weeks.

GETTING BACK TO NORMAL

Your new skin will usually remain bright pink to red in the weeks following the procedure. After about two weeks or so, most patients can safely apply makeup to conceal this temporary color change. However, some pinkness may remain for up to six months.

Above all, in the months following treatment, it’s important to protect the treated area from the sun until all the color has returned to normal. Using sun protection regularly will help to maintain your results and reduce the chance of any new sun damage to your skin. If you must be in the sun, apply a strong sun block with an SPF of 30 or higher and shade your face with a hat or visor. If resurfacing was performed around the eyes, it’s best to also wear good quality sunglasses with UVA and UVB 100 percent protection.

YOUR NEW LOOK!

The final result from laser resurfacing may take several months to fully appear. However, once the pinkness fades, patients usually notice a significant improvement in the quality of their skin and a fresher, smoother appearance.

It’s important to understand that your results will be long-lasting, but not permanent. Remember, your new skin is not immune to the effects of aging. In the months and years following your laser treatment, your natural facial movements will eventually cause any “expression” lines to recur.

As with other methods of skin rejuvenation, laser treatments can usually be repeated. However, by protecting yourself from the sun and following a skin-care regimen recommended by your plastic surgeon, you can help maintain your rejuvenated look.