Dermabrasion is a skin resurfacing technique in which a high-speed diamond burr or rotary wheel is used to smooth out rough, irregular surfaces, sharp edges, or uneven texture in scars, acne conditions (scarring and/or uneven areas), and fine wrinkles, particularly around the mouth.
This technique should be distinguished from "microdermabrasion" which uses "glass beads" to only affect the outer layer of skin or epidermis. Dermabrasion can extend much deeper with the ability to treat these deeper problems.
Depending on the areas treated and the depth of the dermabrasion, the procedure may last a short number of minutes to around an hour for full face dermabrasion. Likewise, recovery is dependent on the depth and amount of the area treated. The patient might be back to work within a few days for small areas of treatment to 7-14 days for more lengthy procedures. The procedure is usually performed on an outpatient basis under either a local or general anesthetic.
Laser resurfacing is a procedure that smoothes the facial skin by using a laser to refinish damaged areas and shrink fine wrinkles. It also corrects areas of uneven pigmentation.
You are a good candidate for laser resurfacing if you have the following conditions:
• fine lines, especially around the eyes
• vertical lines around the mouth
• facial scars caused by injury or accident
• scars caused by acne
• areas of uneven pigmentation, such as "age spots
• lines on cheeks caused by sun damage
People who undergo laser resurfacing choose to have other facial-rejuvenation procedures at the same time, such as facelift, browlift or eyelid surgery.
In laser resurfacing, a beam of laser energy is used to vaporize the upper layers of damaged skin with accurate precision. As new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. During the procedure, the activated laser is carefully passed back and forth over the skin until the surgeon reaches the safest level that will make the wrinkle or scar less visible. This may require a performance of two or more times, depending on the deepness of the imperfection in the skin.
The cosmetic form of botulinum toxin, often referred to by its product name Botox®, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes.
Collagen and other Fillers
Who hasn't wished they could move fat from one area of their body and place it in another area? Most of us dream about this; but is it really possible? While collagen has been discussed quite a bit in the popular press to fill in lines, wrinkles and creases, there are a number of products that are used by cosmetic surgeons as "fillers," including a patient's own fat.
Fat grafts can actually be used as a "filler" substance by harvesting a patient's own fat and injecting it into desired areas. However, with time, most of the fat will reabsorb and will need to be redone. Some other products are more permanent such as alloderm which are "implanted" rather than injected. These are more often used on "deeper" creases such as the nasolabial folds and in the lips. Collagen, however, is the product most well-known as it has been used successfully for many years to treat lines and creases in the forehead, cheeks, lips, etc. There are different consistencies of the collagen product that can be used in specific areas. Also, a skin test is usually applied to make sure that you are not allergic to the product. Collagen does have to be touched up from time-to-time to maintain the correction.
Under certain circumstances (for example, if a patient is having skin removed for a facelift or for abdominoplasty) the patient's own collagen can be harvested and processed to be used with no skin test necessary. This correction is long lasting.
Several other soft tissue injectables can be used for similar purposes as collagen. Many of these products reabsorb and need to be touched up periodically. Botox is really not a filler but does "knock out" expressions lines, "frown lines" and crease lines by preventing specific muscles from contracting. This technique must also be repeated periodically to maintain the correction.
Newer "fillers" are being introduced in this country from Europe, however, experience with them in the United States is currently limited. As always, it is best to discuss any of your individual concerns with Dr. Lugger and his staff.
Spider Veins, also known as telangiectasias or sunburst varicositites, are small, thin veins that lie close to the surface of the skin. The common treatment is called sclerotherapy. With this procedure, the veins are injected with a sclerosing solution which causes them to collapse and fade from view. Two or more sessions are required to achieve maximum results. The procedure treats only those veins which are visible.
While some people are blessed from birth with clear, smooth, problem-free skin, others are plagued with everything from acne to age spots throughout their lifetime. Chemical peels utilize various chemical solutions to smooth and improve facial skin texture for these individuals. Such treatments remove damaged outer layers of skin and can improve wrinkles, blemishes, and uneven skin pigmentation.
There are many different types of peels, among the most common being alphahydroxy acids (AHA), trichloroacetic (TCA), and phenol.
AHA (or glycolic acid) peels are quite popular as they provide improvement, but don't involve a lot of "down time" in terms of healing open wounds, blistering, etc. Also known as the "lunchtime" peel, these treatments are usually done in a series and help to smooth rough, dry skin, to improve the texture of sun-damaged skin, and can aid in acne control. They are very helpful when combined with a bleaching agent to control pigment problems such as "brown spots" and uneven pigmentation. These peels can be used for pre-treatment of deeper peels.
TCA peels are a deeper peel with some associated healing time. They are quite useful to smooth out fine surface wrinkles, to correct pigment problems, and to remove superficial blemishes. They can also be used on the neck and other body areas. Pre-treatment with the use of retinoids (such as Retin A) or AHA creams is helpful in obtaining more uniform results. As with all peels, Dr. Lugger says the use of a good sun block during and after treatments is very helpful.
Phenol peels are combined with croton oil which actually is the more active agent, and are quite good with coarse wrinkles, to correct pigment "blotches" from sun damage, birth control pills, and aging, and to remove pre-cancerous growths. This is the deepest chemical peel, and it is recommended for the face only. Full-face treatment requires monitoring and may take an hour or more to accomplish. The peel can penetrate down to the deep dermis (lower layer of the skin) and results can be dramatic and long lasting. However, there is intensive aftercare involved with slow healing and some skin lightening is common. To discuss any of these chemical peel options, contact Dr. Lugger and his staff.
Alphahydroxy acids (AHA)
Smoothes rough, dry skin
Improves texture of sun-damaged skin
Aids in control of acne
Can be mixed with bleaching agent to correct pigment problems
Can be used as a TCA pre-treatment
A series of peels may be needed
As with most peel treatments, sunblock use is recommended
Trichloroacetic acid (TCA)
Smoothes out fine surface wrinkles
Removes superficial blemishes
Corrects pigment problems
Can be used on neck or other body areas
May require pre-treatment with Retin-A or AHA creams
Preferred for darker-skinned patients
Peel depth can be adjusted
Repeat treatment may be needed to maintain results
Sunblock must be used for several months
Healing is usually quick, much quicker than with a phenol peel
Corrects blotches caused by: sun exposure, birth-control pills, aging
Smoothes out coarse wrinkles
Removes pre-cancerous growths
Used on the face only
Not recommended for dark-skinned patients
Procedure may pose risk for patients with heart problems
Full-face treatment may take one hour or more
Recovery may be slow; complete healing may take several months
Sun protection, including sunblock, must always be used
Results are dramatic and long-lasting
Permanent skin lightening and lines of demarcation may occur