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.
If 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 article can answer
all of your concerns, but this one can provide answers to many common
questions about 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. Dr.
Maloney 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 Dr. Maloney. Expectations of surgery 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 Dr. Maloney of this
condition.
Before deciding
on a skin resurfacing procedure, Dr. Maloney 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 a chemical peel or dermabrasion for functional
or cosmetic reasons, your choice of a qualified facial plastic surgeon
is of paramount importance. Dr. Maloney 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 Dr.
Maloney 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
Dr. Maloney 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, Dr. Maloney will advise you
as to anesthesia options, the surgical facility being used, any
additional surgery options, and the costs for the procedure. Dr.
Maloney may also suggest other surgery, either before or after your
resurfacing procedure in order to enhance your overall appearance.
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, Dr. Maloney
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 where by some deeper scars and wrinkles
can be smoothed. Dr. Maloney uses a local anesthetic and/or a freezing
agent to render the skin numb. Then, using a high speed rotating
brush, he 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 (CO2) 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 a chemical peel or dermabrasion, Dr. Maloney
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. Dr. Maloney 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 Dr. Maloney to the letter. Should
you experience any increase in redness or itching in the days after
surgery, notify Dr. Maloney immediately.
In 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.
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.
The most basic requirement for any surgery is good health. Other
requirements are more subtle and should be carefully considered
in discussions with Dr. Maloney. Expectations of surgery 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. 
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, Dr. Maloney
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.