Do peels thin your skin?

June 25th, 2009

Peels and resurfacing with either chemicals or lasers do take away unwanted layers of your skin. But they usually create a layer of good skin that helps with the reduction of wrinkles. This new layer of collagen is newly produced to help your skin tone, decrease pore size, and improve texture. An additional benefit is that it decreases the chances of skin cancer by allowing new skin to rejuvenate your skin.

There is a thinning affect that adjusts over time.  But it doesn’t really change the basic anatomy of your skin other than increasing an organized layer of collagen underneath the stem cells within the skin.

Consulting a Board Certified Facial Plastic Surgeon would be something that I would recommend. We specialize in the face and are highly qualified to help you with this.

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Chemical Peels and sensitive skin and are peels permanent

June 25th, 2009

I have a lot of patients with sensitive skin and they seemed to do well with resurfacing. Obviously, everybody is different and you would have to get a complete history and physical exam to make sure that you are okay to receive this particular treatment.

Here are some of the contraindications to having a resurfacing:

previous cancers or active skin cancers, on Accutane within the last 1-2 years, medications such as tetracycline, chloroquine, bleomycin, amiodorone, St. John’s wart, recent sun exposure within the last 4-8 weeks, recent skin procedure within the last 4-8 weeks, previous chemical peel or laser within the last 6 mos to a year, skin koebnerizing diseases, autoimmune diseases, hiv, active infections, herpes, lupus, hormonal/endocrine diseases, bleeding disorders, history of keloid and hypertrophic scar formation, pregnancy / nursing, porphyria, previous radiation to the face.

You can always start slow as well and do more superficial chemical peels first before progressing to more advanced and deeper peels.

In terms of whether they are permanent, this is a difficult question because permanent can mean forever and nothing lasts forever.  Studies show that after a resurfacing, and this depends on how it is done and how aggressive, the results lasts around 8-10 years and then you will likely want to do this again.

Consulting a Board Certified Facial Plastic Surgeon would be something that I would recommend. We specialize in the face and are highly qualified to help you with this.

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Hypopigmentation from a chemical peel

June 25th, 2009

This is a question that I answered for someone who had a procedure by another physician.

Hypopigmentation from a chemical peel about a month ago is a little early for permanent hypopigmentation. This condition can and usually shows up months later. If this is permanent there are some special treatment light systems that can help with bringing back the pigmentation. But these do not always completely help the pigmentation. Some others have attempted skin grafts with siginificant recovery and problems. I would wait to do anything extreme. I would consider topical skin medications to possibly cut down on the inflammation if there is any. This will help with the inflammation continuing to hurt the melanocytes and preventing their migration into the skin areas.  Melanocytes are the cells within your skin that produces the pigment melanin that is dispersed throughout the skin cells in the area.

Consulting a Board Certified Facial Plastic Surgeon would be something that I would recommend. We specialize in the face and are highly qualified to help you with this.

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What is Jessner’s Peel and a TCA peel and what should I expect.

June 25th, 2009

A Jessner’s peel is superficial and you should recover quickly. Peeling usually takes about 3-5 days and you won’t be red for more than a week or two at most.  TCA’s, tricholoracetic acid, usually depend on what concentration the TCA you are using. A 10% TCA peeel is superficial and recovery is about the same or a little more that the Jessner’s. 20% is a little deeper and can reach the papillary dermis and will require 5-7 days to peel. 30-35% is a medium depth peel and can reach the deeper papillary dermis and will take 7-10 days to peel. But I wouldn’t worry about the Jessner’s taking too long to recover.  During the recovery phase you will basically have a sunburn in varying degrees depending on how deep of a peel you receive.

Essentially with peels and resurfacing, you are taking away the top layers of the skin to then allow deeper skin cells from within hair units or deep within the hair follicle to resurface or create a new skin surface.  This allows the resurfacing to remove scars, wrinkles, unwanted pigmentation and decrease the size of the pores.

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Accutane and Chemical Peels and Resurfacing.

June 25th, 2009

If you do a chemical peel when you are on accutane you will greatly increase your chances for scarring. Your pilosebaceous units are greatly affected by accutane and this effects there ability to resurface your skin and hence can lead to an increase in scarring. Generally you should be off accutane for 1-2 years before you do any resurfacing type of procedure.

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Reconstructing an eyebrow laceration and loss of tissue

June 24th, 2009

It depends on what type of trauma it is. Many times, the trauma can cause a cut or laceration and sometimes when it is closed the multiple layers that the cut goes through may not be closed individually. This can lead to some layers not being properly opposed and hence a lack of tissue.

The correction of this can entail reclosing the area in multiple layers to bring back the tissue. If it is due to volume loss from just the pure impact, you can graft fat into the area from your abdomen. If you don’t want to use fat, you can use other dermal fillers to do the same but not with the more permanent nature that fat can sometimes possess when done right. Another option is to transfer tissue from an adjacent area.

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Be very careful with liposuction on lower cheeks

June 24th, 2009

Liposuctioning your lower cheeks is always a risky endeavor. Liposuction can create dimpling, and contour changes that usually is not a major deal when it is in your tummy or butt. But when it is in your face, the significance increases greatly. And that is just with traditional liposuction. When you add Smart Lipo to the mix, with their use of lasers during the liposuction that have less general use in terms of the time it has been available to the market and experience among surgeons, you are going into unknown territory, in my opinion. The risks would be higher. If you do decide to go through with it, I would tell your surgeon to be very conservative and that you don’t mind doing it again if you have to. Less is better many times.

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Volumizing the face through facial implants or fat transfer

June 24th, 2009

Some people are afraid of having implants and this an important thing to consider. I usually use implants to volumize the face when a person does not have a lot of fat to use, for example in women that are physically fit and have little body fat.

After implantation, you can then use the little fat that the person has to augment the implant. I usually do this in two phases with the implant first and then fat grafting at a later date. You also have to consider that fat and implants have different characteristics as well.

Implants require more incisions and usually are placed through the mouth. Fat transfer requires small holes instead of long incisions. Implants can also help in that fat transfering is needed less and cuts down on the need for more extensive fat harvesting.

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Things to think about regarding Facial Implants

June 24th, 2009

Facial implants can markedly change the way you look in a good and bad way. It all depends on what you need and what your current aesthetics are. You need to have a surgeon that has an understanding of facial aesthetics.

Depending on what you look like, you can place chin, cheek, jaw and periorbital implants that can really improve your appearance. Silicone implants are the most compatible but have less integration than some other more porous implants like medpor and goretex. I prefer Silicone because of its compatibility but there are many other implants that are very compatible and have proven records in terms of acceptance by your body. Methylmetacrylate has a long history of implantation with very low percentage of problems. Medpor, porous polyethylene, has a low risk but in terms of rejection appears higher than silicone.

To me silicone, is the best implant available due to its low risk of rejection by the body and that’s what I use in the nose, jaw, chin and for implants around the eye, temple, and forehead. Facial implants are great way to augment your facial shape for the better.

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The cost of a browlift depends on the region of the country and the type of brow lift

June 24th, 2009

The price of a brow lift depends on the region of the country where the surgeon is practicing, and also may depend on what is done during the brow lift.

There are different ways to approach the brow lift either by using endoscopes with or without large incisions or through a coronal incision that goes from ear to ear. Also, there are other minor ancillary procedures you can do to treat the muscles that cause wrinkling.

Generally, a browlift costs between $3500 to $5000 or more depending on what is going to be done and if any ancillary procedures are going to be added.

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