RECOMMENDED ARTICLES ABOUT PLASTIC SURGERY

 
 
 

Non Surgical Treatments for Facial Aging,

 Laser Resurfacing, Chemical Peeling & Dermal Abrasion

 
 

HUGO CORTES, M.D.

Plastic Surgeon

BOARD CERTIFIED MEMBER OF THE COLOMBIAN SOCIETY OF PLASTIC SURGERY

     
   
     

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Laser resurfacing: CO2 laser or Erbium-CO2 laser are used in this procedure. Laser destroy the most shallow layers or zones of the epidermis and dermis, in such a way that regeneration of skin and collagen is induced and stimulated. New skin is formed. Besides, there is a skin retraction, which “irons” the finest wrinkles. It is specially useful to treat wrinkles around the eyes, “crow’s foot” and lips wrinkles. When eyelids are treated, fat can be removed from the bags, through an incision in the conjunctiva and then a skin resurfacing treatment can be done in order to eliminate wrinkles.

   
     
     
           
 

Laser treatment requires some skin care before and after surgery. The skin that is produced is new skin and needs hydration, infections protection (specially herpes protection) and a high solar protection. Depending on types of skin, redness in the skin may last up to three months. However, laser results are very good and

This procedure requires just a local anesthesia. 

There are several more treatments for skin aging (wrinkles) or skin pigmentation disorders (stains), which do not cause burns, and get good results. These treatments are based on Intense pulsed light (IPL) and do not require anesthesia,

So that patients can immediately reassume their normal activities. 

Some of these treatments are:  

- Chemical peeling: Also called chemoexfoliation, chemosurgery. It consists on the application of one or more exfoliating agents at the skin, which destroy a portion of the epidermis and/or dermis, thus regenerating new epidermal and/or dermal tissues. 

Types of peeling:

  Superficial peeling: It combines a program at home, based on creams and then, an abrasive peeling at the doctor’s office and a maintenance program at home later. Abrasive treatment is repeated 4-5 times, until a good result is achieved.

It is not painful, results start to appear after 3-4 days, and normal activities are never interrupted. This treatment is indicated for skin stains, fine wrinkles, crow’s foot” wrinkles and light sequela of acne. It is a suitable procedure for all skin types. 

  Medium depth peeling: It combines a preparation program at home, an abrasive peeling by the doctor, and a care program at home. Strong abrasive agents are used, in low concentration. It is indicated for all kinds of patients, gets a big improvement for fine wrinkles, stains, laxity, and acne sequela. It does not require anesthesia, just sedatives. In ten days patients can reassume normal activities and improvements are fully noticed. 

  Deep peeling: It combines a preparation program at home, an abrasive peeling by the doctor, and then controls by the doctor in patients homes for 10-15 days. It requires a local anesthesia, plus sedatives. It is carried out in the doctor’s office operating room. Normal activities can be reassumed after 3-4 weeks, wearing a little make-up. It makes queratosic solar lesions and senile superficial lesions (dark stains) disappear. It achieves a strong rejuvenating result. This treatment can not be practiced in dark skins, and requires one year solar protection.

Abrasive agents used are strong, sessions are held once a week, or, once every 15 days in cases like acne sequela, very shallow scars, or too sensitive skins.

There can be rest periods of one week after 3-4 sessions. 

- Dermal abrasion: It consists on an abrasive process that removes superficial epidermis and dermis, obtaining a much more smooth surface, improving irregularities at the facial outline or facial wrinkles.

This is a mechanical, manual procedure. Doctors use a diamond burr, with an engine, at 12000-15000 r.p.m. (revolutions per minute).

Its big advantage over abrasive peeling is that doctors can exactly know the depth or lesions being caused in the skin.

 
     
 

COMPLEMENTARY AND INJECTION TECHNIQUES

 
       
 

There are many procedures which are based on injecting different compounds. These are the main ones:  

Botulism Toxin  ( Botox  TM, Dysport TM )

Type A botulism toxin is one of seven toxins produced by Clostridium Botulinum, being synthesized at laboratories, for medical uses. This toxin produces a temporary paralysis in the injected muscle. It was previously used for treatment of neurological spastic disorders and it is currently used to treat facial wrinkles. Muscles in the face are responsible for the expression of emotions and feelings(anger, joy, happiness, sadness…) These muscles are located just beneath the skin and produce all different face grins. Their continued use make expression wrinkles appear, which can be noticed even when muscles are not working. The best known wrinkles are forehead wrinkles (due to frontal muscle), wrinkles between eyebrows (due to corrugator muscles), and crow’s foot (orbicular muscle). 

Botulism toxin is injected in the proper amount in the muscle that produces a particular wrinkle. Needle is very fine, and the procedure is carried out at the doctor’s office. Dose is very small and is no harmful at all. The toxin acts directly in the connection between nerve and muscle. It prevents the production of acetilcolina (messenger substance, responsible for the transmission of nerve impulses to the muscle). Effects are not permanent, because nerves produce new nerves endings and connections to the muscle. Normal muscular activity starts again three months after the injection. Aesthetic results are noticed 4-5 days after the treatment and last for 4 to 6 months. After that period, a new treatment is needed. However, it seems that after several injections, muscles are weaker and smaller doses are required. Effects are also longer. 

These zones are the best candidates for botulism toxin treatment:

 
       
  Wrinkles between eyebrows  
       
  Forehead wrinkles  
       
  Crow’s foot  
       
  Neck stripes  
               
           
           
           
           
           
           
           
           
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It is important to notice that results are very good but temporary (4-6 months).

Permanent results require surgery ( frontal lifting, neck lifting, surgery of corrugator muscles, etc… ).

Complications are rare. The most common ones are inflammation or hematoma close to the needle entrance point, which last for just a few days.

Sometimes, the toxin may spread, giving way to a temporary paralysis of a muscle nearby. (a fallen eyelid could be a result, for example). In conclusion, this treatment is a very good choice to eliminate wrinkles without surgery, but outcome is not permanent. 

RESTYLANE TM The Natural Beauty Lifting 

Many people are more and more interested in correcting wrinkles and folds, in shaping facial outline and giving volume to lips. RESTYLANE is a gel with crystalline purity. It is also biodegradable. It is injected in the dermis, in small amounts, using a very fine needle. Results are immediate. Improvements are lasting, natural, and safe. Skin regains smoothness in a very natural way. 

RESTYLANE was introduced in the market in 1996. Many researches have been carried out, both histological and clinical, to test its easy use, its tolerance and good results. More than one million treatments have been done in the world, with complete success. 

RESTYLANE is a “NASHA” (a non animal stabilized hyaluronic acid). It was discovered in Sweden after decades of intensive research by Dr. Begt Agerup and Q-Med Industries in Uppsala, Sweden. The first treatment with this acid was carried out in 1996.

 
               

   

   

THIS IS A GENERAL INFORMATION, EACH CASE MUST BE CONSIDERED INDIVIDUALLY.

   
     
  DR. HUGO CORTES Ask the surgeon by clicking on the envelope
  Plastic Surgeon Visit the surgeon's website by clicking HERE
           
         
         
       

 

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