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Home > Face Surgery > Skin Resurfacing Procedures
Procedures to Improve the Skin Surface
Time, genetics, and many other factors take effect and leave their
traces on our skin. Nowhere are these changes more visible than on the
face.
With the aging process skin of the face begins to sag, volume is
shifted and reduce while texture of the skin changes in color,
pigmentation, luster and becomes weathered with wrinkling. Crow's
feet
wrinkles become evident around the eye area, laugh lines deepen and
fine vertical lines
"smoker's lines" appear on the upper lip around the mouth.
Fortunately, modern aesthetic, cosmetic techniques are available
to address all of the aspects of the aging face. As seen under other
heading of this section as well as the non-surgical procedure
section,
the Dr. Zemplenyi is expert in employing multiple modalities to
Resurface the skin, Restore facial volume, Relax facial muscles and
Reverse gravity-related sag.
Laser Skin Resurfacing
At Bel-Red Center for Aesthetic Surgery we have been using various
lasers for skin resurfacing of the upper layers of the skin since early
1990's. Carbon dioxide laser applied in a precise, painting-like, continuous
fashion replaced older techniques such as dermabrasion, deep phenol and
high-concentration TCA peels in the 90's as a full face resurfacing
modality. In a blood-less field the carbon dioxide CO2 laser generates brief pulses of high-energy light to
vaporize the upper layers of skin and heat up the deeper skin layers.
The wounded outer layer (epithelium) recovers while new collagen is
synthesized in the deeper layers resulting in refreshed, smoother,
younger lookng skin. While very successful in significantly improving
of skin wrinkles as well as acne scars, full face carbon dioxide laser
resurfacing was associated with fairly long wound healing times before
the redness of the new skin layer would disappear. Along with some risk of scarring and
permanent skin bleaching the full skin resurfacing has been been
replaced by the faster healing and much safer fractionation technique.
Since 2009 Dr. Zemplenyi has been the first surgeon in the Seattle
area to use the Cynosure SmartSkin TM micro-ablative, fractionated CO2 laser in gentler, low-energy doses to sequentially
treat wrinkles such as those around the eyes (crow's feet). Treatments
performed using lower power settings result into a faster
recovery-- three to six days after each treatment. Fractional coverage
of the treated skin surface using fractionated CO2 laser
not only allows for faster recovery but also diminishes on the potential
complications such as scarring and delayed hypo-pigmentation
(abnormally white, blotchy skin). While patients may require
several treatments to achieve a pleasing result, the recovery process is
ideal for the person not able to take time off work as is required with
more powerful laser settings. Higher power settings are still utilized
for more resistant problems such as the upper lip smoker lines and acne
scars. SmartSkin TM CO2 laser is imported from Italy and is also
known in the United States as a DOT SmartXide CO2 laser. The results
obtained by this laser system are comparable to other fractionated CO2
lasers such as Fraxel CO2 TM and
Lumenis Active FX TM & Deep FX TM lasers
as well as the Sciton Pro-fractional TM erbium laser.
Pre-operative bleaching creams and retinoids are often begun about three weeks prior to the procedure,
especially in darker skin patients. Anti-viral (herpetic) medications (Zovirax TM or Valtex TM ) are also used in the period immediately before and after the procedure.
Segmental fractionated laser skin resurfacing is very well tolerated
when performed under topical anesthesia (application of a numbing cream
and surface cooling). When the entire face is to be treated at a higher
level setting such as for acne scars Dr. Zemplenyi offers his patients
to under "twilight sleep" for maximum comfort.
Aquaphor or Alba non-petrolatum jelly TM is applied liberally to the treated skin for several days. Post-operative discomfort
is usually very minimal and easily controlled with over-the-counter
anti-inflammatory medications such as Ibuprofen. Sometimes we use anti-inflammatory steroids
to reduce on redness and swelling. Camouflage cover-up make-up is
applied to the healing skin in four to six days. Without make-up the
skin remains pink for about three weeks depending on the energy used for
the treatment. Use of appropriate sunscreen is mandatory. At the Bel-Red Center for Aesthetic Surgery
we also often combine a fractionated CO2 laser treatment with
eyelid surgery, facelift or a forehead lift.
Dermabrasion
There are many scars that warrant special attention from a cosmetic
and facial plastic surgeon. Scars can be improved by a variety of
techniques. Dermabrasion (surgical sanding) of small surface areas
may be the tool used, instead of CO2 laser, to
plane down a raised traumatic scar resulting from an old injury or prior
surgery.
While scars cannot be completely erased, the surface may be leveled to minimize shadowing
and to achieve a smoother appearance. Dermabrasion and scar revision are most often
performed under local anesthesia. Initial healing takes 7-10 days followed by a period of
some redness.
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