Surgical Procedures - Skin Treatments

SKIN MANAGEMENt

Treatments that demonstrably enhance the health and appearance of skin, particularly on the face, without using surgery.

A smooth, clear complexion is part of our physical attractiveness. But, as we age, that healthy look becomes more difficult to maintain. The face is the most vulnerable area: the sun dries and burns it; acne, rashes, allergic reactions, and injuries may leave permanent scars. Here we hope to give you a basic understanding of commonly used treatments for maintaining and improving the look of your skin. What can and should be done in your case will depend on a Consultation with our aesthetic physicians or therapists.

A number of non-surgical 'refinishing' treatments are available that will eliminate or soften facial imperfections and achieve a clearer, fresher look. These include:

Glycolic acids (or 'fruity acids') - natural fruit substances blended into facial preparations that eliminate rough or dried surface skin, and
Tretinoin®, a vitamin A-enriched cream that changes the cellular metabolism of the skin's surface and so can combat fine facial wrinkles and suntan blotches. These treatments can be used alone or in conjunction with an aesthetic surgery procedure, such as a face lift or a chemical peel.

'What To Expect

Surface-repair treatments can give your skin a smoother, fresher look, but they cannot remove deep scars and flaws or stop your skin ageing. Generally speaking, Tretinoin® and glycolic acid treatments offer less dramatic results than surgical approaches like dermabrasion, chemical peel or laser resurfacing. They should not be thought of as mini-face lifts. Before you decide to have a skin-rejuvenating treatment of any type, discuss it fully with your plastic surgeon to make sure that your expectations are realistic.

Planning

If you're planning a non-surgical skin treatment, it's important that you choose a doctor who has training and experience in a variety of skin-management techniques. The best treatment or treatment combination can then be selected from the wide range available. Look elsewhere if a doctor tells you that he or she has perfected a single technique that promises unbelievable results. The choice is yours, but do check your doctor's qualifications and experience, particularly since these treatments involve the most visible part of your body - your face. Discuss your treatment goals frankly with your doctor, bringing all your concerns and questions out into the open. Your surgeon should fully explain the factors that could influence your choice of treatment such as age, skin condition, and previous plastic surgery. He or she will also ask you about your whole medical history and conduct a routine examination. If you are having surgery in conjunction with your skin treatment, your doctor should explain the procedure in detail, the risks and benefits, the recovery period, and the costs. Insurance usually does not normally cover aesthetic procedures.

Where?

Your initial application of Retin-A® or glycolic acid will probably be performed in your doctor's clinic or an outpatient facility.

Treatments

RETIN-A®
In general, Retin-A® works most effectively on older patients who have fine facial wrinkles, or blotchy pigmented areas of skin damaged by the sun. However, Retin-A® is often prescribed for younger, active individuals to combat the ageing effects of sun exposure. It is also a useful preparation treatment for those who are planning to have a chemical peel, face lift or laser procedure. Retin-A® thins the skin's outer layer, allowing the acid solution used in a peel treatment to penetrate more deeply and evenly. Retin-A® is not recommended for pregnant women or nursing mothers, because its effects on the foetus and nursing infant are still being studied.
Reactions/side-effects
No serious medical problems have been associated with Retin-A®, but it can cause temporary skin irritation and redness. In these cases a milder formulation can be used.

Beginning treatment
Your initial application of Retin-A® will include a lesson on how to continue your skin-care routine at home. After your face has been washed thoroughly, a small amount of Retin-A® cream or gel, is rubbed over your face and nose. Only a very small amount of Retin-A® - a pea-sized dab - is needed to cover the entire face. A very gentle formula will probably be used at the beginning - especially if you are younger or have a fair complexion. You may be prescribed a stronger formula once your skin becomes accustomed to the treatment. You will be instructed to apply Retin-A® every night before you go to bed. Because the substance is drying to the skin, your doctor may also recommend that you apply a moisturiser once or twice a day. This routine is usually continued for about eight months to a year, after which you'll be switched to a less-frequent maintenance schedule with perhaps only two or three applications per week. At periodic follow-up visits, your doctor may adjust the strength of your prescription or frequency of use. To maintain the benefits of Retin-A®, you must continue to use it for life.

After treatment
Some redness, irritation, itching, stinging, or skin dryness is normal once you begin using Retin-A®. However, these symptoms should gradually disappear as the skin becomes used to the treatment.

Caring for your new skin
Since Retin-A® thins the skin's outer layer, you will need to use a sun-block consistently to protect yourself from ultraviolet light, and you may have to stop using certain products or cosmetics on your face. The degree of change varies from person to person, but with continued use of Retin-A®, you will begin to see subtle improvements in the texture and tone of your skin. A rosy glow in the early months is followed by the disappearance of fine lines and the shrinking of large pores. After about six months, many Retin-A® users report that wrinkles are barely visible and that age spots have faded.
GLYCOLIC ACID
'Fruity acid' treatments offer smoother skin to people of all ages and seem to work best on patients with rough, sun-damaged skin. Sometimes bleaching chemicals are added to correct areas of uneven pigmentation.
Reactions/side-effects
Side-effects may occur even with non-surgical treatments but no serious medical problems have been associated with glycolic acids. If they cause temporary skin irritation and redness a milder formula usually solves the problem.

Beginning treatment
Your initial application of glycolic acid will include a lesson on how to continue your skin-care routine at home. Two common forms are cream and facial wash and the way you apply the treatment to your face depends upon the form it's in. Both forms contain about 12 percent glycolic acid, which helps slough away dry, sun-damaged skin. Both also contain a special moisturiser and, if needed, a bleaching agent. In most cases, the acid is applied to the face twice daily. Your doctor may adjust the strength of the formulation or the frequency of use after evaluating your skin's condition at follow-up visits.

After treatment
Some redness, irritation, itching, stinging, or skin dryness is normal but these symptoms should gradually disappear as the skin adjusts to the treatment.

Caring for your new skin
Glycolic acid thins the skin's outer layer so you will need to use a sun-block consistently to protect yourself from ultraviolet light. You may also have to stop using certain products or cosmetics on you face.

The degree of change varies from person to person but, after continued use of glycolic acid preparations, you will begin to see subtle improvements in the texture and tone of your skin. Overall freshness and smoothness increases and, after a while, pigmented blotches fade or disappear as the bleaching chemicals work. The time necessary for visible results depends on the individual and the degree of pigmentation. Some patients see results in as little as six weeks.

Your new routine
Most users find that maintaining their new look is easier than expected. Using the cream or facial wash simply becomes a natural part of your morning or evening routine - and the improvements you see are worth the extra effort.

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