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School of Medicine
Skin Resurfacing (Facial Peels & Laser Surgery)
- Is Skin Resurfacing for You?
- Making the Decision for Resurfacing
- Understanding Skin Care Procedures
- What to Expect After Skin Care Procedures
- Follow-up Care
- Request an Appointment
Premature wrinkling is more common now than ever before due to environmental exposures. 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.
The goal of skin resurfacing (including chemical peel and dermabrasion) is to resurface the outer layer of the skin to minimize acne and other scars, age lines and wrinkles.
Important factors to be discussed with your surgeon include:
- Skin type and color
- Ethnic background
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 your surgeon of this condition.
Before deciding on a skin resurfacing procedure, your facial plastic surgeon 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.
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 sun block.
Your surgeon may also suggest other surgery, either before or after your resurfacing procedure in order to enhance your overall appearance.
What you should expect:
- During the preliminary consultation, your surgeon will take a thorough medical history, as well as assess your mental and emotional attitudes toward skin resurfacing. Because a realistic attitude is crucial to the success of the procedure, realistic expectations will be discussed.
- Your surgeon will examine your face and skin.
- After the decision to proceed with skin resurfacing is made jointly by you and your surgeon, the surgeon will describe:
a. The technique indicated
b. The surgical facility
c. Possible complications
d. Costs of the procedure
Following is a general description of skin resurfacing; chemical peels, dermabrasion and laser surgery. Remember, each patient’s individual needs and features are considered before your surgery.
- To understand this procedure, it is important to review how skin grows and repairs itself.
- 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, the surgeon 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.
- The surgeon uses a local anesthetic and/or a freezing agent to render the skin numb.
- Then, using a high speed rotating brush, the surgeon 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.
Note: These are general guidelines. Please ask your doctor to fully explain what your expectations should be post procedure.
- Immediately following a chemical peel or dermabrasion, the surgeon may apply a dressing to your skin.
- Swelling and "crusting" of the skin are normal. 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.
- The surgeon often recommends a soft diet, avoidance of extremes in temperature and any activity that would cause stress to healing skin.
- 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.
- 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.
Follow-up care is vital for this procedure to monitor healing. Obviously, anything unusual should be reported to your surgeon immediately.
Follow-up care involves using sun block in order to protect the skin while new pigment is created. It is essential that you keep your follow-up appointments with your surgeon.
Read more about what you should do after your chemical peel procedure.
To request an appointment or to get more information about the Johns Hopkins Center for Facial Plastic and Reconstructive Surgery, please call 877-546-4530.
Illustrations courtesy of the American Academy of Facial Plastic and Reconstructive Surgery