Program of Facial Skin Rejuvenation
The general health of an individual can often be reflected in the quality of the skin. The skin is a barrier of defence against atmospheric physical, chemical and biological insults.
Adjusting your lifestyle by measures like promoting psychological well being, maintaining moderate physical activity, avoiding smoking, protecting the skin from sun damage, to avoid dehydration, to keep a healthy and balanced diet is an essential step to keep the skin healthy for longer.
The most patent changes in the shape of the face with aging are due to changes of structures deeper than the skin. Aesthetic Plastic Surgery procedures are specifically designed to address these changes.
Whether or not surgery is part of the rejuvenation management, a Program of Skin Rejuvenation is an essential adjunct if one is to achieve the best possible result. The skin conditioning is achieved by the use of topical agents that work synergistically to regulate skin cell’s functions and improve circulation. This action allows skin to constantly renew itself, repair damage, and retain natural moisture and function at a peak level. This type of healthy skin looks beautiful, tolerates cosmetic procedures better and heals faster. You can work with the science of your skin to restore health with help from the medically prescribed Health Restoration System.
When required, and often as part of the preparation for aesthetic procedures, Mr. Matti will prescribe the medical products appropriate for your skin type and colour. These products are often a combination of cleansers, toners and creams that enhance the action of prescription medications like tretinoin and hydroquinone. It may also be required to administer a TCA (trichloroacetic acid) peel.
The concept of taking steps to restore and maintain skin health is a radical departure from the conventional philosophy of correcting specific skin diseases without maintaining the skin after treatment. Less attention has been paid to regulating the function of skin that is not diseased, but simply showing signs of deterioration due to normal aging or sun exposure.
Part of the skin rejuvenation management consists in the use of a medically prescribed tretinoin medication in combination with hydroquinone, alpha hydroxy acids, and phytic acid products. This combination helps make the skin healthier and addresses dysfunctional skin conditions such as acne, hyperpigmentation, and photoaging. Skin Health Restoration also offers adjunct support to many cosmetic procedures.
Zyderm® is purified collagen prepared in a liquid state so that it can be injected into the skin in order to fill out the wrinkle lines or depressed scars. This material is almost identical to the collagen in your skin and so behaves like a graft, the new collagen fibres becoming vascularised and incorporated into the collagen structure of your skin.
This material has been extensively tested during the past twenty years. It is most effective for filling out small contour defects in the skin, for example small-pitted scars, frown lines or lines around the upper lip and cheeks. It is not suitable for filling out larger areas, for example in order to build up cheekbones or chin.
How many injections?
First you require a small test dose in the skin of the forearm to ensure that you are not allergic to the material (a rare occurrence). After three weeks, and a negative reaction, the facial skin is injected and usually requires a second (and occasionally a third) injection to fully smooth out the wrinkle or depression. These injections are done through a very fine needle and any slight swelling subsides within 24 hours. It is better not to use make-up for 24 hours, or go into strong sunlight.Occasionally the site of treatment may be slightly raised, we advise that you massage this area gently with your fingertip.
Is it permanent?
This depends on the type of skin and the, amount of movement. A small depressed scar is sometimes permanently corrected. A strong creaseline frequently moving will inevitably recur to a degree over the 3-4 months, and a "top-up" is then required. Unfortunately there is no method of making time stand still, but injection of collagen is more effective and a safer technique than for example dermabrasion, chemical peel and liquid silicone (this last one I don’t use), and represents a very real advance in the treatment of facial wrinkles and small depressed scars.Restylane®, Perlane® and Newfill®:
In recent years we have been using hyaluronic acid (Restylane®, Perlane®) and other filler substances as Newfill®. Each of these types of injectable fillers have particular advantages for the specific needs of different patients.
Restylane® and Perlane® are preparations of hyaluronic acid. Restylane® is a lighter density preparation than Perlane®, this last preparation tends to provide more solid support and is appropiate in deeper and more well formed folds than Restylane® which is thinner. Both preparations are very suitable substances for lip enhancement and for the filling of skin lines and folds. The occurrence of allergies is less frequent than for collagen hyaluronic acid treatment that does not require a test before the treatment.
Restylane® and Perlane® treatments are repeated usually every 3 to 8 months depending on the rate of re-absorption. Perlane® lasts longer than Restylane® but usually the tissues temporarily swell more and very rarely can be visible or palapable.Newfill® is made with polylactic acid. This filler is reabsorbable as well but the filling effects are longer lasting than with hyaluronic acid (12-18 months). Newfill is not suitable for lip enhancement. Newfill® can be used very successfully for the treatment of deep folds and facial contouring in the cheek and jaw-line.
All the above filling substances tend to have specific indications, advantages and disadvantages that should be balanced in accordance to your specific requirements and complexion.
Side effects and complications are very rare with the use of re-absorbable fillers but will be discussed in detail during consultation.
In our office you will also be provided with information sheets specific for the different products mentioned in these sections.
Dermabrasion is a form of skin planing used for the treatment of certain types of irregular scars and is most often employed for pitted acne scars. It can also sometimes be used to improve the quality of ageing skin and can be combined for this purpose with a face-lift. The operation is performed under a general anaesthetic and can also be carried out on a day case basis.
Post-operatively the face is dressed with a fine, colourless transparent plastic membrane that gradually peels off as the skin heals. Trim away the loose edges of this membrane each day so that by the time you return for your post operative appointment, which is usually within a week, the majority of the skin, has been removed leaving a freshly healed, smooth, pink skin surface. This fades quite quickly over a few weeks, but do not use make up during the initial three weeks. Normally I like to use Vaseline applications immediately after treatment, and after one week 1% Hydrocortisone cream for another week.
Possible Complications
1. You should avoid peeling off the dressing before the skin has healed. This may result in the formation of a crust, so apply a small amount of vaseline daily, which will facilitate trouble free healing.
2. Infection is extremely rare, and you should notify me immediately for the appropriate treatment. If you have a high tendency for cold sores (herpes virus infections) you may need to be prescribed special medication before the dermabrasion procedure to reduce the chances of this infection occurring after treatment.
3. Development of small, pinhead size white spots sometimes appear in the freshly healed skin, and this is due to blocking of the pores. These will clear up spontaneously, and this process is aided by keeping the skin lubricated, as already described.
4. Altered skin pigmentation is a risk that is greater in darker skinned individuals. Protect the skin from sunlight during the first three months when the skin is sensitive and might otherwise tan unevenly or burn excessively. Use a protective sun block until you are confident that your skin has recovered fully from the surgery. Occasionally a person on the contraceptive pill will develop patchy skin pigmentation, so therefore it is advisable to discontinue this for one month before your treatment and two months after the dermabrasion.
Dermabrasion can only remove small shallow acne scars, and improve the deeper scars, so the result will depend on these variations in different people.
It is better to mention any history of taking Acutane for acne for the last 12 months, as this has a detrimental effect on the healing of the skin after laser treatment.
Sometimes after six months it is worthwhile to repeat dermabrasion a second time in areas of deeper scarring, but there is obviously a limit to this as excessive treatment can result in poor healing and remove the pigment-forming layer of the skin.
In general, the results are gratifying and a convalescence of 2-3 weeks will allow enough time before returning to normal activity.
More details about dermabrasion in general and in relation to your specific needs and goals will be discussed during consultation.