Posts Tagged ‘chemical peels’

A New Year, A Fresh Look: Facial Rejuvenation

Facial rejuvenation gives you a fresh new look for the new year. Emory Aesthetic Center offers surgical and nonsurgical options.For many of us, a new year brings new hopes and wishes for a better life and better health. Maybe you’ve resolved to start taking better care of yourself this year but aren’t sure where to start. How about with your skin?

At-home skincare

For some, a simple skin care routine may be enough to achieve a fresh look. Medical-grade exfoliating agents, moisturizers and a broad-spectrum sunscreen can renew and protect the superficial layers of your skin and bring back your natural glow. Skin care products like these are available at the Emory Aesthetic Center Spa.

Non-invasive facial rejuvenation

Chemical peels and Intense Pulse Light (IPL) are popular noninvasive procedures to renovate the top layers of skin. Depending on your skin type, it’s possible to:

  • Soften fine wrinkles
  • Erase sun spots and blemishes
  • Improve melasma and freckles
  • Stimulate collagen production to treat and prevent facial aging

For mature skin, with more intense sun damage and wrinkling, deeper treatments like Croton oil peels or CO2 and Erbium lasers are great options. These procedures work in the deepest layers of the skin to improve stubborn lines and skin laxity. These deeper skin treatments require about a week of downtime but give longer lasting results.

Injectables and fillers

Injectables , like Botox®, and fillers , like hyaluronic acid, are incredible rejuvenating agents that help treat and prevent signs of aging. Botox is used to relax face muscles and treat wrinkles that appear with facial expressions. They also can prevent wrinkles from becoming permanent. Fillers are used to restore volume and enhance the shape of specific facial areas. They are used to treat folds and wrinkles around the mouth, improve the shape and volume of the lips, treat hollow eyelids and improve the cheek bone volume and projection.

Surgical facial rejuvenation

There’s a wide offering of noninvasive procedures that give amazing and natural looking results, but sometimes surgery is the only option. For instance:

  • Neck – Neck laxity may show up as a bulge under your chin or a change in your jawline. It’s hard to treat without surgery because extra skin needs to be removed and lax muscle needs to be tightened. Only a neck lift can treat this and produce a lasting result.
  • Eyes – Upper and lower can lose volume and build up extra skin. Although it’s possible to treat mild aging changes in these areas with noninvasive procedures, a surgical procedure like a blepharoplasty eyelids is usually needed to remove extra skin and under-eye bags.
  • Eyebrows – Eyebrows can droop beneath the brow bone. When this happens, a brow lift is needed to reposition the brows and rejuvenate the area.

Emory Aesthetic Center

If you’re considering a fresh look, come see the expert physicians at the Emory Aesthetic Center for a complimentary consultation. We’re happy to help you find the right surgical or nonsurgical procedure for your goals.

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Facial Rejuvenation- Secrets to Defying the Aging Process

Learn the secrets to defying the aging process with facial rejuvenation. Renew your face with tips from a board-certified cosmetic surgeon.Aging is a part of life. And yes, your appearance will change as you get older. But that doesn’t have to be a bad thing. Aging gracefully is about allowing the best version of yourself to shine through, and there are countless facial rejuvenation tools to help you do just that.

Facial Rejuvenation Starts with Skin Care

Skincare is the first and most important step of facial rejuvenation. You don’t need to ditch your current products and spend a fortune on complete skin care “systems” to get good results.

A licensed aesthetician can help. Find someone who’s willing to listen to your concerns and offer advice to help you get the results you want within your budget.

These products can help you look your best:

• Sunscreen. Use sunscreen every day to prevent aging sun damage, such as dark spots and fine lines.
• Vitamin C. Apply Vitamin C to your skin to reduce the effects of sun damage and significantly brighten your complexion.
• Tretinoin (Retin-A). Use a Retin-A product to penetrate the deeper layers of your skin and stimulate collagen production. It also works as a mild daily exfoliant.
• Prescription medicine. Ask a dermatologist about certain prescription medicines (such as hydroquinone), which can lighten dark brown spots, patches and hormone-induced darkening.

Chemical Peels and Micro-Needling

Minor procedures for facial rejuvenation such as mild to medium facial peels (also known as chemical peels) and micro-needling can do wonders to kick-start a healthy routine and help your skin care products to work even better. Regular peels can help keep your skin texture looking younger as you age.

Injectable Treatments

You may get great results from fillers and/or Botox© if you have these early signs of aging:

• Mild volume loss
• Fine, early creases around your forehead and/or between your eyes
• Crow’s feet

Most patients have more than one of these signs, plus others such as loose skin and fat build up. You may need a multi-step action plan for facial rejuvenation to tackle multiple concerns.

Cosmetic Surgery

If you’re trying to use fillers or Botox for something that really requires cosmetic surgery, you probably won’t be happy with the results.

For example, if you have extra skin or fat around your eyelids and use Botox to lift your eyebrows, you may end up with an unnatural, arched expression. If you use an injectable filler to add a significant amount of volume to your jawline, you may look more “puffy” than youthful.

There are many surgical procedures that can help you put your best face forward. Talk to a board certified cosmetic surgeon to learn which procedures may be right for you.

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About Dr. Sethna

anita-sethna-avatarDr. Sethna understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients.

A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

How To Get Cosmetic Surgical Results Without Surgery

natural-beautyNo one really wants to have surgery if they don’t need it; therefore, it isn’t surprising that cosmetic surgeons are asked quite often how someone can get surgical results without actually having surgery. Well, it certainly sounds good . . surgical results without surgery, right? The problem is that it really doesn’t work that way. The long and the short of it is in order to get the dramatic results of surgery, you have to have surgery. But with all of the new non- and minimally-invasive treatment options that have become available in recent years, the answer isn’t always so cut and dry, and there are options. It is not a matter of good versus bad, but really understanding the differences between the surgical and the non-surgical options, and figuring out which one is going to best help you achieve your goals.

The facial region is the area with the greatest number of non-surgical options, from Botox® to dermal fillers and chemical peels to lasers and micro-needling. Non-surgical treatments can be quite effective in the face when you are treating the right problem. Botox® does a wonderful job of temporarily softening wrinkles in the forehead, between the brows, and the sides of the eyes. Dermal fillers can plump up the cheeks and minimize creases around the mouth. Skin products, in-office chemical peels, Intense Pulsed Light (IPL), micro-needling, and lasers can do a superb job of improving the fine wrinkles, texture, and pigment in the skin. However, if you are looking to reduce the jowls, tighten the neck or lift droopy brows or eyelids, then non-surgical treatments won’t provide the results that you seek. It is extremely common patients will undergo a blend of surgical and non-surgical procedures to take advantage of the strengths of both. In younger patients who are not yet ready for surgery, non-surgical options may provide them exactly what they want.

For breast augmentation, the surgical versus non-surgical comparison doesn’t work, because there really aren’t non-surgical options to do the things that patients want. At the present time you can’t increase the breast size, reduce the breast size, or lift up drooping breasts without surgery. In the breast, though, the discussion is often around full length or reduced incision approaches. Like non-surgical treatments, reduced scar approaches sound really positive – and of course who wouldn’t want that? However, in some cases a full scar approach is required to get the degree of results that a patient wants or needs.

Only recently have significant non-surgical options emerged for treatment of the abdomen, flanks, and thighs. These treatments are directed at two primary goals – reducing the fatty layers and tightening the skin. Infrared therapy, external ultrasound, and cryolipolysis (fat freezing) are all energy devices approved to reduce the thickness of the fatty layer. CoolSculpting® is a fat freezing treatment currently available, and it is the treatment that we have chosen to offer at the Emory Aesthetic Center due to the level of comfort experienced by patients and the medical studies that support its use. But not all patients get the results that they seek. And while a few patients don’t seem to achieve much of a result, a small number of patients are “super-responders” who can get a dramatic result, sometimes with just one treatment. But overall, most patients will see a 10-20 percent improvement in an area with a single treatment, but for additional improvement they will need repeat treatments. Liposuction is the surgical counterpart to fat freezing. Not surprisingly, liposuction allows us to treat more areas at a time, be more aggressive in fat removal, and depending on the number of areas to treat and the number of CoolSculpting® sessions, sometimes liposuction can be less expensive as well.

At this point, non-surgical treatments seem to do a better job at fat removal than skin tightening. For this reason, there isn’t much in the way of non-surgical options for patients that may have significant skin laxity, for example when they need a tummy tuck or thigh lift. In these instances, surgical resection can be combined with liposuction to not only tighten the skin, but to sculpt the tissues as well. It is because of this combined strategy that tummy tucks, for instance, can produce some of the most dramatic improvements of any of the surgeries that plastic surgeons perform. However, if a patient is young and has generally good skin quality, with limited fatty deposits, fat freezing without the need for surgery can be a great option.

To pull it all together, there are some things that surgery can do that non-surgical treatments simply can’t do. In other cases non-surgical treatments can be highly effective and can provide for you the results you want – without the need for a surgical procedure or significant recovery period. What is best for you depends on your specific appearance, your tissues, and your goals. At the Emory Aesthetic Center, we are happy to be able to offer the entire spectrum of surgical and non-surgical options. Our board-certified physicians can work with you to determine the best solution for you and your desired result.

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About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Facial Rejuvenation: Temporary versus Long Lasting Effects

temporary-vs-permanentLike most things in life, when considering a cosmetic procedure to rejuvenate the face, there are many things to take into account. For instance, some procedures are less invasive and have minimal recovery time; others are much more invasive and may require several weeks to fully recover. There is also the cost factor to think through as well. The right procedure for you will depend on many of these factors, along with the goals that you have.

For most patients, this comes down to a question of “Do I need surgery, or will non- (or minimally) invasive procedures give me the results that I’m looking for?”. There is no doubt that non-invasive or minimally-invasive procedures are inherently attractive as an option. They usually offer minimal or short-term discomfort, there are no scars to heal and fade, and patients don’t generally have significant bruising or swelling. Also, the cost of a single minimally invasive treatment is usually significantly less than that of a more aggressive, comparative surgical procedure. Examples of minimally invasive treatments include injectables like Botox© and dermal fillers, lasers and Intense Pulsed Light therapy, high grade skin care products, and skin treatments like chemical peels, facials, or micro-needling. These are some of the most common treatments performed in aesthetic centers.

So with all these great attributes and options for minimally invasive treatment, why do patients still often choose surgery? There are several reasons.

First, minimally invasive treatments are usually temporary. For example, Botox© (and similar products such as Xeomin© and Dysport©) do a great job of relaxing the muscles that create the wrinkles between the eyebrows (“the 11’s”), across the forehead, and in the corners of the eyes (“crow’s feet”). However, these muscle relaxers typically work for 3-4 months and then the effect wears off. This requires the patient to come back to the office for repeat injections. Dermal fillers typically last longer. Depending on the type of filler and the area treated, effects may last anywhere from six months to a couple of years. Some patients simply prefer something more permanent, and they want to avoid repeat treatments.

A second reason is that some aging changes cannot currently be corrected by anything but surgery. Examples include the development of jowling or of significant skin looseness in the neck area. Although some companies might hawk a magic cream or energy device to handle these kinds of issues, these don’t really work and the solution is a facelift (which includes lifting the neck). A facelift can dramatically improve these areas, and the results last for many years. Other examples of changes that require surgery as opposed to non-surgical treatments include significant droopiness of the brows or eyelids.

As plastic surgeons, we are reluctant to call the results of facial rejuvenation surgery “permanent,” although in many ways they are. Let’s say a patient undergoes a facelift and loves the improvement in skin tightness, the jowls, the neck contour, and the folds around the mouth. Once healed, these results will look good for many years. However, over the course of these years, the aging process will continue – skin will become more lax, and tissues may start to droop a bit. At some point, typically after 7-10 years or more, the patient may want to undergo additional surgery to treat these changes. But even at ten or more years after surgery, results are better than they would have been without surgery in the first place. The tendency for some recurrence over time varies by the different area of the face being treated. Brow lifts, upper eyelid tucks, and the neck portion of a facelift tend to last a long time and require repeat surgery less often, or never. Some recurrence of laxity in the lower face, however, is more common. Therefore, many patients may consider a secondary face lift 7-10 years or more after their first procedure. Of note, this secondary procedure may not need to be as extensive as the first procedure.

A third consideration is cost, and there is no doubt that surgical procedures typically cost significantly more in the short term. However over the years the cost of maintenance by means of repeated non-invasive treatments will continue to rise, often to the point that surgery can be far cheaper in the long run.

Finally, it is very helpful to think about temporary (typically minimally invasive) treatments and long lasting treatments (typically surgery) not as an “either or,” but as a “yes, and”. In other words, many patients benefit from both. For younger patients who are not yet ready for surgery, the less aggressive and temporary treatments are an ideal option. For older patients who are undergoing surgery, minimally invasive treatments can enhance and help maintain their results. It is extremely common that we “mix and match” various surgical and non-surgical procedures to offer patients the combination of treatments that will give them the best results.

If you are wondering about temporary versus long lasting treatments, and non-surgical versus surgical, the board certified physicians at the Emory Aesthetic Center can perform a comprehensive skin and anatomical assessment, and can help you think through the options and choose an approach personalized to you and your needs.

 

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About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

New Year Refresh: Solutions to Remove Years of Aging

Remove Years of AgingAh . . . the New Year is already upon us, and while we take time to reflect on the year that just flew by, many of us are also looking at our reflection in the mirror. Perhaps that reflection is looking a little tired . . . worn . . . older than the energy you feel inside. Now is a great time to think about what you can do to refresh and rejuvenate that reflection, and get ready for your best year. More than ever before, there are many options to help you achieve this goal.

When you want your face to glow, you can’t ignore great skin care. It is that ongoing skin care that creates a base for everything else you might do for your face. Skin care means really protecting your skin from the sun with the right kind of sun block. It means using the right kind of moisturizers to keep the skin well hydrated. It may mean using targeted cosmeceuticals like retinoids, fruit acids, and other treatments to address fine lines, pigment irregularity, or texture changes. Getting on the right skin care regimen doesn’t have to be complex and it doesn’t have to be difficult – in fact it should only take a few minutes a day – but getting on the right regimen does take expertise. Working together with our licensed aestheticians of the Emory Aesthetic Center Spa, we can help you find the right mix of products tailored for your skin type.

In addition to the base of skin care, there are exciting technologies that you can use to make significant changes in your skin appearance. Lasers, IPL (intense pulsed light), and other energy based devices can tighten skin, fade dark spots, and treat those pesky broken veins. Facial peels can also be used to the same end, but depending on your specific needs, may need to be done in a series – peels are usually milder with minimal down time but may require a building up effect over multiple treatments. Or perhaps you might be a good candidate for a surgical peel or laser that may complete the treatment in a single stage. One newer technology that we’re very excited about is micro-needling, a process that combines tiny needles to stimulate collagen formation and the penetration of growth factors to rejuvenate the skin. Micro-needling takes only a few minutes and you’ll be able to put on makeup and be out the next day.

In addition to great skin care, injectables are highly effective treatments to smooth out wrinkles, grooves, or depressions. These minimally-invasive treatments come in two main forms – those that weaken the muscles that help prevent wrinkles, and those that fill in deeper wrinkles or plump up areas of the face. The “toxins,” such at Botox®, reduce the activity of the muscles of expression. They are used primarily to treat wrinkles of the forehead, between the eyebrows, and the “crow’s feet,” which are the wrinkles from squinting that occur at the corner of the eyes. There are several types of fillers which can be chosen depending on the individual needs and areas to be treated. Typical uses of fillers are to fill out the cheeks, soften the look of bags under the eyes, or to fill in the grooves near the nose and corner of the mouth. While Botox® may take a few days to develop effect, many of the fillers demonstrate an immediate effect. Both types of injections are done during an office visit and you can resume normal activities immediately.

As wonderful as skin care and minimally-invasive treatments are, there are some aesthetic goals that only surgery can produce. Need to get rid of those jowls? Is the skin under the chin loose and saggy? Is the skin of the eyelids loose and droopy, or is the brow low? In these kinds of situations, surgery comes to the rescue. A face lift or neck lift, a brow lift, or a blepharoplasty can provide long-lasting and dramatic results, and the recovery time may be a less than you think.

Depending on your age, skin type, genetics, sun exposure, and other factors, there are many potential treatment options to help you achieve the changes you want. To get the very best results, it is important to come up with a comprehensive game plan that is tailored specifically for you and your individual needs. The game plan may include minimally-invasive treatments like Botox® or fillers, it may include surgery, or it may just require routine skin care and products. The Emory Aesthetic Center can help you pull all these pieces together to create a strategy just for you. Come in for your complimentary consultation.

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About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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Holiday Glow – Getting Your Skin Ready for the Holidays

Emory Aesthetic Center Winter GlowYou bought the dress, the new shoes and the jewelry. You secured a babysitter. You have an appointment for your hair. But have you thought about your face? Is your skin ready for the holidays?

The Emory Aesthetic Center Spa can help get your skin ready for the holiday season. The question is how much time do you have before that special event? Let’s discuss the options available to get your skin glowing.

For the Planner – You have everything scheduled weeks in advance.

Since the amount of time required for recovery is not an issue for you, you are a candidate for the most effective non-surgical treatments we have available. This means you will have the most significant change to your skin for your upcoming event.

  • Fractional laser resurfacing can be performed to improve fine lines and wrinkles and the overall texture of your skin. The treatment requires premedication and topical numbing cream. The treatment takes about 45minutes to perform. We ask that you have someone available to drive you home. After the procedure you are very red and swollen and this can last for 3-5days. Your skin will be flaky and rough for up to a week after the treatment. Do this well in advance of a special event. The results can be amazing.
  • Micro-needling is the latest innovation for our Spa, and is similar to fractional laser resurfacing. The difference is that micro-needling is done with small needles as opposed to the laser. It helps with fine lines and improving pore size. Topical numbing cream is used. After the treatment your skin is red, lasting for 1-2 days. The redness however can be easily covered with makeup. Depending on how aggressive your treatment is, some bruising may be evident for up to a week. This is another great option for getting your skin to glow.
  • Medium depth chemical peels are another great way to get your holiday glow. The peel is well tolerated. Minimal discomfort is noted. Immediately after the peel the skin will be red. The peeling process typically begins 3 days after the treatment and can last 4-5 days. Your skin peels in sheets as if you have had sunburn. Beautiful skin is uncovered.
  • Intense pulsed laser (IPL) is another option if you have recovery time. IPL uses laser energy to remove dark spots, irregular pigmentation, and broken blood vessels. It is easily tolerated with minimal discomfort. Your skin will be very red the day of treatment. Brown spots and vessels will appear much darker for up to one week. A great option if spots are an issue.

For the Procrastinator – You tend to do things last minute. You just found a dress and the party is in 2 days, but there is still time to improve your skin.

• A microdermabrasion treatment can be performed to reveal brighter skin. Fine crystals speed exfoliation and the superficial and dull layer of skin is removed. Your skin will be slightly pink after the treatment but will resolve in a few hours. Your new glow is evident the following day.

• We offer a variety of facials that will leave you slightly red after the treatment, although it will resolve in a few hours or the following day. They are a wonderful combination of stress reduction and skin improvement.

• A HydraFacial™ is a multi-step treatment that hydrates the skin and results in glowing skin at the completion of the procedure. No down time required.

No matter how much time you have, the licensed aestheticians at the Emory Aesthetic Center Spa can create an individualized care plan that works for you. We offer all of these treatments and can help you accomplish the goal of glowing skin for the holidays. Take the first step to getting your holiday glow and make an appointment. Visit our website to see our current Specials running through the month of December.

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Facial Peels versus Lasers: Which is Better?

Peels vs. LasersFacial peels and lasers fall under the category of skin resurfacing, which includes treatments that improve skin quality. The improvements range from enhancing the complexion to the elimination of deep wrinkles, and everything in between.

Skin resurfacing is recommended to improve the quality of the skin, skin discoloration, wrinkles and even to some extent to tighten the skin. These treatments are not a substitute for facial surgical procedures or even injectables and dermal fillers, but instead, are regularly recommended as an adjunct to them.

Although the final effect on the skin may be the same for facial peels and lasers, they are very different processes and there is no simple answer as to which one is best.

Both lead to the shedding of the top layer of skin and stimulation of collagen in the deeper skin layers. Facial peels do this through the application of “acid “to the skin, while lasers do it through “heat “energy released by the laser. The acid and the heat result in a “controlled burn” of the upper skin layer. The upper skin layer is then replaced by new or regenerated skin which is smoother in appearance and more even in color. The depth of this “controlled burn “is adjusted according to the condition of the skin and the depth of the wrinkles. The more marked the skin changes, the deeper the treatment and the longer the recovery.

Facial peels are compounded chemicals that are general less costly, and have changed very little if at all over time. There is a variety of peels available ranging from Glycolic acid (fruit acids) to Trichloracetic Acid (TCA) to Phenol and Croton oil peels. The type of peel, the concentration and how it is applied to the skin regulate the degree and depth of the “acid burn”.

Lasers are sophisticated and expensive machines which improve with each new model. There are a variety of lasers such as CO2, Erbium, etc., and the application can be fractioned. The energy level, degree and depth of the laser treatment can be adjusted by turning dials on the laser machine.

Both peels and lasers rely on the experience and knowledge of the practitioner applying the peel or the operator of the laser machine. Lighter peels such as Glycolic acids and lighter TCA peels, as well as some laser treatments may be undertaken in medi-spas and skin spas. However, the deeper and more invasive lasers, and higher concentrations of TCA and Croton oil peels should only be performed by a trained physician in a medical facility.

So which is better? The end results are similar and you should follow the recommendation of your doctor who will choose the modality that will, in their experience, provide you with the best results and the lowest risk. The physicians and aestheticians at the Emory Aesthetic Center are experienced in both modalities and can provide an evaluation and recommendation based on your individual skin needs.

About Dr. Nahai

Foad Nahai, MDFoad Nahai, MD, FACS is internationally recognized as an innovator in the field of plastic surgery where he has developed and refined many procedures. He has co-authored ten books and published over 190 scientific articles on all aspects of plastic surgery. The latest book he authored and edited, published in 2011, is the second edition of his three volume text entitled The Art of Aesthetic Surgery.

He has been invited to lecture and demonstrate plastic surgical procedures all over the world. In addition to numerous professional honors and awards, he is listed in the “Best Doctors in America”, the “Best Doctors in the U.S.”, Town & Country Magazine, Good Housekeeping, More Magazine and Atlanta Magazine as one of the country’s top plastic surgeons. He has been listed in W Magazine as one of the top plastic surgeons in the world. Dr. Nahai is in demand internationally to speak at plastic surgery meetings and to demonstrate surgical procedures.

Dr. Nahai served as the 2008-2010 president of the International Society of Aesthetic Plastic Surgery (ISAPS), he is a past president of the American Society of Aesthetic Plastic Surgery (ASAPS), a former director of the American Board of Plastic Surgery, and is currently Editor-in-Chief of Aesthetic Surgery Journal.

His primary area of expertise is in Face, Neck and Eyelid surgery where he has made significant contributions to the advancement of the art and science of Facial Rejuvenation.

Non-Surgical vs. Surgical Facial Rejuvenation: Which is Right for Me?

Facial Rejuvenation OptionsOver the past several years there has been an explosion of options to help your face look better and younger. Fillers, toxins (e.g. Botox®), stem cells, facelifts, fat grafts, skin tightening, and the list goes on and on. With so many options, how can you know what is right for you? Is surgery better, or will non-surgical treatments help you achieve your goals? Do the treatments even work? As you consider your options, understanding a few general principals can help simplify the decision.

First, it’s important to understand that surgery and non-surgical procedures sometimes do different things, but sometimes they do the same thing in different ways. For instance, deepening of the nasolabial folds (the creases from the side of the nose toward the corners of the mouth) can be softened by dermal fillers such as hyaluronic acid (e.g. Juviderm®, Restylane®). This type of injection is performed during an office visit and only takes a few minutes. Surgery, however, can also diminish the folds. Fat grafts can be utilized to soften the folds much like fillers, and often the most dramatic improvement to the folds is when a face lift is combined with fat grafting.

Second, while non-surgical or minimally-invasive treatments are easy to undergo and recover from, they are typically temporary and will need to be repeated to maintain the effect. Neurotoxins (e.g. Botox®, Dysport®, Xeomin®) do a great job of softening wrinkles between the brows, in the forehead, and by the side of the eyes, e.g. ‘crow’s feet’. These injections take only a few minutes to complete, but they typically last about 3 or 4 months and then need to be repeated to maintain the effect. On the other hand, surgical procedures tend to be more long lasting and may never need to be repeated. A brow lift can treat the wrinkles between the eyebrows extremely well, and this improvement is generally permanent.

Third, there are some aging changes that simply can’t be adequately corrected by non-surgical treatments, at least at this point in time. If you have developed significant jowling, only surgery can reliably address this issue. If the brow position is quite low or there is a significant amount of loose skin of the upper eyelids, only eyelid and brow surgery can reliably reposition the brow or eliminate the loose skin of the upper lid. If there is significant skin laxity in the neck, minimally-invasive treatments will not fully correct the looseness, and a neck lift will be required for full correction.

It is also very important to understand that often non-surgical and surgical treatments represent a continuum of effectiveness. Office chemical peels, mechanical treatments, or facial lasers can do a great job if the degree of skin changes and wrinkling is relatively limited. More aggressive lasers or surgical chemical peels, however, can produce more dramatic results when the skin has more established aging. Very often, minimally-invasive treatments are a great option for less severe changes, while surgical treatments are the best for more severe changes. If you are older and have more advanced aging concerns, surgery is more than likely the answer for you, but if you are in your thirties or forties, very often the non-invasive treatments such as fillers, Botox®, and good skin care is the best strategy.

Finally, and most importantly, marketing and hype doesn’t mean that something works. As much as we are always hoping for great, new options, some of the marketed treatments have little or no proven effect. For example, although the potential of stem cells to treat many conditions – including facial aging – is significant, at this time there are not sufficient studies to show that the currently marketed treatments are either safe or effective. Also, just because a treatment is approved by the FDA doesn’t mean that it is better than the older, simpler, or less expensive procedures. The old adage is upheld: If it seems too good to be true, it probably is.

As you work to figure out your best combination of options, remember that the doctors at the Emory Aesthetic Center are trained in both non-surgical and facial surgical solutions to address your aging concerns, and can help you figure out what strategy is best for you. In addition, we can help you develop a long-term, integrated plan to keep your face looking its best, incorporating good skin care along with non-invasive and surgical treatments when the time is right.

Join us for a live chat on Facial Rejuvenation –Surgical and Nonsurgical Solutions on Tuesday, November 11th at Noon to hear more about this topic. Dr. Foad Nahai, cosmetic surgeon, will be available to answer all of your questions. To register for the live chat, click here.

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Chemical Peels 101

Are you looking to obtain brighter, younger looking skin – diminishing those fine lines and wrinkles, skin discoloration and a dull complexion? Watch this segment on Fox 5 Good Day Atlanta featuring Emory Aesthetic Center surgeon, Dr. Erica Anderson, as she gives you the skinny on chemical peels and discusses how they work and who would be a good candidate.

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For more information about chemical peels, what they are and how they work, check out this previous blog post!

Chemical Peels – What Are They and How do They Work?

Chemical PeelThere are three components related to the aging of the face – loss of volume, descent of the tissues and changes in the skin. As we age the skin loses elasticity resulting in the loss of fullness and that youthful glow. In addition, over time the activities of facial muscles such as smiling, frowning, and puckering of the lips lead to those lines we refer to as smile/frown lines and crow’s feet. Eventually these lines become deeper and are etched in the skin. The process is only accelerated by sun exposure and smoking.

However, there are nonsurgical options to help slow down and reverse the aging process. Retinols, such as Retin A and Renova (derivatives of vitamin A) have a proven role in slowing the process, but there are also skin resurfacing treatments available, such as chemical peels and lasers that are also effective in reversing sun damage and, to a certain extent, the changes associated with aging skin.

Lasers and peels basically function in similar fashion. Both remove the top layer of skin and stimulate collagen deposition or tightening in the deeper layers. The laser relies on heat energy, while chemical peels rely on acid to achieve similar effects. The skin which regenerates appears more youthful with diminished lines and a glow. With lasers the amount of heat can be regulated, while with chemical peels, the concentration of the topical agent is adjusted to regulate the depth of penetration and effectiveness.

There are currently three categories of chemical peels – glycolic acids (fruit acid peels), trichloracetic acid (TCA) and croton oil peels. The glycolic acids are the mildest and the croton oil is the strongest. The concentrations of all are adjusted to suit the individual patient’s skin condition. The milder glycolic acid and more dilute TCA peels are often referred to as “lunch time “peels. There is little down time and the redness resulting from the peel is short lived. These lighter peels are best for individuals with slight skin changes, require no anesthesia and are commonly performed in our Emory Aesthetic Center Spa. These lighter peels may be applied to all skin types and colors.

For stronger peels, the concentration of the TCA and croton oil are adjusted according to the changes in the skin and the location. Higher concentrations are applied to areas with deeper lines and lower concentrations for the thinner skin around the eyes. These deeper peels require anesthesia as there is discomfort associated with them. Typically sedation and local or topical anesthesia is required. Peels may be performed as an isolated procedure or in combination with surgical procedures such as facelifts and eyelid lifts.

For best results we advise that our patients prepare their skin by applying retinoids and “skin bleach” creams to the face for up to three weeks before the peel. The deeper peels which can take up to an hour are usually performed as outpatient in a procedure room or, in some cases, the operating room. There is immediate swelling and some red coloration of the peel areas. Recovery varies based on the type of peel used, the concentration applied and skin type. It may take as little as five days to two weeks or more.

Peels are not a substitute for surgical procedures but are often applied in conjunction with surgery to enhance the result and improve skin texture. The Emory Aesthetic Center, and our cosmetic surgeons, have extensive experience with peels and can customize a plan that best fits your individual need.

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