Skin Rejuvenation and Resurfacing
Remember as a child, your skin was soft and smooth. Unfortunately, over the years the sun, wind and airborne toxins have taken its toll and your skin may be showing signs of aging. Aging changes occur in the epidermal, dermal and subcutaneous layers of the skin; resulting in wrinkles, skin laxity, broken capillaries, and various forms of hyperpigmentation. The skin's surface may develop coarse, leathery texture, lose clarity and brilliance, and appear dull, with little or no reflection of natural sunlight. Despite eating better, living healthier, and keeping fit, your facial skin may not reflect the way you feel inside. If you want to reverse these years of wear and tear caused by sun, the environment, and natural aging, skin rejuvenation or resurfacing may be right for you. 
 
Skin Aging
Our skin is constantly rejuvenating itself. New cells develop from the deeper layers and push the older dying cells to the surface. These non-vital cells act as a protective barrier and flake off throughout the day. Due to excess sun exposure, the environment, and natural aging the layers of dead skin cells begin to accumulate on the outer surface. The glue which holds these cells in place becomes more adhesive, resulting in a dull, rough wrinkled texture. At the same time, pigment cells begin to group together, giving rise to splotchy pigmentation and capillary blood vessels become visible on the surface as small spider veins. 
 
What is Skin Rejuvenation and Resurfacing?
Very simply, skin rejuvenation and resurfacing are treatment options which remove the outer layers of the skin to improve the texture, clarity, and overall appearance of your skin. Skin rejuvenation can be achieved in a number of ways. Think of these options like the rungs of a ladder. The bottom rung represents superficial treatments which remove the outer most layers of dead skin cells. As we move up the ladder of options we are penetrating deeper into the skin layers and will effect more change. With more change comes a smoother, clearer, and more youthful appearance. However, deeper treatments are also accompanied by greater risks. So it comes down to choices and fortunately, these days, we have many options. 

What Can Skin Resurfacing Treat?
Conditions that can be treated with skin resurfacing include:

• Static wrinkles: These wrinkles are visible at all times and do not change in appearance with facial movement.
• Dynamic wrinkles: These are expression lines that may appear as folds when the skin is not moving, and deepen with facial movement or expression.
• Pigmentation: Freckles, sun spots, melasma, or other darkened patches of skin result mainly from sun exposure.
• Scars: As a result of acne or injury to the skin, scars may be rolling (a wavy appearance to the skin), pitted, discolored or have raised borders.
• Vascular conditions: Blood vessels visible on the surface of the skin, vascular lesions that appear as tiny blood filled blisters or even a constant flush of facial redness.
• Loss of Skin Tone: Weakening of the supportive skin structures (collagen and elastin fibers) that result in a loss of skin firmness, or the development of cellulite.

Skin Care Products
Skin care products, ones which are either dispensed in a physician's office or sold by prescription, break down the sticky glue between the dead skin cells of the epidermis, causing them to exfoliate. There are literally hundreds of skin care products available on the market, Retin A, Tretenoin, glycolic acid, just to name a few. There are two things you should remember about all these products. One, they all do the same thing and two, they are all equally effective. Therefore, it ultimately comes down to your physician's clinical experience in dealing with your particular skin type and your satisfaction with the product price, look and feel. It may come down to trial and error when trying to find the correct fit. Skin care products are at the lowest rung of the ladder of skin rejuvenation. Results will be subtle, and will take 3-4 months to materialize. These products will typically improve the appearance of your skin from point A to point B, but most of us expect to see significant improvements. We want to be up at point D, E and H, and yesterday. Skin care products alone won't get you there, but they are an important first step in the rejuvenation process. Individuals who are looking for better and faster results need to move up the ladder and consider in office resurfacing options.  
 
CO2 Laser Resurfacing
Ablative skin resurfacing utilizing the CO2 laser continues to be the gold standard anti-wrinkle procedure for facial rejuvenation. The CO2 laser emits an intense beam of high energy that heats and vaporizes tissue instantly. As the laser beam is guided over the wrinkled and sun damaged skin, it gently removes the outer layers leaving a red raw surface. With each pass of the laser, more layers of skin are removed. The skin color is used as an indication of depth of laser penetration. These signs are used by your Facial Plastic Surgeon to minimize the risks of scarring and change in pigmentation.
 
After the procedure in most cases, Flexan, a biological bandaid dressing is applied for a few days to expedite the healing below. Patients report a sun-burn feeling for 2-3 hours following which they have little if any discomfort. Within a few days, new skin cells resurface the raw area resulting in a softer, smoother more youthful appearance quickly.  Most if not all the wrinkles appear to be gone because the tissues are swollen. As the swelling subsides over the ensuing few weeks, some of these lines will reappear. Don't panic; new collagen production takes several months and final results are not evident for 6 months.

After the Flexan is removed, post operative wound care includes cleansing the skin surface with a white vinegar solution and applying Aquaphor to maintain an occlusive seal. By 7-10 days after the procedure most patients can resume normal activities and apply makeup. Redness however can persist for 8-10 weeks.

The CO2 laser is the most aggressive of the resurfacing options. It's the top rung of the ladder of skin rejuvenation. As such, results with the CO2 laser are the most impressive. But most physicians either haven't been adequately trained or don't feel comfortable performing CO2  laser resurfacing and therefore won't offer it as a rejuvenation alternative. The heat from the CO2 laser is intense. If small areas of the face are being treated such as around the eyes or around the mouth, local anesthesia is injected much like going to the dentist to make the procedure more comfortable. In cases where the entire face is being treated, general anesthesia or intravenous sedation is encouraged. Results with CO2  laser resurfacing will last for approximately 5 years.

There isn't any better time than now to turn back the clock of aging. With so many available resurfacing options to choose from, Facial Plastic Surgeons can customize a treatment plan to your expectations and lifestyle.
 

How do I choose my surgeon?
No matter what type of cosmetic surgery you are considering, one of the most important factors in your satisfaction is the surgeon you choose. Make sure your surgeon is board certified by the American Board of Facial Plastic and Reconstructive Surgery. This ensures that your surgeon is specialized in facial procedures. Make sure your procedure is done in an accredited facility. Ask how often your surgeon performs the procedure in question. The more you know about your surgeon and the procedure the more likely you will have a successful outcome.

What is the next step?
If you are interested in exploring the possibility of skin resurfacing, call The Sullivan Centre, central Ohio's only free standing ambulatory surgical facility dedicated to cosmetic surgery at (614) 436-8888.