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SKIN RESURFACING


Aging, sun exposure, heredity and lifestyle factors including nutrition, alcohol, consumption and smoking all may contribute to facial wrinkling. Pigmentary changes of the skin, such as blotchiness or brown spots, may also occur with age or as a result of birth control pills, pregnancy or genetic factors. These problems, as well as certain other skin conditions, may be improved by skin resurfacing.

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ARE THESE PROCEDURES GOOD FOR ME?


You may be a good candidate for skin resurfacing if you have one or more of the following conditions: * wrinkled or sun-damaged facial skin
* vertical wrinkles around your mouth, such as those that cause lipstick "bleed"
* "crow's feet" lines around your eyes and perhaps some skin laxity in your lower eyelid area
* fine wrinkling of your upper eyelids
* brown spots or blotchy skin coloring
* certain precancerous skin growths
* superficial facial scars from a past injury

Patients may have their skin resurfaced at almost any age. You may have certain characteristics that make you a better candidate for one technique rather than another. The amount of time you can allow for recovery may also be an important factor in selecting a particular resurfacing method or determining the extent of treatment. All resurfacing techniques can be performed to varying depths. A more superficial treatment will require minimal healing time, but you may need to have the procedure repeated more than once to achieve the same results as a deeper treatment. If you are having aesthetic (cosmetic) surgery, such as a facelift or eyelid surgery, you may be able to have a skin resurfacing procedure performed at the same time. During the consultation, you may be asked to look in a mirror and point out the specific areas of your face that you would like to see improved. This will help Dr. Saieh understand your expectations and determine whether they can realistically be achieved.

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DURING YOUR INITIAL CONSULTATION


Dr. Saieh will carefully examine your skin to determine which resurfacing technique, or combination of treatments, will provide you with the best results. Your skin type, the severity of any sun damage, the extent of uneven pigmentation and the depth of skin imperfections will be evaluated. Fine lines or coarse wrinkling each may require a different approach to treatment. You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries, and medications that you currently take.

Be sure to tell Dr. Saieh if you have ever had x-ray treatments of your facial skin or if you have had a prior chemical peeling procedure. Current or past use of Accutane™, as well as Retin-A™ and other topical skin preparations, must be reported to Dr. Saieh. For your safety, it is important that you provide complete information. Sunscreen protection before and after any of the treatments for skin resurfacing is very important to prevent complications and to improve the results of your treatments.

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PREPARING YOURSELF FOR ALL SKIN RESURFACING TREATMENTS


How to prepare yourself for skin resurfacing depends upon which of the treatments you are going to have. Dr. Saieh will place you on a before and after-treatment program during which you will apply special creams, lotions or gels to your skin for a few weeks or longer. You may also be given certain oral medications that you should begin taking prior to your treatment. Dr. Saieh will provide you with additional instructions. Sunscreen protection before and after any of the treatments for skin resurfacing is very important to prevent complications and to improve the results of your treatments.

Depending upon the procedure you are going to have, you will be asked to please stop, at least two weeks before the procedure, all prescription and non-prescription herbal-like vitamins, diet pills, energizers, stimulants and appetite suppressants either bought in the USA or a foreign country, i.e. Mexico, etc. Bring them to the office and tell Dr. Saieh about them. Depending upon the laser chosen you may be asked to stop taking Aspirin or Ibuprofen or any other related anti-inflammatory products for a period of three (3) weeks before and after the procedure, because they can cause increased bruising/bleeding. To take Tylenol (Acetaminophen) is okay. If you are a smoker, you will be asked to stop smoking well before and after the procedure. For the deeper, more extensive procedures, local anesthesia alone or combined with intravenous sedation is used for patients undergoing skin resurfacing procedures. When the treatment is completed, your resurfaced skin may be covered with petroleum jelly or other protective ointment. In some cases, dressings, tape or a bandage may be applied.

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DIFFERENT KINDS OF SKIN RESURFACING TECHNIQUES


Laser skin resurfacing, chemical peels and dermabrasion all achieve results in different ways. Layers of your skin are removed and, as the healing process progresses, a new, healthier-looking skin emerges. What differentiates the various resurfacing methods is the way in which the skin's layers are removed. Chemical peels involve the application of a caustic solution, dermabrasion utilizes a high-speed rotary wheel, and laser resurfacing uses a laser beam.

New laser technology permits fine wrinkle reduction without downtime

Pulses of laser energy are applied to target the layers underneath the epidermis, where collagen is produced. The procedure stimulates these skin cells, known as fibroblast cells, to produce more collagen. The end result is a smoothing out of fine wrinkles and scars and a younger, rejuvenated complexion. This type of laser treatment is a marvelous technique for individuals that have any fine wrinkles. The number of treatments required varies from person to person, therefore, during your consultation, Dr. Saieh will recommend the number of treatments required to achieve your desired result The quick and low-pain procedure allows you to resume regular activities afterwards.

For about a half-hour to an hour following the procedure, patients may experience a warm sensation and a blushing of the treated skin, but make-up can be applied immediately afterwards. Improvement in the skin's tone and texture continues to be evident for a period of four to six weeks after the procedure is performed. The deep wrinkles and/or folds will require different treatments. For the newer laser treatments with no down time, the procedure will be performed in Dr. Saieh's office. For the newer laser treatment, topical creams used to decrease the discomfort or pain, will be applied before the laser.

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OTHER TYPES OF LASER RESURFACING


Skin resurfacing using a carbon dioxide (CO2) laser is one of the techniques described here. Its effects are similar to those of chemical peels and dermabrasion, except that the laser removes skin layers by vaporization rather than with chemicals or a sanding device. Dr. Saieh is trained in the safe use of laser equipment. He is able to specify the amount of energy transmitted to the skin's surface by the laser beam and control the depth of penetration. skin resurfacing The subject of risks and potential complications of skin resurfacing is best discussed on a personal basis between you and Dr. Saieh. Following all resurfacing treatments, it is important that you avoid direct or indirect exposure to the sun until all the redness or pinkness of your skin has subsided. Even after that, it is advisable for you to protect your skin by regular use of a sunblock and, whenever possible, a wide-brimmed hat. If the area around your eyes has been treated, you should wear good quality sunglasses when outdoors. After some types of skin resurfacing treatments, you may need to be careful about exposing your skin to chlorinated water. You can minimize certain risks and help to maintain the results of your skin resurfacing treatment by following the instructions of Dr. Saieh.

skin resurfacing

CHEMICAL PEEL TECHNIQUE


A chemical peel solution may be applied to your entire face or just to certain regions, such as the crow's feet area around your eyes or the vertical wrinkles around your mouth. Dr. Saieh will apply the solution using a sponge, a cotton pad or sometimes, for smaller areas, a cotton swab or brush. Dr. Saieh decides how long to leave the solution on your face by carefully observing any changes in the appearance of your skin. With certain types of chemical peels, the solution may be "neutralized" after an appropriate amount of time has elapsed.

skin resurfacing

DIFFERENT TYPES OF CHEMICAL PEELS


The different types of chemical peels vary according to their specific ingredients and their strength. The depth of their peeling action may also be determined by factors such as how long they remain on the skin and whether they are applied lightly or rubbed more vigorously onto the skin.

A trichloracetic acid (TCA) peel is often used for the treatment of wrinkles, pigmentary changes and skin blemishes. Many patients can benefit from having TCA applied not only on the face but also on the neck and other parts of the body that have been exposed to the sun. For spot peeling of limited areas such as around the mouth or eyes, TCA formulas are often preferred because they have less bleaching effect than solutions containing phenol, another popular peeling agent. For the same reason, some surgeons have found TCA to be effective in treating darker-skinned patients.

Milder TCA peels can be repeated frequently in order to achieve cumulative effects, or TCA can be used to achieve a medium or even a deep peel, depending on the acid concentration and manner of application.

A phenol peel is sometimes recommended for treating particularly rough and sun-damaged facial skin. Phenol is effective in reducing the appearance of wrinkles ranging from fine lines to deeper creases. It can correct pigmentary problems including blotchiness or age-related brown spots and may be used in the treatment of precancerous skin conditions. Phenol is particularly useful for minimizing the vertical lines that often form around the mouth as a result of aging. The disadvantage of phenol for spot peeling of limited areas is that it often has a significant bleaching effect. After your skin has been treated with phenol, you may need to wear makeup in order for the treated portions of your skin to more closely match the skin color of the surrounding areas. Unlike TCA peels, phenol cannot be used on your neck or other parts of your body. Certain variations in the phenol peel formula, creating a "buffered" or milder solution, may allow for greater flexibility in its use.

Please do not take Aspirin or Ibuprofen or any other related anti-inflammatory products for a period of three (3) weeks prior to and after the procedure, because they can cause increased bleeding. To take Tylenol (Acetaminophen) is okay. If you are a smoker, you will be asked to stop smoking well before and after the procedure.

skin resurfacing

DERMABRASION TECHNIQUES


Dermabrasion, like the deeper chemical peels, is very effective in reducing the appearance of vertical wrinkles around the mouth that often cause lipstick "bleed." It can be used on a small area of skin and on patients with somewhat darker complexions. The treated area usually will blend with the surrounding skin so that there is little if any noticeable difference in the pigmentation.

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MAINTENANCE


You will return to Dr. Saieh's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. In some cases, you and Dr. Saieh may decide that you will continue treatments on a periodic basis.



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Dr. Saieh is a member of these distinguished honor societies for
Plastic Surgeons and certified by the American Board of Plastic Surgery.