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Facial Peels & Resurfacing

Aging, sun, environment, and genetics are all sources of skin damage, leading to facial lines and splotchy pigment changes. If you want to improve the appearance of your skin, skin rejuvenation or resurfacing may be right for you.

For more information about our smoother skin surgery procedure, please contact us online or call us at 888-463-9532. We look forward to helping you look your best.

A WEALTH OF INFORMATION

Understanding the Skin Resurfacing Procedure

Skin rejuvenation is a treatment to improve the texture, clarity, and overall appearance of your skin. Skin resurfacing procedures can produce a marked improvement in your skin conditions and overall appearance. The technologies and treatments in this field have been advancing rapidly, thus you may be surprised at the improvement that can be achieved by relatively simple procedures.

Conditions that can be treated include:

  • Static wrinkles: These wrinkles are visible at all times and do not change in appearance with facial movements.
  • Dynamic wrinkles: These are expression lines that may appear as folds when the skin is not moving and deepen with facial movements or expressions.
  • Pigmentation: Freckles, sunspots, melasma, or other darkened patches of skin that mainly result from sun exposure.
  • Scars: These may be the 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: This includes 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: This is the weakening of the supportive skin structure (collagen and elastin fibers) that results in a loss of skin firmness or the development of cellulite.

What are the different types of facial resurfacing?

  • Facial resurfacing, or peels, can be separated into three categories:
  • Chemical Peels
  • Dermabrasion, or sanding
  • Laser Resurfacing

Dr. Alexander excels at all three procedures and will select the one—or a combination of procedures—that will suit you and your needs. All of the techniques have the ability to remove a shallow layer of skin, allowing the fresh surface to heal more evenly. In addition, Fillers and BOTOX® can be used to help smooth the skin. The result will be a smoother, clearer, and more youthful appearance.

Skin Resurfacing Before/After Gallery

Before You Decide…

Choosing Your Surgeon

Several important factors should be considered when choosing a surgeon, including the doctor’s personality, recommendations from friends, physician training and board certification, and experience.

Personality: It is important to develop a good relationship with your surgeon so that communication is easy and trust can be developed. You should feel that you are in good hands. Bedside manner is important.

Referral from Friends: Many prospective patients find confidence if they have a close friend or other trusted individual who has already undergone a successful procedure by a certain doctor. This is often a good first step in making a decision. In fact, most of our patients are referred to us by a friend who was very satisfied with their results.

Training and Certification: In years past, only plastic surgeons performed cosmetic surgery. including ear, nose, and throat doctors (also known as otolaryngologists and facial plastic surgeons), dermatologists, ophthalmologists, and gynecologists. However, a surgeon who has been certified by the American Board of Plastic Surgery has received the most extensive training in cosmetic surgery. There are many boards, and it is easy for patients to become confused or assume that when a doctor says they are “board certified,” it all means the same thing. BE CAREFUL!

Experience: Finally, consider the physician’s experience. Without question, this is the most important factor in making a decision. As with all professions, expertise is directly proportional to experience, meaning the total number of procedures performed. Medical literature illustrates that biggest predictor of success in surgery is volume, in other words, the number of times that a doctor has performed a procedure.

If the doctor is recommending a specific procedure, how many has he performed? Also, how often does he do this procedure? While board certifications and training are important, a surgeon’s experience with the procedure itself is more important. Don’t hesitate to ask pointed questions about recommended procedures.

For more information about our smoother skin surgery procedure, please contact us online or call us at 888-463-9532. We look forward to helping you look your best.

The Consultation
To ensure the most natural looking-results, it’s imperative for a surgeon to recommend the procedure which most appropriately matches your needs and to offer realistic expectations for post-surgery outcomes. When you meet with a surgeon, you should expect a full discussion of the surgically appropriate options for your face, which is uniquely yours.

A good surgeon will go through a series of examinations and observations that are individual and dependent upon your specific situation and goals. Also factored into this process are the doctor’s expertise, training, and experience. If a surgeon specializes in a particular type of skin rejuvenation procedure, don’t be surprised if it is recommended over other options. Be wary of the “one-size-fits-all” approach.

This is particularly important because, as medicine continues to advance, patients have more options made available to them. The availability and affordability of options in facial rejuvenation has made it possible for more patients to benefit from these advances.

The best technique is selected based on:

  • Skin type
  • Skin problem
  • Area to be treated
  • Whether or not other surgical procedures are being performed
  • Anesthesia preferences
  • Available down time

Often, more than one of the three techniques will be equally successful in solving your problem.

Who is a good candidate?

In our experience, we have found that most patients are currently satisfied with how they look—they’re just unhappy with changes caused by age. Most patients don’t want to alter the nature of their face via invasive procedures, such as a nose surgery or chin implant, rather they desire to look fresher and younger. In other words, they want to “turn back the clock.” Many patients comment that they look older than they feel, but are wary of cosmetic surgery, especially if they’ve seen poor outcomes in others. Often those considering a peel they will express their concern by saying, “I don’t want to have white, waxy, or unnatural-looking skin.” However, an experienced surgeon can prevent these types of problems.

If you have surface changes of the skin, such as wrinkles or pigment changes that are making you look older, you might be a good candidate for facial resurfacing or a facial peel. While not as invasive as surgical cosmetic procedures, skin rejuvenation is still a medical procedure. In fact, some resurfacing and peels can even require a longer recovery time than surgery.

Skin rejuvenation may be a good option for you if:

  • You are physically healthy
  • You are not taking Accutane®, or have not taken it within the last 6 months
  • You have a positive outlook and specific but realistic goals in mind for the improvement of your appearance.
  • You have surface wrinkles and lines
  • You have significant sun damage
  • You have been or are a smoker
  • You have pigment irregularities from the sun

For more information about our smoother skin surgery procedure, please contact us online or call us at 888-463-9532. We look forward to helping you look your best.

What does it cost?
Cost is always an important consideration with cosmetic procedures. However, when choosing a plastic surgeon for Facial Rejuvenation, remember that the surgeon’s experience and your comfort are just as important as the final cost.

A quote will be provided to you after your consult with Dr. Alexander. Be sure to ask about our patient financing plans.

Cost may include:

  • Surgeon’s fee
  • Operating Room and Supplies
  • Prescriptions for medication
  • Medical tests
  • Anesthesia fees

To learn more about our partner in payment plans, please visit CareCredit.

Want to Talk to Dr. Alexander?

Because every case is unique, the only way to accurately give you advice is to consult with Dr. Alexander. Use this form to schedule a visit.

The Skin Resurfacing Procedure

Preparing for the Procedure
Prior to your procedure, we will have you:

  • Begin taking preventive antibiotics (24 hours before) or adjust your current medications
  • Possibly begin pretreatment with Retin-A and/or bleaching creams
  • Stop smoking well in advance of surgery

During a preoperative appointment, usually 1-2 weeks before surgery, we will:

  • Get lab testing or a medical evaluation
  • Tell you what to do on the night before and morning of surgery
  • Discuss the use of anesthesia during your procedure
  • Explain post-operative care and follow-up as well as what help you will need after the procedure
Anesthesia

Anesthesia requirements vary depending on the procedure.

Chemical peels:

  • No anesthesia (skin feels burning sensation until solution is removed)
  • Topical anesthesia (cream used to numb surface of skin)
  • Local anesthesia (skin numbed up with injection)
  • IV sedation (medications administered through IV)
  • General anesthesia (patient is lightly sleeping)

Dermabrasion:

  • Local anesthesia (skin numbed up with injection)
  • IV sedation (medications administered through IV)
  • General anesthesia (patient is lightly sleeping)

Laser Resurfacing:

  • Topical anesthesia (cream used to numb surface of skin)
  • Local anesthesia (skin numbed up with injection)
  • IV sedation (medications administered through IV)
  • General anesthesia (patient is lightly sleeping)

For more information about our smoother skin surgery procedure, please contact us online or call us at 888-463-9532. We look forward to helping you look your best.

How We Do It: Tutorial
These procedures take between 5-60 minutes, depending on the technique and the number of areas being treated.

Step 1 – Marking
Dr. Alexander marks all of the areas which are to be treated.

Step 2 – Cleansing
The face is cleansed with ether, a liquid that thoroughly removes all dirt, facial oils, and makeup.

Step 3 – Resurfacing
Chemical peel: The solution is applied to the skin with moist Q-tips and is left on for a few seconds until the skin “frosts” (appears white). It is then is then wiped off. If a weaker solution is used (eg Glycolic AHA), it may be left in place several minutes.

Dermabrasion: Dr. Alexander uses a motorized drill with a fine wire brush to gently abrade, or sand, the skin. As the skin is sanded, he is able to see when the rough or high areas have been lowered adequately to create a smooth surface.

Laser Resurfacing: Before the procedure, settings for depth and intensity are entered into the system. The laser treatment is then administered through a hand device, which is connected to a mobile arm. The hand piece is moved over the skin after each pulse until the area is completely treated.

Step 4 – Dressing
Chemical peel: No dressing is needed.

Dermabrasion: A gauze dressing is placed which helps to dry the skin. This ensures that a scab will form over the treated area, allowing it to heal naturally.

Laser Resurfacing: A fine mesh dressing is placed, over which Vaseline is applied.

Informed Consent
Pain from facial resurfacing is usually minimal. Out of the three procedures, dermabrasion tends to cause the most discomfort. Patients usually experience heat or a burning sensation over the treated areas during the first 24 hours. Pain pills are provided but are usually not required after a couple of days.

The decision to receive skin rejuvenation treatment is extremely personal, and you will have to decide if the benefits will help you achieve your goals and if the risks are acceptable.

We will explain in detail the risks associated with the procedure. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:

  • Infection (rare)
  • Prolonged redness
  • Pigmentation problems
  • Lightening of the skin
  • The need for additional treatments

It’s very important to ask Dr. Alexander questions about your procedure. It is natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with us.

Important Terms to Know
  • Ablative: Resurfacing treatments that remove the uppermost layers of the skin (epidermis and dermis) to varying degrees.
  • Anesthesia—General: The patient is asleep, requiring that the airway be protected either by a standard breathing tube or by a laryngeal mask (LMA), an inflatable mask that is placed in the back of the throat but not down the trachea. An anesthesiologist releases gases through the airway which put the patient asleep. Drugs may also be given through the IV.
  • Anesthesia—Local: The surgical area is numbed up with an injection, but the patient is awake. Sometimes a patient will be given an oral medication, like Valium, to help with relaxation.
  • Anesthesia— Sedation (Twilight): The patient is made sleepy with medications given through an IV. The level of sedation can be adjusted, from barely sleepy to very sleepy. Sometimes sedation is given by the surgeon, but most of the time it is administered by an M.D. anesthesiologist.
  • Dynamic Wrinkles: Expression lines that may appear as folds when the skin is not moving and that deepen with facial movements or expressions.
  • Hypertrophic Scar: A hyperactive, usually temporary scarring process that makes a scar raised and red, sometimes called a “baby keloid.” More common on the chest, trunk, and shoulders, as well as in patients with a pigmented complexion. Very uncommon on the face and neck.
  • Laser and Energy Therapies: Ranging from ablative to non-ablative, these treatments use laser energy, light energy, radio waves, ultrasonic energy, or plasma energy to treat the skin.
  • Loss of Skin Tone: Weakening of the supportive skin structure that results in a loss of skin firmness or the development of cellulite.
  • Mesolabial Fold (Marionette Lines): The crease that extends from the corner of the mouth down the side of the chin.
  • Nasolabial Fold: The crease that extends from the side of the nose to the corner of the mouth.
  • Non-Ablative Therapy: Treatments that do not remove any skin but rather penetrate the skin or treat the skin superficially (only on the surface).
  • Pigmentation: Freckles, sun spots, melasma, or other darkened patches of skin which result mainly from sun exposure.
  • Scar: Disfigured skin resulting from acne or injury to the skin, scars may be rolling (a wavy appearance to the skin), pitted, discolored, or have raised borders.
  • Static Wrinkles: Wrinkles that are visible at all times.
  • Tear Trough: A groove below the lower eyelids extending from the nose across the upper cheek.
  • 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.

Recovery

Your Recovery

Although our society is increasingly geared toward instant gratification, rushing the healing process is never a good idea. It’s easy for patients to get a little too active too quickly. Each body has its own pace, and your body’s recovery speed is unique to you. As with any procedure, we have specific guidelines for preparation and recovery.

It is normal for the face to feel tight and for the skin to burn for 24 hours. Your new skin will be a bit swollen, sensitive, and bright pink for a few weeks. During this time, you can begin gradually resuming your normal activities. You can expect to be back at work in about 10-14 days. Redness gradually fades over several weeks to months, depending on the depth of the treatment. Makeup can be used to cover the redness once the skin is healed.

When your new skin is fully re-pigmented, the color should closely match the surrounding skin, making the procedure virtually undetectable.

A special note about sun exposure: Absolute sun protection is essential for the several months after any of these resurfacing treatments to prevent irregular pigmentation. Diligent sun protection for life will help to maintain your new, smoother skin.

For more information about our smoother skin surgery procedure, please contact us online or call us at 888-463-9532. We look forward to helping you look your best.

The Specifics
Following our instructions regarding medications and other post-operative measures is the key to a quick recovery. Herbal medications are available to reduce swelling and bruising and to speed the healing process.

It is important that your skin is subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head. We will give you specific instructions on how to care for yourself.

You will need someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Chemical Peel: Your skin will look fairly normal for 12 hours. If one area is treated, swelling can be minimal. If your entire face is treated, swelling can be significant for 24-48 hours. After the first 24 hours, your skin will begin to ooze serum. You should keep it coated with a thin layer of Vaseline or antibiotic ointment. It is safe to get your face completely wet in the shower. Don’t be alarmed if your face looks worse at 3-5 days. That is completely normal. At that point, the dead skin will begin to flake off, revealing new, soft, pink skin below. Once the skin is healed, no more ointment is required.

Dermabrasion: A gauze dressing is applied that will dry and create a scab over the treated area. Right after the procedure, your skin will be red and swollen; eating and talking may be difficult. You will probably feel some tingling, burning, or aching. However, any pain you feel can be controlled with medications. It is safe to get your face completely wet in the shower. The swelling will begin to subside in a few days to a week.

If you remember the scrapes you got when you fell down as a child, you’ll have an idea of what to expect from this type of surgery. A scab or crust will form over the treated area as it begins to heal. This will fall off as a new layer of tight, pink skin forms underneath. Your face may itch as new skin starts to develop.

Laser Resurfacing: A fine mesh dressing is applied, over which Vaseline is placed. Patients should keep a light coat of Vaseline over the gauze at all times. Cold compresses can also be used and should be left in place for 10-15 minutes at a time, and when they are removed they will lift off much of the dried yellow serum. It is safe to get the face completely wet in the shower. Once the skin is healed, the gauze can be removed. If the gauze falls off it can be replaced or left off. Ointment can be applied directly to the skin.

You will be given specific instructions that include:

  • How to care for the peeled site
  • Medications to apply or take orally to aid healing and reduce the potential for infection
  • Specific concerns to look for at the surgical site or in overall health
  • When to return to the office

We will see you the day after procedure and then again on the 4th or 5th day to check your progress. At one week you can resume normal activities, at two weeks you can begin light exercise, and at four weeks there are no restrictions.

Results
Resurfacing treatments can offer dramatic improvements in the surface of your skin, but it will take some time before you will see the final results. A series of treatments may be required to achieve improvement in skin texture and clarity and a good skin care program is essential to maintain your results.

Facial resurfacing doesn’t stop the aging process, but turns back the clock on your face and age. Following your treatment of skin resurfacing or rejuvenation, your skin will continue to age naturally and you may develop similar conditions—or other skin conditions—to those that have been treated. If you look five years younger after resurfacing, it will take about five years or more for your face to age back to the preoperative condition.

It’s natural to feel impatient about seeing the “new” you, but you’ll need to be patient as your face heals from the procedure. The visible improvements appear as swelling subsides. Occasionally, wrinkles may temporarily appear deeper at about fou weeks because the swelling leaves the wrinkle sooner than it does the nearby skin.