Our skin is the most noticeable part of our bodies, but as we age, so does our skin. Every day we expose our skin to elements that contribute to the aging process. Factors such as sun exposure, smoking and just growing older cause age spots, fine lines, wrinkles, and a number of other skin conditions to appear on our faces. The good news is that there is a way that we can regain our youthful appearance with facial rejuvenation. Although these treatments cannot prevent us from aging or stop the aging process, they can literally take years off of our faces by reducing the appearance of fine lines, wrinkles, and age spots. Plastic surgeons can offer a number of treatments to help our skin regain its youthful, natural glow.

What are the different forms of facial rejuvenation procedures?

Traditionally, there were two main types of lasers. One was the CO2 and the other one was urbium. The CO2 laser was made to target the quality of the skin, basically sun damage, fine wrinkles, and pigmentation. It would take half an hour to 45 minutes to perform the procedure, usually under sedation or anesthesia. What the laser did was peel off the top layer of the skin. The results looked like a bad sun burn, with blistering and redness, which may last up to 6 months. With individuals with darker skin colors, such as Hispanic women, the procedure resulted in problems such as pigmentation and irregularities. For this reason, the procedure never became popular with Hispanic women. Then the urbium laser came out. It was another laser that did more or less the same thing as the CO2 laser, supposedly with fewer complications, but providing the same results.. Dermabrasion was another method that basically removed the top layer of the skin, but it was less precise. It is comparable to sand paper. It is a hand-held apparatus with a spur that turns so it is easy to go to deep into the skin, which could create scars. This is the same case with chemical peels. They come in different strengths, and you peel the skin off in the same fashion, but again, with darker skinned individuals, you have to be very careful because you can easily run into problems. Another drawback to these procedures was the downtime, which was at least a few weeks. You couldn’t go out in public because you could have a red face for up to six months, so people didn’t like it. Some people got great results, but for others, it was miserable. Then non-invasive or non-ablating lasers came out meaning that they did not ablate the skin. These include Cool Touch and IPL. These lasers worked to a certain extent, but were not as effective as CO2 lasers. The advantage to the non-ablating lasers was that downtime was minimal; however, multiple treatments were required to see moderate results. These lasers are still widely used. The IPL is not really a laser, but a light. It is called intense pulse light. The difference between a laser and the IPL is that a laser only has one wave length, whereas the IPL has a spectrum of wave lengths. It targets irregularities, sun damage, and wrinkles in the skin. There is a new technology called the fractional CO2. They took the CO2 laser and improved the computer behind it. Instead of ablating the whole face, it fractionates the face. It hits one spot, leaves one spot untouched, and then hits another spot. With this laser, the downtime is only 3 to 4 days, requires only one treatment, and it provides great results. We have already purchased this laser, and it will be here in 6 weeks. It is a state of the art laser that does so many great things.

There are two companies that provide radiofrequency technologies, they are Thermage and Titan. What this technology does is, by radiofrequency, it creates scarring under the skin, and then tightens the skin. There are different areas where this can be performed to tighten the skin, such as under the neck or on top of the brow to do a brow lift; however there are issues with this procedure. Treatment is very expensive and painful because every time you treat a patient, they must purchase a handle because it is a disposable unit. This is what makes treatment so expensive. It can go up to $3000. Some patients may develop contour irregularities due to uneven scarring or thinning of the tissue under the skin. People use it on the abdomen and wrinkles as well. If you go to websites, you always see these miracle results, but one thing people have to understand is that these advertising campaigns can be very misleading. They put up this one-in-a-million result and try to give patients the impression that it can be achieved with every patient, but that is a lie. To me, Thermage and Titan are not very popular devices.

Of course there are other treatments such as microdermabrasion, etc., but these treatments are more like maintenance type of treatments that a person can have a number of times. Once you do a facelift or a laser treatment, you maintain them with microdemabrasion, or light facial peels and they work, but there is no dramatic change. It just gives a shiny, nice look and even texture to the skin We also have topical products. Products sold by doctors are effective, because their active ingredients are higher than in over-the-counter products. We do get good success with them in treating pigmentation and fine wrinkles, but you must be consistent with them. It takes months to see results.

What are the main differences between the lasers that are used to perform facial rejuvenation procedures?

Lasers come in different wavelengths; each wavelength has a different target tissue. For example, the CO2 laser targets the water in the tissue, so it basically burns it. We do have a nedmium yag laser that targets the red blood cell, so if you have vascularity, and we hit with that laser, nothing get effected but the red blood cell in your vessel explodes causing your vascularity to go away. There are hair removal lasers that target the hair follicle. Only brown and black hair is treatable, not blonde or white. There is no technology available to treat white or blonde hair. We classify lasers according to the type of work they were designed to perform. In other words, by altering the wavelength of the light, you treat different target tissues.

What kinds of skin conditions do facial rejuvenation procedures treat and/or correct?

We treat wrinkles, sun damage, and pigmentation like after pregnancy, we clean those up. We also treat acne with our acne treatment center. To treat acne, we use blue light, the IPL laser, and a solution called Levulan. We treat severe acne cases. If you have an acne problem, it is very important to get it treated because once you develop acne scars, it becomes difficult to treat.

Is anesthesia or sedation required for facial rejuvenation procedures?

We apply a cream with a local anesthetic in it that must remain between 45 minutes to two hours, but all the treatments I have mentioned are very tolerable.

What is the cost range for facial rejuvenation procedures?

The cost range for packages can range, depending on the practice, from $2000 to $4000.

Are there are any risks or complications associated with facial rejuvenation procedures?

The good thing with these procedures is that the complication rate is extremely low. Complications are very rare. There are instances where pigmentation and burns occur, but it is very rare

Dr.Sozer Q&A Interview