SMOOTHER SKIN

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:

1. Chemical Peels
2. Dermabrasion, or sanding
3. 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.

Effective chemical peels have been performed for over a hundred years. Peels use a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for individuals with facial blemishes, wrinkles and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet your needs.

Although a chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process.

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the formulas and thus produce light peels. This type of peel can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation, and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. These peels can be safely performed on the neck, chest, and hands.

AHA peels may cause stinging, redness, irritation, and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside.

Uses:

• Smooths rough, dry skin
• Improves texture of sun-damaged skin
• Aids in control of acne
• Can be mixed with bleaching agent to correct pigment problems
• Can be used as TCA pre-treatment

Considerations:

• A series of peels may be needed
• As with most peel treatments, sunblock use is recommended

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes, and pigment problems are commonly treated with TCA. The results of a TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. In fact, more than one TCA peel may be needed to achieve the desired result. The recovery from a TCA peel is usually shorter than with a phenol peel.

With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin. Even though TCA is considered by most doctors to be milder than phenol, it may also produce some unintended color changes in the skin and has been associated with scarring.

Uses:

• Smooths out fine surface wrinkles
• Removes superficial blemishes
• Corrects pigment problems

Considerations:

• Can be used on neck or other body areas
• May require pre-treatment with Retin-A or AHA creams
• Treatment takes only 10-15 minutes
• Preferred for darker-skinned patients
• Peel depth can be adjusted
• Healing is usually quick, much quicker than a phenol peel
• Repeat treatment may be needed to maintain results
• Sunblock must be used for several months

Modified Phenol is the strongest of the chemical solutions and produces a deep peel. However, the depth can be controlled by the concentration, making it possible to perform light, medium, and deep peels. An important ingredient in the phenol solution is croton oil, and it is the concentration of this component that determines the overall strength of the solution.

Phenol is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Since very deep phenol peels sometimes lighten the treated areas, your skin pigmentation may be a determining factor as to whether or not this is an appropriate treatment for you. Phenol is primarily used on the face. However, light phenol can be used on the neck and chest if performed by an experienced surgeon.

Uses:

• Corrects blotches caused by sun exposure, birth-control pills, aging
• Smoothes coarse wrinkles
• Removes pre-cancerous growths

Considerations:

• Used on the face only, unless croton oil is removed from solution
• Not recommended for dark-skinned individuals
• Procedure may pose risk for patients with heart problems
• Full-face treatment may take one hour
• Recovery may be slow – complete healing may take several months
• May permanently remove facial freckles
• Permanent skin lightening and lines of demarcation may occur
• Sun protection, including sunblock, should be used
• Results are dramatic and long-lasting

Dermabrasion has been performed for many decades and helps to "refinish" the skin's top layers through a method of controlled surgical scraping. The treatments soften the sharp edges of surface irregularities, giving the skin a smoother appearance.

Dermabrasion is most often used to improve the look of facial skin left scarred by accidents or previous surgery. Other candidates may be those wishing to remove deep acne scars or even smooth out fine facial wrinkles, such as those around the mouth. It can be performed on small areas of skin or on the entire face. Dermabrasion can be received as a stand-alone procedure or in conjunction with others, such as a facelift, scar removal or revision, or chemical peel.

Men and women of all ages can benefit from dermabrasion. However, there are important factors that should be considered such as skin type, coloring, and medical history. For example, those of African, Asian, or Latin decent who have dark complexions may become permanently discolored or blotchy after a skin-refinishing treatment. In addition, dermabrasion should not be performed during the active stages of acne because of a greater risk of infection. The same may be true if you have had radiation treatments, a serious burn, or a previous chemical peel.

Laser resurfacing, originally developed in the mid 90s, continues to evolve. New technology arrives on a regular basis, but not every new “advancement” can deliver what the manufacturers promise. Thus it is important to research the effectiveness of laser treatments before wasting money and time.

Laser resurfacing can improve the appearance of fine lines and wrinkles of the entire face or those that develop only in specific regions, such as the upper lip and around the eyes. Several lasers can be used for this procedure, all of which delicately remove the top layer of skin, thereby allowing a new, smooth layer to heal in its place.

This is an effective laser that is still in use. It is considered “hotter” than newer lasers. Deep peels performed with this laser were found to leave sharp lines of demarcation along the jaw line, making it obvious where the treatment had been stopped. This problem does not tend to appear until approximately 18 months after the procedure. We do not use this laser in our practice.

CO2 (Carbon Dioxide) Laser (1st Generation)
This is an effective laser that is still in use. However, it is considered “hotter” than newer lasers. Deep peels performed with this laser were found to leave sharp lines of demarcation along the jaw line, making it obvious where the treatment had been stopped. This problem does not tend to appear until approximately 18 months after the procedure. We do not use this laser in our practice.

Erbium Laser (2nd Generation)
The Erbium Laser also removes the top layer of skin but is "cooler" then the CO2 laser. This prevents the problems with light hypopigmentation associated with the CO2 laser. However, because this laser is "cooler," there is more pinpoint bleeding with treatment. This bleeding prevents the surgeon from treating deeper wrinkles because the bleeding impedes the laser energy. We do not use this laser in our practice.

Dual Mode Erbium Laser ((3rd Generation)
This laser actually has two separate Erbium lasers. The first laser works exactly like the Erbium laser described above. This allows resurfacing to be performed in a conservative manner to provide quick healing. The second laser has been modified so that even though it uses a cooler laser, the length of time that the laser energy remains on the skin has been increased, helping coagulate pinpoint bleeding. This simulates the effect of the CO2 laser without the pigmentation complications. Each of the two lasers can be adjusted so they can be used individually or simultaneously to provide the desired result. It is highly versatile. This is the only resurfacing laser we currently use in our practice.

Fraxel®
This is a fractionated laser which uses the same technology as the resurfacing lasers described above. However, the software has been changed so that the energy delivered to the face is different.

With resurfacing lasers described above, energy is delivered to the face at a very shallow depth but over the entire face, thus creating a shallow burn wound. The Fraxel® laser delivers the energy in small pinpoints but at a deeper depth. This allows the laser energy to be delivered deep into the skin without creating an open wound.

The Fraxel® is also highly versatile. When it is set to deliver energy at a shallow depth with very scattered patterns, healing is extremely quick. However, long-term results can be disappointing. When the settings are deeper and the pattern is tighter, results are much more effective but healing times can be similar to conventional resurfacing. In general, as with other peels, long-term results are highly correlated to the amount of downtime required. Regardless of the treatment type, if healing is extremely rapid then long-term results may not be satisfactory.

Fraxel® laser is effective in treating the skin of the neck, chest, and hands.

Non-invasive (non-ablative) Lasers and Light Treatments
Fotofacial® Rejuvenation (IPL)
Breakthrough laser technology uses Intense Pulse Light (IPL) to correct a variety of skin imperfections and signs of aging, including brown spots, broken capillaries, blemishes and fine lines, all with minimal downtime. This procedure is performed by our Physician Assistant in our Medical Spa.

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. However, in recent years doctors from many different specialties commonly perform cosmetic surgery procedures. Only a surgeon who has completed residency training in an accredited training program can become certified by the American Board of Plastic 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! Learn more about the significance of Board Certification here.

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.

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. Patients don’t want to alter the nature of their face, 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

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.

Dermabrasion, while effective, causes the most discomfort and has been widely replaced by chemical peels and laser resurfacing. Dermabrasion is done to smooth scars, deep lines on the tip of the nose, and irregular acne scarring. This technique requires a great deal of experience.

Chemical peels can be done with many different types and strengths of solutions. Chemical peels are considered the “gold standard” for facial resurfacing, because of their ability to smooth the deepest wrinkles and permanently lighten brown spots, especially those associated with pregnancy. When lasers became available, chemical peels were temporarily abandoned because they had been associated with permanent hypopigmentation, or lightening of the skin, especially in patients with darker skin. New formulations allow us to achieve exceptional results without pigment problems, even in patients with darker complexions. This procedure also requires a great deal of experience by the surgeon.

Laser resurfacing is also very effective at reducing wrinkles. This procedure is performed by using a high tech laser. Settings control the depth of the treatment. Surgical experience is essential, but the laser technology lessens the need for experience.

What to expect during your consulation The success of your procedure depends very much on your complete candidness during your consultation. We will ask you questions about your health, desires, and lifestyle.

Be prepared to discuss:

• Why you want the procedure, your expectations, and desired outcome
• The options available to you for facial rejuvenation
• Medical conditions, drug allergies, and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco, and drugs
• Past cosmetic treatments

We may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Discuss the options available to you for Facial Rejuvenation
• Examine your face
• Take digital photographs for computer imaging
• Discuss likely outcomes of a skin rejuvenation and any risks or potential complications
• Discuss the anesthesia options available

Other procedures can further enhance the outcome of Facial Rejuvenation. They include:

• Soft tissue augmentation to re-contour the facial structure
• Fat transfers to fill lines or plump up soft tissue
• Wrinkle reduction by injection

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.

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

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 Pre-Operative 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 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))

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.

Pain
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.

Important facts about the safety and risks of Facial Resurfacing
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

Be sure to ask questions
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.

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.

Be careful
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.

When you go home
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.

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 4 weeks because the swelling leaves the wrinkle sooner than it does the nearby skin.

Continuing a Skin Care program can help maintain your result and help keep your skin young and healthy. We offer a complimentary facial after your procedure to introduce you to our Aesthetician, Leanne, and our Physician Assistant, Joanna, in our excellent Skin Care Clinic.

Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.