Everyone in Australia should know about skin care. We have arguably the worst skin in the world, seeing as we do amongst the most sun, with some of us bearing the fairest skin, and thanks to our health care system living amongst the longest lifespans on the planet.
Easy, superficial procedures for facial skin rejuvenation
“Walk-in-walk-out, no pain, no downtime, no side effects and you’ll look ten years younger!” – what is wrong with this sentence?It’s implausible. Our easy, superficial procedures for facial rejuvenation include microdermabrasion, microhydrabrasion, chemical peels, derma-needling, Refirme and Omnilux.
Omnilux is the easiest. This pleasant bright red light stimulates the production of new collagen in the dermis by tricking your skin into thinking its been a bit burnt. It stimulates blood flow and seems to hasten healing after some of our other procedures. There is evidence of it improving crows feet wrinkles. You need to do a series of these in order to see a reasonable difference, and we cannot guarantee the degree of improvement that occurs in any given individual.
What we do offer are superficial hydroxy acid and retinol peels. These act primarily at the epidermal level, inducing dermal collagen as a secondary event. They can cause some redness and stinging, varying from patient to patient and from peel type to peel type. And the skin looks fresher and renewed afterwards, and a series of these will brighten your appearance.
Microdermabrasion and microhydrabrasion are our great workhorses when it comes to easy superficial procedures. These predictably safely and inexpensively induce dermal collagen and tightening. We see exfoliation, brightening, firming, improvement in pores and acne.
ReFirme is a radiofrequency-based device that creates little zaps of thermal energy under the surface of your skin with a view to inducing collagen formation and tightening. We have found ReFirme’s primary role to be in the inducing of firming of quite thin skin, such as that found on the neck. It’s role on thicker facial skin is limited.
Derma-needling is yet another approach. The idea here is to directly stimulate new deep skin collagen by pricking the skin with thousands of tiny pinpricks. And before you pass out at the thought of it, relax – the needles are extremely tiny and our anaesthetic cream makes this one of our most comfortable treatments.
Step two: facial skin procedures with a bit more downtime
IPL Photorejuvenation involves intense pulses of light flashed onto and into the skin. The light will heat, specifically and in a targeted manner, red blood cells, melanin pigment, and therefore also dark hair. The penetrating light will also stimulate some new collagen formation, improving skin texture and reducing fine lines.
The treatment is mildly uncomfortable – typically we aim for discomfort around 4 -5 out 10 on a 0-10 pain scale. Enough to bring about an effect but not enough to cause damage. Afterwards your skin may be pink for hours to days. Freckles will appear darker for about a week then mostly flake off!
After a microdermabrasion session to exfoliate the surface, we apply a solution of 5aminolevulinic acid (5ALA) which is then kept under a light-opaque cover for 1 to 2 hours. During this time the 5ALA is preferentially taken up into early skin cancer cells and acne-producing cells. After this time, we expose the area to an Omnilux session, and the Omnilux light activates the 5ALA to kill the cancer cell or the acne-producing cell. This is a great way to get rid of all those flakey unsightly little precancerous “sunspots”
The Fractionated Erbium laser applies the laser energy into tiny “pixels”, each only 300 microns wide. Each tiny treatment zone ablates a dot of old skin, which later heals in from its edges, leaving your skin with a more even appearance and with more collagen.
Fractionated ablative lasers such as ours and the CO2 lasers take facial skin rejuvenation further than is possible with IPL or non-ablative lasers. Lines improve, texture firms, tone evens.
Maximum skin rejuvenation treatments
You might consider deep fractionated erbium laser resurfacing or full erbium laser resurfacing. This is the most potent skin rejuvenative treatment we offer. The goal is to eliminate tonal irregularities and further reduce dermal lines. However, there really is around a week of time at home.
Some skin types are not suitable. The treatment can cause pigment increase, pigment loss, or an irregular patchwork of the two in susceptible patients. And who is susceptible to these side effects? Anyone with moderate natural skin pigment, such as people from Asia, Middle East, Africa, etc. So, this sort of treatment is really only well suited to those with very fair skin.
Going under the skin – facial rejuvenation treatments with a needle
To have a young-looking face (or “younger-looking”, if you prefer) you need more than young-looking skin. First steps in this direction usually involve reducing the line-forming actions of certain facial muscles with anti-wrinkle injections. By relaxing the muscles that cause lines we allow the skin to remodel and diminish these lines.
Time will also leave certain depressions and creases on the face. Fine ones can be treated with the skin treatments mentioned above, but deeper ones will need a filler. When there’s a dish of emptiness, such as in the temple or under the cheekbone, you should look at replenishing that volume with Agent SS, and if the need for volume is greater still, there’s no better substance to use than your own fat in a fat transfer procedure.
Sometimes time will give you too much volume in a certain spot. Here I’m thinking jowls, and that double chin.
Going further still – facial rejuvenation with threads and loops
Around ten years ago we saw the emergence of APTOS threads as an alternative to face-lift surgery. These threads were 10-15cm pieces of monofilament polypropylene (like 20lb fishing line) with little notches or “barbs” cut into them. The idea was that the careful placement of these barbed threads under facial skin would create little suspension bridges of support. With time, some patients remained happy with their results, but most did not.
Then we saw the emergence of Contour threads as a stronger alternative. These were still barbed bits of fishing line, but were anchored in the galea aponeuritica to provide a firmer base for support. But they didn’t last. The company ended in 2007. Some Contour patients remained happy with the lift they achieved, but most did not.
I then started offering lifts using the technique of South African plastic surgeon Des Fernandes. These “Fernandes loops” are technically more demanding to put in, but because they rely on a firm knotted loop to achieve a lift rather than the rather flimsy barbs of the APTOS and Contour devices, they promised better duration. And this has been my experience – that the Fernandes loop lift lasts.
HOWEVER, each Fernandes loop lifts a POINT. Therefore, the technique is prone to lead to skin dimpling at the lifted point. In order to overcome this problem, one has to apply quite a number of loops in order to distribute the lifting load over all these points.
We’re calling it the Peach Loop Lift and patients thus far treated report seeing an agreeable and even lift to cheeks and/or brows.
There are no facial skin incisions involved. No scars. Local anaesthetic. No scars. Reversible. Augmentable (put in another loop). Looks to be long-lasting. Smooth natural-looking lift using natural silk.