Once we hit our 30’s, skin is already slowing down and aging. A lot of this is from sun exposure so excellent sunscreen is a must to forestall those wrinkles (and reduce skin cancer risk). Home skin products with a rejuvenating ingredient in therapeutic amounts is as simple as putting on a moisturizer before bed (with the right rejuvenating ingredient). Still, everyone reaches a point where skin is looking older, rougher, more uneven. This is when in office treatments come into play. There are so many chemical and laser peeling options along with the no recovery lasers that have evolved from the laser peels. Fractional non-ablative treatments like Fraxel and PicoSure MicroFocused Array treatments work on pigment, texture, redness and generally ramp the metabolism of the skin while encouraging neocollagenesis –the formation of new collagen and neovascularization–development of new blood supply. Typically done as a series of 3-4 monthly treatments at a cost of $750-1250, depending on the size of the area treated. There is some redness after the treatment but the skin is never raw. Fraxel tends to be more hot and prickly with more redness afterwards but works faster –better for older patients with more sun damage. Pico tends to be a great choice for younger patients or people who can’t even afford walking around looking red for a day or two. The treatments take 15-45 minutes and are usually preceded by 15-30 minutes sitting with numbing gel to prepare. For people with fixed wrinkles that are mild and who can afford a weekend of skin washing and protective ointment, fractional ablative peels like Sciton Halo are a great option to clean up the skin’s appearance in one to two treatments depending on the degree of aging changes. Deep fixed wrinkles are still recovery based laser and chemical peels.
Our cheeks descending, jowl forming, softening of the sharpness of the jawline and hanging skin in the neck. The leading treatment non-invasive treatment for this is Ultherapy –dots of sound energy are placed at multiple depths under the skin. As the skin heals from this treatment, collagen is added–like thousands of tiny guy lines pulling the skin tighter and lifting it. The treatment has a specific FDA clearance for lifting the skin along the jawline, face and neck. While the treatment is rather hot and prickly during the 45 minutes it takes to do (we often give some oral pain reliever and relaxing medications or have the patient breath a nitrous oxide/oxygen mixture to take the edge off), you look normal after the procedure and don’t feel any pain. You can resume normal activities immediately. It takes several months to see the results–up to 6 months. The typical cost is around $3500. This is not a substitute for a facelift; the amount of improvement is modest so this is perfect for people in the 40’s or early 50’s who have mild laxity and want to clean things up and put off a facelift. It is also great as a preventative and maintainer for younger patients (in their 30’s) who want to take an aggressive approach to looking young. There are minimally invasive alternatives like Thermi and Facetite which involve small procedures and recovery time. These may offer the prospect of a bigger result (still not a replacement for the facelift) but less data is available and they don’t have specific FDA clearances for skin lifting.
Dr. Lawrence Bass, FACS, is certified by the American Board of Plastic Surgery and is the founder of Bass Plastic Surgery, PLLC in Manhattan
and Great Neck, NY where he specializes in providing surgical and nonsurgical facial rejuvenation and body contouring.