Facial rejuvenation: non-surgical

Dr Mark Kohout
Thursday, October 13, 2005
It's a common problem and one that most people will face one day. We get on, we live well and we get a little older. And then one day we look in the mirror and the realisation dawns. We have aged. For many of us, this takes the form of both drooping of the neck skin and eyebrows, jowling, baggy eyelids and also sun damage-related changes like brown spots, uneven pigmentation, sunspots, and fine wrinkles. You may also sport a double chin which you never had before. Or it may simply be that you just don't look fresh and vibrant any more.

So what can be done?
Photo ageing

We all know the signs of sun damage and photo ageing. There are the fine, crepe lines around the eyes and mouth, the uneven pigmentation, from light freckles to dark lentigines to crusty, peeling keratoses. Skin thickening, dryness and loss of skin elasticity contribute to the appearance of photo ageing. To top it off, broken capillaries and redness add to the blotchy pigmentation.

The question is what can be done once prevention is obviously not enough? It may be useful to look at some treatments and put them into perspective. One very important principle you should keep in mind: the more effective the treatment, the longer the recovery and downtime.

This is a great treatment option for busy people. It can be performed in a salon or medical centre. A light probe is placed against your facial skin and pulses of light are delivered to your skin. The light energy targets the pigments in your skin and does three things: it lightens brown pigmentation, treats redness and broken capillaries, and remodels skin collagen to produce a toned, fresher look. The treatment takes about 20 minutes. About four to six treatments, two weeks apart, are needed for optimal results. The cost is around $250-300 per treatment.

Another "lunchtime" treatment, microdermabrasion involves your skin being "sanded", either by a shower of abrasive particles or by a rotating abrasive tool. This treatment removes the dry, upper layers of the skin and again, delivers smoother-looking and feeling skin. Superficial sunspots look lighter and scaly skin feels smoother. The treatment takes about 15 minutes. Microdermabrasion does not treat skin redness or broken capillaries. You can expect to pay about $100 for a full face treatment.

Chemical peels
Peels come in different strengths. The commonest peels, in increasing order of effectiveness and downtime are: fruit acid peels (AHA or glycolic), Jessner peel and trichloroacetic acid (TCA) peel. The mild peels achieve results similar to the microdermabrasion in that they remove the upper layers for the skin and make it look and feel fresher and smoother. However, they do not treat redness and only very superficial pigmentation is removed. The medium peels, such as the three-layer Jessner will have a good and noticeable effect on the tone, texture and pigmentation, but you can expect about three to seven days downtime as the treated skin will darken, then crack and peel, revealing pink sooth skin underneath. A strong peel will deliver even better results but with a longer (up to two weeks) downtime. No anaesthetic is required to have the treatment. The cost of peels depends on the strength and ranges from $120 for the glycolic to about $1,200 for the TCA.

Laser resurfacing
This is the most effective way of reversing the signs of photo ageing. The treatment requires admission to a day surgery facility and having a light anaesthetic. It also means a two-week downtime but there is no substitute for it when it comes to improving the blotchy pigmentation and wrinkles. Your skin will be smooth and even-toned for many years after treatment. The overall cost is about $5,500.

Dr Mark Kohout FRACS
Plastic Surgeon
Ph: 1300 551 151
Leichhardt — Bondi Junction — Orange NSW

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