Skin Care/Botox

The skin is a very complex organ - as complex as the liver or cardiovascular systems. It is the first line of defense of the body, and is constantly exposed to sunlight and harmful substances. Ultraviolet irradiation damages the skin and may result in malignancies (basal cell carcinoma, squamous cell carcinoma and malignant melanoma). UV light and smoking can destroy elastin and collagen fibers in the dermis, contributing to wrinkling and an aged appearance.

The degree of sun damage depends on how much exposure a person receives, the anatomic area (the scalp and nose project outward, and are more exposed) and the complexion of the individual. Skin cancer is common in those with fair complexions of European heritage, and rare in dark skinned individuals of Mediterranean, Asian or African descent.

Smoking cessation and avoiding excessive sun exposure are important measures in maintaining the skin’s health and appearance. Once the effects of aging and sun damage become apparent, a variety of non-surgical techniques may be used to rejuvenate the skin.

Chemical Peels and Dermabrasion:

Skin, of course, is frequently injured. When you fall and skin your knee or suffer a minor burn, the end result is often a healthy, smooth skin that appears after the scab/blister has separated. These injuries are analogous to the process of chemical peeling. Such an injury may be termed as "partial thickness," in which the injury triggers a process of regeneration in the remaining skin.

There has been much publicity about various peeling solutions (trichloroacetic acid, phenol, glycolic/alpha-hydroxy acids) and also about the use of the laser for skin resurfacing. Chemical peels, dermabrasion and the laser all work in a similar manner - they create a partial thickness skin injury, allowing the remaining skin to regenerate. Each technique has specific risks and benefits, and none are perfect. If the injury becomes too deep, each can create scarring. If the injury is too superficial, little lasting benefit is obtained. Properly performed, each of these techniques can be used to diminish the appearance of wrinkles, and enhance skin tone and coloration.

Other agents, including retinoids (Retin-A, Renova) and hydroquinones (Melanex, a bleaching agent) may be used in conjunction with the above methods to enhance the result, or independently to improve skin tone and coloration.

"Botox" or Botulinum Toxin:

Facial wrinkles are often created by the movement of small muscles under the skin. Produced by bacteria, "Botox" is a chemical agent which has the ability to paralyze these muscles, and thus reduce or "soften" wrinkles. As only very small amounts are used, the proper use of Botox is both safe and effective. Small amounts of Botox are injected into the muscles between the eyebrows (the "corrugator" muscles) to soften frown lines, or into the forehead muscle (the "frontalis" muscle) to soften transverse forehead wrinkles. Botox is also used in the "crow’s feet" area around the eyes, and sometimes in other areas as well.

Botox begins to take effect after approximately 24 hours, but the full effect may not be seen for a week, at which time "touch-ups" may be performed. The effects of a treatment last for three to six months, and the injections may then be repeated as necessary.

Collagen is a protein normally found in human skin. Available in a variety of preparations (Zyderm I and II, Zyplast), collagen may be injected into wrinkles or depressed scars to diminish their appearance. Collagen injections may also be used to "augment" the lips, enhancing their shape and appearance. A small "test" injection must be performed four weeks prior to definitive therapy, as some patients are found to be allergic to the collagen preparation (about three percent of patients are allergic). The injected collagen is absorbed by the body after two to six months, at which time the injections may be repeated.

Fat injections: Fat obtained from liposuction or syringe aspiration may be re-injected into specific areas to smooth wrinkles, improve contour or enhance lips. Not all of the fat injected survives, however, limiting the amount of correction attained using this technique.