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Sun damage is the main factor for 60% of the signs of aging that show up on our face, and can be visible as early as our late twenties. Remember, most solar damage has taken place by the age of 18. Another big factor in the aging force is smoking, whether you smoke or are around second hand smoke. The best solution to prevent aging is not to smoke, stay out of the sun, and use a SPF 15 sunscreen daily, even in the winter. Other vital products in your skin care regimen would involve morning use of vitamin C Serum, a glycolic moisturizer, and an eye product with retinal. At bedtime, a retinol or Retin-A® is quite beneficial along with a glycolic mask 3 times weekly. All would help with solar spots, lines and wrinkles.
CONSERVATIVE SKIN REMODELING, PART II - NON ABLATIVE LASER COLLAGEN REPLENISHMENT The latest advancement in facial remodeling is known as laser collagen replenishment, or non-ablative laser resurfacing sometimes known as "sub-surfacing." The basic idea is quite simple. From C02 = ablative laser resurfacing, we learned that the laser beam did not vaporize the wrinkles off. We learned that the laser beam merely vaporized the epidermis and part of the upper dermis and created a layer, (in the mid dermis) of "thermal damage" about 150 microns in depth. This thermal damage in the mid dermis was the stimulus for the skin to heal itself. Thus resulting in the production of new collagen fibrils in parallel rows, rather than the chaotic disorganized collagen layer in wrinkled skin. In essence, the CO2, ablative laser resurfacing "healed away" the wrinkles. The obvious problem with the C02 laser resurfacing technique, although miraculous in it's ability to improve wrinkled skin, was the "down time" of about 10-14 days. This time is required to heal the second-degree thermal injury imparted to the skin, to "grow back" the upper dermis and epidermis. Cosmetic clients today are an eclectic group of patients, yet they usually have one thing in common: they are fast paced, active people who would rather not have "down time." The newest trend in laser skin therapy today is Non Ablative Laser Collagen Replacement, accomplishing the same long-term result in restoration and increased collagen production in the dermis, but without the required healing time. Several new laser devices have been developed and tested to accomplish the task. The first was Cool Touch I, then Cool Touch II using a "thermal quenching" hand piece and a 1320 nm (nanometer is the wavelength designation) laser beam. Then there was the N-Lite Laser using a 585 nm wavelength, and many others followed. Basically the laser wavelengths in modern non-ablative systems span from 550 nm to 2940 nm, indicating that no single wavelength is the "perfect one." I have carefully reviewed the clinical literature on the efficacy of these lasers. Many techniques to study their effectiveness have been developed. These study parameters range from clinical observation of "percent wrinkle reduction" in photographs judged by Board Certified Cosmetic Surgeons. By obtaining silicon imprint images of the wrinkles and measuring their depths, we see the biochemical analysis of serum removed from the dermis for collagen synthesis by-products, an actual microscopic examination of the thickness in the collagen layer of the dermis at various times after irradiation with the laser beam. Of all the extensive Literature I have reviewed, the evaluation in the Journal of Dermatologic Surgery: Profilometric Evaluation of a 1540 nm Er:Glass Laser.,Dermatologic Surgery 27 (9), 799-806., was, by far the most impressive. This study reviewed the Aramis 1540 French Erbium Glass laser for efficacy in the treatment of rhytids, (wrinkles). In this study 60 patients were treated four times with the Aramis 1540 (1540 is the wavelength of the laser beam). Digital Photographs, Ultrasound Imaging, Silicone Imprints of the Wrinkles and Skin Biopsy studies were performed. All subjects showed marked improvement in wrinkles by all techniques studied with no downtime or pain, redness, swelling, burning, skin irritation, photosensitivity or ANY adverse effect to the procedure. The actual clinical results were so remarkable that I went to my local laser representative and ordered one! GreatSkin® now has one of the 8 Aramis 1540 lasers in the United States today. It is my belief, that the procedure of non-ablative skin remodeling can be significantly augmented by following a prescribed schedule of procedures and skin care therapies. With the combination of microdermabrasion (in-office sodium bicarbonate crystal epidermal abrasion), the use of topical Vitamin C (Skinceuticals® or Primacy® C serums), or Ester C® (GreatSkin® Serum C), and tretinoin (Retin A®) plus epidermal growth factor (EGF) found in our Rhonda Allison EGF cream, and the monthly use of the Aramis 1540 thermally quenched laser, one can achieve the long term wrinkle reduction of major C02 laser resurfacing, with no down time at all! At GreatSkin® we have developed a "Scalpel-less™" face-lift protocol for rhytid reduction without pain, redness, healing time. In part III, I will discuss the in-office procedures, such as Botox®, Dermologen®, and Dermaplant®, which augment the pharmacologically active skin care program and the Non Ablative Collagen Replenishment with the combination of microdermabrasion and the Aramis 1540 Laser.
Are you planning on having facial surgery? We have put together two excellent kits for our Pre and Postop clients. Read about both of these programs -- plus the protocols that Dr. Van Wormer uses to prevent scarring, bleeding and swelling when he does laser resurfacing.
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