Facial Skin Rejuvenation
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The skin is the largest and most visible organ of the body. As skin ages, it becomes thinner and less elastic. Collagen and elastin, the tissues that keep the skin firm, become weaker. These changes lead to fine lines, sagging skin, and other unwanted signs of aging.
The goal of facial rejuvenation is to give the patient a more youthful look by diminishing the signs of aging and the damage caused by years of unprotected sun exposure.
Why Consider Facial Skin Rejuvenation
Your appearance greatly affects how you feel and how others feel about you. It is, therefore, perfectly natural for people who feel young and healthy to want to look young and healthy. Facial rejuvenation can effectively reduce wrinkles, treat sun spots, tighten loose skin, improve skin tone and color, remove blotchiness, and eliminate damaged blood vessels. Millions of men and women undergo some form of facial skin rejuvenation every year.
Great strides in surgical techniques and technology enable dermatologists to achieve subtle, effective results. Today, procedures are safer and less invasive, allowing patients to heal more quickly than ever before. This means little or no downtime. Treatment is usually performed in a dermatologist's office, which offers the patient a convenient and cost-effective option for treating signs of aging and with little or no down time.
Are There Any Risks?
All medical procedures have associated risks. In general, the more invasive the procedure, the greater the associated risk. Patients who undergo facial rejuvenation may experience some temporary side effects, such as mild redness, swelling, bruising, and minor discomfort. Scarring, persistent redness, or permanent pigment changes are possible with more invasive procedures.
Treatment Options
Many factors influence the treatment that your dermatologist may recommend to rejuvenate your face. Your age, health, and the amount of sun damage all play a role. Your skin type also is crucial in deciding which method or combination of methods may be best for you. A dermatologist also can recommend rejuvenation procedures for other areas, such as the skin on your neck, shoulders, or hands. In some cases, more than one treatment may be used to produce better and longer-lasting results.
Facial rejuvenation procedures fall into nine key categories:
- Topical Products
- Fillers and Botulinum Rejuvenation
- Chemical Peels
- Dermabrasion and Microdermabrasion
- Laser Resurfacing, IPL, and LED
- Radiofrequency Technologies
- Photodynamic Therapy
- Surgical Excision
- Tumescent Liposuction
Topical Products
Topicals can be either prescription or non-prescription products and are usually used to treat milder signs of aging, such as fine lines and superficial wrinkles. These treatments may be combined with other therapies to increase effectiveness. Topicals also offer preventive value, and can reduce the need to repeat procedures or increase the time between them.
Fillers and Botulinum Rejuvenation
Soft-tissue fillers are generally used to "plump" furrows and hollows in the face, reduce wrinkles, and give the skin a smoother and more youthful-looking appearance. Filler substances include collagen, self-donated fat (fat is removed from one part of a patient's body and injected into another part), hyaluronic acid, hydroxyapatite, poly-L-lactic acid, and polymer implants.
Fillers are very effective at contouring specific areas on the face, such as around the lips and mouth. They also can correct depressions and scars.
Naso-labial fold furrows
in a 38-year-old woman
before collagen injection
Three months post
collagen injection
Lines and wrinkles associated with facial expression may be diminished with injections of botulinum toxin type A. A very safe and effective procedure, it involves injecting very tiny amounts into specific muscles in order to relax the muscles. Relaxed muscles reduce the appearance of fine lines and wrinkles. Botulinum rejuvenation is used to treat vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and crow's feet. This procedure also may be used to diminish visible bands on the neck.
Chemical Peels
Chemical peels are used to treat wrinkles around the eyes and mouth, skin discoloration, age spots, dull skin texture, and mild acne scars. The procedure involves applying a chemical solution to remove the outer layers of skin. This stimulates new skin growth. The new skin is usually smoother, less wrinkled, and more even in color. Chemical peels may produce reddening and peeling similar to a sunburn. This typically lasts a few days to several weeks, depending on the strength and depth of the peel.
Dermabrasion and Microdermabrasion
Dermabrasion is a resurfacing procedure that mechanically sands the skin to achieve a rejuvenated appearance. This technique is used to treat substantial scarring, discoloration, and sun damage. During dermabrasion, an abrasive instrument removes outer skin layers and smoothes the treated skin. The results are generally remarkable and long-lasting.
Microdermabrasion uses micro-particles, or a diamond-tipped wand, to remove some of the top skin layer (epidermis) and stimulate new skin growth. This non-invasive treatment produces virtually no discomfort, requires no topical or local anesthetic, and involves practically no recovery or downtime. Multiple treatments spaced two to three weeks apart are needed. Microdermabrasion can be used in combination with other rejuvenation treatments.
Laser Resurfacing - Lasers, IPL and LED
Laser resurfacing can effectively treat wrinkles, certain scars, skin discoloration, broken blood vessels, and early changes leading to cancerous skin growths. It also effectively treats lines and blemishes on the neck and can modestly tighten sagging skin. However, laser resurfacing is not a substitute for the facelift. Having laser resurfacing may, however, delay more invasive procedures by tightening loose skin and diminishing certain folds and creases.
Today many different lasers are used to rejuvenate the skin. One of the newer laser resurfacing technologies is fractional rejuvenation. This non-invasive technology precisely targets the small areas of skin where damage has occurred, leaving the surrounding, healthy skin untouched and better able to assist in the healing of the damaged cells.
A dermatologist may combine laser resurfacing with another facial rejuvenation procedure, such as a chemical peel or blepharoplasty (eyelid surgery).
38-year-old white female with small
periorbital blue vein. The larger size and blue
appearance of the vein requires a more
penetrating wavelength.
Immediately after laser treatment
One month later vein has completely resolved
Intense pulsed light (IPL) uses broad-spectrum light, which filters out unwanted harmful wavelengths. It can be used to treat vascular lesions, improve skin texture and color, and reduce pore size. IPL can be combined with other treatments, such as microdermabrasion and botulinum rejuvenation.
Light emitting devices (LED) may help to treat skin discoloration and fine wrinkling.
Radiofrequency Technologies
These non-invasive technologies cause skin contraction and tightening that can lead to lifting of the face, brow, and cheeks without surgery or downtime.
Photodynamic Therapy
Used to treat sun-damaged skin, this procedure involves applying a topical medication, 5-aminolevulinic acid (ALA), to the skin. The medication is left on the skin for a specified time. The area is then treated with blue light, IPL, or a pulsed dye laser. The procedure can effectively treat early changes in the skin that may lead to skin cancer.
Surgical Excision
A number of surgical procedures are used to remove (excise) moles, scars, and benign skin growths that may enlarge with age. If surgical excision is appropriate, the dermatologist can explain how the procedure is performed and explain the risks and benefits of the chosen procedure.
Tumescent Liposuction
This minimally invasive surgical procedure is used to remove unwanted fat. When used on the face, it can eliminate sagging jowls or a double chin. Removing excess fat improves the contour of the face and neck areas and rejuvenates the aging face. Tumescent liposuction can be performed in a dermatologist's office under local anesthetic.
Neck and Jowl Treatments
A growing number of facial rejuvenation procedures are being applied to improve the neck and jowl areas. Depending on how advanced the condition, treatment options may include a combination of different techniques including chemical peels, botulinum rejuvenation, laser resurfacing, tumescent liposuction, and neck lifting.
New Treatment Options
Recent technological advances in resurfacing have spurred new potential treatment options for facial rejuvenation, including:
- Coblation, uses a micro-electrical radio frequency to achieve precise tissue removal. Coblation is short for "cold ablation", and, as the name implies, the procedure actually delivers cold electrical energy rather than heating the skin. This approach tends to minimize skin damage
- Non-Ablative Lasers work beneath the surface skin layer to stimulate collagen growth and tighten underlying skin to remove fine lines with fewer side effects and faster healing than that associated with traditional laser therapy.
Facial Rejuvenation Treatments
| Minimal amounts of aging and skin damage: |
Topicals |
| Moderate amounts of aging and skin damage: |
Topicals |
| Severe amounts of aging and skin damage: |
Topicals Deep Chemical Peels Fillers, Botulinum Rejuvenation Dermabrasion CO2 Laser Surgical Excision Tumescent Liposuction |
If you are bothered by signs of aging when you look in the mirror, be sure to see a dermatologist. Dermatologists and dermatologic surgeons have the medical training and experience required to use of a wide range of surgical and non-surgical methods to treat skin conditions. As experts on skin aging, these doctors are uniquely qualified to keep skin healthy and youthful looking.
To learn more about facial skin rejuvenation, log onto www.aad.org, or call toll free (888) 462-DERM (3376) to find a dermatologist in your area.
AAD Web site: www.aad.org
Toll-free: (888) 462-DERM (3376)
Images used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides
© 2006 American Academy of Dermatology
Revised 2002, 2006
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Copyright © 2007 American Academy of Dermatology
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