Over the years, as the skin of the face loosens and sags, the texture of the skin also changes. The skin becomes dull and weathered in appearance. Freckling and blotchy pigmentation may occur, as well as, sun damaged in the form of pre-cancerous lesions. Fine lines develop in the crow’s feet area and under the eyes. The laugh lines on the sides of the mouth deepen, and small vertical wrinkles appear on the lips. Frown lines appear between the eyebrows and some people also develop rows of wrinkles across their cheeks.
These changes are the result of the aging process, heredity and gravity. They are accelerated by skin abuse, over exposure to the sun, alcohol, smoking, pregnancy, and poor nutrition.
The function of a chemical peel is to create an even controlled shedding of several layers of damaged skin cells; this exposures a new fresh layer of skin, with a more even color and a smoother texture. In addition the peel stimulates new cells to grow, thereby tightening the skin, which decreases wrinkling.
Peeling solutions are available that penetrate the skin to varying levels, controlling the depth of the peel and subsequent skin shedding. All peel solutions will help improve the texture of the skin. The deeper the peel solution penetrates, however, the greater will be the improvement in patchy pigmentation and wrinkling.
The peeling procedure involves the careful application of a chemical solution to the skin which stings as it is applied, but this is short lived, a matter of seconds. Later discomfort can be eased with appropriate medications.
This procedure is much like having sunburn or a blister in that the top layer of skin begins to “peel off” over a 4-5 day period revealing the fresh new deep pink layer underneath. Swelling of the peeled area may be extreme for the first few days but subsides after 5-7 days.
In most cases by the second day gentle washing of the skin followed by the application of special softening product is possible. Makeup may be used approximately ten to fourteen days after the application of the peeling solution; therefore by about seven to fourteen days most patients may return to work or go out socially. The redness of the skin slowly subsides over the ensuing two to eight weeks. But can ordinarily be camouflaged by makeup during this time.
Avoidance of prolonged exposure to sunlight (as in sun bathing, fishing, golfing, etc) for three to six months is the primary restriction after peeling because the “new” skin must build up a tolerance; otherwise some patients develop pigmentation.
Patients are often misinformed about the long-term restriction of activities following a peel. They have heard that once they have had a peel they can never get in the sun again- this has not been our experience. While it is very important to avoid sun exposure and to use sunscreen products for the first six months, ordinary sun exposure after that is allowed. It simply takes time for the new skin to toughen or build up on a natural resistance to sun and wind.
Peeling alone is not indicated for treatment of sagging tissues- this requires surgery. If classical peeling formulas are used new collagen and elastic fibers are produced in the deeper layers of skin and some tightening of facial tissues occur, but not to the extent that can be accomplished with surgical removal through conventional facelift techniques.
Peeling may be done as an isolated procedure (for example around the lips, around the eyes, or the entire face) or it may be used as an indispensable adjunct to a facelift and/or eyelid plastic surgery in an overall facial rejuvenation program. We usually wait 3-6 months before peeling an area that has been operated upon.
Remember, surgery is designed to improve sags and bulges and a peel should improve wrinkles.
The peel can sometimes produce a significant improvement in the texture and wrinkles of you face, often with a dramatic exchange of “peaches for prunes.” It may be the best treatment available to the facial surgeon to help obtain a fresher, more youthful skin for his patients. Certainly it is not indicated for every patient, therefore, we will give you our opinion as to whether we feel you are a candidate for this procedure.