Facial Rejuvenation is the process of using any combination of modalities to restore a youthful glow to your skin, fewer wrinkles, fewer lines, fewer age spots, fewer growths on the face and improved texture and tone to the skin. The following list of procedures each has a role in doing this in its own way. Depending on your particular situation, one procedure may or may not be the best option for you. If you think that you would benefit from any of these rejuvenation measures, feel free to come in for a free consultation with our Master Esthetician.
1. Microlaser peel: This is a great way to get rid of unwanted freckles, age spots, melasma and irregular or uneven pigmentation. You can watch a video of a microlaser peel here.
2. Fractional Resurfacing: This resurfacing procedure is used for the following indications:
a. Lines and wrinkles around the eye.
b. Lines and wrinkles around the mouth.
c. Elastotic, wrinkled and sun-damaged skin of the cheeks.
d. Rejuvenation of the neck and chest—for improvement in dyspigmentation, redness and wrinkles.
e. Acne scars or acne scarring…especially the “rolling” scars.
f. Scars from picking or scratching your skin. This is often seen in people with olive-toned skin who like to pick at their faces. This picking tends to leave a whitish, hypopigmented spot on the skin that looks like a scar. The most common area it is seen is on the cheeks, the angle of the jaw, and the upper part of the neck by the jaw. This procedure is one of the only effective treatments for this type of scarring.
g. Treatment of precancerous lesions called actinic keratoses. Can be used almost anywhere on the body for this indication–the face, neck, chest, arms, back etc…Actinic keratoses are a precursor to squamous cell carcinoma and can be a significant problem for some people because they have so many of them and because they do lead to skin cancer. This procedure has been shown to actually reverse or correct the genetic mutations that are seen in the actinic keratoses. This procedure may also decrease the number of skin cancers you will get in the treated area in the future. Some people have so many actinic keratoses that other treatment options are not very effective and we have seen some significant improvements in our patients who undergo this procedure for that reason.
Fractional resurfacing has nearly replaced deep resurfacing procedures because it has significaly less down time than traditional deep resurfacing. Fractional resurfacing is kind of like aerating your lawn, but we are aerating the skin. With the ProFractional XC laser (the first one in Utah!) we are also able to heat or tighten the skin to different depths during the procedure to get even more improvement and tightening. In addition to the benefits in appearance that one can get from fractional resurfacing, there are many studies that have shown the reversal of mutations in precancerous lesions called actinic keratoses after this procedure. So, you can get the benefit of youthfulness as well as fewer wrinkles and age spots and possibly skin cancers too!
If you are employing Fractional Resurfacing for wrinkles, a series of three to five treatments is usually recommended. The down time is usually about four to six days of pinkness where you need to keep a nice layer of Vaseline on the skin until it has recovered. We recommend you exercise great sun precaution for 21 days after the procedure.
3. Photofacial or IPL (intense pulsed light): A photofacial is a procedure where we use a laser-like device called an intense pulsed light device. At Alpine Dermatology, we employ the Sciton BBL IPL. This is the most powerful IPL device in the world.
The BBL can be used to lighten age spots, improve melasma, decrease pinkness and the appearance of blood vessels as well as mild tightening of the skin. Depending on the severity of your problem anywhere from one to five of these treatments are indicated.
In addition to removing age spots on the face, the BBL can also be used to remove age spots from the hands, arms, chest, back and legs…almost anywhere you get them! This is a very low downtime procedure with some pinkness the day of the procedure and then some mild darkening and sloughing off of age spots over the few days after the procedure.
The BBL can also be used to treat hair growth (almost anywhere on the body), blood vessels, acne and more.
4. Botox and its competitors “the neurotoxins”: A very effective way to knock out your wrinkles in an instant is to use Botox or one of competitors the “neurotoxins”. We call these products neurotoxins because they basically inhibit the nerve from doing its job; move the muscle. If the muscle can’t move, it can’t make a wrinkle! So say goodbye to the following types of wrinkles with the use of neurotoxins:
a. Glabellar lines (these are the deep folds between your eyebrows: some people have 1s, 11s, or 111s…meaning the shape of the folds in their foreheads. Neurotoxins works great at eliminating or greatly minimizing these creases. In general though, if you have a wrinkle that is almost like a scar; one that if you stretch the skin out tight and you can see a permanently creased line, be informed that that line will not go away. The fold will, but not the line.
b. Crow’s feet: We have many patients who have had a neurotixin in this area and it “didn’t work”. This is most-likely due to improper placement of the product. The product must actually be injected INTO the muscle that makes the wrinkle or it won’t work. As you can imagine, this muscle is as thin as a piece of paper and it takes some finesse to put it in the right spot!
c. Lip Wrinkles: I mean the creases that go up and down above and below the lip. By using a tiny, tiny, tiny amount of neurotoxin in just the right spot, we can minimize these wrinkles.
d. Down-turned mouth: As we age, the angle of our mouths tend to droop downward and look like a permanent frown. By weakening one of the muscles that actually pulls the angles of the mouth down, we can quickly turn your frown into a smile and take a few years off of your face.
e. Brow Lift: When injected in just the right spot, neurotoxins can actually give you a very slight lateral brow lift. Again, there is some finesse involved here.
f. Many more: depending on your particular problem area, the neurotoxins can be used to minimize wrinkles in other areas than those listed above.
Summary: It is thought that by “staying up” on your Botox; meaning having done before it wears completely out, will actually atrophy the offending muscle and make it so it can’t make the wrinkle in the long run…and may mean less neurotoxin in the long run as well. Also, the benefits gained from the neurotoxins are kind of “addicting” in a way because they work so well, you will want to maintain it over time.
5. Fillers (Restylane and Perlane): At Alpine Dermatology, we choose to use Restylane and Perlane over other fillers due to their proven safety in the long run. Restylane and Perlane are hyaluronic acids; a naturally-ocurring chemical in our skin. By injecting something that is native to our skin already as compared to something that comes from a pig for example (like injectable collagen) there are markedly fewer reactions and problems. Also, because they are naturally-occurring chemicals, there is also an enzyme that can be used to dissolve the fillers should there be a problem (granted, this enzyme does come from a pig, but if you need it, it is wonderful to have!).
The option for non-permanance that you get from Restylane and Perlane is extremely useful and appreciated by patients. Dr. Eberting really enjoys doing these fillers because they are literally an instant facelift in a syringe for her patients. “We can have someone walk in here and then walk out 30 minutes later looking 10 years younger. It is really that good, that fast, and is relatively very safe when it comes to cosmetic procedures.” Dr. Eberting has many happy, repeat filler patients who love the instant improvement in their faces.
Because Restylane and Perlane come with lidocaine compounded into them, they are quite painless too.
Restylane and Perlane can be used to fill just about any void…in your face or other parts of the body too. The most popular areas to have fillers done are the following:
a. Cheekbones: by lifting your cheekbones which have drifted down over the years, you will actually notice improvement in your nasolabial folds, or marionette lines. Restore your facial structure of yesteryear in a few minutes!
b. Nasolabial folds or Marionette lines: these are the deep creases that we start to get in the early thirties and then it is down-hill from here. By filling the depressions, your youthful face shines through again!
c. Brow-lift: this is yet another fun way to give your eyes a little pop or widening and a bit of a lid lift too.
d. Jowls: By filling the depressions around the jowls on your jaw-line, you can restore the actual jaw-line to its jowl-less (or less jowly) state in an instant.
e. Droopy Mouth: As we age, a depression develops at the angle of the jaw and the jaw down-turns. This can be filled and makes a great improvement.
f. Saggy Eyes: This area can also be filled to restore the face of your youth.
g. Sallow cheeks: Some people’s cheeks tend to “suck in” or “sink in” as they age. This is another home-run spot to have fillers.
h. Earlobe creases: Again, these can be filled to eliminate that annoying fold in your ear lobes.
i. Lips: If the size, shape or asymmetry of your lips is a problem, this can be easily addressed with Restylane or Perlane.
j. Old hands: If your veins are becoming more prominent and annoying to you, a filler can be injected to correct this problem in a flash.
Note*: Many of the above areas are considered off-label areas for the use of fillers and are not FDA-approved for those particular indications. Please discuss this with your provider when you come in.
6. Age Spot Removal: This is a favorite for most of our patients because, by removing those ugly, unsightly age spots, you can get instant clearing of your face or skin and can quickly take years off of your appearance. The types of age spots that we remove include:
a. Seborrheic Keratoses or SKs (also called barnacles by some): These are technically “age spots” though one does not need to be very old to get them. SKs are very ugly, can stick up or out, can be whitish, brown, or blackish and can itch and do grow. They are virtually benign and have no malignant potential. These can be removed by cryosurgery (liquid nitrogen), curettage (scraping with a special tool), and electrocautery. By removing these, one can really see great improvement in their appearance. Unless they are very itchy, painful or bleeding, insurance will not pay for their removal and their removal are usually considered a cosmetic procedure.
b. Lentigo or lentigines (liver spots, or sun spots): These are ugly brown spots that show up from years of chronic sun exposure. These can easily be removed using an IPL device (great for backs of the hand, arms, chest, face) or if you only have a few little ones, they can be very quickly removed with a small spray with liquid nitrogen. These also are not covered by insurance.
c. Sebacceous Hyperplasia: These are over-grown sebaceous glands that are commonly seen on the face as we age. They are almost salmony or yellow-colored and can be quite small or big. These are treated with electrocautery or with a localized chemical peel right on the gland. These also are not covered by insurance.
d. Milia or Milium: These are tiny little white bumps “in” the skin that just don’t go away. They are actually a tiny little cyst of keratin that is stuck between the two layers of skin. These also can be skillfully removed without much down-time.
e. Angiomas: These are the little “red dots” that people start to get on their faces, chest, arms, legs…and anywhere else as they age. They are a nest of capillaries on the surface of the skin and they too can be cauterized or removed with a laser.
f. Syringomas: These are tiny little sweat glands found under the eye and can become quite prominent and unsightly in some. These glands can also be treated (very carefully mind you) with electocautery. This usually takes two to three visits to complete, but improvement can be drastic and extremely gratifying when they are disfiguring.
g. Skin tags: these are those pesky, fleshy, “hanging moles” that many people get on their necks, armpits, eyelids and elsewhere. These can also be removed. People who have lots of skin tags may be at increased risk for, or may already have type II diabetes and should be monitored.
