To treat large pores, Dr. Kauvar recommended the use of non-ablative lasers to heat the layer of tissue in the superficial dermis, resulting in the production of new, thicker and smoother skin.Often referred to as a "lunchtime procedure," non-ablative lasers have minimum side effects that only last for a few hours - primarily redness and puffiness that can be covered by make-up following the procedure.
While non-ablative lasers are designed for patients with superficial skin damage who are not expecting dramatic results, fractional non ablative lasers can deliver better results for patients with more extensive signs of aging.
Fractional non ablative lasers heat pixilated columns of skin to depths three-to-four times deeper than traditional non-ablative heating, creating increased collagen production that provides improved results in skin texture, fine wrinkles and acne scars. The primary side effect of fractional non ablative lasers is redness that lasts slightly longer than their non ablative counterparts - in most cases overnight as compared to a few hours.For patients with even deeper wrinkles and scars, fractional ablative lasers are considered comparable to the traditional ablative lasers, such as the CO2 laser that is considered the gold standard in laser skin resurfacing. With fractional ablative lasers, microscopic plugs of tissue are removed and heated at the same time.Since only 10 percent to 40 percent of the surface area of the skin is treated, Dr. Kauvar noted that the procedure requires much less downtime and the risks are lower than with other ablative lasers. "Fractional ablative lasers are a dramatic advance over traditional laser resurfacing," she said.
Even with laser resurfacing, wrinkles that are a result of constant muscle movement (frown lines and crow's feet, for example) can be hard to treat. Dr. Kauvar added that the popular injectible botulinum toxin, which works by relaxing the muscles that cause wrinkles, works well for these hard-to-treat wrinkles when used in combination with skin resurfacing.For deeper folds and creases, vertical lip lines search as or smile lines, Dr. Kauvar suggests hyaluronic acid fillers.
With the further loss of collagen, the skin loses elasticity and becomes lax. These deeper folds result in jowl formation or what is commonly referred to as "chicken neck."Fortunately, there are a variety of options to tighten loose skin.Mono-polar and bipolar radiofrequency infrared light pulse and infrared lasers all work by deeply heating the skin's tissue, which causes collagen contraction and new collagen production without visibly wounding the skin.These procedures typically require four to six treatment sessions, with side effects limited to redness and swelling that last several hours.
When the skin loose volume from the loss and movement of the subcutaneous fat layer, the result is a drawn appearance with more angular features. To replace volume, a number of proven fillers can be used to plump up the skin. For example, hyaluronic acid fillers last four to 12 months, while polylactic acid and hydroxyapatite are semi-permanent fillers that last from 12 to 18 months.In each case these filler materials stimulate collagen production, as the material injected into the skin is replaced by the body's own collagen.
"Fillers are an excellent option for softening angular lines, filling the hollows under the eyes and early jowl formation and correcting deep smile lines," said Dr. Kauvar."A patient with more advanced aging could benefit from a combination of procedures, such as lasers and fillers, to improve the overall appearance of their skin."Dr. Kauvar added that a permanent filler, polymethylmethacrylate (PMMA), is now available in the U.S. This filler consists of tiny acrylic plastic beads suspended in collages that once placed into the skin cannot be reversed.
Unlike the hyaluronic acid fillers that can be dissolved at any time with an enzyme that reverses the effects, PMMA cannot be removed.Dr. Kauvar cautioned patients to thoroughly discuss their expectations with their dermatologist before considering this irreversible procedure."For the average person with mild-to-moderate skin problems, minimally invasive skin rejuvenation offers a range of options to slow down or reverse the aging process," said Dr. Kauvar."Your dermatologist can help you decide what procedures are right for you."For more information on aging skin, visit http://www.skincarephysicians.com/, a Web site developed by dermatologists that provides patients with up to date information on the treatment and management of conditions of the skin, hair and nails.
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