Posts Tagged ‘Laser Skin Resurfacing’

Cosmetic Surgery after weight loss

Constantly reminded by health experts and physicians to get our eight hours of beauty rest, sleep is regarded as one of the biggest defenses against aging. However, sleep may be responsible for giving you wrinkles…in an inadvertent way.

While an adequate night’s rest is a legitimate way to ward off premature aging, the position in which you sleep may be responsible for fine lines and wrinkles. In fact, the American Academy of Dermatology explains that sleeping face-down or sideways may cause lines of the face, neck and chest. Crow’s feet and cleavage wrinkles are common results of repeatedly sleeping on one’s side or stomach. In fact, you can distinguish sleep lines from average wrinkles by applying pressure to the area you sleep on. Are the lines magnified? Chances are, these lines are a result of sleep positioning.

Not to worry, there are very simple, natural solutions to this sleep dilemma. The most straightforward way to prevent such wrinkling is to change your sleep position by training yourself to sleep on your back. This is the most cost-effective way to address sleep lines. If sleeping flat on your back is not an option, there are specialty pillows available for purchase.

Worn like a bra, there is a pillow intended to prevent chest wrinkling by acting as a wedge between the cleavage. To prevent lines of the face, there are memory foam type pillows claiming to prevent wrinkling. Keep in mind, not much is known regarding the actual proof of effectiveness. Many cosmetic surgeons and dermatologist believe claims by such pillow manufacturers to be dubious. While specialty pillows may provide a little aid, you should not expect a miracle. If it sounds too good to be true, it probably is.

If crow’s feet are already visible, you may want to consider a solid plan of attack with a neuromodulator like Botox, Dysport or Xeomin as they are long proven to erase these lines. Neuromodulator treatments start around $300, take only 30 minutes to complete and results last up to four months. Chemical peels and microdermabrasion are the most conservative ways to approach “cleavage wrinkles” and are generally suited for patients on the less severe end of the spectrum as they only address the most superficial layers of skin. These mild treatments start around only $100 and do not take long to complete but may cause temporary redness and peeling of the skin. If cleavage wrinkles have become permanent fixtures on your chest, laser treatment, dermabrasion or deep chemical peels are likely a viable solution.

Laser resurfacing is ideal for patients with deeper wrinkling of the chest. A variety of laser technology is available to address these conditions. Erbium, YAG and CO2 (carbon dioxide) lasers are the most common types of lasers used for skin resurfacing. Erbium works at a more superficial, less invasive level while CO2 Laser works at a deeper skin level and is one of the most invasive lasers. Another option is the fractionated YAG laser which is less invasive yet does not penetrate as deep as the CO2 laser. Laser resurfacing costs around $300-$1000 per session.

Undoubtedly, sufficient sleep is important for your health, but make sure your positioning is not wrinkling you. It is best to train yourself to sleep flat on your back, but if it is already too late, you may need cosmetic intervention.

To find out which treatment is best for you, call 423-648-4011 and schedule a complimentary consultation with our Board Certified Surgeons.

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cosmetic surgery Chattanooga, TennesseeYou have been good all year…why not treat yourself to a long-term investment like cosmetic surgery for the holidays? Unlike designer handbags and shoes which eventually go out of style, looking fabulous and improved self-esteem never gets old. Plus, colder weather and more time off during the holidays allows for ideal recovery conditions. Here are some procedures we have found popular in our practice this time of year.

Face Lift and Laser Resurfacing

A Facelift is a surgical procedure used to lift sagging facial tissues to a higher more youthful position. Most facelift procedures address the SMAS [underlying fibrous tissues of the face/neck], the platysma [neck muscle] and the skin of the face/neck. Confirming what we have seen in our Cosmetic Surgery practice for years, a study published in the Archives of Facial Plastic Surgery revealed that patients looked an average of 9 years younger than their actual age after receiving facial rejuvenation procedures like facelift surgery. More recently, it was proven through scientific research that more than five years after facelift surgery, three-fourths of patients still look younger than they did before surgery. For optimal results, many patients combine facelift surgery with laser skin resurfacing.

Laser resurfacing is a less-invasive yet effective way to correct sun damage exhibited by age spots, fine lines and wrinkles. Laser treatments use thermal technology to remove the damaged, superficial layers of skin to ultimately reveal more fresh and youthful skin.

While recovering from facial rejuvenation procedures like laser resurfacing and facelift surgery, patients are instructed to avoid sunlight exposure. The shorter days of winter make such post-op recommendations more ideal and feasible . After all, many patients will see minimal sunlight given it is dark during their daily commutes. Even more, between sunny vacations, boating and a plethora of outdoor activities, avoiding the summer sun is almost impossible for many thus making winter a practical choice for facial rejuvenation procedures.

Body Contouring through liposuction and breast augmentation

Liposuction removes excess fatty tissues to reveal a trimmer silhouette while breast augmentation, by surgical implantation, can provide feminine curves by providing shape and volume. Although sun exposure is not particularly an issue in regards to liposuction and breast enhancement recovery , patients are required to wear post-operative garments while healing. Wearing such garments in the hot summer months can be uncomfortable and difficult to conceal. Even more, patients may not feel comfortable baring their bodies in skimpier clothing until they have fully healed. Cold weather attire allows for easy concealment of compression garments and bandages.

An added benefit to undergoing cosmetic surgery during this time of year, is more ample recovery time. With extra time off from school or work, the holidays allow many patients extra downtime. Many cosmetic surgery procedures require a 1 to 2 week recovery period in which many patients do not feel comfortable being seen in public. To ensure recovery time without having to ask for additional time away from school or work, many individuals book their surgery over Christmas vacation.

If you have been seriously contemplating cosmetic surgery, you may want to consider scheduling your procedure within the next few months. As an added incentive, many cosmetic surgery practices offer holiday specials. Until January 31, 2013, we are offering a discounted rate on silicone breast implants. To schedule your complimentary consultation, call 423-648-4011.

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Laser Rejuvenation in Chattanooga
Age spots; those ugly brown indicators of skin maturity. We hate them and their partners in crime, wrinkles. Unfortunately, our skin is an unforgiving, historical record of exposures. Exposure to chemicals, exposure to trauma and exposure to sun. Most brown spots are skin stains caused by sun damage and the first line of defense is SPF 30 sunscreen (or higher). To improve already existing brown spots, there are several different forms of treatments. Photodynamic therapy, chemical peels and laser resurfacing are the mainstay for the treatment of sun spots and wrinkles.

CO2 laser resurfacing

Skin Resurfacing is a medical procedure which modulates the skin to have a more youthful appearance. Some skin resurfacing devices, such as CO2 lasers, use the ablative method: removing the epidermis and some of the dermis as a deep, thermal injury. Basically, a second degree burn, the ablative method is quite invasive. While a great result is eventually evident, the drawbacks include red, raw and unsightly skin and risk of infection for several weeks after the treatment. The injury inflicted by this laser is actually quite impressive. Most patients require two to three weeks of down time, out of the public eye, after CO2 laser ablation. However, the results are impressive with the growth of new, pink and supple skin.

Intense Pulsed Light Therapy (IPL)

Other devices use the non-ablative method:sending light pulses into the dermis, while leaving the epidermis intact. This method is called IPL or intense pulsed light therapy. This IPL therapy allows quick recovery, but when the light pulses don’t penetrate far enough into the dermis, the change in skin tone and texture is negligible. Therefore the options: great results with extensive downtime or limited results with no downtime.

Fractional Skin Rejuvenation

Thankfully technology has yet advanced. Fractional non-ablative skin resurfacing is now available. So what makes fractional non-ablative skin resurfacing different?

Fractional non-ablative skin resurfacing is the only method which offers both excellent results and no downtime. Fractional skin treatments deliver laser light in an array of narrow, focused “microbeams” to create columns of heat within the skin. These “microbeams” penetrate deep into the dermis for the most effective, long-term results obtainable. The heated tissue within the columns starts a natural healing process that forms new, healthy tissue. This results in a decrease in sunspots, fine lines, wrinkles and acne scarring, and a fresher, more youthful skin tone and texture.

Now for the down side of fractional therapy. A series of treatments may be required to achieve the desired results. Fractional skin rejuvenation is designed to alter only portions of the target skin tissue. Think of it as digital tissue editing. Fractional skin rejuvenation creates millions of microscopic, thermal columns within the skin. Together these micro-treatments cause a change in the collagen and elastin below your skin’s surface which gradually improves the appearance of your aging and sun-damaged skin. It also results in a healing process with minimal downtime.

The number of fractional laser treatments varies from patient to patient depending on the severity of the condition, the skin type and the desired results. Most patients choose fractional skin resurfacing to decrease sun or age spots, decrease fine and moderate facial wrinkles as well as decrease the appearance of scars and stretchmarks.

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Melasma is an acquired hyperpigmentation of sunexposed skin areas, or in plain English, “dull brown spots.” It presents as symmetric hyperpigmented spots which can be separated or bunched together along the cheeks, nose, the upper lip, the chin and the forehead, and can occasionally occur in other sun-exposed locations. Melasma spots are dark, irregular brown-toblack patches that gradually, over time, may develop into mask-like patterns.

What Causes Melasma?

The exact cause of melasma is uncertain. In many cases, there is a direct relationship with female hormonal activity because melasma occurs with pregnancy and with the use of oral birth control pills. Other factors related to melasma include “sun” sensitizing medications, mild ovarian or thyroid dysfunction, and certain cosmetics.

Yet the most important factor in the development of melasma is exposure to sunlight. Without the strict avoidance of sunlight, potentially successful treatments of melasma are doomed to fail. Tanning bed exposure has increased the incidence of melasma in the United States. Melasma, though distressing, is a benign process.

Melasma is rare before puberty and most commonly occurs in women during their reproductive years. Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral contraceptives or hormone replacement therapy (HRT) medications. It is much more common in women than in men; in fact, women are affected in 90 percent of cases. When men are affected, the clinical presentation is identical. Melasma does not cause any other symptoms beyond the cosmetic discoloration. However, the facial discoloration can be devastating.

Persons of any race can be affected by melasma, however, it is much more common in people of darker skin types than in lighter skin types, and it may be more common in light brown skin types from areas of the world with intense sun exposure. Melasma is also prevalent in men and women of Native American descent (on the forearms) and in men and women of German/Russian Jewish descent (on the face).

Melasma is usually diagnosed by a physician visually or with assistance of a Wood’s lamp (black lamp). Under the Wood’s lamp, excess melanin pigments in the epidermis can be identified. Some melanin deposits are superficial in the skin while others may be deep in the dermis. The deeper the pigment deposits, the more difficult it is to treat. The discoloration of melasma usually disappears spontaneously over a period of several months after giving birth or stopping the oral contraceptives or hormone replacement therapy.

Melasma Treatment

Treatments to hasten the fading of the discolored patches include; topical depigmentation creams, acid peels, and laser skin resurfacing. Depigmentation creams such as hyproquinone (HQ) can be used directly on the dark spots. HQ is a chemical that inhibits a specific enzyme involved in the production of melanin pigments. Acids ointments are used to increase skin cell turn-over, pushing the brown discolorations to the surface so rapidly that it results in pigment fading. Other acid treatments are thought to decrease the activity of melanocytes or pigment cells.

When topical treat-ments fail, most patients proceed with facial peels using alpha hydroxy acids or chemical peels with glycolic acid. Yet, some of the most dramatic changes in melasma spots have been attained with laser skin resurfacing treatments. In all of these treatments, the effects are gradual and a strict avoidance of sunlight is required before, during and after completion of therapy. The use of broad-spectrum sunscreens with physical blockers such as titanium dioxide and zinc dioxide is preferred over that with other chemical blockers. This is because UV-A, UV-B and visible lights are all capable of stimulating pigment production. Say goodbye to the tan beds! Last, but not least, cosmetic makeup can be used to reduce the appearance of melasma. Melasma, though annoying, has no known relationship to skin malignancy.

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Laser resurfacing uses heat induced by laser light to destroy and remove (vaporize) the upper layers of the skin. This causes new skin to grow. It is typically used to remove or improve the appearance of wrinkles shallow scars (from acne, surgery or trauma) and other skin defects. The laser sends out brief pulses of high-energy light that are absorbed by water and certain substances in the skin called chromophores. The light is changed into heat energy, and the heat then vaporizes thin sections of skin, layer by layer. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment.

Fractionated CO2 Laser

The CO2 (carbon dioxide) laser is the most common type of laser used for resurfacing. Fractionated lasers are also used frequently and are growing in popularity because they do a similar job, but penetrate less deeply and therefore heal more quickly with little or no down time. Laser resurfacing is usually very precise and causes little damage to the surrounding skin and tissue. It is done most often on the face, but it may be done on skin in other areas of the body like the chest, back and hands.

The areas to be treated by laser resurfacing are cleaned and marked with a pen. A nerve block with a local anesthetic is usually used to numb the area before treatment. You may also be given a sedative or anti-anxiety medication. If your entire face is going to be treated, you may need stronger anesthesia (in some cases, general anesthesia), pain relievers or sedation.

Laser Resurfacing: The Procedure

You may be given goggles to wear to prevent eye damage by the laser. The laser is passed over the skin, sending out pulses. Each pulse lasts less than a millisecond. Between passes with the laser, the skin may be cooled. The number of passes required depends on how large the area is and what type of skin is being treated as well as the type laser used for the treatment. Thin skin around the eyes, for instance, requires very few passes with the laser. Thicker skin or skin with more severe lesions requires a greater number of passes. The pulses from the laser may sting or burn slightly, or you may feel a snapping sensation against your skin. Laser resurfacing is usually done in a doctor’s office or out-patient surgery center.

Conditions Improved by Laser Resurfacing

Laser resurfacing may be used to remove or improve the appearance of:

• Wrinkles

• Superficial scars caused by acne, surgery or trauma that are not growing or getting thicker

• Color (pigment) changes or defects in the skin, such as liver spots (lentigines), port-wine stains or coffee spots. (Any growth that could be malignant should be evaluatedusing a biopsy before laser resurfacing is done.)

In general, laser resurfacing tends to have good results with fairly low risks. Wrinkles caused by aging and long-term sun exposure, such as those around the eyes and mouth, respond well to laser resurfacing. The long-term results for these types of wrinkles are unknown, and you should keep in mind that new wrinkles will probably appear as your skin continues to age. Wrinkles caused by repeated movement and muscle use (such as those on the forehead or along the sides of the nose) may be improved but not eliminated. They often come back months or years after treatment because the muscles continue to perform the activities that caused the wrinkles before treatment.

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Scratch the Surface

Skin that is smooth and supple with a warm glow is a sure sign of youth. As we age, our skin is marked with reminders of our past experiences. The canvas of skin tells a tale of our sun exposure, wrinkles, superficial scars caused by acne, surgery or trauma. The etched skin surface is then painted by color (pigment) changes or defects in the skin, such as liver spots or coffee spots and tattoos. Stressed by smoking and environmental chemicals, all combined, our skin shows the signs of aging.

Controlled Skin Damage

Skin repair techniques have been around for centuries: chemical peels were very popular in the early part of the 20th century, but with a price: scarring and pigment changes. Now safer high tech laser resurfacing techniques result in consistent skin resurfacing, also with a price: the cost of technology. Each technique, from chemical peels to laser resurfacing, have similar properties. They cause controlled damage to the skin, causing the underlying skin to rapidly reproduce and slough off the old damaged skin, resulting in new, more youthful skin in place of the timeworn and etched skin.

Laser Skin Resurfacing

Laser resurfacing uses heat induced by laser light to destroy and remove (vaporize) the upper layers of the skin. This causes new skin to grow. It is typically used to remove or improve the appearance of wrinkles, shallow scars (from acne, surgery or trauma), tattoos and other skin defects. The laser sends out brief pulses of high-energy light that are absorbed by water and certain substances in the skin called chromophores. The light is changed into heat energy, and the heat then vaporizes thin sections of skin, layer by layer. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment.

The CO2 (carbon dioxide) laser is the most common type of laser used for resurfacing. Fractionated lasers are also used frequently and are growing in popularity because they do a similar job, but penetrate less deeply and therefore heal more quickly. Laser resurfacing is usually very precise and causes little damage to the surrounding skin and tissue. It is done most often on the face, but it may be done on skin in other areas of the body. Laser resurfacing is usually done in a doctor’s office. The time needed for healing and recovery after laser resurfacing varies according to the size and depth of the treated area.

Chemical Peels

Chemical peeling is completed by applying a chemical solution to the skin. Mild scarring and certain types of acne may be treated. The procedure enables new, regenerated skin to appear, improving the appearance of the condition. Chemical peels are generally recommended for discoloration caused by acne, not deep pitted scars. Commonly used chemical peels are glycolic and lactic acid, which are also available for home use.


Subcision (undermining), needling with dermabrasion are used for depressed scars, pitted scarring and ice pick type scars. During a subcision session, a small needle is used to break up the scar tissue underneath the depression. Subcision along with needle rolling are highly effective methods in the treatment of depressed scars, but usually require multiple sessions depending on the number and depth of the scars. These sessions are normally spaced four weeks apart, and require five to seven days downtime after the procedure. Skin manipulation techniques have been used by physicians for decades. When used correctly, the techniques fool the skin to insight repair without scarring, pigment changes or significant down time.

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Not a week goes by that someone doesn’t seek consultation in regard to facial aging with these very words, “ I want to look fresh, younger but not pulled or plastic.” Well, times have changed in the world of facial aesthetics. Gone are the days of the cookie cutter facelifts which often times left patients looking pulled, pinched or wind blown. Newer short-scar mini-lifts, along with procedures to add facial volume and decrease the lines and wrinkles, have revolutionized the art of facial rejuvenation.

Mini Face Lift: A more natural approach to sagging facial tissue

As we age, most individuals lose elasticity in their skin and develop varying degrees of descent along the jaw line and beneath the chin. The office-based mini face lift is a surgical face lift to address the mid to lower face/neck with minimal surgical exposure as a minimally invasive office procedure. The post operative effect provides a more natural appearance with limited down time when compared to other formal face lift procedures.

Most traditional facelifts are performed with general anesthesia and involve multiple weeks of downtime with a long incision beginning at the upper temples and extending behind the hairline on either side of the face to the nape. Due to the length of the formal face lift procedure and the type of anesthesia, there is an increased risk of complications. The S-Lift minimal incision face lift has been performed since the late 1990s.

The office based mini face lift not only tightens skin, it is designed to permanently suspend the underlying muscles and fibrous structures of the lower face and upper neck. This suspension of the lower face offers men and women the benefit of a more youthful appearance without the “wind blown” look of a formal face lift.

Replacing Facial Volume

Key to a natural looking facial rejuvenation is replacement of lost volume. Facial volume can be replaced by fillers or fat transfer. Fat transplant is performed by extracting fat from one area of the body (typically thighs or abdomen) via liposuction and then injecting the filtered fat through a syringe to various areas of the face to increase volume and decrease wrinkles. The fat also has the added benefit of stem cells.

Laser Skin Resurfacing for age spots and cell regeneration

As we age, our skin thins and appears more translucent. Sun damage becomes more evident through age spots and a decrease in collagen is pronounced through folds and wrinkles. Laser skin resurfacing is an effective way to correct these issues. The fractionated CO2 laser, heats and vaporizes skin tissue one spot at a time. The heat removes superficial layers of the treated skin while the untouched, surrounding skin aides in the healing process. This healing process stimulates cell regeneration is induced with production of new skin cells.

Botox for frown lines and crow’s feet

Neuromodulators like Botox can also be injected to relax facial muscles. It is most beneficial for the treatment of lines caused by overactive muscles of the forehead, cheeks and mouth. This makes it an ideal treatment for frown lines, forehead furrows, and also “crow’s feet.” It can also be injected to reverse the downward turn of the angle of the mouth.

As with any cosmetic procedure; choose your surgical artist well. The combination of mini-lifts, volume replacement, neuromodulators and skin resurfacing yield more lasting natural facial rejuvenation without the pulled or plastic look of days gone by.

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All skin resurfacing procedures function in basically the same way. The top layers of skin are eliminated, leaving smoother, tighter skin on the surface after a period of healing. In other words, one has to trick the skin to think that it has been damaged in order for it to go into a healing phase. Along with healing, tissues are renewed, regenerated and ultimately younger looking. There are several advantages to laser skin resurfacing that aren’t available with other resurfacing procedures such as deep chemical peels or dermabrasion. One benefit of the laser is that it heats the deep layers of skin, stimulating collagen production. Collagen and elastin are the foundation materials which gives skin thickness, texture and pliability. Another benefit is a decrease in downtime for final healing.

Laser skin resurfacing is a time-tested procedure using a carbon dioxide (CO2) laser beam to eliminate damaged outer layers of skin at specific and varying depth levels. This resurfacing replaces the damaged skin with new, fresh skin. Many of the systems used for this process are capable of deep, moderate, or light resurfacing depending on the level of damage. The process is also known as laser peel or skin resurfacing. It may be used to improve the appearance of just certain areas of the face or the whole face, but is mostly beneficial for reducing fine lines in the areas around the mouth, forehead, and eyes. This procedure can also be useful for treating acne scars or areas with brown spots or uneven pigmentation.

Many are familiar with the older formal CO2 laser skin resurfacing. The older CO2 laser treatments cause skin damage as an ablative procedure. A majority portion of the upper layers of the skin are damaged, similar to a 2nd degree burn. This damaged layer of skin peels in sheets revealing new skin resurfaced. Results with formal CO2 laser resurfacing can be dramatic; but with drawbacks. Ablative resurfacing carries higher risks for skin pigment changes, scarring and longer downtime for healing.

New cutting edge technology has developed fractionated laser treatments. These advanced laser techniques fractionate the laser beam to produce thousands of tiny localized highly focused laser beams. These microscopic beams damaged skin in columns known as MicroThermal Zones. These zones define an area that will undergo replacement and an area of normal skin that will remain untouched. The laser beams can be of different wave lengths–YAG, CO2, Erbium. Each have different levels of penetration and benefits. During the healing process, collagen and elastin are regenerated and a defined portion of the skin is resurfaced with each session. The “fractional” treatment area is what makes the healing process work so quickly. Instead of the body facing a large portion of skin to re-grow, it can focus on smaller micro areas for skin renewal. Deeper layers of the skin stimulate collagen remodeling to give the skin a much healthier, firmer appearance over six months after the laser treatment. The new skin effect can last for years.


After Laser Skin Resurfacing and Mini Lift

Laser skin resurfacing is typically performed under local anesthesia, meaning one will be awake, but feel no pain, and be given a sedative to help with relaxation. Sometimes with more extensive procedures for scarring and deep wrinkles, deep sedation IV anesthesia is administered. After the procedure patients are required to apply some kind of cream or ointment may be used to protect the treated skin. The skin will be pink with crusts formation over a few days. The length of recovery may vary depending on the level of damage to the skin. Most people can return to regular makeup after about 5-7 days, but is extremely important to stay away from sun until the new skin has changed to a healed state. Of course, this means using sunscreens and wearing a hat.

Some are not good candidates for laser skin resurfacing. Skin color types of black, brown, or dark olive are at high risk for changes in pigmentation after laser resurfacing. Anyone who has used accutane in the last 2 years or who has frequent skin infections may not be good candidate.

Patients are finding out that they don’t have to pay high costs or take many days off work to enjoy smooth, youthful-looking skin. Both women and men often notice improvements in wrinkles and acne scarring at the surface within the first few weeks following fractionated laser treatments, and the long-term effects of laser resurfacing can be more dramatic. After limited downtime recovery, with proper care one’s skin will appear younger and fresher for many years to come.

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