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Facial Rejuvenation

Cosmetic Procedures
With the passage of time, our inner feelings of youth are betrayed by our outward appearance of growing older.   The development of fine lines, creases and wrinkles cause us to appear older and less vibrant than we feel.  Repeated exposure to the sun can leave tell tale signs of dark spots, blotchiness and a rough skin texture.   In recent years, numerous advances in cosmetic dermatology have led to a wide array of options that can repair and restore our complexion.  Listed below are some of the most popular state-of-the-art cosmetic dermatology procedures in present use and enjoyed by patients at the Skin Center Of South Miami.

Non-Surgical Rejuvenation
Chemical Skin Rejuvenation

Non-Surgical Rejuvenation

• Topical prescription creams are commonly used to treat aging or sun damaged skin.  Tretinoin, a derivative of Vitamin A, is one of the most commonly prescribed topical treatments to reduce the visible signs of aging.  Tretinoin can lessen blotchy discoloration and fine lines as well as improve skin texture.  Hydroquinone, a skin bleaching agent, can be very useful in treating brown spots and other conditions of facial discoloration.  

• Anti-oxidant treatments are popular choices to reduce inflammation and protect the skin against environmental exposures that may cause visible damage.  Some common anti-oxidants include Vitamins C and E as well as CoQ10.  The effectiveness of these treatments is controversial and can vary with each person.

• Exfoliating treatments, such as those containing alpha and beta hydroxyacids an be used to remove dead cells on the skin surface and restore a more youthful glow.  These treatments can be in the form of a skin care regimen to be used daily or in the form of skin peeling treatments that are applied in the dermatologist's office.  The type and strength of each treatment is individualized for each patient.

• Sun blocking agents are the most commonly overlooked yet the most potent non-surgical anti-aging treatments available.  The harmful ultraviolet rays of the sun are perhaps the most important causes of premature aging of the skin.  By blocking the ultraviolet light, sun blocking agents protect the skin from damage and help to maintain a youthful appearance despite advancing age.  The importance of the sun as a cause of skin aging an be easily appreciated by comparing the visible signs of damage in an area of skin that has received long term sun exposure with the healthy and youthful appearing skin in an area that has remained protected from the sun over the years.
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Chemical Skin Rejuvenation

Skin is one of the fastest growing organs in the body, undergoing continual cell turnover.  Most skin cells are found in a thin layer called the epidermis.  This layer of skin is the top most layer and covers the deeper layers which consist mostly of fibers and supporting structures. At the bottom most layer of the epidermis, cells begin their lives and progressively make their way to the top where they flatten and die.  Dead skin cells eventually flake off in a process called exfoliation. In youth, this process works efficiently with continual exfoliation making way for the next wave of skin cells to grow.   As the skin ages, however, it loses the ability to exfoliate normally.  This leads to a retained layer of dead, flaky skin at the surface, leaving the skin feeling dry and appearing dull.    

Chemical exfoliation, also known as chemical peeling, is a helpful treatment for a variety of skin conditions.  By removing the dead skin cell layer on the surface of skin and inside skin pores, chemical peels can help in the treatment of acne breakouts, acne scarring, skin discoloration, sun damage and can be very helpful in the rejuvenation of aging skin.  There are many types of chemical exfoliating peels.  The type of peel most appropriate for you is determined by consultation with your dermatologist and depends on various factors including your particular skin condition, the degree of pigmentation of your normal skin, the degree of sensitivity of your skin, as well as your expectations and the level of comfort with the proposed treatment plan.  Before undergoing any skin peel, all prescriptions of over-the-counter creams should be discontinued at least three days preceding treatment.  The doctor should be informed if there is a history of cold sores that may need to be treated with suppressive medication to prevent an outbreak that may spread to the treated skin areas.  

Listed below are some of the most common chemical peeling treatments:

Beta-Hydroxy acid peels
Salicylic acid, a beta-hydroxy acid, is a superficial skin peel that is useful for a variety of skin conditions.  It is especially beneficial for patients with acne breakouts.  It penetrates easily into skin pores where it exfoliates dead skin cells to clean and unclog acne-prone pores.  It is also an effective treatment for skin discoloration and for rejuvenating skin that has been affected by sun exposure.  This type of peel is safe for patients with sensitive skin and for conditions such as rosacea.  During the treatment, a mild burning sensation is experienced while the peel is working.  At the conclusion of the treatment, mild to moderate redness will be evident that will become less noticeable over several hours. The treated skin will feel tight and dry for the next several days followed by mild to moderate skin peeling.  Occasionally, some areas will be affected more than others and may lead to more prominent redness and occasionally crusting.  A moisturizer is recommended following treatment which should be used liberally over the next several days.  Sun block and sun avoidance are also important while the skin is healing.

Alpha-hydroxy acid peels    
Glycolic acid, an alpha-hydroxy acid peel, is a common exfoliating peel used for a variety of skin conditions.  It is effective for acne and acne-prone skin, skin discoloration and for skin rejuvenation.  It can be more irritating than a salicylic acid peel and is not recommended for patients with sensitive skin or rosacea.  During treatment, patients experience a burning sensation followed by the appearance of redness in the treated areas.  Some areas may be more sensitive than others, causing more prominent redness and occasionally crusting.  As in salicylic acid peels, a moisturizer is recommended following treatment which should be used liberally over the next several days.  Sun block and sun avoidance are also important while the skin is healing.

Trichloroacetic acid (TCA) peels
The TCA peel is a deeper and more aggressive peel than alpha or beta hydroxy acid peels.  Different strengths are available and selected based on skin type as well as  the condition being treated.  The TCA peel is useful for a variety of different skin conditions including acne, acne scarring, sun damage, skin discoloration and for the treatment of precancerous lesions.  The application of TCA causes a burning sensation followed by prominent redness.  Some areas of whiteness or crusting may occur.  Depending on the strength of the peel, significant skin peeling may occur over the following week.   Sun block and sun avoidance are also important while the skin is healing.

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• Microdermabrasion is a form of skin exfoliation using crystals of aluminum oxide to physically remove the dry, flaky layer of dead skin cells on the skin surface.  By removing dead skin cells that build up on the surface and in pores, this treatment is effective for a variety of skin conditions.   Microdermabrasion can target clogged pores in acne and acne-prone skin to promote clearing of acne breakouts.  By peeling off superficial layers of skin overlying blotchy patches, skin discoloration and uneven complexions can be improved.  Similarly, rough or sun damaged skin can be treated resulting in a smoother texture and freshened appearance.  Another benefit of microdermabrasion is its ability to remove dead cell buildup that can prevent prescription creams from readily penetrating the skin surface.  By exposing the underlying normal skin, microdermabrasion treatment can help medications to be absorbed more easily and to reach deeper levels where they can be more effective.  This is especially important in conditions such as acne and discoloration which are commonly treated with topically applied medicines. Although this treatment is very safe for most skin types, patients with sensitive skin conditions such as rosacea may require more gentle treatment parameters than patients with normal, less sensitive skin.  

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Botulinum toxin (Botox®) treatments

Facial expression lines, also kn own as worry lines, frown lines, laugh lines or crows feet are caused by repeated contractions of delicate facial muscles.  With every laugh, smile or frown, the wrinkles deepen, eventually becoming telltale marks of a lifetime of emotions.  Botulinum toxin,  a medical form of a bacterial substance, can prevent nerve impulses from stimulating the muscles of facial expression thereby causing the muscles to relax.  The result is a reduction and softening of facial lines and wrinkles.  Results are gradual over 7 to 10 days after treatment.  Once fully effective, results can be dramatic and may last up to 3 or 4 months.  Botulinum toxin treatment is one of the most common non-surgical cosmetic treatments in the United States.  Few treatments are as effective as botulinum toxin for rejuvenating the upper face areas.  The doctors at the Skin Center of South Miami are certified injectors of Botox®, the most commonly used brand of botulinum toxin.  

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Injectable Fillers

As our skin matures, the underlying youthful fullness gives way to noticeable creases and folds that cause us to appear tired and older than we feel. This is caused by a gradual loss of  supporting skin structures that give strength, fullness and integrity to the skin. Also, acne breakouts can leave deep scars that can detract from an otherwise smooth complexion. At the Skin Center of South Miami, we use a variety of injectable fillers to restore a more youthful look. These treatments can improve the appearance of noticeable lines and wrinkles, exaggerated skin folds and acne scars. Also, filler injections can enhance and accentuate lip contour to impart a stunning look to otherwise unremarkable, plain or thin lips.  Still other injections can restore overall volume to sunken facial features that accompany the aging process.  Below are some of the common filling treatments available at the Skin Center of South Miami.

• Sculptra®
A natural, youthful face is full and not tight.  Age related changes of the lips and mouth include thinning of the lips and a downturn of the corners of the mouth.  Another early sign of aging is the development of deep creases along the side of the nose extending downward to the margins of the mouth.  Although the upper face can be easily rejuvenated with botulinum toxin, the lower face is less amenable to this treatment and responds better to injections of filling substances, such as Sculptra®.  

Sculptra® is a safe, synthetic and biocompatible material that is injected below the surface of the skin.  It is made up of microspheres (a spherical shell) of poly-L-lactic acid, a material similar to that used in dissolvable sutures.  Because poly-L-lactic acid is the main ingredient in Sculptra®, patients do not require a test for allergic reactions.  Unlike other filler treatments such as Restylane®, Perlane® or Juvederm®, treatment with Sculptra® does not result in an immediate effect.  Sculptra® takes time to gradually correct skin depressions by stimulating the formation of collagen by the cells in the lower layer of skin.  Multiple treatment sessions are usually required at monthly intervals to achieve the desired result.

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