Features Of Old Skin:
With the passing years, many changes occur in the outermost layer of skin called the “epidermis”, and the deeper layer called the “dermis”, due to genetic effects as well as the effects of environmental factors such solar rays, smoking, working outdoor, cosmetics, and irregular lifestyle. The epidermal layer gets thicker and becomes a rougher surface. The distribution of pigmentation becomes abnormal. Dark and light-colored spots begin to occur from place to place. The skin color turns into more matte and yellowish. Collagen synthesis in the dermis layer decays and the alignment becomes more irregular. Elastic fibers that provide elasticity to the skin decrease. The decrease in hyaluronic acid and its derivatives, which surround the collagen and elastic fibers and ensure the moisture of the skin, leads to dryness and wrinkling in the skin. As a result of all these epidermal and dermal changes, a skin appear which has lost its moisture, thickness, elasticity, and brightness; which has a surface felt rough and uneven when touched, and which is accompanied by wrinkles, abnormal pigmentation, and expanded capillaries.
A number of surgical operations are performed for facial rejuvenation. Rejuvenation of the facial skin is an irreplaceable part of facial rejuvenation procedures. Today, the treatment of aging-related changes, not only in the facial skin but also in the skins of the neck, decollete area, hand dorsum, and forearm, is on the agenda.
Facial Rejuvenation Procedures
Today, there are many procedures performed for facial rejuvenation. Most of the conventionally used methods are based on the principle of peeling the worn epidermal layer and the upper parts of the dermal layer, in order to allow for the formation of a new epidermal layer from cells in deeper places. In addition to this, it is aimed at increasing the quality of collagen fibers in the dermal layer of the strata, and forming a firmer dermis.
In general, skin peeling processes are carried out with mechanical tools (classic dermabrasion), chemical substances (chemical peeling), or laser.
Properly analyzing the skin’s type and structure, and determining the appropriate treatment accordingly is one of the most important points in facial rejuvenation. There is not a standard treatment. The treatment needs to be customized for each patient, and for different areas of the same patient.
There is a direct proportional relation between the depth of the skin peeling procedure and the pain felt during the procedure, the erythema that appears after the procedure, the time that passes before the complete healing of the edema or wound, the possibility of complication, and the clinical result (no matter what method is used). More superficial peeling means less pain, less erythema and edema, and shorter recovery time. The possibility of encountering any complication is also lower. However, the improvement to be obtained in the treated skin will be less accordingly. In parallel with the increase in the peeling depth, the wrinkles are treated much more effectively. However, since the uppermost layer of the processed skin is completely removed, an open wound occurs; and therefore, it causes more severe pain, swelling and erythema. It takes a longer time to return to social life. The possibility of encountering undesirable effects such as dark or light colored blemishes on the skin, poor wound healing, or long-lasting erythema increases. Therefore, the method ideal for the individual is determined based on his/her skin type, the extent of the skin damage, how long he/she can venture staying away from his/her job and social life, and his/her expectation from the procedure.
Procedures performed for skin peeling have different advantages and disadvantages compared to each other. I think, the command of the doctors applying these methods on these procedures as well as their experience in this regard is as important as the method itself. It is possible to obtain both successful and unsuccessful results from each method.
In recent years, less radical procedures which do not leave much edema, erythema, or wound on the face are preferred, due to the increasing business and social life tempos. Techniques such as Light Peeling, Erbium Laser and Microdermabrasion are used with intent to peel only the epidermis layer of the skin in a very controlled way. When these procedures are repeated a few times at certain intervals, it is possible to get good results without staying away from daily life. On the other hand, some other methods have also been developed with intent to ensure the stimulation of the collagen synthesis on the dermis layer as well as skin tightening, in such a way as to target the dermis layer only, by keeping the epidermis layer undamaged. In the procedures called ‘Non-ablative skin tightening’ or ‘Non-ablative dermal remodeling’ in the English literature, directly the deeper dermis layer is targeted, by keeping intact the epidermis layer that is the outermost layer of the skin. For this purpose, lasers such as Nd:YAG, IPL (Intense Pulsed Light) systems and radiofrequency devices are used in company with special cooling systems. When more than on session is applied with these devices at certain intervals, a renewal and tightening is obtained in the dermal layer, at varying rates.
“Fractional photothermolysis” is another laser treatment procedure developed in recent years that targets both epidermis and dermis, and has a shorter recovery time and less side effects compared to traditional methods. In this procedure, cylindrical wells with an average depth of 1.4 mm and an average diameter of 250 micron are opened in the skin by usually using Erbium laser. The skin tissue inside these cylinders evaporates; and in the following days, a renewal and tightening is seen in both the epidermis and dermis layers, while these micron-scale wells get better rapidly. In a session, 5-20% of the skin surface is treated. The most important advantage of the procedure is the fact that it causes no significant wound or erythema formation after operation. The patient returns to normal life within about 1 to 3 days. However, 3-6 sessions with intervals of 3 weeks are required for ensuring the targeted skin surface to be completely treated.
For getting information about facial rejuvenation, please fill out the contact form.
Prof. Dr. Cengiz Açıkel, Aesthetic Plastic Surgery Specialist, Facial Rejuvenation
Frequently Asked Questions about Facial Rejuvenation: