Skin Resurfacing Mobile
Skin resurfacing utilizes either chemical peels, manual dermabrasion, or laser light to dessicate or remove the outer layers of skin and as skin regenerates from appendages (follicles or glands), it appears rejuvenated with more organized epidermis, dermis, collagen, elastin, and glycosaminoglycans. This translates to reduced wrinkles, increased elasticity, improved wrinkles, removal of dysplastic changes, more regular pigmentation, and improved scarring and inflammatory conditions of the skin (acne, seborrheic dermatitis, rosacea, milia). Skin resurfacing cannot, however, correct the loss of structural support from muscle, bone, or fat that contributes to the changes of aging and create deeper wrinkles and depressions. Dr. Park applies skin resurfacing based on the amount of damage present, the desired amount of change, and the acceptable downtime and budget for each patient.
Chemical peels are medical procedures that use a variety of chemicals to either lyse or coagulate the skin, leading to rapid exfoliation of the epidermis and superficial dermis. They are designed to treat the changes that occur with genetic and photo-aging, including irregular pigmentation, reduced elastic fibers, fine wrinkling, and slow cellular turnover.
Superficial peels (Glycolic Acid, Salicylic Acid, Jessner’s solution, and numerous proprietary peels, such as Skinmedica’s Vitalize and Illuminize peels) are nonablative but remove the top layer of the epidermis and stimulate healing, thickening, and hydration. A superficial peel is appropriate for a patient wishing to correct fine wrinkles and mild degrees of hyperpigmentation. These should be repeated frequently
Medium depth peels (Trichloroacetic acid :TCA, and several proprietary peels such as the V I Peel, Obagi Blue Peel, and Skinmedica’s Rejuvenize peel) are ablative and reach into the dermis. Depth of treatment is not only dependent on the concentration but on preparation of skin and the number of applications and can be judged by the frosting that occurs during the procedure. With the increased depth of peel comes significant additional improvements in skin elasticity, hydration, tone, and color, but also increased discomfort and risks of scarring, infection, and altered pigmentation.
Deep peels (Phenol / Croton Oil) are ablative and extend into the deep dermis, leading to the deposition of new epidermis and dermis with normal elastic fibers, glycosaminoglycans, and collagen. However, this is a deep, painful burn done only under sedation and the patient needs to be monitored and resuscitation equipment should be available. These peels have essentially been replaced by CO2 resurfacing.
Dermabrasion uses a rapidly rotating diamond burr or wire brush to remove the outer layers of skin to smooth scars or correct wrinkles. If performed on a small area, local anesthesia is sufficient. If larger areas are being treated, intravenous sedation or general anesthesia may be necessary. This procedure is done by your surgeon and is different than micro-dermabrasion which can be performed by nonmedical personnel who propel crystals to exfoliate the epidermis and improve dilated pores, oily skin, and mild sun damage.
Resurfacing lasers can be used to apply controlled injury to the skin, prompting regeneration with either a continuous wave or a pulsed-laser light. The deeper resurfacing lasers such as carbon dioxide lasers, CO2 lasers, and our ClarO2 laser, are significant medical procedures that should be undertaken only by highly qualified physicians, such as Dr. Park, Rebowe, and Massinople, who have been trained in the use of resurfacing lasers. Blemishes and pigmented spots are removed and wrinkles should be significantly improved. More superficial resurfacing lasers such as Erbium can provide some wrinkle removal, sun damage removal, and rejuvenation while being less deep, less recovery, and appropriate for licensed aestheticians to perform.
IPL, or Intense Pulsed Light, is a broad, noncoherent wavelength also known as phototherapy that can be utilized to treat hyperpigmentation or brown spots, undesired hair, large pores, oily skin, and fine wrinkles. Dr. Park offers a Lumenis IPL, one of the standards of IPL. The downtime is essentially zero.
Nd:YAG is a coherent laser light of 1064 nm wavelength that targets melanin and ablates the dermis and epidermis. It can be used to tighten skin, can remove unwanted hair, and can be used to treat angiomas and spider veins.
Erbium:YAG is a coherent laser light of 2940 nm wavelength that targets water and ablates the epidermis. Its depth of penetration is similar to a superficial peel, but does also target and ablate collagen (3030 nm) augmenting its rejuvenation. The results are less extreme than CO2 resurfacing but the recovery and discomfort are also significantly less.
CO2 laser is a coherent laser light of 10,400 nm wavelength that targets water and ablates the skin deeper with sequential passes. This laser has tremendous ability to resurface the skin with dramatic improvement in skin texture, elasticity, and even appearance. Thus improving the glow of skin and removing wrinkles. The intensity or strength can be adjusted for each treatment and patient and can also be fractionated.
Fractionated lasers divide the standard laser signal into microbeams of light, leaving intervening skin without treatment. This less traumatic technique minimizes procedural pain, down time, and redness. However, the overall benefit is less and multiple treatments are required to eventually treat all areas of the skin, typically 3 laser treatments at monthly intervals. Fractionated lasers include Erbium and CO2. Erbium lasers, ie Fraxel, have been shown to be of limited effect. Drs. Park, Rebowe, and Massinople are happy to provide the optimal combination of an adjustable CO2 laser that is fractionated, giving him the ability to adjust treatment to the desired level and achieve superior results through the depth of CO2 while limiting the recovery period. Our aestheticians are also able to fractionate Erbium resurfacing.
with Dr. Park or Dr. Rebowe
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Due to COVID-19, MPRSD and the Med Spa will be closed indefinitely beginning March 30th, 2020. Both Dr. Park and Dr. Rebowe will only be seeing post-operative patients, patients with pressing issues, and will continue working hospital consults and ER coverage. However, during this time we will not be seeing new elective patients. Staff will reach out to cancel appointments and notify patients, and will be reaching out to reschedule when we are back in the office.