Many times we hear of fantastic claims made by dermatologists or plastic surgeons concerning a “revolutionary treatment” designed to enhance the skin and eliminate aging.

I have taken a different approach to aging skin and facial rejuvenation. If you consider the aging problem to be related to deterioration of the skin with loss of skin elasticity then it makes sense to try to improve the quality of the skin first. As a plastic surgeon if I can improve the quality of the patient’s skin then it makes sense that their final result will be longer lasting.

Many times the news I have seen even experienced dermatologists state that their treatment, whether Thermage, Retin A, Renova, IPL improves the quality of the skin but they have not proof that it does or even can.

My approach is a much different result oriented one. It begins with a diagnostic ultrasound of the skin. From this scan we can document the quality of the skin and come to a conclusion concerning the thickness of the epidermis, the thickness of the dermis and the level of collagen and elastin in this layer. From the scan an individualized treatment protocol is created. Currently there are two steps to the program but I am getting ready to introduce the third step.

Step 1 - Diagnostic skin ultrasound examination
a. From this scan we can determine skin aging and degree of photodamage. This also gives us a baseline for further treatment
b. The skin clearly demonstrates the thickness of the epidermis and dermis as well as amount of collagen, elastin and moisture retaining polysaccarides in the dermis.

Step 2 - Treatment protocol using either Beaute Pacifique Super 3 booster

Step 3- Repeat skin ultrasound examination every 90 days to record and document improvement.

Skin Needling

Using a drum type instrument multiple tiny punctures are placed into the skin. The needles are designed to penetrate the skin at horizontal, vertical, and oblique angles to create a confluent zone of treatment.
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The punctures create a wound in the papillary dermis while the epidermis remains virtually intact, with only microscopic clefts in the skin. Each of these very small holes or wounds passes through a wound healing cascade : inflammation, proliferation, and maturation or tissue remodeling.

The key is to avoid injury to the epidermis while inciting an inflammatory response to the dermis. This causes a release of TGF, Transforming Growth Factor. These growth factors promote the deposition of normal in a lattice or woven network and not in a linear fashion such as seen with scar collagen.

Collagen takes time to be deposited and converted to normal adult collagen. Therefore, the results seen over time (three to six skin cycles, approximately 6 – 9 months) are smoother upper lips and reduced facial wrinkling and skin laxity with greatly lessened fine lines. The texture of the lips and skin is also rejuvenated. This would be followed with a repeat diagnostic ultrasound to measure improvement.

It is helpful to repeat the needling procedure several times to obtain better results, because each session improves on the previous one. If the tissues of the upper lip are deficient, it is essential to restore the normal thickness of the upper lip with fat injections or other injections or implants.