FILLERS, PEELING AND EXFOLIATION Posted in: Most Frequent Procedures

These are surgical procedures that should be performed when the person begins to show signs of aging or simply at the start of appearance of fine folds and wrinkles on the face.

Usually these procedures are in the office and do not require anesthesia, except for deep peels with phenol.

Fillers and other auxiliary procedures may be recommended alone or in combination with other facial rejuvenation surgery.

Facial Fillers:

There are several is on the market several trademark products available to fill fine wrinkles of the face, as well as the most  noticeable facial crease – the nasolabial folds which is present in between the nose and the corners of the lips.

Prior to the mid 20th century, medical grade silicone was used for filling. By the end of the twentieth century, we used collagen, which is a byproduct of bovine type animals. And now, at the beginning of this century, hyaluronic acid has become the most commonly used of filler material because for its great tolerance and minimal adverse effects.

After an initial evaluation, the best product will be selected based on you unique skin type and prblem being corrected. The filler is injected with a very fine needle under the skin to  filling the groove of the wrinkle.  Pain during the procedure is minimal.

Fat Auto-transplantation (Fat of the own patient).

A patient’s own fat is an excellent material for filling.  The advantage that is easy to obtain and it is free.  The procedure is a double task:  it must first be  removed from some part of your body and then, after sterilization, we inject it into the area where it is needed.  Of course, there is a cost involved.

Fat has excellent durability, although it undergoes some re-asorption (degree of disappearance) that varies between 30 to 40 percent. Therefore, it is my custom to over-correct the areas, that is to say, to inject a little more fat to compensate for the re-absorption. The over-correction will cause some initial inflammation which will resolve by the 6th or 7th day.

Both the donor and receptor sites must be meticulously cleansed with Isodine (Betadine in the US, or Dial, or Safeguard) for three days consecutively before the procedure.

This procedure will be done under local anesthesia in the office and  lasts for about one hour. There may be slight discomfort when the anesthesia is administered to the sites to produce the local numbness. The results are almost instantaneous and you will be able to leave soon after the conclusion of the procedure.

Peeling or exfoliation.

Exfoliation, chemical peel or peeling are synonymous and mean a sanding effect of the most superficial layer of the skin, in order to improve its smoothness, and leave it looking younger and less wrinkled.

Peels involve applying various acids to produce a thin, superficial burn to the skin surface.  A  new layer of skin cells replaces those that were destroyed, giving additional softness and smoothness to the skin.  The one disadvantage of  this procedure is that the skin is very sensitive to sunlight’s ultraviolet radiation. To take care of your skin, you must use sunscreens for about at least 6 months after this procedure.

Gentler peels are a practical solution for working people. They are made with fruit acids which produce less intense burning. The patient is scheduled to receive four applications, one every other day. Every time they leave the office, the face will be slightly flushed, but, without pain. They are  able to perform their normal activities after each treatment.

Deeper peels are made using more aggressive substances, including phenol. This is a powerful exfoliant and I use it to improve heavy wrinkles around the lips, and lower eyelids. In clearer skin, types I, II and III on the Fitzpatrick scale (click Skin Types) the result  is excellent and is comparable to mechanical dermabrasion (mechanical abrasive sanding of superficial layers of skin with a bur) a procedure that has been almost abandoned  I do not like using deep peels in patients with very dark skin, type IV, V or VI  as they are more prone to blotching.

Deep peeling with phenol, which requires anesthesia with sedation. Phenol peels will require a short stay, usually up to an hour, or in major cases, a half-day stay in the clinic.
Once the peeling with phenol is over, we leave a layer of adhesive tape on the treated area which we remove two days late. The exfoliated area is then covered with an absorbent powder until the ninth day. This forms a thin brown crust which falls off, revealing the new skin, remarkably free of wrinkles.

Botox:

Is the brand name of one of the many commercial preparations of Type A Botulinum Toxin. This deserves a special chapter, so for this, click Botulinic Toxin and find more information.

Below are some important pointers ‘before & after’ the application of your filler or peeling:

BEFORE PROCEDURE:
1.   Wash of your face normal.
2. Do not  wear makeup or creams in areas that are going to be treated.
3. Degrease your face with an astringent lotion.

AFTER PROCEDURE:
1. Apply an ice pack for 15 minutes every 4 hours for about two to three times a day.
2. You may resume your normal activities immediately following treatment.
The result will be immediately evident and will last at least 12 to 18 months.  Botulinic toxin will last for 5 to 6 months.

For deep peeling:
1. Rest for a few days at home, while the scab falls off
2. Eat with a spoon or straw, so as not to injure the treated area.

To see some of this cases treated by Dr. Valero, click Photo Gallery.

Any questions before and after your treatment may be answered in person by calling the office, 684-2551  (US: 619-730-1917) or my cell 664-283-0976 or click Contact us for more information.

I wish you an excellent experience in Plastic Surgery and a speedy recovery.

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