Is it possible to rejuvenate the face without any surgery? A variety of practitioners are making that claim.
To clarify: "Non-surgical" applies to procedures that are either topical - peels and lasers, or injected, meaning muscle-relaxers such as Botox and fillers including fat, Restylane, silicone, and other FDA-approved materials.
Definitely not in the non-surgical category is the thread, or string, lift in which Velcro-like substances are threaded through the tissues below the skin, then pulled to "lift" it. Although no sutures are used, this procedure is decidedly surgical in nature. It requires local anesthesia or sedation, and healing time. Furthermore, the safety and longevity are debatable.
In light of all this, can we rejuvenate the face without making an incision? The answer is yes, in certain situations, with certain patients. What are the options?
Injectables
This category includes a variety of injectable products that can reduce wrinkles and fill in folds. Injectables fall into two classes: Botox and other muscle-relaxers; and fillers, substances that add volume to the face from below the surface of the skin.
Botox, or botulinim toxin type A, temporarily disables the nerves that trigger contractions of the muscles that create facial expressions. Years of frowning, smiling, and eyebrow-raising create wrinkles and furrows across the forehead, between the brows, and at the corners of the eyes and mouth. These are known as "dynamic wrinkles." Judiciousl treatment of dynamic wrinkles with Botox injections can dramatically improve a tired, aged look in the upper face and jowl area. Botox is fast and very safe, and when used before wrinkles become too pronounced, offers a natural-looking correction. A Botox treatment lasts approximately four months and can be repeated up to three times a year.
"Static wrinkles," folds that are evident when the face is at rest — can be improved significantly with filling agents. The most natural of these is fat. The patient's own fat is used, removed from the abdomen with a syringe. If the patient is having liposuction at the same time as facial rejuvenation, the surgeon will save some of the fat from the liposuction to inject into the face. Depending upon the person and the area of the body to be filled, fat injections may be permanent. Fillers like Restylane (made of hyaluronic acid, a natural substance found in the body) and Sculptra (poly-L-lactic acid, a synthetic material) may last from seven months to several years.
Safe and relatively inexpensive, injectables can correct aging changes as long as the wrinkling is not overly pronounced. Once signs of aging progress pass a certain point, however, injectables are no longer effective. They can buy time, but do not eliminate the need for a subsequent, more thorough surgical procedure.
Laser Peels
Laser peels to refresh or tighten the skin represent another class of agents effective for non-surgical rejuvenation. The deeper or more aggressive of these treatments requires some form of local anesthesia or sedation and involves recovery time. But since no incisions are involved, laser peels are considered non-surgical procedures.
Milder peels like acetic acid that do not penetrate below the skin's surface can reduce wrinkles and brown spots and encourage new collagen production. However, they will not tighten or "lift" the face. The same is true of gentle resurfacing lasers like the Erbium and Intense Pulsed Light (IPL) therapy, which uses non-laser light. Both treat brown spots and roseacea effectively but do not lift.
The ultimate laser treatment is the carbon dioxide (CO2) laser. In use for about fifteen years, it is still the standard by which all other laser procedures are judged. For sun damage, severe wrinkles, brown spots, pre-cancerous lesions, and early skin sagging, there is nothing comparable. In the hands of a skilled practitioner, the CO2 laser will not only tighten and lift a sagging face but also totally restore the damaged surface and encourage the growth of new, youthful collagen. The resulting rejuvenated look may last for seven years or more.
In the right patient, the CO2 laser is an excellent alternative to a surgery. Treatment involves sedation, as well as dressings and meticulous care for a week following the procedure. The only downside of the CO2 laser is that redness may persist more than a week, and the face remains pink for another six to eight weeks. (The pink color is easily covered with makeup, however.)
|
