Before

After Rhinoplasty and Superficial Chemical Peels

The facelift will not remove the fine crinkly wrinkles of dry, weathered skin most evident around the mouth, lower eyelids and corners of the eyes (crow's feet). Nor will it treat the wrinkles of the midcheek or vertical forehead creases. Chemical peel and now, laserbrasion, is effective and often necessary to achieve the smoother look that most patients seek. A chemical peel can also provide additional improvements to facelift and eyelid surgery. 

Splotchy pigmentation, rough areas of facial skin, dark circles which some people have under their eyes may all be improved by chemical peel or laserbrasion.
 

Before	After Rhinoplasty and Superficial Chemical Peels

There are three depths of chemical peeling. Superficial peeling, with chemicals such as alpha-hydroxy acids, are used as a complexion enhancer, and do not improve wrinkles. A medium depth peel treats chloasma, or blotchy pigmentation, and some wrinkling. A deep phenol peel is useful for deeper wrinkles and fine wrinkles and must be applied with several factors in mind. 

The laser may be applied at a superficial or medium depth wrinkle with great safety and represents a new method of treating an old problem. (See the Laserbrasion section). 
 

Before

After Chemical Peel

The Procedure
The chemical peel may be a separate procedure or be used in combination with other procedures. It involves using cotton swabs to apply a specific chemical mixture to the skin with accuracy and an understanding of the healing process. Initially, stinging occurs and quickly subsides. Some discomfort returns within the next half hour and remains for a few hours. By the following morning, virtually all discomfort subsides. Swelling is often significant over the following several days but most often disappears within one week. 

After Care 
The procedure results in swelling and peeling of the skin. The skin peels off with blisters and crusting which requires specific and attentive care. Frequent showering and ointment application resolves the crusting and blistering over several days. The resulting "new" skin is then deep pink and can be concealed with makeup four to ten days after the procedure. The pinkness or redness will then resolve slowly over three to six months. 
 

Before

After Chemical Peels

It is particularly important for these patients to avoid direct sun exposure for at least three to six months after any skin resurfacing procedure. Sunscreens and hats are necessary to allow continued enjoyment of any outdoor activities. UV radiation causes hyperpigmentation (dark blotchy areas) when allowed to directly radiate the new skin. Estrogens have also been reported in the medical literature to cause pigmentary changes in these patients. This risk is minimal, however, and patients are not required to stop hormones for chemical peels or laserbrasion. Overall, the results of chemical peeling are quite gratifying and dramatic and well worth the process.