Skin Resurfacing in New Orleans
Dr. Velargo performs CO2 laser resurfacing, deep chemical peels, and dermabrasion, while Dr. Hendrick also performs CO2 laser resurfacing. As a rule, surgical procedures (facelift, blepharoplasty, etc.) improve sagging and bulges, whereas resurfacing procedures target wrinkles.
Resurfacing can sometimes produce a dramatic improvement in the texture of facial skin. However, it is not indicated for every patient. Therefore, we will provide our professional opinion on whether you are a candidate for these procedures. These treatments generally give the skin a more youthful fullness, replacing the “old” wrinkles. In short, resurfacing procedures offer a rewarding and often dramatic exchange of “prunes for peaches.”
Skin resurfacing procedures can be performed in a delayed manner or, in select cases, simultaneously with facelifting or blepharoplasty, as in the Renaissance Lift™, offered exclusively by Dr. Velargo.
Some skin types are more favorable for skin resurfacing than others. Fair complexions tend to respond better than darker ones. Thick, tough, deeply etched, or oily skin may require a two-stage approach for optimal results (i.e., a second procedure or “touch-up” of several areas at a later time). Like painting a roughly textured wall, deep creases may require a touch-up procedure to achieve maximal benefit.
Skin pores are the surface openings of the oil glands. Neither dermabrasion, laser, nor chemical peels are designed to alter them. A pore is the surface opening of an oil gland or hair follicle. Attempts to reduce its size may lead to the development of a pimple.
Skin resurfacing is considered a surgical procedure. Therefore, the risks associated with surgery must be considered. Since skin resurfacing is a cosmetic procedure, it is not covered by insurance.
Please inform us if you have taken Accutane.
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What Can Skin Resurfacing Accomplish?
Skin resurfacing can:
- Smooth rough and “leathery” skin
- Smooth fine lines and wrinkles
- Brighten the skin, lightening hyperpigmentation, brown spots, and sun damage
- Smooth scars
- Improve acne scars and blemishes
- Stimulate natural collagen production for an overall enhancement of the skin
- Be the “icing on the cake” when used as an adjunct to facial rejuvenation surgery
Resurfacing alone is not indicated for the treatment of sagging tissue. Although the new skin may have improved elasticity after resurfacing, sagging still requires surgical intervention. Even so, we have observed additional tightening of the skin in many patients following resurfacing.
Types of Skin Resurfacing
Laser skin resurfacing​
Laser skin resurfacing with the CO2 laser (both ablative and fractional CO2 lasers) uses light energy to treat the skin. Fractional technology is less invasive because it leaves islands of untreated skin to facilitate the healing process.
Dr. Velargo and Dr. Hendrick are skilled at assessing the needs of each individual patient to determine which type of CO2 laser treatment is indicated. CO2 laser treatment is often performed on the face, neck, and chest and is also part of our hand rejuvenation program.
Drs. Velargo and Hendrick utilize a Matrix LS-40 CO2 laser system. As with most technology, there is an art to operating it. Experience is required to achieve the maximum benefit. CO2 lasers, like any technology, must be used for the “right reason.” The “right reason” is when the doctor determines that the CO2 laser is superior to other forms of treatment for a patient’s unique condition.
Drs. Velargo and Hendrick are experienced in counseling their patients appropriately. Dr. Velargo also performs other forms of facial rejuvenation, such as deep chemical peels and dermabrasion, when these methods are deemed superior for treating a patient’s specific condition.
CO2 laser resurfacing is performed in the outpatient procedure room at our clinic and is generally well-tolerated with oral sedation, topical anesthesia, our cooling machine, and select nerve blocks if absolutely necessary.
Dermabrasion​
Dermabrasion should not be confused with microdermabrasion. The latter is performed by non-medical aestheticians to “buff,” “polish,” and exfoliate the most superficial layers of the skin. Dermabrasion, on the other hand, is a surgical procedure in which a device removes the top layers of skin down to the dermis. The body responds by creating new skin over a period of days.
When the skin has an irregular or uneven texture due to acne scarring or previous injuries, dermabrasion may provide improvement. The technique is similar to sanding a scratch from a wooden table: the procedure targets elevated areas in an attempt to bring them closer to the level of the defect. When successful, this diminishes the high-low junctions that cast shadows when light strikes the face, leaving the skin smoother and tighter than before.
If the texture of the facial skin is very irregular from excessive or deep scarring, a second treatment may be required 6–12 months after the initial procedure. Following dermabrasion, more superficial defects may be completely removed, moderately deep scars may be improved but not fully eliminated, and some deep or “ice-pick” scars may not improve at all.
In select cases, a second dermabrasion within 6–12 months can provide additional improvement for moderately deep scars. While a third treatment is possible, there is a practical limit. Prior to surgery, it is difficult to predict the degree of improvement, and each patient’s skin may respond differently, even with the same surgeon. Because of his training, Dr. Velargo is highly experienced in dermabrasion, a technique that is becoming a rare art in facial plastic surgery.
Dermabrasion may be performed in the outpatient procedure room at our clinic and is generally well-tolerated with oral sedation and local anesthesia. For patients who prefer general or twilight anesthesia, the procedure can be performed at an outpatient surgery center in the community.
Chemical peels​
Chemical peels vary by formula and depth. The deep chemical peel procedure utilizes a special formulation of phenol and croton oil, among other ingredients. A chemical peel involves the careful application of a scientifically formulated solution to the skin, which causes the top layers to separate and shed (like a blister), taking with them sun-damaged and wrinkled layers.
Deep chemical peeling is an art and requires extensive experience with the formulation, concentration, amount applied to each area of the face, and the method of application. Most importantly, deep chemical peeling requires thorough experience in post-operative care. Having trained with one of the early innovators in deep peeling techniques, Dr. Velargo is highly qualified to perform this procedure.
Deep chemical peels are performed only in a monitored setting because of the strength of the ingredients used. All patients are connected to cardiac monitors, and an IV is started. The procedure can be performed in the outpatient procedure room at our clinic or in an outpatient surgical facility in the community. If performed without general anesthesia, the solution stings upon application, but this discomfort is brief (a matter of seconds).
Later discomfort can be eased with appropriate medications. Skin may recover more quickly from a mild or light chemical peel (e.g., TCA, glycolic acid, or salicylic acid), but these lighter peels offer fewer benefits.
Acne scar treatment​
Acne scars are addressed using a combination of methods. For large, deep pits, direct excision with replacement by a more favorable linear scar may be indicated. For smaller pits and ice-pick scars, Dr. Velargo employs a modified CROSS technique. CROSS stands for “Chemical Reconstruction of Skin Scars.” Unlike traditional CROSS methods, which use TCA, Dr. Velargo prefers a stronger chemical peeling agent called phenol.
In the same session as CROSS, Dr. Velargo may also perform dermabrasion or CO2 laser treatment. This approach promotes collagen growth, particularly in the pitted scars themselves, with the goal of achieving more even skin. Acne scars are very difficult to treat, and Dr. Velargo emphasizes that the goal of surgery is improvement, not perfection. More than one treatment is generally required.
What Happens During Skin Resurfacing?
Different areas of the face generally require varying types and depths of treatment. For example, the thin skin of the eyelids may not tolerate the same treatment depth as the thicker skin of the forehead, nose, lips, or chin. Additionally, certain facial areas and skin types respond more favorably to chemical peels than others. An experienced surgeon like Dr. Velargo will know how to adjust the type and depth of treatment to meet your specific needs.
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Contact the New Orleans Center for Aesthetics and Plastic Surgery today to learn more about expert skin resurfacing.