However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three weeks, prolonged facial redness that can last three months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring.

During the past three years new technology called fractional laser resurfacing or fractional skin rejuvenation has been developed which has dramatically shortened recovery time and lessened the occurrence of complications.

With Fractional Skin Rejuvenation the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production and resultant facial skin rejuvenation.

The first fractional laser made by Reliant the Fraxel laser and subsequently Palomar Medical’s Lux1540 have produced excellent results treating acne scars and facial pigmentation and have improved skin texture and facial rejuvenation. They have not however achieved the same degree of wrinkle removal and skin tightening as the traditional ablative CO2 laser resurfacing technique.

To ablate means to “surgically remove”. The Fraxel and Lux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are much less dramatic.

The results achieved by ablative CO2 resurfacing are more significant because ablation removes damaged, aged skin as well as heating the deeper skin layers to promote new collagen production.

Recently several new micro fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. The diagram below shows how this new technology works in comparison to previous laser methods.

The first on the left is traditional CO2 and Erbium laser resurfacing. Next is the Lumenis CO2 ActiveFX which fractionally ablated the surface of the skin down to a depth of 70-100 microns. Next are the non ablative fractional technologies which heated but did not ablate the skin. More recently the Palomar Lux2940, the Sciton Profractional, the new Lumenis Bridge Therapy and Reliant’s FDDA or Repair lasers have all developed new ablative or microablative fractional laser systems that reach much deeper into the skin, 200 to 1000 microns, and can produce much more effective wrinkle removal, new collagen production and skin rejuvenation with significantly less down time and recovery than traditional CO2 ablative laser resurfacing.

The photo below shows the wrinkle removal results achieved with Palomar’s new Lux2940 micro fractional ablative laser with 4-6 days of down time and a week of redness as compared to 3 weeks of down time and 3 months of redness with a traditional CO2 laser resurfacing.

The new Fractional Skin Rejuvenation lasers are a very exciting advance in the field of non surgical facial rejuvenation and wrinkle removal. Many new applications are being developed which will likely improve our ability to rejuvenate the skin and possibly improve scars, stretch marks, and remove pigment.

Another very exciting aspect of Fractional Skin Rejuvenation is that unlike older ablative laser resurfacing techniques, the new Fractional Skin Rejuvenation lasers appear to be safe to use on darker skin for Asian Skin Rejuvenation and African American Skin Rejuvenation. This will make the latest skin rejuvenation techniques available to millions of people with dark skin who could not be safely treated with previous skin rejuvenation techniques.

The patient below was treated with the Lumenis ActiveFX fractional ablative CO2 laser by Dr Bosniak in NY:

To learn more about non surgical facial rejuvenation and Fractional Skin Rejuvenation, read Save Your Face or contact me.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

978-369-4499

Traditional CO2 laser resurfacing is the Gold Standard for wrinkle removal-see below:

New fractional ablative laser technology will soon be released that can remove wrinkles with only 5-6 days of recovery compared to the three weeks down time after CO2 full laser resurfacing.

The new Lux2940 Fractional Ablative Laser is different from traditional CO2 and Erbium laser resurfacing in that the laser beam is broken up into many small micro beams so that the laser beam hits the skin on only small areas separated by normal skin, leaving intact skin bridges between the laser treated spots. These small bridges of untreated skin allow for very rapid healing thus the down time is about 1/3 that of the traditional CO2 and Erbium laser resurfacing treatments.

A crucial difference and improvement in the Lux 2940 is that the Lux 2940 is an ablative laser. Wrinkle removal requires ablation. Ablative means that the dead skin and wrinkles are ablated and removed from the skin. This is very different from the non-ablative fractional laser treatments the lux1540 and the Fraxel.

Wrinkle removal requires both ablation-smoothing of the skin surface, and stimulation of new collagen in the deeper layers of the skin to plump the wrinkle. The non-ablative fractional lasers like the Lux1540 and the Fraxel plump the wrinkle by stimulating new collagen to grow in the deep skin layers but do not ablate the surface sufficiently to remove dead skin and the surface irregularity of the wrinkle.

The new Lux2940 provides both ablation of the surface irregularity of the wrinkle and also goes deep to stimulate collagen growth and plump the wrinkle and improve skin texture.

Final FDA approval studies are nearing completion and the Lux 2940 fractional Ablative laser will soon be released.

The lux2940 fractional ablative laser is the newest wrinkle removal technique and is a significant improvement over the non-ablative technologies currently in use.

For more information on wrinkle removal or facial rejuvenation read Save Your Face or contact me.

Be sure to sign up for my free email newsletter so you will be informed of new developments in the field of facial rejuvenation and wrinkle removal.

Dr Seckel

Concord, Massachusetts

Boston, Massachusetts

Most wrinkle removal creams cannot get into the skin wrinkle to correct the skin damage that is causing the wrinkle and thus achieve wrinkle removal. There are fabulous skin wrinkle removal and facial rejuvenation techniques available today but they do not come in a jar. Save yourself a lot of money, time and aggravation and read this article and learn what causes wrinkles on your facial skin and how you can effectively remove skin wrinkles from your facial skin and rejuvenate your aging face and re-evaluate the wrinkle cure myth.

A Facial Skin Wrinkle is A Surface Irregularity like a scratch on Your Facial Skin

A skin wrinkle is a surface irregularity. In an oversimplification (there are also folds around a skin wrinkle) it is an irregular depression in an otherwise smooth surface-like a scratch on a piece of wood. How do you perform wrinkle removal on a scratched piece of wood? One way is to sand the wood surrounding the scratch down to the level of the scratch which makes the surface smooth and wrinkle free again. This is an older method used for skin wrinkle removal called dermabrasion, which is a fancy word for sanding your face, but dermabrasion is not used much anymore because it is a surgical wrinkle removal procedure which requires healing, and dermabrasion for wrinkle removal can leave the skin white, thin and susceptible to injury, and the surrounding skin can be left a different color. Newer high tech laser skin peels and deep skin exfoliation techniques can be very effective at “sanding “the wrinkled face for wrinkle removal and removing wrinkles without damaging the surrounding skin.

A Facial Skin Wrinkle is also Caused by Volume Loss in the Dermis, The Deep Layer of The Skin and loss of elasticity

Think of a nice juicy plum with no wrinkles, which is placed in the sun to dry. After time the nice juicy plumb becomes a dried wrinkled prune. The plum loses its inner volume of water and the tissue volume becomes less and the plumb shrinks, the plum skin falls into wrinkles and becomes a wrinkled prune. To perform wrinkle removal on a prune you would have to restore the inner volume of the plum with water.

Our skin loses volume from the deeper layer, the dermis after years of collagen loss which is caused by the breakdown of collagen from damage by the ultraviolet rays of the sun and aging of the skin. As our deep skin layers loose collagen, the skin collapses onto the new depleted dermis and forms skin wrinkles. Sun damage causes about 80% of the facial aging changes we see in the mirror. Wrinkle removal requires restoration of the volume loss caused by collagen loss in the deper layer of the skin, the dermis.

In addition to volume loss, some of the damaged collagen in the deep layers of the dermis loses elasticity, so the skin also loosens, stretches and falls into folds which cause additional wrinkles. Restoration of the skin elasticity is a very effective wrinkle removal technique.

Another potential method for skin wrinkle removal is to restore new volume to the dermis by adding new collagen. This method is the basis of many therapies designed to stimulate new collagen production to plump the skin for wrinkle removal. There are many examples including lasers, IPL or Photo facial, and other forms of light energy such as infrared and radiofrequency energy, all wrinkle removal methods which will be discussed below.

Modern effective skin wrinkle removal requires:

1. Correction or removal of the facial skin wrinkle surface irregularity e.g. removal of damaged wrinkled skin surface to smooth the surface and,

2. Plumping the deep skin layers beneath the facial skin wrinkle by restoring the volume of collagen in the dermis and

3. Remodeling or tightening of dermal collagen of the facial skin to restore elasticity.

Deep skin exfoliation is the first step in any effective facial skin wrinkle removal and facial rejuvenation program. Exfoliation removes dead skin cells and helps reduce skin wrinkles and fine lines. Deep skin exfoliation is in a way like sanding the skin. The irritation caused by deep exfoliation also stimulates the dermis to make new collagen which helps with wrinkle removal by plumping the deeper dermal layer of the skin.

There are many excellent methods for deep skin exfoliation and laser wrinkle removal available today. Prescription Retinoids like Retin A have this effect in topical cream form. Microdermabrasion, skin peels with Glycolic and salicylic acid and Dermasound are excellent exfoliation methods done by aestheticians and skin care professionals. The most effective deep exfoliation methods are done by newer laser skin rejuvenation techniques such as the ActiveFX Laser Skin Peel and the Microlaserpeel which provide deep laser skin exfoliation and wrinkle removal, stimulation of new plumping collagen growth in the dermis, and also remodeling or tightening of the skin all in one treatment with minimal down time. These new effective wrinkle removal skin exfoliation techniques are step 1 of my 6-step non-surgical facial rejuvenation program which is the most effective wrinkle removal and facial rejuvenation program available today. Results of the Lux2940 can be excellent-see before and after photos below:

Plumping the deep facial skin layer by stimulating new collagen production for wrinkle removal and modern facial rejuvenation.

The second essential step for modern facial skin wrinkle removal is to restore the deep collagen volume to the skin. This is like re hydrating a wrinkled prune to make it a nice firm juicy plum again. The collagen in the dermis or deep layer of the skin is produced by a cell called the fibroblast when the skin is irritated or inflamed. This is a normal response of the skin to injury. Thus new effective methods for wrinkle removal gently injure the skin so that the skin will respond by producing fibroblasts which will produce new collagen which will plump the skin and help remove the wrinkle. This collagen producing skin injury can be caused by irritation by a skin cream like Retin A, repeated deep skin exfoliation techniques, and more commonly today by heating the deeper dermal skin layers with a laser or other form of heat produced by light energy such as IPL-Intense Pulsed Light-also called photo facial, and specially designed non-ablative laser wrinkle removal lasers.

New sophisticated non-ablative lasers and IPL have specially designed cooling devices placed on the skin before the laser or other light heating device is turned on so that the collagen stimulating heat gets down into the dermis to heat the tissues and stimulate new collagen production by the fibroblasts to promote wrinkle removal without burning the overlying skin surface. This minimizes down time since a burn would cause the skin to peel and turn red. These newer collagen stimulating wrinkle removal facial rejuvenation therapies are called non-ablative laser and light therapies because the superficial skin is not injured or peeled-that is the skin is not ablated or removed. These new skin plumping, new collagen forming, non-ablative laser and light wrinkle removal therapies do work, with no down time and minimal pinkness of the skin, but wrinkle removal using these methods takes time. I use the Lux1540 by Palomar and the Fraxel Restore , results can be excellent-see before and after Lux1540 photos below:

The wrinkle plumping new collagen production is step 2 of my 6-step non-surgical facial rejuvenation program.

After a treatment it takes 6 weeks for the fibroblasts in the dermis to start making new skin plumping collagen for wrinkle removal and this process goes on for many months. Expect at least 4-6 months to see beneficial visible skin plumping and wrinkle removal from these high tech laser and light therapies, but the good thing is that you are forming new collagen in your skin, which should last if you take care of your skin, eat healthy, and use sun block.

Remodeling or tightening of dermal collagen to restore elasticity, remove wrinkles, and rejuvenate your face.

The most recent new wrinkle removal facial rejuvenation technology is the deep dermal collagen remodeling methods commonly referred to as “skin tightening” or non-ablative skin tightening. Skin tightening involves the same heat injury induced new collagen production used to plump the skin for wrinkle removal, but the elastin collagen fibers which control skin elasticity and tightness reside in the deeper layers of the dermis. Thus new technology has been required to get heat deep into the dermis without damaging or ablating the overlying skin surface while heating the deep layers. This has required the development of very effective skin cooling devices and the employment of new types of skin heating energy, infrared and radiofrequency energy as opposed to laser and IPL Photo facial energy.

Infrared and radiofrequency energy have much different wavelengths and are able to penetrate the skin more deeply than lasers and IPL thus they can heat the much deeper layers of the dermis and injure the deep elastin containing layers to remodel elastin and collagen to plump and tighten the skin for wrinkle removal. These new machines have very powerful skin cooling mechanisms to prevent burn injury to the skin, and treatments produce only minimal redness and down time. Newer skin tightening devices are LuxIR by Palomar, Aluma by Lumenis, Thermage, Titan by Cutera, and Refirme by Syneron. Skin tightening is the 6^th and final step of my 6-step non-surgical facial rejuvenation program.

 Results from the Palomar LuxIR Deep can be gratifying-see before and after photos below:

From the above you can see that effective, modern facial skin wrinkle removal for facial rejuvenation is a complex scientifically sophisticated process and not something that can be achieved by a cream purchased over the counter or on the internet. Laser skin rejuvenation techniques have improved dramatically in the past few years and new laser skin peels provide effective wrinkle removal with faster recovery and less side effects.

For effective, modern wrinkle removal and facial rejuvenation you need the advice of an experienced board certified doctor, usually a board certified plastic surgeon or dermatologist to help you remove and prevent facial wrinkles.

You need to be an informed consumer, there is so much misinformation on the topic of wrinkle removal and facial rejuvenation and billions of dollars are spent each year on “wrinkle cures” that simply don’t work. If you have knowledge you have power, so educate yourself on what causes facial wrinkles and what are the proven methods for effective wrinkle removal and facial rejuvenation that are scientifically proven to work. An excellent place to start is by reading my book on facial rejuvenation entitled Save Your Face-The truth About Facial Aging Its Prevention and “Cure”. Also check the archives of my blogs “What’s New” and “Ask Dr Seckel” where you will find non-commercial unbiased discussions of most contemporary wrinkle removal, facial rejuvenation and facial aging topics, or contact me.

Dr Seckel

Boston, Massachusetts

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However the prolonged and difficult recovery following laser facial skin rejuvenation with both the older CO2 and Erbium lasers prevents most people from considering this technique.

The New Laserlyte Peel™ is the latest revolutionary technological break through in laser skin peeling technology and non-surgical laser facial skin rejuvenation. This technique uses fractional micro ablative laser technology to vaporise small areas of damaged skin but leaves intact skin bridges between the laser treated spots. This exciting new method provides high tech deep facial skin exfoliation for removal of wrinkles and sun damage, stimulation of new collagen production, and tightening of facial skin, with minimal down time and recovery.

Ablative CO2 and Erbium laser beams at at specific energy settings and fractional overlap are used to provide deep skin exfoliation or removal of dead skin, wrinkles, fine lines, crow’s feet, pigment, skin irregularities, and tightens skin with only 5-7 days of facial skin pinkness. This is accomplished by leaving intact skin bridges for rapid regrowth of new skin cells in 4-6 days as opposed to 2 weeks with other laser resurfacing methods. You can have the procedure done on Thursday and return to work on Wednesday, thus you only miss 2 -3 days of work. The procedure does not require injections or anesthesia, but I do apply a topical anesthetic cream to the face for my patient’s comfor

The benefit of the New Laserlyte Peel™, wrinkle removal and skin tightening method over other superficial laser and superficial chemical skin peels is that you get immediate skin tightening as well as wrinkle removal and stimulation of new collagen production to replace the skin collagen damaged by years of aging and photo damage.

The Laserlyte Peel™ is also excellent for eyelid rejuvenation, and can improve or remove eyelid wrinkles, crow’s feet, and fine lines and tighten eyelid skin much more safely than can be done with traditional laser resurfacing methods. The Laserlyte Peel can be done in combination with a laser transconjunctival blepharoplasty for a much improved blepharoplasty result for true total eyelid rejuvenation.

The Laserlyte Peel is a revolutionary new method for laser skin peel or deep exfoliation which provides effective facial skin rejuvenation and non-surgical facial rejuvenation by removing facial skin wrinkles, tightening facial skin, and restoring new collagen in the skin with minimal down time.

To learn more about the Laserlyte Peel or other non-surgical or surgical facial rejuvenation techniques, Contact me or read Save Your Face.

Dr Seckel

Boston, Massachusetts

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More importantly, with early intervention and new facial anti-aging techniques most people can prevent skin aging and facial aging and maintain a youthful skin and facial appearance and avoid looking older.

However, the shear number of new, heavily marketed facial skin rejuvenation techniques and the often-complex methodologies involved can be very confusing for the lay reader and physicians alike. To better understand the new facial rejuvenation treatments it is very helpful to first understand facial skin aging changes and then review how these changers can be reversed and the skin rejuvenated.

Facial Skin aging – Is that my mother I see looking back at me in the mirror?

The earliest skin aging changes most of us notice on our face, are fine lines and wrinkles around the eyes often referred to as crow’s feet and later deep furrows on our forehead called the frown lines and worry lines. These changes occur for most of us in our 30’s. We also begin to see brown spots and red spots or small blood vessels on our face and around the nostrils of our noses. Later the skin becomes dryer and loses the fresh glowing appearance of our youth. These superficial or surface changes are called type 1 skin aging or facial aging changes and are caused by sun damage and free radical damage from other inflammatory agents in our diet and environment and our heredity.

Later, in our late 40’s and 50’s we begin to see sagging facial skin. Usually the first sign is loose skin beneath our chin on the neck often called the turkey wattle. Later we see loose folds beginning along the jaw-line, often called jowls. As the skin sags we begin to see deep lines on either side of the mouth, called the nasal-labial fold lines and marionette lines. Aged skin also can begin to droop over the eyes and the eyebrows can begin to fall. These later skin-aging changes are called type 2 facial aging changes and are caused by the loss of skin elasticity. Sun damage, inflammation from free radicals released by our diet, and our heredity are the basic causes.

6-Step Facial Skin Rejuvenation – Help is on the way

Today we do not have to stand by and helplessly watch our skin age. With sun block, a healthy diet and lifestyle and new facial skin rejuvenation technology we can prevent or correct most skin aging changes. But first let’s understand what is meant by the term “skin rejuvenation.

To rejuvenate means to “make young or youthful again or restore to an original state”. To me this means correcting or removing not only wrinkles, but also the brown spots, red spots and dry skin, but also tightening sagging skin that is all of the facial aging changes, not just one or two. Wrinkle removal is only part of the process.

Filler-Contact Dr Seckel

True facial skin rejuvenation is possible with today’s new technology, but skin rejuvenation must be performed in a logical, comprehensive, step-by-step process that addresses all of the major skin aging changes. Most skin rejuvenation treatments offered today only address one or two changes and as a result are ineffective. A laser can remove brown spots and blood vessels, but the skin is left with wrinkles and sagging skin. A face-lift can tighten the facial skin but leaves you with a tight old looking face.

For effective modern skin rejuvenation I offer my patients a 6-step facial rejuvenation program® which addresses each of the facial aging changes described above. The result is true facial skin rejuvenation that makes the face truly look young or youthful again. The 6 steps to non-surgical facial rejuvenation are:

Exfoliation – removes dead dry skin cells and superficial pigment restoring a youthful glow to the skin and helping removewrinkles.

Stimulation of new collagen production – New collagen must be restored to replace the collagen damaged by sun and aging. New collagen plumps the skin, helps remove wrinkles and firms the skin

Removal of pigment and blood vessels - This step removes the brown spots and red spots or blood vessels from the facial skin

Relax muscles of facial expression – Frown lines, worry lines, and crow’s feet are caused by the pull of some of the facial muscles. When these muscles are relaxed, the lines disappear and wrinkles are removed.

Botox-Contact Dr Seckel

Fill deep facial lines – The deep nasal-labial fold and marionette lines are plumped up to make them less noticeable. These are deep lines, not wrinkles.

Tighten facial skin – The facial skin is tightened to improve the jowls, sagging brow and neck skin. Skin tightening also helps with wrinkle removal.

This 6-step facial rejuvenation program® is a comprehensive, scientific medically proven method for true facial skin rejuvenation, wrinkle removal and skin tightening.This is modern non-surgical method for effective true facial skin rejuvenation. The details of the program are carefully outlined in Chapter 5 of my book Save Your Face. For further information contact me.

Dr Seckel

Boston, Massachusetts

Facelift-Contact Dr Seckel

While Plastic Surgery is truly a much more comprehensive field including reconstructive surgery following burns, cancer surgery, and birth defects, the image most often projected in the media is that of image or beauty enhancement and non-surgical and surgical facial rejuvenation of otherwise normal people by surgery.

Blepharoplasty-Contact Dr Seckel

Revolutionary technological advancements in the past decade have significantly impacted the field of Plastic Surgery creating a shift from traditional surgical procedures to new non-surgical methods for correcting aging changes and improving appearance.

Laser Resurfacing-Contact Dr Seckel

Today Botox® injections can remove crow’s feet, frown lines, worry lines, and help lift the sagging brow. Prior to Botox® major facial surgery such as a brow lift and blepharoplasty (eyelid lift) were performed to correct these aging changes.

Botox-Contact Dr Seckel

New fillers such as Restylane® and Radiesse® are injected into the nasal-labial fold, lips, and marionette lines, those deep lines running from the lips down around the mouth and chin. Previously, a face lift was performed to correct these lines.

Fillers-Contact Dr Seckel

Skin tightening technology such as aluma, ActiveFX, LuxIR, Titan® and Thermage® are becoming better and can improve facial sagging in 30% patients if used early before the sagging is severe. Many patients choose to have one of these techniques rather than a face-lift. Many other new exciting techniques for laser restoration of skin collagen (Laser Genesis®) and improvement in skin wrinkling, removal of pigment, and removal of red spots and blood vessels on the face are already in use today.

These dramatic advances coupled with increasing public awareness of the importance of sun protection, a healthy anti-inflammatory diet, exercise, stress reduction, and a healthy lifestyle undoubtedly will impact the Plastic Surgery practice of the future. The Plastic Surgeon of the future will still have to be a highly skilled, knowledgeable surgeon, but I predict he/she will need to be an expert in the newer laser, light, pharmacological, and lifestyle therapies as well.

Plastic Surgery is becoming more non-surgical with every new technological advancement. The 6-step facial rejuvenation program encompases all the new non-surgical facial rejuvenation techniques. For questions read Save Your Face, or contact me.

Dr Seckel

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Wrinkles on the face are surface irregularities and must be smoothed out by deep skin exfoliation to remove dead skin and wrinkle debris from the surface of the face. Non-ablative technologies such as IPL, Photo Facial, Thermage, Titan, Aluma, LuxIR and other photo-facial therapies work by stimulating new collagen to grow in the deeper layers of the skin but do not provide skin exfoliation which is required to remove the surface irregularities. Restylane, Radiesse, Sculptra, Collagen, Hylaform, Cosmoplast, and Cosmoderm are non-surgical facial rejuvenation fillers which are injected into the deep layers of the skin to plump lines, but again they do not provide skin exfoliation and do not address the surface wrinkles.

Skin Exfoliation removes dead skin and surface irregularities similar to the way imperfections on wood are removed by sanding, but in a much gentler and safe way. Deep skin exfoliation also stimulates the deeper layers of the skin to grow new collagen. After exfoliation, once the dead skin cells are removed, topical creams such as Retin A, Tazarotine, Vitamin C, and Prevage will penetrated the skin more easily and be more effective.

Effective skin exfoliation can be accomplished by microdermabrasion, micropeel, and ablative laser skin exfoliation therapies like microlaserpeel, ActiveFX Laserlyte Peel, or by various chemical peels. I start my patients on gentle no down time methods like Obagi Skin Care and skin exfoliation with microdermabrasion first. When the patient decides they want more skin exfoliation and wrinkle removal I advance to the new effective deep skin exfoliation provided by the ActiveFX Laser Peel, an exciting effective laser skin peel which provides deep skin exfoliation and skin tightening as well with minimal down time.

There are many new exciting facial rejuvenation methods available today, but they must be applied in the proper order. Skin Exfoliation is the first basic step in the 6-step facial rejuvenation program. To spend money and time on therapies that work on the deeper layers of your skin to promote new collagen formation without first using skin exfoliation to remove dead skin and the wrinkle surface irregularities is in my opinion-wasted effort.

First things first, start with the first step, deep skin exfoliation for effective wrinkle removal. Contact me for further information or questions or read Save Your Face.

Dr Seckel

Boston, Massachusetts

I use this exciting new technology to treat fine lines, sun damage, brown spots, blotchy pigment, uneven skin tone, and acne scarring with excellent results.

Unlike so many widely advertised non-ablative, photofacial laser and IPL treatments that require 5-7 months to see a result, the results of the MicroLaserPeel are evident immediately. Better, the beneficial effects of the MicroLaserPeel, new collagen formation, and softer more uniform younger looking healthy skin continue for months after the treatment.

MicroLaserPeel removes the outer dead skin cells from the face and stimulates the deeper skin layers to from new healthy young skin cells and new collagen in the deeper skin layers. The result is fresher looking, glowing new skin with fewer fine wrinkles and fewer brown spots and pigment irregularities.

The first step in any skin rejuvenation program is exfoliation, the removal of the dead skin cells covering the outer surface of the facial skin. None of the many non-ablative laser and IPL therapies offered today provides this important first step. Only the MicroLasaerPeel using the Erbium laser provides this important basic first step facial rejuvenation process, in a uniform manner, with minimal down time.

The MicroLaserPeel is the perfect minimal down time alternative to the “gold standard” laser resurfacing for facial rejuvenation.

Contact my office via e-mail, or call 978-369-4499 for more information on any of the above procedures, or read Save Your Face.

Dr Seckel

Boston, Massachusetts

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A startling 12.4 million cosmetic plastic surgey operations were performed in this country last year and estimates are that nearly half of them were to correct facial aging and this does not include the millions of non-surgical facial rejuvenation procedures.

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As the baby boomers reach their 50’s everyone wants to look younger but no one wants to have surgery. Most people do not want to have surgery especially if it is not for serious medical reasons.

However, revolutionary advances in technology have made it possible for many people to reverse facial aging changes using new non-surgical facial rejuvenation techniques without having to undergo plastic surgery.

This past Wednesday, September 28, 2005, I spoke on a panel entitled Non-surgical Facial Rejuvenation at the meeting of the American Society of Plastic Surgeons in Chicago, Illinois. My topic was Botox, the soft tissue fillers including Restylane and Radiesse and the many skin peels used for exfoliation to remove wrinkles and signs of facial aging. I came away from that meeting very excited and enthused about all the wonderful new non-surgical facial rejuvenation therapies that are safe and effective for patients today.

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Fillers-Contact Dr Seckel

There are so many new wrinkle removing and skin tightening non-surgical facial rejuvention options available that the patient must understand exactly what facial aging change it is that they want to correct. Usually the patient just feels that their face looks older but cannot pinpoint exactly which facial aging change is causing concern. It is important to seek consultation with an experienced board certified Plastic Surgeon or Dermatologist who understands all the options so that the correct option is chosen for your very unique face. I advise you to avoid doctors who only do one or two facial rejuvenation procedures and tend to push patients to have the procedure that he/she performs rather than customizing the procedure to the patient’s needs.

The 6 Step Facial Rejuvenation Program™ consists of:

Step 1-Exfoliation-topical cremes, microdermabrasion, superficial skin peels with various fruit and salicylic acids to produce exfoliation to freshen the skin and give it a youthful glow and remove wrinkles. These treatments also stimulate the skin to form new collagen to replace the old damaged aged collagen, and help rejuvenate and tighten the facial skin.

Step 2- Stimulation of new collagen production- Controlled inflammation of the deep skin layer called the dermis causes the dermal skin cells called fibroblasts to manufacture new collagen to replace the collagen lost by sun damage and aging. Topical RetinA and the deep exfoliative process in step 1 start this process. Newer technological interventions like the Lux1540, Fraxel, Lux294o, Sciton Profractional, and Lumenis bridge therapy are powerful stimulators of new collagen production.

Step 3-Remove pigment and red spots-In addition to exfoliation new light and laser therapies such as IPL, Photo facial, Lux1540 and Fraxel® can be used to remove brown spots, pignent, broken blood vessels called telangiectasias, and rosacea from the facial skin. Pigment and blood vessels are a classic sign of facial aging and the non-surgical removal of these skin discolorations provides noticeable facial rejuvenation. These high tech yherapies can also remove wrinkles.

Step 4-Remove lines of facial expression wrinkles- Botox can be used to relax the muscles of facial expression and remove crow’s feet, worry lines, frown lines, and bunny lines and dynamic wrinkles, all of which are very early signs of facial aging. Botox® effectively removes these lines in most people for 6 to 9 months after a simple nearly painless injection.

Step 5-Fill deep facial lines called the nasolabial fold lines and marionette lines make the face look tired and old and coupled with the frown lines often make people look angry. Deep facial lines are deeper than wrinkles, and I do not use fillers for wrinkle removal. New soft tissue fillers can soften the nasal labial fold lines and marionette lines when they are injected into the skin beneath the aging lines. Commonly used soft tissue fillers are Restylane, Radiesse, Zyderm, Zyplast, Juvaderm, Sculptra®, Fascian®, Cymetra®, and Isolagen®. Each of these fillers has different characteristics and are better for some facial aging changes than others. For a thorough discusion of fillers consult Chapter 7 “No Down Time Facial Anti-aging Procedures” in Save Your Face, available on line at www.saveyourface.com.

Step 6-Skin Tightening. The final facial aging change to treat is loose sagging skin. While the plastic surgical operation called a facelift is still the “gold standard” for facial rejuvenation, several new technologies are evolving which can tighten aged facial skin. LuxIR and Titan®, devices using infrared waves, and Aluma and Thermage® which use radiofrequency waves, are all being used to heat the collagen in the deep layers of the skin called the dermis causing the collagen to shorten and tighten the skin. While these technologies are new and only about 30% effective and require multiple treatments, they will most certainly be improved in the future and effective skin tightening of aging facial skin will be possible. Some wrinkle removal is seen following successful skin tightening.

Non-surgical facial rejuvenation is here and is getting more effective as new products come out every month. One of my common expressions whenever I speak about the new non-surgical options for facial rejuvination is “plastic surgery is becoming non-surgical” and try to encourage my fellow plastic surgeons to embrace the new technology. I still believe that an experienced board certified plastic surgeon is the best doctor to provide the non-surgical facial rejuvenation procedures to patients because these doctors are the facial aging experts and they have the ability to do what is necessary for the patient whether it is Botox or a facelift. Each face is unique and a “one size fits all” approach just does not work in facial rejuvenation.

Contact me for more information on any of the above procedures, or read Save Your Face.

Dr Seckel

Boston, Massachusetts