Dear Dr. Winder:
Q. I'm just about to turn 50 and I'm really starting to look old. I'm confused as to whether I should have a chemical peel or laser for my wrinkles. What do you think?

A. Of course, I would have to see you in my office in consultation to be able to tell you what might be most appropriate. But, let me tell you a little about the different methods of skin resurfacing that are being used by Board Certified Plastic Surgeons today.

CHEMICAL PEELS
I use two different types of chemical peels for wrinkles, either TCA (Trichloroacetic Acid) or Phenol, depending upon the patient's objective and desires. While a Phenol peel delivers a more dramatic result, it also has a more significant recovery period. The main advantages of TCA are that it can be repeated more often, has less "down time", and causes less pigmentary changes. You may also consider a series of patented PCA peels that have no down time.

DERMABRASION
Dermabrasion can be used for resurfacing deeper skin wrinkles, acne scars and even tattoo removal and is done with a hand-held, high speed rotary wheel. It causes less pigmentary changes than chemical peels.

LASER
Laser is usually the preferred treatment for skin imperfections. A CO2 laser actually vaporizes the upper layers of the skin. Although slightly more expensive, it offers the plastic surgeon the most control of all the methods. We believe that laser is most appropriate for facial wrinkles.

Q. I have one friend who had a laser treatment and one who had a facelift; I am the same age as both of them, and don't know how to tell which is for me. Can you give me any hints as how to tell?

A. It is a difficult thing to make a treatment recommendation without the benefit of seeing you; the best approach would be for you to come into our Durango office for a consultation. At this meeting, I will make a treatment recommendation, and explain the surgery in detail. In the meantime, I can give you some basic information that I hope you will find helpful.

The best candidates for laser skin resurfacing can be any age. A carbon dioxide (CO2) laser can resurface your skin to remove areas of damaged or wrinkled skin, layer by layer. The laser directs a beam of concentrated light on the area(s) to be treated and actually vaporizes the upper layers of skin. Laser skin resurfacing is most commonly used to minimize the appearance of facial rhytids, or wrinkles. It does not, however, treat a sagging face, as a facelift does.

There are three kinds of facelifts . . . a forehead lift, mid-face or subperiosteal facelift and a conventional facelift of the lower face and neck. A forehead lift raises the brows back to their preferred position. A mid-face or subperiosteal facelift lifts the cheek back where it was when you were younger. And a conventional facelift lifts the lower face and neck. All of these procedures combine the removal of excess fat, tighten the underlying muscles and then the skin is redraped and the excess removed.

Neither laser skin resurfacing or any form of facelift will "stop the clock"; your face will continue to age with time. However, the effects of these procedures are long-lasting; you'll always be "more ahead of the clock" than if you'd had neither done at all.

Read more about Dermabrasion.
More about laser resurfacing
Laser Skin Resurfacing FAQ.

"Micro-Dermabrasion" now available in Durango!