Skin Resurfacing

The skin is the largest organ of the body. As we age, the skin quality decreases and what you see are changes in the skin texture, blotchy hyperpigmentation, and increased redness especially in patients that have rosacea. What really happens microscopically is that the dead skin on the surface becomes much thicker with aging giving the appearance dullness and sallowness. There are increased broken capillaries on the face as well as increased pigmentation, usually because of the long history of sun exposure over one’s lifetime. This can start at the age of 40 to 50. However, in the late 60’s in females the skin loses the elasticity and begins to wrinkle. At this stage, more ablative laser techniques can be used.

Nowadays, there are nonsurgical techniques to tighten the skin and improve the skin texture.

  1. one uses techniques of radiofrequency, non-ablative laser, and ultrasound to heat up the skin to cause it to shrink. Ulthera, Tripollar Apollo, ReFirme, and ThermaCool® NXT are the names of these techniques.
  2. PRP or platelet rich plasma which is tapped on to the skin to induce patients to form new collagen . PRP comes from the patient’s own blood is tapped painless into the superficial layers of the epidermis. It has no down time and stimulates the patient to manufacture their own collagen. Tapped into the hair has shown to change the hair follicles to grow thicker and produce longer growing sessions.
  3. Chemical peels such as glycolic acid and micro dermabrasion help to exfoliate the skin giving it a more even tone and appearance. It is thought that repetitive micro dermabrasion helps to stimulate the deeper dermis to lay down new collagen in the dermis of the skin. Chemical peels have been modified to improve hyperpigmentation and improve acne prone skin.


In blotchy areas of increased pigmentation on the face, it is important to have a diagnosis and rule out the possibility of melanoma. Therefore people with that problem should see a facial plastic surgeon who deals with skin malignancies. Hyperpigmentation can be treated quite nicely with a combination of specialized home care medication as well as office treatments such as  laser IPL.  Multiple treatments are needed as well as a superb sunscreen. A facial plastic surgeon who deals with hyperpigmentation can help you significantly improve the blotchy brown spots. Melasma is a more difficult type of facial hyperpigmentation and a good deal of treatment guidance is needed.

The Red Face or Rosacea

Broken capillaries on the face can occur at the age of 40 especially people who have inherited rosacea from one of their parents. Multiple lasers can be used for the redness on the face. Laser IPL such as Limelight is very effective. However, if one sees large dilated veins on the face, then the Nd:Yag laser can be used to make those red to blue veins disappear especially around the nose without a significant complication. Lastly a technique called Laser Genesis that destroys the vessels deep in the dermis is a very effective tool and has the additional effect of tightening the skin. Special home care topical are often required.

A facial plastic surgeon can properly analyze your skin’s texture or condition and lead you in the right direction to maintain quality and elasticity of your skin.