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"Getting older is mandatory, looking older is optional."
Aging and sun cause fine lines, wrinkles, creases, brown spots, hollowing and sagging skin. How early these changes occur is determined by heredity and amount of sun exposure (see facial aging for more details). Other common issues of facial skin include rosacea, acne scars and melasma.
We broke the issues people have in their skin into 10 categories (seen below) and listed all treatment options for each set of concerns. In addition, Dr. Chasin developed a paradigm, the 5 R's of Facial Rejuvenation to help understand these treatment options.
The final treatment plan is determined by the issues that need to be addressed in the skin, the ability for any downtime, budget and desired level of aggressiveness.
Please get a mirror and try to best determine what your individual issues are. Then let us help you walk through the myriad of choices for facial rejuvenation, first online and then together in our office.
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Below are facial skin concerns broken into 10 categories, with detailed explanations
of all treatment options:
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Lines, wrinkles and sun spots (texture and pigmentation issues) (this is most common presentation of aging and sun damage) |
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Sun spots, age spots, brown spots (pigmentation issues)
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Fine lines and wrinkles at rest, enlarged pores (texture issues)
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Wrinkles seen with facial expression (frown lines, smile lines, worry lines ('dynamic wrinkles') |
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Facial creases, folds and hollowing (ie. naso labial folds) |
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Acne Scars
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Broken capillaries, spider veins, facial redness (redness issues)
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Sagging skin, laxity of skin (laxity issues)
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Minor surface irregularities |
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Melasma |
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Fine lines, wrinkles, enlarged pores, age spots, skin laxity (pigmentation and textural issues)
This section describes treatment options for the most common presentation of aged and sun damaged skin, with sun spots, lines and wrinkles as well as laxity of the skin.
The two most well known procedures for comprehensive skin rejuvenation are Fraxel and Plasma resurfacing.
Determining the right procedure for you depends on the specific goals of therapy, ability for downtime and budget.
"I want to let you that you have changed my life, making me feel beautiful again. I was feeling discouraged and old and it was embarrassing to admit how much it bothered me. You have been extremely kind and sensitive and the staff has been so reassuring.
Dr. Chasin, because of your skill, patience, and genuine concern to help me, I feel better about my appearance then I have in years. Family and friends are amazed at how good I look.
Competent, sensitive physicians like you are the prize of the medical profession."
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Sun or age spots, brown spots, (pigmentation issues)
Just about everyone has brown spots on their skin. Age spots (solar lentigos), freckles, and birthmarks are just a few of the commonly known marks generally referred to as pigmented lesions and they occur on many areas of the face and body. Brown spots that are conspicuous detract from the skin’s natural beauty. Most brown spots that develop later in life are caused by over exposure to the sun’s damaging ultraviolet rays.
With the development of advanced laser technologies, these annoying brown spots can be safely and effectively removed. The choice of technology used depends on many variables including your skin type, the size and number of spots and other associated conditions that you may want treated at the same time. The most well known therapies here are Intense Pulsed Light and Q switched lasers.
When we are looking for more comprehensive improvement in the skin, with improvement of fine lines, wrinkles, acne scars, enlarged pores (and brown spots, of course), we recommend using the Fraxel laser, Portrait PSR or Tridemal rejuvenation.
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Melasma is another type of pigmentation abnormality in the skin. It can be caused by pregnancy, oral contraceptive use or develop without any known cause. Information on causes and treatments can be found in the corresponding section.
"those brown spots were making me feel so old. I never imagined how good i would feel with them gone. Thank you so much!"
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Fine lines, wrinkles, enlarged pores (textural abnormalities)
Fine lines are caused by sun exposure, the environment and various aging effects. Deeper wrinkles are caused by repetitive muscle action creasing the skin and by loss of volume under the skin.
Treatment for lines and wrinkles include various lasers which stimulate collagen and remodel the skin, dermal fillers to replace lost volume supporting the skin and BOTOX Cosmetic to reduce muscle activity causing some of the wrinkles.
When we are also looking to improve sun spots and other pigment disorders, Fraxel and Portrait are the treatments of choice.
"i felt young but I didnt look it. The Fraxel treatments worked wonderfully and i am so happy"
Debbie Schoenfeld
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Acne Scars
Acne scars represent a very common and troublesome condition. Scars may be flat, raised or depressed. They may be white, red or dark in color. Treatment may include lasers, dermal fillers or surgery, depending on the nature of the scars.
Lasers work by stimulating collagen in the skin which decreases the depth of the scars or by targeting the blood vessels in the scar to reduce redness. Dermal fillers are used underneath the scars to give them additional support and improve their appearance. The Fraxel and Vbeam lasers are the most well known treatment options here.
"my skin continues to look better and better, week after week. My mirror is now my friend" |
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Rosacea, spider veins, facial telengiectasias, facial redness
Rosacea is a very common condition, causing redness, flushing, broken capillaries and bumps in the skin. A variety of technologies are utilized, often in combination, to treat the many forms of this condition.
Facial spider veins or telengiectasias are also common and easily treated with a variety of laser technologies. Intense Pulsed light and Pulsed Dye Lasers (Vbeam) are the most common technologies utilzed.
click for more on Rosacea
"To say that your laser treatments were successful would fail to recognize the dramatic result that has occurred. The painless procedure removed redness and blotching that had overtaken my face."
- Marion P.
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Sagging skin, laxity of skin
Recommendations for the treatment of sagging skin may be surgical or non surgical. Non surgical alternatives include lasers that cause collagen synthesis and a contraction in the skin’s elements, tightening the skin in the process. If laxity is caused by volume loss under the skin, dermal fillers or injectable fat is used to correct the problem.
The most well known technology here is Thermage.
"Not that I don't love my mother, it's just that i was too young to look like her"
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