Many people think of plastic surgery as purely cosmetic, but there’s a lot more to this surgical specialty. Plastic surgeons often do reconstructive procedures that can rebuild body parts after an injury or illness.
What is cosmetic dermatology?
Cosmetic dermatology is a specialized field within dermatology that deals with improving the appearance of skin, hair and nails. It focuses on enhancing the aesthetic appeal of an individual, rather than diagnosing or treating a specific medical condition.
Soft tissue augmentation
Loss of volume and enhancement of dermal (surface skin), subcutaneous (beneath the first layer of the skin) and muscular deficiencies can be treated with a synthetic or biological product or surgical restructuring. While often used to improve photoaging and chronological aging, these techniques are also helpful in treating loss of volume from trauma, surgical defects and lipoatrophic conditions (those where there is some loss of adipose or fat tissue as in some metabolic diseases and HIV.
Injection of fillers
Collagen and other wrinkle fillers give your skin a plumper, smoother appearance. Although collagen is the best known wrinkle filler, there are many other substances doctors can use to plump up your skin, including fat from your own body and synthetic materials such as calcium, hyaluronic acid, poly-L lactic acid, and polymethyl methacrylate beads that "fill in" to create volume and fullness.
This procedure destroys parts of the skin in a controlled way so that new skin can grow in its place. The new skin is usually smoother and less wrinkled than the old skin. Chemical peels can be done on the face, neck, or hands. They can be used to:
- Reduce fine lines around the eyes and mouth
- Treat wrinkles caused by sun damage and aging
- Improve the appearance of mild scars
- Treat certain types of acne
- Reduce age spots, freckles, and dark patches (melasma) due to pregnancy or taking birth control pills
- Improve the look and feel of skin
A chemical solution, called an exfoliating agent, is applied to the skin and allowed to soak in. The skin will "blister" and eventually peel off. There are three depth levels of peels—superficial, medium and deep. The acid concentration in the peeling agent, the number of coats that are applied, and the amount of time allowed before the acid is neutralized determine the depth of the peel.
Dermabrasion is a technique in which a dermatologist "sands" your skin with a special instrument - a wire brush or a diamond wheel with rough edges (called a burr or fraise) to remove the upper layers of the skin. The face is the most common site for treatment, but other areas of the skin can be treated this way. The procedure is almost always done in your doctor's office or on an outpatient basis. The procedure makes way for a new, smoother layer of skin to replace the skin that's been treated.
Dermabrasion is used to treat damage and defects in the upper layers of the skin, such as acne scars and scars caused by surgery, trauma or disease, if the scars are not deep. Dermabrasion may also be an option to treat other superficial skin growths, some tattoo removals, color changes in the skin from melasma or age spots and fine lines and wrinkles around the mouth.
The procedure, involves abrading or planning the top layers of the skin. As the wound heals, new skin grows to replace the damaged skin that was removed during dermabrasion. For deeper abrasions, or if the entire face is going to be treated, you may need stronger anesthesia, pain killers, sedation, or general anesthesia. One small area at a time is treated.
Microdermabrasion works on all skin types and colors. Microdermabrasion uses tiny exfoliating crystals that are sprayed on the skin. It works best on problems such as dull skin, brown spots, and age. It makes subtle changes, causing no skin color change or scarring. It is not effective for deeper problems such as scars, stretch marks, wrinkles, or deep acne scars.
With microdermabrasion, there is less down time than with dermabrasion. Skin is temporarily pink but fully recovers within 24 hours. It doesn't require surgery or anesthetics. That may help people who cannot take "down time" for healing.
Laser resurfacing is a technique uses a laser to direct short, concentrated pulsating beams of high-energy light at irregular skin, precisely removing skin layer by layer. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment. Some lasers only tighten the skin by heating it but do not destroy the skin. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment.
Laser resurfacing reduces facial wrinkles and skin irregularities, ad can treat:
- blemishes or acne scars
- enlarged oil glands on the nose
- superficial scars caused by surgery, or trauma that are not growing or that are getting thicker
- color (pigment) changes or defects in the skin, such as liver spots (lentigines), port-wine stains, or café-au-lait spots
- Actinic keratoses—precancerous skin lesions
Laser resurfacing is usually very precise and causes little damage to the surrounding skin and tissue. It is done most often on the face, but it may be done on skin in other areas of the body. The hands, neck, and chest may be avoided because skin in these areas does not heal as well as it does in other areas. It tends to thicken and scar as a result of the laser treatment.
The tumescent technique involves the injection of a large quantity of a medical solution into a fatty area. The medical solution is a combination of drugs that numb the area, as well as shrink the capillaries and prevent blood loss. After the injection, a small incision is made into the skin and a tube connected to a vacuum is inserted into the fatty mass. The fat is then suctioned out.