What is it?

A procedure that helps counteract the affects of aging   by removing the top layers of   the skin of the face and thereby eliminating   wrinkles, blemishes, and large facial pores. As we age wrinkles occur in the corners of the eyes (laugh lines), the lip, or forehead. Such fine lines cannot be removed by the classic techniques of face-lifting or other methods of skin tightening. Resurfacing procedures such as Chemical peel, dermabrasion,and, and Laser Resurfacing are methods that specifically address such problems. Each technique uses a different method of creating a superficial burn in the face. The new skin is formed by the deeper layers of the skin will have fewer wrinkles and blemishes.

What does it accomplish?

The purpose of the Chemical peel procedure is to remove the signs of aging in the face by removing the top layers of the skin. The lower layers of the skin then create new skin that has less wrinkles, pores and blemishes.   The beneficial effects of a Chemical peel can vary depending on the patient's anatomy and lifestyle.   In addition, the depth of the wrinkles, pores and color differences in the skin will be important in the result achieved.

What happens during the first consultation?

In the first consultation you will get a chance to discuss your concerns with our patient care coordinators and Dr, Marefat. We will tell you what you need to know about your procedure and will help you determine what is best for you.   You will receive information booklets, review before and after photographs, and receive pricing on the procedures.

How is it done?  

We usually perform this operation in an out patient surgical facility under general anesthesia.   The skin of the face is treated with the laser. The light creates a superficial facial burn that causes the top layers of the skin to peel off. The skin cells that are in the lower layers of the skin will then regenerate a new skin layer that has less wrinkles, pores and pigmented spots. You can think of it as a laser induced 'sun burn' that peels you skin and you get fresh new skin.   The skin of the face will be tighter giving the affect of a face-lift without the scars. Of course

Procedure: Chemical peel continued

What can I expect after surgery?

There will be a moderate amount of swelling and with a Chemical peel. You cannot do this procedure and plan to go back to work the following week. Most patients elect to take two weeks off from work.   This would give them adequate time to recover sufficiently from surgery and to be seen without drawing attention.   Although most of the evidence of surgery has disappeared by the end of the third week the ultimate result of the Chemical peel will not be evident until at least five or six months have passed.   You should expect a moderate degree of redness in the skin of face during this period that will slowly resolve. This is because Lasers create new vessel growth to the skin and give a blush to the face. As this blush goes away you will have a lighter color in the area that was lasered as compared to your natural skin color. This depigmentation results from all resurfacing procedures to one extent or another. The risk of depigmentation is directly related to the depth of the peel. You will also remain very sensitive to sunlight and therefore using sun block and protecting of the skin from direct sunlight is advocated.

When are the sutures removed?

There are usually no sutures with Chemical peels unless they are combined with another procedure.

How many visits do I have after surgery?

We like to see our patients frequently after surgery. You are seen by the doctor or nurse within 2-3 days of surgery. Then the normal routine is 1 week, 1month, 3 months.6months, and 12 months after surgery. Of course if there is a need, you are seen as many times as necessary. We encourage our patients to come for routine follow-up visits every 3-5 years.

When can I cover my bruises with make-up?

You should be able to put makeup on your bruises after one week. However, we do not recommend your putting makeup on your incisions until the skin is completely healed because this may result in tattooing of the skin by the pigments of the makeup.

Am I a good candidate?

The ideal candidate for a Chemical peel is person good facial skeletal structure but loose and sagging skin. There is no definite age category when the surgery should be done.

In general, the ideal candidate for plastic surgery is a self-motivated patient who has realistic expectations about the results.   Generally the younger you are the better a candidate you are for surgery. But the physiologic age of person is more important than the chronological age. That is to say you may be 60 years old, but your skin and general health could be better than most who are 50 years old.

Procedure: Chemical peel continued

What does the surgery cost?

The cost of surgery varies but here are some guidelines that will help you determine roughly what you could expect. Remember that these are only rough estimates. The best way for you get an accurate cost analysis is to see a doctor.

How do I pay for surgery?

You can pay for surgery by certified check, Credit card, or cash. Payments for cosmetic surgery are expected prior to the procedure. If you are scheduling several weeks in advance of surgery you can pay by personal check.

Are there scars?

Yes. The extent of the scars depends on the type of Chemical peel you are having. If you have a Mini-Chemical peel the scars are quite short and inconspicuous. The traditional Chemical peel incision starts in the temple area and comes down in front of the ear. Then it curves back around the earlobe towards the posterior scalp. About half of the incision is in the hair-bearing scalp and the rest is well hidden in the natural folds around the ear. If you look closely you can see the scars but from a normal conversational distance the scars can go unnoticed.

Does it hurt?

Yes. However, the pain involved in Chemical peel procedures is very tolerable. We have heard our patients describe it as 'discomfort' or 'soreness'. For some reason, injuries to the face (including ones surgically induced) do not hurt as bad as they look. Many patients do not finish the pain medications prescribed to them for pain relief. But having said that remember that pain is very subjective, and it is not easy to predict what degree of pain you will have.

Will I be awake during surgery?

If you are having a regular Chemical peel operation you will be asleep. It is to your advantage to be comfortable and have an anesthesiologist monitor your heart and lung. This would also help the surgeon because he can concentrate on his work and accomplish what he wishes to do with expediency.

Where is the surgery performed? (i.e. office suite or hospital)

The operation is performed in an out patient surgical facility under general anesthesia. Only in rare situations in which the patient may have medical risk factors does Dr.Marefat suggest the hospital environment for surgery.

Are medical photographs taken?

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory because this is the only way for us to compare you before and after results. Photographs in plastic surgery serve much the same role that x-rays serve for orthopedic surgery.

Date Revised: 1/23/07

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