“I wanted to talk a little bit today about resurfacing and some of the myths that are out there about resurfacing and really disprove some of those myths because resurfacing of the skin is a technique that is certainly not new, is one that we know revitalizes the skin. If done correctly, (lasers) can really totally eliminate fine lines and even deeper lines and wrinkles around the face and neck area, and now we’re even using it on hands and chest region.

The principle of resurfacing is harnessing the bodies power for wound healing, and so what we’re doing really is, injuring the skin in a very controlled way, down to and including the second layer of the skin, it’s called the dermis, and we’re into the second layer of the second layer of the skin, the papillary reticular dermis, and once that injury is achieved and in a very controlled way again, the skin will remodel itself that will lay down new collagen, it will remodel the existing collagen to be nice, even, parallel bundles of collagen which smooth the skin, and it will actually lay new skin cells over the surface which gives the smoothing effect.

Common targets are around the mouth, around the eyes. Typically when we’re doing aging face surgery and sun damage and wrinkled skin, we can do the entire face, neck and chest area, and even the hands and other body areas now using fractional resurfacing.

The categories I’ve described before resurfacing are pretty universal and commonly known. The first and original one was doing sanding or dermabrasion of the skin. It’s a very technique-sensitive way of doing it, and really, with the rotary wheel or dermabrator, it can be quite effective but its messy and most people don’t used to do it anymore.

Deep chemical peels came around in the 60’s and certainly have been really refined since then, and there’s a very nice way, a controlled way of getting a good improvement and then finally there’s laser resurfacing which really has two categories, original full laser resurfacing, which I stopped doing in the 90’s because people were red for too long, and really got way too swollen and now fractional laser resurfacing where there’s tiny little dots of thermal injury that are delivered in the area, or target area that we’re doing.

All of them are good techniques, there’s nothing wrong with all of any of them. They all do, in the right hands, the same thing, they harness the power of the body’s wound healing. It doesn’t matter whether you’re 8 or 80, they all do the same things and those, the power of the skin in remodeling itself is phenomenal, just absolutely phenomenal.

Questions come up often about, well, if you do resurfacing, will it thin the skin? The answers absolutely not, it’s the opposite. The dermal layer actually thickens, the second layer, the foundation layer of the skin will thicken. Temporarily of course while the skin is healing, it’s not thicker, but as it heals that second layer gets thicker, the epidermal layer with the dead skin cell layers is thinner initially, eventually it comes back to full thickness with a little bit thicker dermis.

I think people confuse that with the image of over peeled skin or skin that has been treated too aggressively where they’ve lost all the pigment or nearly all the pigment and they have that sort of pearlescent almost translucent appearance to their skin, that’s where appeals been done too deeply, resulting in pigment loss, and that’s a very uncommon in today’s world. In fact, I’ve never seen it just due to depth of injury, that’s an uncommon side effect, hypopigmentation. But, there’s a big difference between the lightning of the skin, and there’s relative lightning and then there’s absolute lightning. The relative lightning would be if you had sun damage on your face and neck and chest and you just did the face, you’d have clearing of the pigment on the face with the chest and neck would still be sun damage.

Hypo-pigmentation, really just a loss of the pigment, again quite a rare incident but very different than thinning of the skin, a common misconception with resurfacing that really doesn’t happen.

In general, resurfacing creates thickening of the second layer of the skin, the dermis, it improves the distribution of pigment, it treats fine lines and wrinkles, and it’s a great option for many people who have aging and sun damage related changes to the skin, typically on the face, but also the neck, chest and hands.

If you have any other questions on resurfacing please don’t hesitate to write me an email, send me a picture at DrMaas.com at our video blog or you can go to our website MaasClinic.com, I’m welcome to have all those questions, and certainly invite anyone to send a video or photo that we can discuss, either privately or publicly, and get you the best possible results, because in the end its really all these about looking your very best.

This is Dr. Corey Mass on “Looking Your Best.” Thank you.”

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