Face and Eyelid Plastic Surgery Beverly Hills Los Angeles


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Chemical Peels

Chemical peels can accomplish a variety of different results, depending on the type of chemical used, the depth of treatment, and the condition that is being treated. Chemical peels are commonly used to improve or reduce the appearance of fine lines, brown spots or freckles, acne, scarring, and skin texture changes associated with aging, smoking, and sun exposure. it does not effectively tighten the skin and does not replace the need for a face lift.

A chemical peel does actually burn off the top layers of skin, much like a sunburn does (without the ultraviolet exposure). It can be used to treat targeted areas such as around the eyes (crow’s feet) and mouth (lip lines), on the cheeks for pigmentation changes, or on the full face or face and neck. Chemical peels can also be used on other areas of the body that are commonly damaged by the sun such as the chest (décolleté), arms, and hands.

Several different chemical solutions can be used, depending on the desired result and depth of peel. More superficial peels result from lactic acid, glycolic acid (up to 35%), salicylic acid, and Jessner’s peels. A TCA (tricholaracetic acid) peel up to 20% can also be considered a light peel. Deeper peels are accomplished with higher concentrations of glycolic acid (up to 65%), TCA (trichloracetic acid) (over 25%), and phenol. Sometimes laser skin resurfacing is used instead of a chemical peel and this can produce a deeper peel, still, depending on the laser used.

Do I have to pre-treat my skin before the chemical peel?
Sometimes Dr Hoenig will prescribe a pretreatment skin regimen for 4 to 8 weeks before performing a chemical peel to condition your skin, minimize the risk of hyper-pigmentation (brown spots), and speed your healing. This skin program may include sun avoidance, Retin-A, hydroquinone 4%, glycolic acid, and anti-oxidants.

Will I need anesthesia for my chemical peel?
During a chemical peel, you may experience stinging and burning as the chemical peel solution is applied. The type of anesthesia used, if any, will depend on the depth of the treatment and you tolerance to pain. For most of the more superficial peels, you will hold a small fan during the procedure that you can use to cool the skin. The time it takes for the peel depends on the size of the area covered , the number of times (“coats”) the chemical solution is applied, and your tolerance for pain while the peel is performed. For a full face peel, it may take 5 to 20 minutes or more. Immediately after the peel, cool compresses may be applied. Deeper peels may require oral or intravenous sedation to keep you comfortable. A topical (cream) anesthetic is usually not used for a chemical peel because it will cause the blood vessels to constrict and the doctor or skin specialist will not be able to tell how your skin is reacting to the treatment or how deep the peel is penetrating.

What is the recovery like after a chemical peel?
After your chemical peel, you will be instructed to keep the skin lubricated and stay out of the sun. If you must go in the sun, it is imperative to wear a hat and sunblock to prevent further deepening of the peel, dark spots, and permanent scarring. Recovering from a chemical peel is not very painful. (If you have severe pain, this can be a sign of an infection. Call your doctor if you are unsure). Many patients describe a sunburn feeling but keeping the skin covered with ointment, Aquaphor, or A & D ointment (as instructed by your doctor should allay the discomfort.

After a chemical peel, your skin will appear “dirty”, darker, and any spots will be more noticeable. Your skin may feel tight and your face may be swollen for up to a week, with clear or yellow crusting or oozing. Depending on the depth of your peel, you may notice light flaking or peeling after 3 to 5 days. (A light peel may note produce any visible peeling, while a deep peel may require several weeks for complete healing). During the peeling phase, your skin may itch and tingle. Your doctor may prescribe a steroid cream or antihistamine to minimize the itching. It may take up to a week or more before the peeling is complete.

No matter what you do, do not pick, peel, or scratch your skin. You might want to sleep with gloves on at night to prevent subconscious or unintentional skin damage. Premature removal of your skin as it flakes and peels can cause scarring. Your doctor may instruct you to cleanse your skin with vinegar or mild soap compresses which will help to separate the dead skin from the fresh, new skin beneath and keep the skin clean. Check with your doctor for his or her specific post-peel care instructions.

Do I need to take antibiotics after the chemical peel?
You won’t need to take antibiotics after your peel, but if you are going to peel around your mouth, you will be given a prescription for anti-viral pills (such as Valtrex or valcyclovir). Almost everyone carries the Herpes virus, whether you get cold sores or not. Taking an anti-viral medication will prevent a breakout of cold sores around your mouth that can be activated from the chemical injury to your skin. You’ll need to take 2 pills, twice a day for 5-7 days after surgery.

What are the risks of a chemical peel?
In experienced hands, complications from a chemical peel are rare, but include infection, skin color changes, and scarring.

How much does a chemical peel cost?
The cost of a chemical peel varies greatly depending on the depth of the peel , the amount of skin that is treated, and the location on your face or body. For a light peel, the cost may $150-$500, but that peel might need to be repeated 3 to 6 times or more. A medium depth peel may cost $500 to $1000, and a deep peel may cost up to $2500.

How long do the chemical peel results last?
While it is possible for lines, spots and poor texture to return, a chemical peel can take years of skin damage away and proper skin care on your part can help maintain your healthier, fresher skin for many years to come. Some people choose to repeat a light chemical peel once a year to keep their skin looking its best.

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