It has been mentioned in the preceding sections that the fine wrinkles of dry, weather-beaten skin with transverse creases of the forehead or vertical etching of the upper and lower lips cannot be removed by the face lift. These effects of aging are best treated by the chemical face peel; Fig. 29; Fig. 30 or laser; Fig. 31; Fig. 15. The results of this treatment are frequently described as the exchange of "prunes for peaches". In some instances the chemical peel may also help the dark circles which some people have under their eyes.

    Peeling or laser treatment may be done as a separate procedure or it may be a part of facial rejuvenation in conjunction with face lifting and eyelid surgery. YOU MUST STOP USING MAKEUP AND ALL FACIAL CREAMS ONE DAY BEFORE SURGERY. Wash your face several times with soap and water before coming for treatment. A face peel or laser resurfacing are performed under sedation with local freezing. You will receive explicit instructions regarding topical preparations to be used on the skin before and after the treatment.

AVOID facial movements ie. smiling and talking, pursing of the lips as these will interfere with the healing process.

    During the first seven to ten days following the treatment, the skin will be "weeping" and you will apply the necessary preparation to diminish crust formation. At this stage you will be required to wash the entire face gently with lukewarm water and soap at least four times a day. After ten days, when new skin is formed, makeup may be used to camouflage the redness. The redness usually disappears after eight weeks but, at times, may last up to eight months. The only restriction after these procedures is avoidance of prolonged exposure to sun light for at least eight months to prevent the development of blotchy pigmentation.

You Should Also Know That:

1. Fair complexions tend to do better than others. Thick, coarse, more deeply wrinkled skin may need two applications in certain areas.

2. Post-operative discomfort may last from one to four days and may be eased with medication.

3. Considerable crusting and swelling, which occurs after a few days may cause a frightening appearance. The patient must be mature enough emotionally and willing to accept this in order to achieve the desirable end result.

4. The most commonly treated area is that around the mouth. If multiple segments of the face require treatment, general anaesthetic may be preferable.

    What are the risks? Some areas of the skin may become lighter in tone permanently and therefore light makeup may have to be used to effect a uniform appearance. This side effect is less likely to occur after laser treatment than after chemical peeling. Patients with a history of recurring fever blisters may have a bad flareup after peeling or laser resurfacing. SCRATCHING THE FACE WITH ONE’S FINGER NAILS too soon after the treatment may cause scarring. There are also other remote risks as in any form of treatment. Please discuss them with me during your office visit.

Figure 29a	Figure 29b
Figure 30a	Figure 30b

Figure 31a	Figure 31b