With our aging American population, there is a heightened interest in skin rejuvenation, especially of the face, neck, and exposed skin of the chest, hands, and arms. It seems, however, that many individuals automatically think that a facelift is the only option to rejuvenate the face, and nothing is possible for the other areas of exposure. As a board-certified plastic surgeon with experience in this area, I want to give some thoughts about rejuvenation of the face and skin, both surgical and non-surgical. First of all, remember that many things have cumulative effects on the skin throughout life: sun, age, chemicals, pregnancy, and genetics. These serve to decrease elasticity, allow the formation of age spots, and result in the typical changes of aging.

As for skin wrinkles, there are two major categories: fine wrinkles that look like crepe paper, and the broader "folds" that form the jowls and fallen cheeks.

Facelifts, eyelid lifts, forehead lifts, etc. are surgical procedures involving lifting up the skin, advancing it to remove the broad folds and cutting off the excess.

Most of these procedures are done in surgical centers, hospitals, or in-office surgical suites, and require anesthesia, usually general anesthesia. The operations are quite popular, require little down-time, and produce phenomenal results in most patients.

Now, there are also "non-surgical" facelifts, performed with barbed sutures which can be placed in the office under local anesthesia. These lifts are not interchangeable with the "open" lifts described above, but give great results in carefully selected patients. These nice results usually do not last as long as open procedures, require as much downtime as the open procedures, but are less expensive with less risk involved.

As for the fine wrinkles and pigmentation changes, there are many options. To provide a somewhat general order of effectiveness: ablative laser skin resurfacing, non-ablative laser treatments, intense pulsed light treatments, skin-tightening lasers, TCA chemical peels, medical microdermabrasion, salon-strength peels and microdermabrasion, and pharmaceutical-grade skin care products. Except for the first treatment on the list, there is usually little down-time, usually none, in fact, but often multiple treatments are required to achieve what is desired, with maintenance treatments required.

I finish with a final word about botulism toxin injections and fillers. The botulism toxin injections stop the action of small facial muscles that create wrinkles, particularly in the forehead, upper nose, and around the eyes.

Fillers can fill up wrinkles quite nicely, and create fuller lips and cheeks. Both of these very popular treatments are safe but temporary, and usually must be repeated every few months.

My office has relocated our practice to the new Lakeview Medical Arts tower, contiguous with Lakeview Hospital on its northwest corner. The staff will be on hand to answer your questions about plastic surgery and skin care.

Other skin services offered in the clinic include laser hair removal, photo-facials, medical grade microdermabrasion and skin care products.