More wrinkles 2 years post blepharoplasty and co2 laser resurfacing (I am 30 years old)?
I had a lower lid blepharoplasty and co2 laser resurfacing procedure two years ago.
I am now 30 years old and have significantly more wrinkles than before the procedure mostly
seen when I smile but they can also be seen when I am not smiling when the light hits
just right.
Is there any type of cream (such as retin A or similar) that can be used to help the
creepy/wrinkled skin that is under my eyes now?
Other recommendations?
Thank you for your time.
Thank you for your question!
You are 30 years old and 2 years ago you had blepharoplasty and CO2 laser and you believe
that your skin has become thin, wrinkly and more crepey than before.
So you're looking for options and this is something that we have seen for many years.
Not necessarily specific to one type of laser.
But just to go over to some of the history of the though process of why ablation is part
of the rejuvenation of skin.
For many years, pre-lasers, the standard was chemical peels.
So we would do chemical peels, superficial, medium or deep.
And the idea was that if you took a certain level of skin, up to the upper levels of the
dermis, then the new skin that comes in has an area of collagen called the grenz zone,
it would be covered by fresher newer looking skin.
Now in the mid-90s, the CO2 laser became the first lasers to become the step beyond chemical
peels.
One of the key elements of that is the thermal energy delivery which provided a certain amount
of tightness and a certain amount of collagen stimulation.
And from that point forward, there has been different permutations of different types
of lasers, variations of the CO2 laser and with the ultimate goal of improving the appearance
of wrinkles and generating more collagen.
Now a certain group of people, even though they had gotten an improvement of wrinkles,
I notice that the skin has gotten a little bit thin.
Now moving on to this time frame, I have always asked my patients about their lifestyle in
addition to the solutions we offer.
We have to understand are there factors that are contributing to the skin to become thin.
These factors include such as lifestyle aspects such as smoking, excess sun exposure, not
enough sleep, stress.
All of the things are factors that can contribute to the skin becoming thinner.
Now that being said, in terms of alternatives for improving skin quality under the eyes
when you feel you can't laser some more, a lot of our colleagues will keep using heat.
Basically laser energy is converting light energy to heat and that heat induces a certain
tissue response.
So what we're focusing now is regenerative medicine.
And in our practice, we've been applying something called platelet-rich plasma.
This is a part of your own blood where we take your own blood and we spin it and we
take the part has the platelet and growth factors that are necessary for healing.
So when you think about healing, you think about a cut.
A simple cut in your finger first becomes a little clot or scab and the skin heals over.
This healing process is due to the platelets and growth factors in the skin.
So in other fields of medicine in particular, orthosurgery or orthopedic surgery, the benefits
of platlelet-rich plasma for wound healing is already well-established.
And right now, it is extremely popular for professional athletes to get injections of
platelet-rich plasma for areas that has had a lot of impact, stress and inflammation.
In aesthetic field, we have been using this platelet-rich plasma for many indications.
We're using it for acne scars and fine lines and wrinkles.
In our hair loss division, we're actually combining this with extracellular matrix to
reverse and to thicken hair that is thicken.
This is a remarkable technology that we have been developing over the past couple of year
and now we have had consistent results with this.
So platelet-rich plasma is something that we would consider for someone like yourself
if you come to our practice.
We would be injecting it and we would allow the skin to benefit from it.
Usually we would wait for a couple of months and we would use some topicals.
Topicals can be beneficial with a limitation.
And so retenoids can be considered but you have to very careful about the strength and
the type of retenoids that you use.
As an answer to your question, from my perspective, to help improve skin quality, the choices
after you have exhausted the laser option become more and more limited.
So platelet-rich plasma is something that we have leveraged quite well and what's nice,
as opposed to laser, when you get laser treatment, it is something that you don't want to do
anytime soon after you've done laser because you will allow months of healing.
Yet with platelet-rich plasma, we can inject it several times during the year.
And observe the benefit and make a decision whether it is worthwhile to try again.
So consider that as an option, reflect on your lifestyle is about and see if there's
any way you can improve your quality of life.
There are other things that I suggest to my patients which is more in the alternative
medicine such as the use of fish oils and supplements.
I do believe in the use of supplements particularly when I listen to my patients and their diet
and see what we can do to enhance the supplement.
Then be patient but I would not recommend additional laser but rather consider this
regenerative medicine of platelet-rich plasma.
So I hope that was helpful and thank you for your question!