Dynamic Skin Care in Modern Facial Aesthetics

Julius W. Few, MD
The importance of skin care in facial aesthetics has never been more important or clear than today. The “holy Trinity” of facial aging is variable skin atrophic change, volume lost, and ptosis (drooping) of deeper tissue. An attempt to treat all three issues with isolated surgery or filler will likely result in incomplete aesthetic results or worse, over treatment leading to unnatural results.

Skin care not only preserves the benefit of other treatment modalities, it has a dramatic potential to primarily limit the signs of aging. In present day, the aesthetic plastic surgeon should consider all patients candidates for comprehensive skin care.

What are the key components? A cleanser, moisturizer, sunblock, and some form of exfoliation/cell turnover stimulation. At The Few Institute, we recommend a cleanser and moisturizer regimen that is without harsh detergents, fragrance, or additives. There are a variety of offending agents found in products that can be avoided, alcohol and artificial fragrance to name a few.

The sunscreen can be physical or chemical. We tend to use the physical, either powder or crème, for sensitive skin or peri procedural – after laser procedures or surgery. We prefer to place patients on retinal serums for skin stimulation/exfoliation effects, combined with strategic use of chemical peel and laser resurfacing. But it is crucial to eliminate use at least one week before and after an invasive skin resurfacing.

Finally, there is clear growth in the number of patients that have skin of color, according to the American Society for Aesthetic Plastic Surgery 2010 statistics. There is a lesser tendency towards sun related damage and wrinkle formation in skin of color, that can reduce aged appearance.  At the same time, darker skin will be more susceptible to dyspigmentation and sensitive to scarring. As a result, it is even more important to use judicious skin care and avoid potential irritants, and yes, darker skin often benefits from sun protection.  Just because darker skin is more resistant to actinic (Sun) damage does not mean skin care is unnecessary in this population. The reality is every skin type can benefit from skin care and having clear, healthy skin requires support in most cases.

With skin care, whether you are just starting to utilize it in your medical setting or are a seasoned veteran, remember to reinforce the basics to all of your patients and realize the benefit that both you and your patients will see!

Dr. Julius Few is a board certified plastic surgeon who specializes in advanced cosmetic surgery and cosmetic medicine. He is the director of the Few Institute for Aesthetic Plastic Surgery, as well as a clinical associate at the University of Chicago. Dr. Few has more than 50 publications and serves as a clinical editor for the Aesthetic Surgery Journal, commissioner of cosmetic medicine / board of directors in the American Society for Aesthetic Plastic Surgery, and medical advisor for ABCnews.com. Julius Few is a reviewer for Plastic and Reconstructive Surgery Journal and Aesthetic Plastic Surgery Journal, while being an active scientific investigator/principle investigator in clinical research.  He currently serves on the editorial advisory board for Medscape by WebMD and  New Beauty magazine.

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