Nonsurgical Options

Nonsurgical Options 2018-04-16T12:48:31+00:00

Botulinum Toxin (Botox Cosmetic)

Nonsurgical options including Botulinum Toxin (Botox Cosmetic, Dysport and Xeomin)

Click here for the nonsurgical options (Fillers)

Click here for the nonsurgical options (Peels)

Nonsurgical Options

Botulinum Toxin

Also known as BOTOX® Cosmetic, Dysport®, Xeomin, or Botulinum Toxin Type A is a popular nonsurgical option for facial rejuvenation.

Botulinum toxin (Type A) is a nonsurgical cosmetic injection that blocks the nerve signals that cause muscles to contract. This effect relaxes and smooths the look of lines and wrinkles caused by repetitive movements on the face—most commonly, between the brows, crows-feet around the eyes, and horizontal forehead creases. Botulinum toxin is also used cosmetically to balance facial asymmetry and relax tight neck bands, as well as medically to reduce perspiration and to treat migraine headaches and muscle spasticity.

When to Consider Botulinum Toxin (Nonsurgical Options)

  • Deep lines between your eyes make you look tired, angry, sad, or upset.
  • Your facial expressions cause wrinkles in and around your eyes and forehead.
  • There is asymmetry in your eyebrows or face that can be corrected by relaxing a muscle.
  • You suffer from migraine headaches and botulinum toxin may provide relief from this condition.

Considerations for Nonsurgical Options

Pros

  • Injections are relatively painless and carry a low risk, with little-to-no downtime.
  • Can help you appear less angry and more approachable
  • Make subtle changes that give you a refreshed or well-rested look

Cons

  • Effects of injections will only last three to six months
  • Risk of droopy eye or muscle if injected incorrectly
  • If area to be injected is sensitive, bruising may occur

These are the top three pros and cons to weigh when considering botulinum toxin. If you wish to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for botulinum toxin injections?

You may consider botulinum toxin injections for cosmetic reasons if you are developing lines and wrinkles on your face due to common facial movements. Depending on genetics, lines can appear on the face as early as your late twenties to as late as your early forties. If you are prone to developing lines and to making facial expressions that lead to wrinkles, your plastic surgeon may also recommend using botulinum toxin as a preventative measure.

Certain wrinkles or creases in the face caused by the weakening or sinking of the soft tissue, such as the nasolabial folds, which extend from the sides of the nose to the corners of the mouth, are generally best treated with fillers, fat grafts or surgery (although occasionally botulinum toxin is used to soften or partially improve them).

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Detailed Procedural Info Nonsurgical Options

How is a botulinum toxin procedure performed?

Botulinum toxin injections can usually be completed on the same day as the initial evaluation. They do not require hours to perform or days to recover. Once you and your surgeon have decided on an appropriate treatment, he or she will prepare you and the medication for the procedure. The injection site will be cleansed and will usually not require anesthesia prior to injection. The needles used are very short and thin, causing minimal pain. Depending on your specific concerns and condition, a number of injections will be needed to achieve the desired result. Slight pain, short-lasting swelling, and minimal redness and bleeding will likely occur as a result of your procedure.

Nonsurgical Options Botox

Botulinum Toxin is an injection to target the areas of concern.  Nonsurgical options include Botulinum toxin injection to correct vertical lines between the eyebrows

Nonsurgical Options Botox
 Botulinum toxin nonsurgical options have many potential uses

Once the neurotoxin has been injected, it will take several days to reach full effect and a follow-up visit is often scheduled weeks to months after the initial injection.

In the hands of an experienced injector, such as a board-certified plastic surgeon, your procedure will seem simple and you will experience minimal discomfort. The injector’s understanding of the muscles in the face and body is essential for a safe and successful procedure.

What are my Nonsurgical Options?

BOTOX® Cosmetic is widely recognized and was the first neurotoxin to be FDA-approved for cosmetic use in the United States. Other brands, such as Dysport® and Xeomin, are also used for cosmetic reasons and share many of the same attributes as BOTOX® Cosmetic, but may vary in dosage, propensity to spread, time of onset and duration of action.

There are many formulations of botulinum toxin; some are only appropriate for cosmetic use (Botulinum Toxin Type A). Here is a list of both cosmetic and medical conditions that botulinum toxin can help treat:

  • Lines and wrinkles
  • Facial asymmetry
  • Muscle spasticity
  • Eyelid spasms (blepharospasms)
  • Hyperhidrosis or excessive sweating (see perspiration reducer)
  • Chronic migraines
  • Cervical dystonia
  • Movement disorders
  • Crossed or lazy eyes

Your plastic surgeon and/or injector will help you determine which botulinum toxin will be best for you.

Selecting a Surgeon for Nonsurgical Options

Select a surgeon you can trust

It’s important to choose your surgeon or injector based on:

  • Education, training and certification
  • Experience with botulinum toxin injections
  • Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure.

Your initial consultation appointment (Nonsurgical Options)

A realistic, open discussion with your surgeon should occur before proceeding and is important in achieving a good result. It is critical to discuss your specific concerns and your overall objectives to help determine if botulinum toxin will be a benefit to you. Once this conversation occurs, your surgeon will obtain other relevant medical information. It is very important to disclose the recent or chronic use of NSAIDs such as aspirin, ibuprofen (Advil or Aleve), anticoagulants or blood thinners.

Your treatment plan for Botulinum Toxin (Nonsurgical Options)

After a full medical history, your plastic surgeon will perform an examination to determine the best course of treatment to meet your expectations. Your surgeon or injector will fully explain:

  • How the injections will be performed.
  • What can be reasonably expected of the procedure.
  • Advantages and disadvantages of alternative treatment options, including the use of fillers, fat grafts, surgery, skin resurfacing or chemical peels.
  • Possible complications of botulinum toxin.

Once the evaluation and discussion are complete your consent will be obtained. Your surgeon will encourage you to ask questions and will give you honest answers about the procedure. Photos may be taken to document your condition and appearance before and sometimes after the treatment.

Questions to ask your aesthetic plastic surgeon about the nonsurgical options

We developed these questions to help you:

  • Make the most informed and intelligent decisions about your procedure.
  • Confirm that you have the right surgeon for your procedure.
  • Make your initial consultation as rewarding as possible.
  • Understand your options, potential outcomes and risks.

It is important for you to take an active role in your treatment, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for botulinum toxin?
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • Do you recommend numbing cream?
  • What will be the costs associated with my treatment?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing for Your Procedure (Nonsurgical Options)

How do I prepare for a botulinum toxin procedure?

Although botulinum toxin injections are generally low-risk and do not require the intensive screening of a surgical procedure, you should always disclose a full medical history and any medications you are currently using to your plastic surgeon. Regardless of the type of procedure to be performed, hydration is very important before and after treatment for safe recovery. Your doctor or injector may ask you to stop smoking at least six weeks before your procedure.

Inform the plastic surgeon’s office if:

  • You have had botulinum toxin injections in the past.
  • You are using NSAIDs such as aspirin, ibuprofen (Advil or Aleve), anticoagulants or blood thinners.
  • You are taking muscle relaxants, allergy or sleeping medication.

Some medications could cause complications, bleeding or extra bruising. Find out if you need to discontinue or skip the medications for several days before your procedure to prevent any problems.

Aftercare and Recovery (Nonsurgical Options)

After the injections you can return to your regular activities immediately; however, strenuous activity is discouraged for the remainder of the day. Redness and swelling that occur at the time of injection usually resolve quickly. Any bruising that might occur will usually resolve over a week or two.

Some quick tips for the best results:

  • Avoid massaging or touching the injected area afterwards; this may inadvertently cause the botulinum toxin to spread to an unintended area.
  • Lying down or inverting the body shortly after injection can also cause complications.
  • Avoid strenuous or vigorous activities for the rest of the day.
  • Ask or call the office before taking painkillers or medication.

How Long Will the Results of the Nonsurgical Options Last?

Nonsurgical Options Botox

Nonsurgical Options (Botulinum Toxin for the glabellar and forehead areas)

Nonsurgical Options Botox

Nonsurgical Options (Botulinum Toxin for the glabellar and forehead areas

Nonsurgical Options Botox

Nonsurgical Options (Botulinum Toxin for the “Crow’s feet”/lower eyelids)

Depending on your age, skin condition and habits, effects of botulinum toxin could last anywhere from three to six months.

Maintain a relationship with your aesthetic plastic surgeon regarding your nonsurgical options
A follow-up appointment in weeks or months may be scheduled after the injection for re-evaluation, touch-up or additional treatments as indicated. You are of course encouraged to schedule your own follow-up sooner if you have any questions or concerns. Because the effect of the botulinum toxin is not permanent, it is best to develop a good relationship with your plastic surgeon and set a schedule for additional injections.

Associated Costs of the Nonsurgical Options (Botulinum Toxin)

The cost of botulinum toxin injections varies greatly and depends on a number of factors, including the number and location of the areas to be treated. Charges may be determined based on the amount used or simply the areas of the face treated. For example, treating a large body area, such as the under arms, will require much more medication than in the face. A discussion with the surgeon or his staff concerning costs is important before any treatment is begun. The surgeon’s policy regarding the cost of touch-ups within weeks of the initial injection should also be explained to the patient.

Because botulinum toxin injections are elective nonsurgical options, insurance does not cover the costs. Many surgeons offer patient financing plans to make the procedure more affordable. The practice of Michael P. Vincent MD FACS and Brent C. Faulkner MD participates with CareCredit.  Click on the Logo for more information.  However, if you are prescribed the injections to reduce perspiration, or to treat migraine headaches or muscle spasticity, the costs may be covered, and you should check with your plastic surgeon or injector.

Nonsurgical Options

Choose your surgeon based on quality, training and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery for both surgical and nonsurgical options by viewing their basic credentials, training, and certifications.

Limitations and Risks of Nonsurgical Options

Although all procedures have some degree of risk, FDA-approved injections of botulinum toxin and other nonsurgical options are relatively low risk in the hands of an expert injector. The most common side effects are:

  • Temporary muscle weakness.
  • Redness, irritation and swelling at the injection site.
  • In rare instances, patients may experience dry mouth, headache, dizziness, nausea and fever.

If you have a symptom that is more serious, such as a rash or trouble breathing, please call your doctor immediately.

You can help minimize certain risks of these nonsurgical options by following the advice and instructions of your board-certified plastic surgeon, both before and after your botulinum toxin injection.

Photos and illustrations of the nonsurgical options are examples and are meant to be helpful, informative, and educational.  No implicit guarantees regarding similar results can be given.  Additional information and the above text can be found on Dr. Vincent’s American Society for Aesthetic Plastic Surgery Smart Beauty Guide home page

Fillers

Nonsurgical Options including the common fillers (Restylane, Perlane, Juvederm, Voluma, Radiesse, Belotero, and others

Nonsurgical Options

Fillers

Nonsurical Options include Fillers, also known as dermal fillers and soft tissue fillers

Fillers are a type of minimally invasive aesthetic medicine used to add volume, alter the contours of the face, and fill in wrinkles. Common areas to inject fillers are in the face, neck, and hands, resulting in a fuller, smoother and more youthful appearance. Dermal fillers are among the most popular aesthetic procedures because they carry immediate results, very few risks and little recovery time.

When to Consider Fillers

  • If you have deep lines around the eyes, brow or mouth
  • If you would like to change the contours of your jaw or lips
  • If you are interested in a minimally invasive procedure

Considerations for Fillers (Nonsurgical Options)

Pros

  • Filler injections are quick and only require a topical anesthetic at most
  • Results are immediate and there is little to no downtime
  • Fillers provide a subtle look that can be adjusted to meet your aesthetic needs

Cons

  • Fillers are temporary and require repeat injections to maintain your goal
  • Some people may be sensitive and experience bruising and swelling
  • Results are dependent on the experience and qualifications of your injector

These are the top three pros and cons to weigh when considering fillers. If you want to focus on those specifically unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for fillers?

The following are some common reason why you may want to consider fillers:

  • You have lines or wrinkles around your mouth, eyes or forehead.
  • You’d like to enhance the volume in areas such as the cheeks, jaw line or lips.
  • If you have scars and depressions in the skin resulting from acne, injury or congenital imperfections.

Nonsurgical Options

Injectable fillers can help diminish the appearance of deep nasolabial lines and add volume to areas like the cheekbones which can create a more defined contour

Nonsurgical Options
 Injectable fillers can help diminish the appearance of upper and lower lip lines

Detailed Procedural Info for your Nonsurgical Options (Fillers)

How is a fillers procedure performed?

Fillers are administered with a syringe to various areas on the face and head, including around the eyes, along the jaw, around the lips and in the forehead. The number, location and depth of the injections depend largely on the type of dermal fillers used and the desired results.

IMAGES: lipenh_03.jpg
Some fillers contain a local anesthetic like lidocaine to enhance comfort during injection. Numbing cream may also be used.

What are my Filler Nonsurgical Options?

There are three types of fillers commonly used: temporary, semi-permanent, and permanent. Hyaluronic acid-based fillers are temporary, while other types of fillers offer longer-lasting results.

Temporary Fillers

  • Collagen-Based Fillers: Collagen is a naturally occurring protein that adds strength and structure to the skin. Collagen was the first filler on the market, but the arrival of hyaluronic acid-based fillers has decreased its popularity.
  • Hyaluronic Acid-Based Fillers Like collagen, hyaluronic acid is a naturally occurring substance and primarily used to promote fullness and volume.
  • Calcium Hydroxylapatite: Heavier and denser than hyaluronic acid, this filler is injected deeper, underneath the skin, and does not usually cause immune or allergic responses because the material is usually found in bones.

Semi-Permanent Fillers
Longer-lasting dermal fillers typically contain thicker substances, such as the biodegradable synthetic filler known as poly-L-lactic acid. These types of soft tissue fillers are used to treat deeper facial lines, and though they offer semi-permanent results, it’s possible that you’ll need an occasional “touch up” several weeks after your initial injections.

Permanent Fillers
Permanent fillers are made of polymethylmethacrylate (PMMA), which are microspheres that are not absorbed by the body. The filler also contains collagen and is only recommended for thick-skin areas such as the nasolabial folds. It is not recommended for any areas around the eyes or for the lips.

Silicone Injections – Patient Safety Warning
Silicone injections are an unsafe and unacceptable option to use as a filler. These injections are not FDA approved and often offered by unlicensed individuals and should be avoided. Always consult with a board-certified plastic surgeon, preferably an ASAPS member, if you have questions about a particular type or brand.

What are the brand names for fillers?

There are a number of soft tissue filler brand names, but some of the most common are:

  • Hyaluronic Acid-Based Fillers: Restylane®, Restylane® Lyft, Restylane® Silk, Juvederm, PREVELLE Silk, Hydrelle, Belotero
  • Collagen-Based Fillers: Cosmoplast, Cosmoderm, Evolence
  • Semi-Permanent Fillers: Sculptra, Radiesse
  • Permanent Fillers: Bellafill

Selecting a Surgeon for your Nonsurgical Options

Select a surgeon you can trust

It’s important to choose your surgeon or injector based on:

  • Education, training, and certification
  • Experience with filler injections
  • Your comfort with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to Select an Injector.

After finding a board-certified plastic surgeon in your area who is experienced in performing filler injections, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment for possible Fillers or other Nonsurgical Options

During your initial consultation with your plastic surgeon, he or she will ask you about the areas on your face that concern you the most and what outcomes you’d most like to see. He or she will also evaluate the lines on your face to make recommendations. Together, you’ll decide on a type of dermal filler that will be best suited for your needs as well as injection sites to target. Once your surgeon or injector understands your goals, alternative and additional treatments may be considered.

Your treatment plan for Nonsurgical Options

Fillers can be administered the same day as your consultation because of their minimally invasive nature, low downtime, and safety record. Based on your goals, physical characteristics and many years of training and experience, your surgeon will share recommendations and information with you, including:

  • Filler injection recommendations that will give you the best outcome
  • The outcomes that you can anticipate
  • Your financial investment in the procedure
  • Associated risks and complications
  • What is needed to prepare for filler injections
  • What you can expect to experience after fillers
  • Share before-and-after photos of cases similar to yours and answer any questions.

Questions to ask your aesthetic plastic surgeon

We developed these questions to help you:

  • Make the most informed and intelligent decision about your procedure
  • Confirm that you have the right surgeon for your procedure
  • Make your initial consultation as rewarding as possible
  • Understand your options, potential outcomes, and risks

It is important for you to take an active role in your procedure, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for filler injections?
  • Who will be performing my filler injections? (If not the surgeon, then ask about licensing and qualifications.)
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for this procedure?
  • Do I need topical anesthetic?
  • What will be the costs associated with my fillers treatment?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect, and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my filler injections does not meet the goals we agreed on?

Preparing for Your Filler Procedure (Nonsurgical Options)

How do I prepare for a fillers procedure?

Your surgeon will provide thorough pre-treatment instructions and answer any questions you may have. In the weeks before your injections, you’ll be asked to refrain from taking aspirin, ibuprofen, vitamin E, St. John’s Wort, and any other medications that could cause bruising. Be sure to inform your physician of any medicines you are taking. If you have a history of cold sores, your surgeon may recommend taking Valtrex as a precaution. Your doctor may ask you to stop smoking before the procedure. Regardless of the type of procedure to be performed, hydration is very important before and after treatment for safe recovery.

Before going for a consultation, it would be a good idea to read the Injectable Safety Planning Guide.  Click on Safety Guide below for more information.

Injectable Safety Planning Guide

The American Society for Aesthetic Plastic Surgery (ASAPS) recommends the following guidelines for those seeking cosmetic injectable treatments:

  • Don’t choose a provider based on price. Injectables are pharmaceutical products and must be administered by trained, qualified clinicians
  • Make sure the benefits and risks are fully explained to you in a patient consultation. Plastic surgeons use the consultation process to educate patients about the proposed procedure. Every procedure has inherent risks and benefits; the hallmark of informed consent is the understanding of risks and benefits, and realistic expectations.
  • Fully disclose any medical conditions you might have, and medications you are taking including vitamins and over-the-counter drugs. This information will help your clinician select the most effective procedure for you, with the fewest side-effects.
  • Any injectable should be administered in an appropriate setting using sterile instruments. A non-physician who is appropriately licensed and trained may perform the injections under the supervision of a qualified plastic surgeon or dermatologist. Malls and private homes are not medical environments and may be unsanitary.
  • Know what you are being injected with. Disturbing reports of patients being injected with everything from liquid silicone to baby oil and other unapproved products are appearing in the press on a regular basis. Make sure your clinician is using only FDA-approved products purchased within the United States. If he or she refuses to give you this information, seek another clinician.

The position of the Aesthetic Society is that injectable fillers are medical procedures and should be performed only by qualified clinicians in an appropriate medical setting.

Aftercare and Recovery after Fillers (Nonsurgical Options)

Immediately after injection
You will likely see the results of your injections immediately following the procedure, though it’s not uncommon for patients to experience swelling or minimal bruising in the area of the injection site. Your physician may give you an ice pack or cold compress to help stem swelling. The period of swelling will depend largely on the type of soft tissue filler you received, though most swelling, bruising, and redness should dissipate within one week to ten days.

Recovery time frame
One of the most enticing features of soft tissue fillers is their minimal recovery time. In the approximate week it takes for swelling and bruising to disappear, your doctor may advise you to avoid wearing hats or other headgear and only use small amounts of makeup.

How Long Will the Results Last?

Nonsurgical Options

Nonsurgical Options (Perioral Fillers)

Nonsurgical Options

Nonsurgical Options (Perioral Fillers)

Nonsurgical Options

Nonsurgical Options (Fillers for the upper and lower lip lines)

Nonsurgical Options

Nonsurgical Options (Fillers for the Marionette/lateral chin areas)

The length of results from your dermal fillers is dependent on the type of injection you received:

  • Collagen-Based Fillers: Results will last from two to four months.
  • Hyaluronic Acid-Based Fillers: Results vary, though results of most common brands will last six to twelve months.
  • Semi-Permanent Fillers: Results will last between twelve and eighteen months.
  • Permanent Fillers: Results are typically still visible after five or more years.

Associated Costs of Fillers (Nonsurgical Options)

The cost of filler injections varies from doctor to doctor and from one geographic area to another.

Filler injections are elective treatment, so insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.  The practice of Michael P. Vincent MD FACS and Brent C. Faulkner MD participates with CareCredit.

Choose your surgeon based on quality, training, and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.

Limitations and Risks of Fillers (Nonsurgical Options)

As with any cosmetic procedure, patients must be in contact with their doctor during their recovery period. You should get in touch with your surgeon at the first sign of an abnormality or unexpected side effect. Prolonged pain and swelling could be a sign of infection or an allergic reaction.

There are very few risks associated with fillers, but you should contact your doctor if:

  • Swelling, bruising, or redness does not dissipate after one week
  • You experience acute pain near the injection site coupled with asymmetry, lasting more than seven to ten days after the procedure
  • You develop any nodules or bumps in or around injected areas or any uneven areas around the skin

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your filler injection procedure.

Photos and illustrations are examples and are meant to be helpful, informative, and educational.  No implicit guarantees regarding similar results can be given.  Additional information and the above text can be found on Dr. Vincent’s American Society for Aesthetic Plastic Surgery Smart Beauty Guide home page

Facial Peels

Nonsurgical Options Peels

Facial Peels

Nonsurgical Options include Chemical Facial Peels, also known as light chemical peels and deep chemical peels

As we age, dead skin cells do not slough off as easily as when we are younger, causing the skin to appear dull. Light, medium and deep chemical peels are a popular nonsurgical cosmetic procedure used to peel away the skin’s top layer to improve sun-damaged, unevenly pigmented and wrinkled skin. Improving the evenness of color and texture in your skin creates a youthful look and restores a healthy, luminous and radiant appearance.

When to Consider Chemical Peel Nonsurgical Options

  • If you have wrinkles or sun-damaged skin.
  • If you have skin discolorations, blotchiness or brown spots.
  • If you have scars that have made the surface of your skin uneven.
  • If you have certain precancerous skin growths.

Considerations for Chemical Peels (Nonsurgical Options)

Pros

  • No anesthesia or sedation is needed.
  • Light and medium chemical peels have minimal aftercare and recovery.
  • Deep chemical peels have long-lasting effects on treating deep wrinkles.

Cons

  • After peel, there will be sun sensitivity and pores may appear larger.
  • Deep chemical peels may have a bleaching effect.
  • Can exacerbate skin disorders, including allergic reactions or cold sores.

These are the top three pros and cons to weigh when considering chemical peels. If you wish to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for a chemical peel?
The following are some common reasons why you may want to consider a chemical peel:

  • You have sun-damaged skin
  • You have significant facial wrinkling
  • Your skin color is uneven with blotchiness, sunspots and brown spots
  • You have scars that have made the surface of your skin uneven
  • You have certain precancerous skin growths

Other characteristics of your skin, such as its thickness and texture, may influence whether you are a good candidate for chemical peels.

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Detailed Procedural Info Nonsurgical Options (Facial Peels)

How is a chemical peel procedure performed?

Your treatment may be performed by a licensed skincare professional in plastic surgeon’s office, but in our office, all nonsurgical options including facial peels are personally performed by our plastic surgeons. Peels involve the application of a chemical solution to your entire face or just to certain regions, such as the crow’s feet area around your eyes or the vertical wrinkles around your mouth.

The chemical solution is either applied lightly or rubbed more vigorously onto the skin being treated using a sponge, cotton pad, swab, or brush (avoiding your brows, eyes and lips). During peel application, you may experience a slight tingling (light to medium peels) or a burning sensation (deep peels). These sensations are usually minimal for light and medium peels but are more severe for deep peels. The length of time the solution is allowed to work is determined by carefully observing the changes in the appearance of your skin. With certain types of chemical peels, the solution may be “neutralized” after an appropriate amount of time has elapsed.

The different types of chemical peels vary according to their specific ingredients and their strength. The depth of their peeling action may also be determined by factors such as how long they remain on the skin and how they are applied onto the skin.

No covering or after-peel ointment is necessary after a light or medium peel and you can expect little to no downtime. However, after a deep peel, a thick coating of petroleum jelly or other protective ointment is layered over the face, covering the protective crust that develops rapidly over the area. This stays in place for one to two days. In some cases, dressings, tape or a bandage may be applied (this is particularly effective in cases of severe wrinkling). A deep peel requires a longer recuperation period.

Nonsurgical Options

Application of facial chemical peel (nonsurgical options)

Nonsurgical Options
Application of facial chemical peel (nonsurgical options)
Nonsurgical Options
Application of facial chemical peel (nonsurgical options)
Chemical peels exfoliate dead cells and can improve texture, acne, sun damage and congested pores. Deeper peels can address wrinkles and uneven skin tone.

What are my nonsurgical options for facial peels?

Your options will depend on the treatment depth you require and your surgeon will recommend an approach based upon your aesthetic goals. The amount of time you can allow for recovery may be an important factor to consider when selecting a particular chemical peel or determining the extent of treatment.

Light to Medium Peels

Glycolic (AHA) peel

Generally, the most superficial peels are those using alpha hydroxy acids (AHA), such as glycolic, lactic or fruit acid. AHA peels can reduce the effects of aging and sun damage including fine wrinkling and brown spots. Sometimes a single treatment with an AHA peel will give your skin a fresher, healthier appearance and a radiant glow. No anesthesia is needed and you will only feel a tingling or mild stinging sensation when the solution is applied. Immediately after the procedure, you generally will be able to wear makeup and you can drive yourself home or back to work. Various concentrations of an AHA may be applied weekly or at longer intervals to further improve the texture of your skin. Your surgeon may recommend a maintenance program using AHA products that you can apply at home on a regular basis.

Trichloracetic (TCA) acid peel

A TCA peel is a stronger, medium depth peel. TCA peels are often used for the treatment of wrinkles, skin pigment changes and blemishes. Many patients can benefit from having TCA applied not only on the face but also on the neck and other parts of the body that have been exposed to the sun. For spot peeling of limited areas such as around the mouth or eyes, TCA formulas are often preferred because they have a reduced bleaching effect compared to solutions containing phenol, another popular peeling agent. Some surgeons have found TCA to be effective in treating darker-skinned patients. Milder TCA peels can be repeated frequently in order to achieve cumulative effects or TCA can be used to achieve a medium or even a deep peel, depending on the acid concentration and manner of application.

Deep Peels

Phenol peels

A phenol peel is a deep peel that is sometimes recommended for treating severe wrinkles (from fine lines to deep creases), sun damage, uneven skin tone and texture and may be used in the treatment of precancerous skin conditions. Phenol is particularly useful for minimizing the vertical lines that often form around the mouth as a result of aging. Deep peels take longer to perform and will leave a healing crust on the skin that must be covered with protective ointment and limited from sun exposure. There is a burning sensation, but it is relieved somewhat because the solution also acts as an anesthetic. Phenol often has a significant bleaching effect and you may need to wear makeup in order for the treated portions of your skin to more closely match the skin color of the surrounding areas. Phenol cannot be used on your neck or other parts of your body.

ASAPS Position
The effectiveness of phenol chemical peeling has been proven in clinical studies over the last 30 years. Because this is a serious procedure, it is ASAPS’ position that phenol chemical peels should only be performed under the direction of a qualified physician.

Croton oil peels

Croton oil enhances the penetration of phenol and the depth of the peel. Croton oil peels are used to treat severe wrinkles caused by sun damage and extensive acne damage. The ideal patient has fair, dry skin. The application of this peel is painful, and intravenous sedation or general anesthesia is usually necessary. Patients are usually pain free the following morning.

There have been tremendous improvements in the formulations for phenol/croton oil peels that have made them safer than ever before.

What are the brand names for chemical peels?

A variety of chemical treatments can be used to exfoliate and rejuvenate the skin. Depending on the depth of treatment required, your surgeon may choose one of the following peels:

  • Alpha-hydroxy acid peel (AHA)
  • Trichloroacetic acid peel (TCA)
  • Phenol peel
  • Croton oil peel

Selecting a Surgeon for your Nonsurgical Options

Select a surgeon you can trust

It’s important to choose your surgeon based on:

  • Education, training and certification
  • Experience with chemical peels
  • Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your cosmetic surgery and nonsurgical options. Learn how to select a surgeon.

After finding a board-certified plastic surgeon in your area who is experienced in performing the many nonsurgical options like chemical peels, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment for Nonsurgical Options (Facial Peels)

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for a chemical peel and clarify what it can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered.

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

  • Previous surgeries
  • Previous nonsurgical options
  • Past and present medical conditions
  • Allergies and current medications

Additionally, it is important to tell your surgeon if you have ever had x-ray treatments of your facial skin, such as those used in the treatment of acne or if you have had a chemical peeling procedure. Current or past use of Accutane (isotretinoin), as well as Retin-A (tretinoin) and other topical skin preparations, must be reported to your surgeon.

Your treatment plan (Nonsurgical Options-Facial Peels)

Based on your goals, physical characteristics and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:

  • An approach to your treatment, including the type of procedure or combination of procedures.
  • The outcomes that you can anticipate.
  • Your financial investment for the procedure.
  • Associated risks and complications.
  • Options for anesthesia and treatment location.
  • What you need to prepare for your treatment.
  • What you can expect to experience after treatment.
  • Show before and after photos of cases similar to yours and answer any questions.

Questions to ask your aesthetic plastic surgeon about your Nonsurgical Options

We developed these questions to help you:

  • Make the most informed and intelligent decisions about your procedure.
  • Confirm that you have the right surgeon for your procedure.
  • Make your initial consultation as rewarding as possible.
  • Understand your options, potential outcomes and risks.

It is important for you to take an active role in your treatment, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for the nonsurgical options like a chemical peel?
  • Are the results of the nonsurgical options that I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • Will I have any scarring?
  • What kind of anesthesia do you recommend for me?
  • What will be the costs associated with my treatment?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my treatment does not meet the goals we agreed on?

Preparing for Your Procedure Nonsurgical Options (Facial Peels)

How do I prepare for a chemical peel procedure?

Your surgeon will provide thorough pretreatment instructions, answer any questions that you may have, take a detailed medical history, and perform a physical exam to determine your fitness for treatment.

Depending on the depth of your chemical peel treatment, you may be placed on a pretreatment program during which you will apply special creams, lotions or gels to your skin for a few weeks or longer. If you have a history of herpes infections around your mouth, your doctor will prescribe an antiviral medication before and after treatment to prevent viral infection. You may also be given certain oral medications that you should begin taking prior to your treatment.

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking at least six weeks before undergoing the chemical peel to promote better healing.
  • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding.
  • Regardless of the type of treatment to be performed, hydration is very important before and after surgery for safe recovery.

Chemical peels are usually performed on an outpatient basis. If you have a deep peel be sure to arrange for someone to drive you home after treatment and to stay with you at least the first night following treatment.

*What can I expect on the day of a chemical peel treatment?

Light to Medium Peels

A light or medium chemical peels is often performed in an office-based setting. Generally the procedure takes about 30 minutes to an hour. No sedation or anesthesia is needed.

Deep Peels

A deep chemical peel may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Most chemical peel procedures take at least 30 minutes to two hours to complete but may take longer.

  • Medications are administered for your comfort during the procedure.
  • Depending on the type of chemical peel chosen and the area treated, local anesthesia may be adequate; however, for larger areas, sedation or general anesthesia may be recommended.
  • For your safety during the treatment, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
  • Your surgeon will follow the treatment plan discussed with you.
  • After your procedure is completed, you will be taken into a recovery area where you will continue to be closely monitored.

You will be permitted to go home after a short observation period unless you and your plastic surgeon have made other plans for your immediate post-treatment recovery.

Aftercare and Recovery of Nonsurgical Options (Facial Peels)

Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:

  • Normal symptoms you will experience
  • Potential signs of complications

Following all chemical peel treatments, it is important to avoid direct or indirect sun exposure until all the redness or pinkness of your skin has subsided. Even after that, it is advisable to protect your skin by regular use of sunscreen and, whenever possible, a wide-brimmed hat. This is particularly important if you have had a phenol peel which eliminates your skin’s ability to tan. If the area around your eyes has been treated, you should wear good quality sunglasses when outdoors. After some types of chemical peel treatments, you may need to be careful about exposing your skin to chlorinated water.

Immediately after a chemical peel

For deep peels, your treated skin may be covered with petroleum jelly or other protective ointment and, in some cases, dressings may be applied.

You may have some pain, particularly with the deeper peels. If the pain is extreme or long-lasting, contact your physician. You will also have some redness and swelling after the surgery. Contact your surgeon to find out if your pain, redness and swelling are normal or a sign of a problem.

Recovery time frame after chemical peels

Your recovery will depend on the technique and depth of treatment.

Light Peels

A more superficial treatment will have no down time and you can return to your normal activities immediately.

Medium to Deep Peels

A deeper peel will involve a more prolonged healing period. You will be advised about cleansing your skin and if you should apply any ointments. For men who have undergone resurfacing procedures, shaving must be delayed for a while.

It is vitally important that you follow all patient care instructions provided by your surgeon. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

The first two weeks

  • Depending on the post-treatment regimen selected by your surgeon, a scab may or may not form over the treated area in medium and deep peels.
  • For deeper peels, your wounded skin may be moist and ooze serous (“clear watery”) fluid.
  • Depending on the depth of the peel you might have, swelling and redness will gradually change to pink, signalling that your new skin has begun to form.

Week two to eight

  • Your skin may still be pink.
  • Your skin tones will begin to blend naturally.
  • Your surgeon will advise if camouflage makeup can be used.

How long will my results from a chemical peel last?

Nonsurgical Options

Nonsurgical Options (Facial peels for pigmentation concerns)

Nonsurgical Options

Nonsurgical Options (Light Facial Peels)

Nonsurgical Options

Nonsurgical Options (Perioral facial chemical peel)

Nonsurgical Options Peels

Nonsurgical Options (Deeper full face chemical peel)

Because of the persistence of skin pinkness following deeper chemical peel procedures, it may take months before you can fully appreciate your new look. Most patients feel that the results are definitely worth waiting for and, in the case of deeper treatments, the benefits are relatively long-lasting. Superficial resurfacing procedures may need to be repeated periodically in order to maintain their benefits.

Your skin will continue to age, and wrinkles caused by movement of your facial muscles will eventually reappear. Some wrinkles may recur sooner than others, depending on their location as well as the type and extent of your chemical peel treatment. Despite this, you can expect that improvements in skin quality and texture achieved by a chemical peel will make your complexion appear younger and fresher for many years to come.

Maintain a relationship with your aesthetic plastic surgeon when it comes to surgical and nonsurgical options.

For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you notice any changes in your skin that has been treated. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs of Nonsurgical Options (Facial Peels)

The cost of chemical peels varies from the type of peel, from doctor to doctor, and from one geographic area to another.

Because chemical peels are elective nonsurgical options, insurance usually does not cover these costs. Occasionally, however, if the peel is being performed to treat precancerous skin conditions or improves certain types of scars, insurance coverage may be available. Your plastic surgeon’s office will explain how you can find out from your insurance company if a particular procedure will be covered. Many surgeons offer patient financing plans to make the nonsurgical options more affordable.  The practice of Michael P. Vincent MD FACS and Brent C. Faulkner MD participates with CareCredit.  C

Choose your surgeon based on quality, training and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of cosmetic surgery and nonsurgical options by viewing their basic credentials, training and certifications.

Limitations and Risks of Nonsurgical Options (Facial Peels)

Fortunately, significant complications from chemical peels and other nonsurgical options are infrequent. Your specific risks for chemical peels will be discussed during your consultation.

All nonsurgical options have some degree of risk. Some of the potential complications of all surgeries are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures

Other risks specific to chemical peels are outlined below:

  • Scarring
  • Abnormal healing
  • Unanticipated color changes or skin blotchiness
  • Eruption of cold sore (herpes virus)
  • Tiny whiteheads

You can help minimize certain risks by following the advice and instructions of your board certified plastic surgeon, both before and after your chemical peel treatment.

There are other nonsurgical options to chemical peels including laser resurfacing, dermabrasion, Fractional laser treatments, and other laser and light treatments.  We would be glad to discuss the pros and cons of each nonsurgical option.

Photos and illustrations are examples and are meant to be helpful, informative, and educational.  No implicit guarantees regarding similar nonsurgical options results can be given.  Additional information and the above text can be found on Dr. Vincent’s American Society for Aesthetic Plastic Surgery Smart Beauty Guide home page

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