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4. Wrinkles upper and lower lip

These wrinkles are cause by dermal breakdown under the relentless action of the underlying muscle.

Treatment

Every treatment is aimed at the destruction of the epidermis and a small portion of dermis. It is a kind of superficial controlled second-degree burn. In the healing process there is :

 

Several techniques are possible :

Dermabrasion

An abrading device is used to shave off the epidermis and part of the dermis.

A full explanation here

http://emedicine.medscape.com/article/1297069-overview

Advantages :

Disadvantages

 

Microdermabrasion is a technique to remove only the epidermis and has no value in correcting even the smallest wrinkles

 

Chemical Peeling

The skin is shaven off by a chemical product . There are different solutions giving each a different depth of action. The skin needs to be prepared first.

Here is a youtube movie about the procedure http://www.youtube.com/watch?v=81rO08kNzuc

Advantages

Disadvantages

 

Lasers

http://www.youtube.com/watch?v=4nFYuSV5AcY

Lasers first abraded the epidermis and dermis to such an extend that scar tissue formation was a risk.

The new lasers such as fraxel lasers burn a grid of small microscopic holes in the skin, every one at the same depth. The skin stretches and flattens because of the retraction process involved in this grid like pattern. There is little downtime after treatment

Lasers provide a clear advantage over other methods in terms of healing time, but not necessarily in results.

Advantages

Disadvantages

 

Here are some examples of what can be achieved with a fraxellisation laser

http://www.fraxel.com/photoGallery.cfm

Postoperatively

Removing the epidermis and part of the dermis can be quite painful, because the underlying sensitive nerves are exposed. This will only last for a few days until the skin itself secretes a protective sheet -made of fibrin-.

Repeated application of an antiseptic cream such as Flammazine ( Silver sulfadiazine) will soothe the pain. A crust will form, which should be left untouched until it falls of by itself after 7-10 days

After the crust has fallen off, pink colored skin will be visible. It should be protected from drying out and from UV sun rays for as long as the color remains. This may take several weeks to months.

Possible complications short and long term

Redness

Will fade with time and appropriate protective measures ( avoid sun, sun block, hydratation) need to be taken

Viral infection

A dormant herpes infection can be reactivated by dermabrasion. If the medical history points towards earlier infections, antiviral medication should be applied before treatment.

Skin sensitivity

Can be a problem in the first days because of the cutaneous nerve ends being exposed to all sorts of influences. This will go away within a week or so.

Hyper and hypo-pigmentation

Milia

Milia are small fat deposits in the scar. They are visible as small white dots on the scar. They can easily be removed with a small needle.

Scarring

A deep removal of dermis can trigger a scar formation. The skin is not able to regenerate itself and deeper wound healing sets in with deposit of extensive scar tissue ( collagen) that does not contain any pigmentation

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