Dermabrasion is Back as Skin Resurfacing Tool

Minimally invasive procedures to tighten and lift skin give natural results with minimal risk and recovery time. Monopolar radiofrequency delivers a high-frequency electric current—tissue resistance to electrical current results in volumetric heating to the deep dermis and underlying tissue. The resulting heat leads to immediate collagen contraction and a delayed wound healing response, with new collagen formation up to 4 to 6-month post-treatment. INITIALLY, the FDA approved monopolar radiofrequency (RF) devices to treat periorbital wrinkles. Since then, they have been used to treat laxity of the forehead, cheeks, nasolabial folds, marionette, lines, jawline, and neck. Although the results of RF are not as dramatic as a facelift, over 90% of patients obtain noticeable tightening of the treated areas, and it never looks “pulled.” Another benefit of radiofrequency is reducing fat and tightening the skin by directing energy to target collagen. For example, a patient with flabby upper arms may have more loose skin than fat in this area. In this instance, Prof Moawad might use radiofrequency to tighten the skin first and then remove excess fat. However, if he determines that there is fat mainly in an area, he will remove the fat first and then tighten the skin afterward. “Radiofrequency is a versatile procedure that can be used on any area of the body – from large areas like the abdomen to minimal areas such as the chin – with the same degree of success.

Acne and acne rosacea treatment results are satisfactory for both patients and physicians. Acne is one of the most common diseases with a point prevalence of up to 100% among adolescents and often persists into adulthood, with detrimental effects on self-esteem. The conception of acne has been refined towards ‘chronic disease.’ Therefore, the strategy of acne treatment is a critical intervention and maintenance. Acne medications are very efficient, but only when patients use them correctly. Newer methods include radiofrequency, light or laser, and photodynamic therapy that represent treatment alternatives for systemic medications. A treatment plan for rosacea includes avoiding triggers, using gentle skin care products, and treating the rosacea. Many skincare products can irritate skin with rosacea. While medicine or laser treatment can help reduce or clear signs of rosacea, your everyday habits may cause a new flare-up.

Acne scars lead to emotional embarrassment, poor self-esteem, social isolation, low confidence, body image alterations, unemployment, lowered academic performance, and exacerbation of the psychiatric disease of anxiety or depression. Acne scars treatment must consider the cost of treatment, the severity of lesions, physician goals, patient expectations, side-effect profiles, psychological or emotional effects to the patient, and prevention measures. Various treatment modalities range from topical therapies, chemical peelings, micro-needling, or microdermabrasion, subcision, autologous ⁄ non-autologous dermal fillers to energy-based technology such as fractioned ⁄ non-fractionated lasers, ablative/non-ablative lasers, pigment or vascular-specific lasers, and minor surgical procedures. Whatever the choice, it should be clearly understood by both physicians and patients that, at present, improvement of scarring, rather than total cure, is the goal. Any intervention or treatment aims to improve scars, not for a total cure or perfection.

Fractional radiofrequency (FRF) is the newest in the nonabrasive approach. FRF uses an array of microneedles arranged in pairs between which bipolar RF energy is delivered. The fractionally delivered energy creates zones of thermally damaged skin adjacent to unaffected areas. The damaged skin stimulates wound healing and deposits new collagen, elastin, and hyaluronic acid formation. The unaffected areas serve as a reservoir of stem cells that accelerate wound healing.  FRF improves acne scars, large facial pores, and skin quality. FRF devices are safe, tolerable, and effective modalities for wrinkles and facial laxity reduction. I may use a topical anesthetic cream before the treatment to minimize pain. Fractional radiofrequency is combined with PRP with significant amounts of growth factor and heal promoting factors to fasten healing. Recently, Nanofat has been combined with fractional radiofrequency to enhance skin quality and stimulate hair follicles. Fractional radiofrequency gives a wake-up call to your skin to remove injured collagen and elastic fibers, encouraging your fibroblast to synthesize new collagen and stimulate hair follicles to stem cells.

Skin rejuvenation laser peel involves the removal of the outer layer of damaged skin. Many ablative skin resurfacing techniques are available at MSI, broadly grouped as mechanical, chemical, and laser abrasion. All ablative techniques result in upper to the mid-dermal wound. Dermabrasion relies on mechanical 'cold steel' injury, acid peels result in a 'caustic' injury, and lasers result in a thermal injury. All ablative resurfacing treatments work the same way. First, the outer layers of damaged skin are stripped away. Then, as new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. Superficial or medium resurfacing is limited to the epidermis and papillary dermis. For deeper resurfacing, I can also remove the upper levels of the reticular dermis. Unlike chemical peels and dermabrasion, laser skin resurfacing (LSR) with the CO2 laser generates heat, which results in immediate tightening because of the shrinkage of collagen, which forcefully shortens the collagen fibers by 30%. This translates clinically into the smoothing out of superficial irregularities, including wrinkles, acne scars, nevi, epidermal growths, and even tumors, and a tightening effect that improves the skin's overall appearance. The laser stimulates the growth of healthy new collagen and elastic fibers in the skin continuously for six months after resurfacing. Therefore, any wrinkles or scars will continue to improve for up to one year. Nonablative or minimal ablative fractional CO2 holds great promise in both treatments of skin textural abnormalities (acne scarring, wrinkles, and skin mottling associated with photoaging) and pigmentary variation (melasma, hyperpigmented scars, lentigines, and dyschromia

Acne inversa or hidradenitis suppurativa (HS) is a disease that usually begins as pimple-like bumps on the skin. The pimple-like bumps tend to develop in places where everyday pimples do not appear. HS is most common on the underarms and groin. Getting treatment for HS is important. Early diagnosis and treatment can prevent HS from worsening. If HS worsens, the pimple-like bumps can grow deep into the skin and become painful. They can rupture, leaking bloodstained pus onto clothing. This fluid often has a foul odor. As the deep bumps heal, scars can form. Some people develop tunnel-like tracts under their skin. As the skin continues to improve and scar, the scars thicken. When thick scars form in the underarm, moving the arm can be difficult. Thick scars in the groin area can make walking difficult. Because HS can look a lot like acne, folliculitis, or boils, it is best to see a dermatologist for a diagnosis.

A dermatologic surgeon usually does plantar warts removal. Plantar warts are small growths that usually appear on your feet' heels or other weight-bearing areas. This pressure may also cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by HPV. The virus enters your body through tiny cuts, breaks, or other weak spots on the bottom of your feet. Dermatologists have many treatments for warts. The procedure used depends on the patient's age and health. I prefer to cut the callus by scalpel. Then I use a curette to remove the viral material. Then I use a vascular laser to burn or cauterize tiny blood vessels that feed the virus. Then it cauterizes the base using an ablative laser or chemical TCA. A topical antibiotic is applied, and a special dressing is applied. The patient can walk without any pain immediately

Hair loss treatment is mistakenly thought to be a strictly male disease, women make up a significant percentage of American hair loss sufferers. Hair loss in women can be devastating for self-image and emotional well-being. Unfortunately, society has forced women to suffer in silence. It is considered far more acceptable for men to undergo the same hair loss process. Unfortunately, the medical community pays little attention to the issue of women's hair loss. Since hair loss doesn't appear to be life-threatening, physicians often overlook women's complaints about hair loss and essentially tell their patients that" it's no big deal" and that "you'll just have to live with it." Of course, these physicians don't realize that the psychological damage caused by hair loss and feeling unattractive can be just as devastating as any severe disease. It can take an emotional toll that directly affects physical health. The most recent available hair preservation and restoration treatment is the newly introduced combination of mesotherapy, infrared technology, and oxygen therapy only at the MSI hair care unit. A tiny amount of active ingredients of minoxidil, and finasteride together with all vitamins and trace elements are injected via computerized mesogun into the mesoderm of bald areas. It gives excellent results in both Androgenic and pseudo androgenic alopecia.

Upper eyelid lift surgery or blepharoplasty is required when the eyelids require recontouring. Specifically, blepharoplasty is most useful when excess skin needs to be removed, the orbicularis oculi muscle is hypertrophic or requires tightening, or orbital fat should be removed or redistributed. Upper eyelid lift surgery typically involves an incision made in the natural crease above the eye. Your cosmetic surgeon will remove a precise amount of excess skin and fat and adjust the surrounding muscles to make the desired improvements.

Lower eyelid lift surgery or blepharoplasty involves several surgical approaches. Cosmetic surgeons can use various surgical techniques to improve the lower eyelids; incisions are located on the outer edge of the lower eyelid, just beneath the eyelashes, or inside the eyelid. Your cosmetic surgeon will explain the approach they determine is best for you. Your cosmetic surgeon will remove or reposition fat through the incisions to create a smooth, natural contour beneath the eyelid. Depending on the case, I may remove excess, sagging skin or tighten the lower eyelid muscle to supply the most natural, effective results. Lower eyelid transconjunctival blepharoplasty is readily carried out using the CO2 laser or standard incisional devices (radiofrequency)