Total Body Surgical Blog

In the past few weeks we have discussed how lasers work, removing tattoos, removing unwanted hair, and renewing the skin.  These are important uses for laser technology and as it gets better, we will see more uses pop up.  Today I want to discuss pigment issues on the face, arms, and chest. 

Why do we get them and what are they??  is picture shows melasma, aka "pregnancy mask".  It is caused by sun in combination with hormonal changes.  It is quite common and cases can vary a great deal in severity.  These changes can occur on anyone but seem to be worse in ethnic skin.  It can occur over the entire face but is the most common on the cheek area.

The second area is on the chest.  Brown spots and red spots occur with age and again.....the sun.  Sun worshipers get this and the more you worship the worse it gets.

The third area is on the hands.  Age spots, liver spots, whatever you want to call them are caused by sun damage and can be present over the entire arm.

Even if you don't worship the sun, we all get exposure during normal daily activites of walking out doors, driving, etc.  So they can occur on any of us.

How do we treat them??  First, I suggest a good skin care regimen.  This is key to getting the skin to heal and to slow down the pigmentation process.  It also prepares the skin for more aggressive treatments.  At Total Body Surgical we like to use the Obagi system for treating damaged skin.  Obagi contains tretinoin and hydroquinone.  These stimulate the skin to grow faster and shed the dead portion of the skin.  It also turns off the melanocyte or pigment cell.  Lastly, it contains a good sun screen to prevent further damage.  Once used for a short period of time, we treat these areas in a couple of ways.  First is the IPL (flashlamp or Intense Pulsed Light).  This is a machine that shoots short bursts of intense light.  The wavelength is set to target the darker colors in the skin and some red pigments.  These areas then peel off and since the pigment cells are turned off, their recurrence is much less severe.  Continued protection from the sun makes them "stay away".  Treatments are usually done in a series of 3-5 treatments and the areas gradually disappear.  We can also use laser to resurface the skin and remove pigment.  The Pearl laser is perfect for this killing "two birds with one stone".  This gives you rejuvenated skin texture, helps with fine lines and wrinkles, and rids the pigment too.  Recovery time for this treatment is only about 4-5 days.  The IPL recovery time is minor redness for about 24 hours then crusting of dark areas that will peel off.  The Obagi system causes the sensation of dryness and may cause some minor shedding of dead skin for a few weeks.

Come see us at Total Body Surgical where our staff is trained and experienced with Obagi and Skinceutical products.  We also have a full product line in the office and can get you started.

Remember our specials that are still going on too!!

Call 918-786-7780 for a complimentary cosmetic consult or fill out a contact form and we will contact you!!

More laser stuff next week!

We also have special Christmas pricing on products and gift certificates available for all laser services and skin care, Latisse and more!!

What can lasers do for your skin??  ALOT!!!!  As time goes on and the natural aging process of the skin occurs there are many changes that occur.  Ultraviolet light from the sun, pollutants in the air, pollutants in what we eat, the loss of collagen as we age, genetics, loss of fat,....and the list goes on and on.  All of these things lead to the aging of our skin causing spots, wrinkles, enlarged pores, and even skin cancers.

Here is a comparison of young and old skin...here you see how the age spots form, the outer layer thins, and fat is diminished.  On a smaller scale we would see collagen loss as well.

    What we see on the outside is this....

  How can laser treatment alter these changes??  There are a number of effects that a good laser treatment can cause making the skin look and feel younger.  Laser can tighten the skin by causing new collagen to form as the damage caused by the laser is healed.  The outer layer of skin (stratum corneum) is also thinned and made more organized by laser treatment making the skin look and feel smoother and softer.  Dark spots (age spots) or dark patches (melasma) are not only caused by sun damage but also are aggravated by hormonal changes.  When lasers are used carefully and these treatments are combined with targeted skin care and sun protection, these spots can usually be treated and removed.

Laser skin resurfacing today is safer, cheaper, and recovery times are significantly less than ever before.  At Total Body Surgical we use the Cutera Pearl laser.  This laser is unique for a number of reasons.  It is a wavelength that penetrates well into the skin but shortens recovery time.  We have the only pearl in the area.  It gives the same results as a CO2 laser but the recovery time is only around 4 days.  This means that you can wear makeup after about 4 days but will have some redness for a week or two. 

Laser resurfacing can make a huge difference in acne scarring too.  Smoothing them and helping pigment changes they can cause. 

So if you want to get rid of age spots, melasma, acne scarring, or just tighten the skin up to look younger, come see us at Total Body Surgical.  We can get you started on the new you in 2012.  Now laser treatments are as cheap as $800....much cheaper than the big city.....schedule today!!   918-786-7780...cosmetic consultations always complimentary...

Don't forget our specials too!!

Last week I tried to explain, in easy to understand terms, how lasers work.  Of course this is a very complicated subject involving physics and science so I tried to make it simple.  What you should try to understand is this....with lasers in Cosmetic and vein surgery, what we are trying to accomplish is using the right wavelength of light to excite or remove a certain color or tissue.  Over the next few weeks, I will attempt to help you understand what is possible using lasers.  I hope I am successful.

Today I am going to discuss how we use lasers to remove tattoos. 

When I was a kid....a long time ago....tattoos were one of the things that were considered very exotic.  You only ever saw them on merchant marines, sailors, WWII vets, etc.  I'm not sure when they came into vogue, but today, they are more than common.  Whether good or bad, they have also become much more complicated.

  (Typical WWII era tattoo...single color, small in size, shallow depth of ink)

Todays tattoos have multiple colors, can be very large, and use technology that puts the ink in the skin with more uniformity and depth. 

(new tattoo...larger, more colors, broad spacing, deeper pigment)

The other thing we see is that the inks are mixed to create some of these colors which makes it more difficult to remove.

People get tattoos for various reasons and they usually get them when they are young.  Later in life, as skin changes and we age, they may become less attractive...and...styles change.  Some designs may fall out of vogue.  Another problem is employment.  Visible tattoos that are difficult to conceal may become a problem with some job seekers.  They were put on without regard for the future.  We run into this often.  Individuals want to advance in a job but cannot because of policies against visible body art.  For these reasons, many people want them removed.

The simple fact is that tattoos are by nature associated with scar tissue which can never be removed.  For this reason, the skin can never be returned to its pristine, pre-tattoo state... but we can get close... most of the time.  In comes the q-switched laser (see last weeks blog for information on what this means).  The ink in a tattoo is deposited in the layers of the skin in "globs".  These packets of ink are a foreign body and our immune system is constantly eating away at them.  They are large though and this takes time....lots of it.  If you look at an older tattoo, the color is not as vivid, real old tattos may fade completely, and this is why.  By choosing the right wavelength of laser light and firing it at the ink there is a percussive effect that breaks up the "globs" into more manageable smaller deposits.  The body can handle these quicker and easier.

The easiest tattoos to remove are the black and red ones.  The q-switched 1064nm yag laser hits black very well and the q-switched 532 nm hits red.  When fired at the ink, there is a pop as it is dispersed into smaller packets that the immune system can handle.  The idea is to break up the ink without creating a lot of heat.  Too much heat can cause a burn and create a tattoo shaped burn scar.  The harder colors are greens, blues, and pastels.  For these we have to use blended wave lengths or pulsed dye lasers that have less quality and power.  Black and red tattos can usually be removed in several treatments 6-9, the other colors can take years to remove.  The other factor is the quality of ink used.  Some inks are easy and others are not.  Some inks contain iron oxides that are impossible to treat without creating heat AND resulting scar tissue.  Fortunately we see these inks infrequently.  That is what makes tattoo removal difficult and somewhat unpredictable.  There is a movement to standardize ink and this would be good.  It would make the removal process much more standardized as well.  Ethnic skin adds a whole other dimension to removal as pigment in the skin also attracts the light and changes in skin color can occur after removal that may be permanent.

Tattoo removal without local anesthetic is not without discomfort.  We usually use topical anethesia at a minimum and injected local on most.  Treatments are usually quick and done at 6 week intervals to allow the body to catch up absorbing the ink.  Removal can be costly due to the number of treatments and the expense of the laser equipment.  Q-switched lasers are not cheap and it takes multiple devices due to the different wavelengths required.

That's it...tattoo removal in a nutshell.  It is much more complicated but I don't want to overwhelm. Come see us at Total Body Surgical for a no cost evaluation and estimate if you want your tattoo removed....Call 918-786-7780 for an appointment to see our tattoo removal specialist or fill out the contact form and we will call you!!

Don't forget our special pricing on liposuction, lap bands, and nail fungus too.

I want to spend some time discussing lasers and how we use them today.  Lasers have been around for some time.  In the past, at least as far as medicine is concerned, they have been a technology looking for an application.  In the past several years, improvements in technology have made them much safer and applications have greatly increased.

  Austin Powers....demonstrated his ignorance of laser technology.  Lasers have been a mystery to most!! 

Laser and intense light or flash lamp therapy are both based on concentrated light.  Let's talk about lasers first.

Lasers are concentrated light that can be used for multiple applications.  They have been used in industrial applications for years. Medical lasers have numerous applications as well.  We use them to to clear up and make skin look prettier.  We use them to remove tattoo's.  They are used to treat veins and vascular problems on the body and face, even varicose veins.  We can remove unwanted hair, laser fat cells, make skin contract, use them to cut skin, and now we can treat toenail fungus which has been a nagging problem.

Pulsed light therapy is based on a bright flash of light shot onto the skin.  Also called a flash lamp, this technology has been used for other applications, photography, etc.  In cosmetic surgery we use it to treat spots and different pigments on the skin of the face or body.

Unfortunately, there is no single laser that can be used for all applications.  Not to get too complicated (because it is complicated) the way we choose what laser or lamp to used is based on the chromophore we are trying to treat.  A chromophore is the part of a molecule or cell that produces its color.  Each laser or flash lamp has a wave length that attacks that color.  This is why one laser or lamp will not work on all colors.  We know what colors we are trying to treat and select the laser or lamp that will work on that specific color.  This is where the art meets the science.  With some applications, we are aiming at water in the skin as the chromophore, especially when resurfacing the skin. 

The most common laser currently used in Cosmetic Surgery are the nd-YAG, the KTP, the CO2, and the pulsed dye lasers.  Each of these target a different chromophore or color.  The newest developments in the technology is the fractional and q-switched technologies.  We used to resurface skin by ablating or lasering the entire skin surface.  Since the skin recovers by healing from the hair follicle, recovery was slower than desired and this scared people.  Fractional lasers give us the ability to divide or fractionate the pulse of light from the laser.  This leaves islands of undamaged skin between the areas treated.  There are more and larger areas for the skin to heal.  The advantages are that healing is much faster and complication rates are less.  The disadvantages are that the treatment is not quite as good and may require more than a single session.  Q switching is a way to modulate the laser output to get a better "quality" of light energy, more intense output per pulse.  I will talk more about Q-switching when I discuss tattoo removal.

Flash lamps also treat specific colors in the skin.  They are used for treatment of brown pigment, red pigment, and hair in the treatment areas.  With flash lamps, we must change the wavelength of the light to treat each problem.

Now that the boring part is over, next week we will begin to explore the problems we treat and what we use to treat them.

Don't forget our nail fungus, lap band, and liposuction deals that are currently running.  We also are having multiple Botox events in Tulsa and Grove to get everyone ready for the holidays!!  Send me a message, fill out a contact form, or call 918-786-7780 to find out when and where.

This week we are still talking about wrinkles!!  Ya'll will enjoy this one...

http://youtu.be/NCvHgppVey4

To sum things up at this point, young skin, ages up to about 30 just need protection from the sun and some type of vitamin C product to maintain collagen production (Obagi or Skinceuticals make great products).  From ages 30-40 or 50 most can get by with good skin care, and add Botox to slow the musculature down that is causing the typical wrinkles between the eyes, crows feet, and forehead lines.  For stubborn wrinkles that are too deep for Botox, fillers such as Juvederm and Radiesse can be used to soften them.  Laser procedures and peels can help a great deal as well and that is what we will discuss in this installment. 

Lasers have come a long way in the past several years and this is exciting.  Laser technology has come a long way and this seriously benefits our patients. The old complications can still occur but are not as common with fractional techniques.  The most common problems are hyperpigmentation, hypopigmentation, persistant redness, and scarring.  These problems are less likely with the new technologies and pre treatment.

Who needs or wants laser treatment?  There are many indications.  The most prevalent use is for treatment of mild to moderate wrinkling.  It also helps a great deal in rejuvenating the skin and helping remove spots from sun damage.  Lasers stimulate the skin to make more collagen and make it look much healthier by removing damaged stratum corneum (the outer layer) and promoting new skin growth. 

Older "full ablation" laser techniques removed all of the outer layer.  Since the skin heals from either hair follicles or by expanding from undamaged areas, this took awhile.  Newer laser technology allows us to "fractionate" the damage.  This means that we can now regulate the energy put into the skin, the depth of penetration , and the separation of spots that are treated.  In other words, we are treating small areas that are surrounded by normal skin.  This allows the skin to heal much quicker so recovery time is much shorter and complications are less.  The down side is that multiple treatments may be required to get the same result.

At Total Body Surgical, we have the Pearl Laser by Cutera. www.cutera.com  .  We have access to other lasers as well, depending on the need.  This laser is a great tool to treat both younger and older skin.  The recovery time is usually only 4 days.  This means you can begin wearing makeup after four days and look about back to normal in a week or two.

Come see us at Total Body Surgical Cosmetic Surgery for complimentary cosmetic consultations, Obagi Products, or laser therapy.

Don't forget our Breast Augmentation and Laser hair removal specials!!