Before Surgery
Dr. Bentkover will carefully evaluate your skin and suggest which procedure he thinks will be most effective for you. Your choice of procedure may also depend on how much time you can take off from work or your regular activities. He will often recommend that you establish a routine of deep cleaning, manual facials from a high quality aesthetician before either procedure. This will help prevent infection and the formation of milia (small white cysts) after the procedure. If you do not have an aesthetician of your own, we can usually recommend one.
If you are having laser resurfacing, we will recommend preparing your skin for at least 4-6 weeks before surgery with a bleaching agent plus a retinol or one of our Obagi systems. Since the major risk of laser resurfacing is hyperpigmentation (increased brown pigment in your skin), these regimens are designed to protect your skin from this possible complication.
If you are having Rhytec Portrait® Skin Regeneration®, there is no significant skin preparation. But if you are on a retinol like Retin-A™ and Renova™ or any kind of frequent fruit acid treatements to your face (like glycolic acid or vitamin C), we will ask that you stop using these about 3-4 weeks before the procedure. The reason for this is that your epidermis acts as what is called a "biologic dressing" after the treatment, and these products thin the outer most layer of the epidermis, the stratum corneum.
Method of Surgery
For laser resurfacing under local anesthesia in the office, you will be offered prescriptions to calm your nerves before the procedure. Usually we will only treat small scars, the lower eyelids, crows feet, upper lip, lower lip and chin under local anesthesia. A full face procedure will be done in the operating room at St. Vincent Hospital under general anesthesia or local anesthesia with sedation. The lasered area is usually covered with a special tape called Flexzan™ for 3-5 days and then copper a containing cream and lotion from ProCyte®. Your skin will be red to deep pink for 3-4 months, fading gradually. Lower eyelids usually resurface in about a week, the rest of the face in about 10-14 days. You can usually wear a mineral make up in 14 days. We stock Jane Iredale™ make-up for this purpose. Your skin will continue to tighten for 3-4 months as your body produces more collagen.
Rhytec Portrait® Skin Regeneration requires only a topical anesthesia for a low energy treatment and topical plus injected local anesthesia with an oral medication to calm your nerves for a high energy treatment, even of the whole face. Low energy treatments are usually done in a series of 3-4 treatments, spaced 1 month apart. High energy treatments are usually a single treatment. After either procedure you will be asked to keep your face covered with a petroleum based product like Aquaphor. You may not wash your face for 24 hours. Depending on the level of energy delivered to your skin, you can expect to see your skin turn brown between 1 and 4 days after the procedure. This brown mask will slowly peel over a few days. After it is all peeled, you may return to you usual skin care except for the use of retinols and fruit acids like glycolic acid or vitamin C. You should avoid those product for another 3 weeks or so. Our aesthetic nurse will advise you when to resume such products or Obagi skin care regimens. Your skin will continue to tighten for a year. Usually by 7-10 days after surgery most of the pinkness is gone. You may use a mineral make-up like Jane Iredale™ at one week.
Recovery: What to Expect
Neither procedure is very painful afterwards. You will feel like you have a bad sunburn the first night after surgery and might take a prescribed pain pill or extra strength acetaminophen. The next day you will usually not require any pain medication. With laser resurfacing, it will take 3-4 months for all the redness to fade completely. It is a deep pink color and can be covered by a mineral based make up like Jane Iredale. With Rhytec Portrait® Skin Regeneration, there is less pinkness; and it should fade in 7-10 days. Your skin will look improved, but usually no one will be able to tell you had a procedure by day 10. Your skin may continue to improve for up to a year. Mineral make-up may be used at one week.
