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If You Are Considering A Chemical Peel...

Chemical peels use a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Renaissance Plastic Surgery offers a variety of peel depths and formulas from alphahydroxy acid (AHAs) peels to deeper trichloroacetic acid (TCA) peels. The precise formula used may be adjusted to meet each patient's needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process.

Once you and Dr. Angobaldo have decided on a specific peel program, be sure to ask about any details that you do not understand. Chemical peel is most commonly performed for cosmetic reasons -- to enhance your appearance and your self confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed.  

Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. AHA peels may be used to treat fine wrinkling, areas of dryness, uneven pigmentation and acne. Various concentrations of an AHA may be applied weekly or at longer intervals to obtain the best result. Dr. Angobaldo will make this decision during your consultation and as the treatment proceeds. An alphahydroxy acid, such as glycolic acid, can also be mixed with a facial wash or cream in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture. AHA peels may cause stinging, redness, irritation and crusting. However, as the skin adjusts to the treatment regimen, these problems will subside. The AHA peels offered at renaissance include:

 -The Vivite Lunchtime Peel.  Vivite’s lunchtime peel has GLX Technology which is an advanced formula to help improve the overall skin clarity and smoothness to help reduce the appearance of fine lines and wrinkles.  Leaving your skin looking rejuvenated and feeling refreshed.

-A full line of Auspect peels. These include 20-60% Lactobotanical and Treatment Peels (specific formulas such as "pigment punch" "retinol brulee") meant to treat aging, pigmented, or acne prone skin.

Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium to deep peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. More than one TCA peel may be needed to achieve the desired result.  With a TCA peel, your healed skin will be able to produce pigment as always; the peel will not bleach the skin. However, TCA-peel patients are advised to avoid sun exposure for several months after treatment to protect the newly formed layers of skin.
All chemical peels carry some uncertainty and risk. Chemical peel is a safe procedure when it is performed by a qualified, experienced plastic surgeon. However, some unpredictability and risks such as infection and scarring, while infrequent, are possible.

 Peel Formulas at a Glance

Alphahydroxy acids (AHAs) Uses:
 • Smooths rough, dry skin
 • Improves texture of sun-damaged skin
 • Aids in control of acne
 • Can be mixed with a bleaching agent to correct pigment problems
 • Can be used as a TCA pre-treatment

   Considerations:

 • A series of peels may be needed
   • As with most peel treatments, sunblock use is recommended

Trichloroacetic acid (TCA) Uses:

Smooths out fine surface wrinkles
Removes superficial blemishes
Corrects pigment problems Considerations:
Can be used on neck or other body areas
May require pre-treatment with Retin-A or AHA creams
Treatment takes only 10-15 minutes
        •   Preferred for darker-skinned patients
Peel depth can be adjusted
Repeat treatment may be needed to maintain results
Sunblock must be used for several months

Planning for a Chemical Peel

 Dr. Angobaldo may offer you a choice of peel techniques or suggest a combination of peels to obtain the best result for you.
During your initial consultation, don't hesitate to ask any questions or express any concerns that you may have. Expect Dr.Angobaldo to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform Dr.Angobaldo prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems.

Preparing For Your Chemical Peel

Dr.Angobaldo will instruct you on how to prepare for your peel treatment. Retin A - a prescription medication derived from Vitamin A - is used to pre-treat the skin. This thins out the skin's surface layer, allowing the TCA solution to penetrate more deeply and evenly. If your skin won't tolerate Retin-A pre-treatment, an AHA cream may be used instead. Hydroquinone, a bleaching agent, is sometimes used in conjunction with Retin-A or AHA pre-treatment, especially if you have blotchy skin areas or pigmentation problems. You may have to spend a month or more in the pre-treatment phase before Dr.Angobaldo will schedule your actual peel.

Where Your Peel Will Be Performed

 Most chemical peels may be safely performed at Renaissance Plastic Surgery, an accredited surgical facility on an outpatient basis. Dr.Angobaldo may want you to stay overnight in a facility or hospital if other cosmetic procedures are performed simultaneously.

 Types of Anesthesia

Anesthesia isn't required for AHA or TCA peels because the chemical solution acts as an anesthetic. However, sedation may be used before and during the procedure to relax you and keep you comfortable.  

The Peel

 AHA peels/treatments:
Dr.Angobaldo or assistive staff will apply the AHA solution to your cleansed facial skin, a process that usually takes no more than 10 minutes. No after-peel ointment or covering is required. Depending on the strength of the peel, periodic treatments may be necessary until the desired effects are achieved. For some patients, the application of an AHA-based face wash or cream once or twice a day at home will be sufficient to accomplish the desired goal. Complementary skincare to optimize your peel results can be identified by the staff at Renaissance Plastic Surgery. Your plastic surgeon may add Retin-A or a bleaching agent to your at-home treatment schedule. After several weeks of at-home use, your doctor will examine your skin to determine if your regimen needs adjustment.

  TCA peels:
Typically, the skin is first thoroughly cleansed. Then, the TCA solution will be carefully applied. You may feel a stinging sensation as the peel solution is applied, but this feeling will quickly pass. A full-face TCA peel usually takes no more than 15 minutes. Two or more TCA peels may be needed to obtain the desired result, and those may be spaced out over several months. Mild TCA peels may be repeated as often as every month.

  After Your Treatment

After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment.
After a TCA peel, Dr.Angobaldo may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor's specific post-operative instructions.A TCA peel may also cause significant swelling, depending on the strength of the peel used.  

Getting Back to Normal

With an AHA peel, the temporary redness, flaking and dryness that you experience will not prevent you from working or engaging in your normal activities. A fresher and improved skin texture will result with continued AHA treatments. Remember, protecting your skin from the sun is also important following these mild acid peels. Ask Dr.Angobaldo to recommend a sunblock with adequate UVA and UVB protection and use it every day.
With a TCA peel, the moderate discomfort and mild swelling you may experience will subside within the first week. In about a week to ten days, your new skin will be apparent and you should be healed sufficiently to return to your normal activities. It is best to avoid sun exposure unless you are adequately protected.

 Your New Look

Improvements from AHA peels may be very subtle at first. You may detect a healthier glow to your skin. With continued treatments, you will notice a general improvement in the texture of your skin.
Typical results following a TCA peel are skin that is noticeably smoother and fresher-looking, with fewer fine wrinkles, fewer blemishes and more even-toned skin.  

The results from peels can be dramatic, but are not immune to the effects of aging and sun exposure. Good SPF protection and complementary skin care products are beneficial for lengthening the results of your treatment. If you are interested in a chemical peel or have questions, contact our office for a complimentary consultation.