Plastic surgeons have been frustrated in their search for rejuvenation procedures for significant sun damage and aging skin. While surgical face-lifts provide answers for jowls and saggy skin, poor solutions remain for a patient with significant facial aging due to sun damage. Specifically the severe leather-like criss-cross skin wrinkling and severe smoker lines around the lips (perioral rhitids) along with irregular pigmentation and bronzing of the skin as well as the waxy brown patches on the skin sometimes called age spots, but more commonly known as actinic keratosis and the fine wrinkles and irregular pigmentation are often not addressed during classic face lift surgery. These skin issues were addressed with skin resurfacing type procedures ranging from the most minimally invasive, such as the weekend alpha hydroxy peels or the micro dermabrasion procedures. Unfortunately, these lack sufficient penetration for even short-term benefits. Traditional Phenol chemical peels, as well as carbon dioxide and Erbium laser resurfacing were used to counteract these significant aging changes of the skin. These more severe treatments were able to remove old skin, but resulted in significant de-pigmentation and prolonged healing time. They were also significantly painful and unable to treat the neck and décolletage area. Credit goes to Dr. Gregory Hetter who presented the Variable penetration Croton Peel at the annual meeting of the American Society for Aesthetic Plastic Surgery in Orlando, Florida. His fellow plastic surgeons were so impressed that the presentation received the Tiffany Award for the best scientific presentation during this meeting.
The variable Croton Peel (VCP) offers a number of advantages over previous skin resurfacing procedures. It specifically avoids the depigmentation often seen with laser and Phenol peel and therefore also avoids the areas of demarcation between normally pigmented skin and peeled skin, which is often so noticeable after traditional resurfacing procedures. Because of the variable penetration prolonged healing times are avoided. More significantly damaged skin is treated first with the most powerful agent while thin and slow healing areas are either avoided altogether or treated with lesser agents. The procedure is less painful therefore deep general anesthesia, which was required for laser treatments, is no longer needed. VCP is able to treat the entire face, forehead, as well as the neck and décolletage area.
Depending on the patient’s degree of facial aging and skin damage, VCP can be used in a number of different penetration depths, resulting in short or longer healing times; light peel within five days, medium to light peels are completed within 8-9 days, medium to heavy peels require 10-12 days for healing and heavy peels require 12 days for healing. Truly remarkable changes can be achieved. “No other treatment comes close to giving this kind of result in one sitting” according to Dr. Hetter.
All pictures are from Dr Hetter’s patient
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