As a plastic surgeon, I see many patients for facial surgery who often ask about their skin care. Or more specifically, what can they do to improve their skin either before or after surgery. Skin care is a very bewildering world for all patients with ten of thousands of products available in stores and on-line as well as cosmeceutical ads which have no boundaries to claims given that they are retail beauty products and not FDA-sanctioned pharmaceuticals. Where does the patient start and how do they work their way through the skin care maze?



First and foremost, like all things in medicine, a diagnosis has to be made. You can't very well select the right treatment if you don't have a working diagnosis as to the skin problems. THis can be done in two ways; being evaluated by a very experienced aesthetician who has a lot of medical experience (i.e., working in a doctor's office preferably a plastic surgeon or dermatologist) and/or getting a Visia skin complexion analysis. Like a CAT scan for your skin, this computerized digital skin analysis system evaluates everything from wrinkles, pore size, to the amount of sun damage...and documents it photographically. This provides not onlya set of diagnoses for the skin but also becomes a reference from which to judge the results of any future treatments.

From a product and treatment standpoint, there are only 5 things you can do to your skin...that's it! All skin care products and even more invasive skin treatments attempt to address one or all of them..as there is nothing topically more that can be done. These five functions include: cleanse, hydrate, protect, exfoliate, and stimulate. All of these different effects combined create smoother and tighter skin. If all five functions are achieved in a skin care program, then the best results can be obtained. If only one or two of these product functions are done, then the skin results will be less. Simplistically, a cleanser is needed morning and night, a daytime moisturizer/sunscreen protectant, and noctural regimens of exfoliation (e.g., AHA, lactic acids, Retin-A) alternating with stimulants (e.g., Vitamin C and peptides) comprise a basic program. The most variable part of this regimen is what you do at night with exfoliation and collagen stimulation. Getting professional aesthetician help is critical. Many product lines today already have it laid out for you in kits or steps. As you can see, thre is no good reason for more than 5 to 7 skin care products, if they are properly selected and monitored. And the good news is....it is no more expensive to get a good medical line than buying that big jar of hope sold over the counter at the department or drug store by someone who has no idea, really, about comprehensive skin care.

The fundamental concept in medical skin care to day is....simplify, a focused approach, and monitor the results and how you react to them. If you then add in regular exfoliations with microdermabrasions and chemical peels....with an injectable filler or a little Botox if needed...you are on your way to better-looking skin with a good return on your investment.