Beauty is Skin Deep

By: Katharine Griffiths
Created on 11th August 2010

We do know when we see pictures of models and actresses in the magazines that computer trickery has ironed out the lines and wrinkles, eradicated all blemishes and pigmentation and bestowed a zing to their skin, but it’s hard not to feel envious.

Now with Total FX, it is possible to get photoshopped in real life. Mr Kambiz Golchin of the Cadogan Clinic has been offering laser skin resurfacing with the Total FX from Lumenis for last four years:

“There is no doubt that laser skin resurfacing is getting more and more popular because it can address a number of problems all at the same time. You can get rid of fine lines and wrinkles, improve tone and texture, remove skin pigmentation and sun damage, all in one treatment.

“The beauty of it is that results continue to get better as time goes on and you can’t say that about all procedures. From the day I do my facelift, time and gravity start working. But with laser we know you get the huge boost in collagen production so the results continue to improve over the first six months.”

Cosmeticsurgerytoday.co.uk probes Mr Golchin more about the procedure:

The concept of beauty is continually evolving. Why does laser resurfacing fit so well into current thinking?

The concept of beauty has changed and whereas before we used to think symmetry was the only factor that defines beauty, now there is more evidence that skin quality is also important.

There has been a lot of work done in Germany using computer software and morphing technology; you create a perfectly symmetrical face but there is nothing attractive about the face, because the blemishes and dull skin are still present.

If you use the same image and sharpen the skin quality, the person appears much softer and more attractive.

How do you know what is best to offer your patients?

One of the difficulties is that often ‘the new’ is not always ‘the best’. The industry is driven by companies that introduce these products that are not necessarily well researched or have enough science behind them.

It is difficult, for both the consumer and the practitioner, because there are so many treatments out there but they have no real evidence behind them – is it safe first of all and, if it is safe, does it give the desired results. I feel that Total FX from Lumenis is the best to offer my patients.

Lumenis is the market leader in terms of lasers and this laser system has FDA approval for over 200 surgical applications and, on the aesthetic side, has FDA approval for over thirty different procedures.

Total FX has been used in the NHS for several years but has only recently been approved for cosmetic use in the UK.This gives you the assurance that this is not some Mickey Mouse machine that in six months time will be replaced with something else.

Can you explain a little bit about the history of laser skin resurfacing?

It is not new. If you talk to most plastic surgeons and dermatologists – the ones that are older than me! – they were using CO2 lasers 20 years ago for skin resurfacing. And they were getting great results, but there were also problems.

The heat of the laser caused a long period of recovery that was easily a good few weeks. And, like in everything else, practitioners started to get more confident with the lasers and began to push boundaries. They got more aggressive to achieve better results and that’s when you started to see complications.

Complications in medical procedures usually occur in two stages – at the start when a practitioner doesn’t really know what they are doing. And, at the other end, when they really know what they are doing, but they start to push boundaries.

And that’s what happened; people were getting problems with scarring and pigmentation and so lasers became less popular compared to other modalities. However, over the last few years, that has changed as technology has provided the solution to the problem.

Lasers are now given in a fractionated fashion rather than treating the skin in a sheet fashion and that’s made the whole treatment lot safer and lessened recovery time.

What place does laser skin resurfacing have in your practice?

I’m a facial plastic surgeon, so I can offer both surgical and nonsurgical treatments and this puts me in a unique position because I don’t have to sell anything.

All treatments have their place, from injectables, chemical peels, laser treatments, all the way through to surgical procedures, and they all have patients that are most suitable for those treatments. It’s about what suits the individual and their circumstances.

That is one of the problems with the cosmetic industry. If you only have injectables to offer or just one piece of equipment in your practice, that’s what you are going to offer your patients, whether it is suitable for them or not.

So who is laser resurfacing suitable for?

Actually, laser resurfacing has something for everyone. From patients in their mid to late thirties who are looking for a boost to their skin or to get rid of the fine lines and wrinkles or sun damage they might have just started to notice. It will get rid of those and produce a collagen boost that may delay the need for other treatments for a number of years.

Then there is the patient in their late fifties, where the ageing process is well-established, who needs to remove deeper lines and wrinkles and heavier sun damage. It can tackle deep folds and wrinkles but you need to be more aggressive, which makes the treatment closer to traditional laser skin resurfacing. It’s still a lot safer though.

It is also great for acne scarring, which can mean patients of any age. Acne scarring has always been a difficult area to treat; we’ve tried dermabrasion, skin grafting, fillers, but the results have been disappointing.The results of laser resurfacing are stunning.

How does it compare to the needle?

The amount of collagen stimulation you get with an injectable is nowhere near what you get with a laser. With an injectable, you achieve a minimal collagen boost.

The laser, on the other hand, targets the exact skin level where you need it for collagen stimulation. The results peak six months post treatment when often the effects of injectables are starting to wear off.

It’s impossible to say exactly how long the results will last, as it depends on lifestyle, but it can last five to ten years. It can literally take ten years off someone with a single treatment.