Ask Dr. Barber

Barber QA - Sept 15Q.  I have read on the internet about a new procedure that does not involve surgery that will improve the quality of skin and help with pigment and wrinkles.  The technique is called micro-needling.  Do you have any experience with this new technique?

A.  Yes, we are now incorporating micro-needling at Barber Plastic Surgery Center.  The technique utilizes nine precisely spaced micro-needles in a device called a Rejuvepen.  When the device is activated next to the skin of the face, hands, or chest, the needles vibrate and create invisible perforations in the epidermis and top layers of the dermis.  This controlled needle injury to the skin will activate your body’s natural healing process, which then stimulates new collagen and elastin at the treatment site.  The micro-needling treatment is combined with the application of Recovery Serum which uses growth factor technology and antioxidants to help speed and improve healing time, and calm the inflammation following the treatment.  Depending on the area treated and the amount of skin damage, the number of treatments recommended can vary from four to six.  The treatment takes about an hour including the preparation time.  There is little or no discomfort during the treatment, and no pain medication is required following the treatment.  Recovery of the skin is in as little as a couple of days.  The treatments are spaced a month apart.  Sun exposure following the treatment is discouraged without the use of a good sunscreen.  After completing the prescribed number of treatments, you can expect improvement in pore size, reduction of fine lines, and tighter skin.  The process also has favorable effects on stretch marks, surgical scars, and acne scars.  Although this is relatively new technology, the initial results are very encouraging for improvement in the quality and appearance of your skin.

Q.  What is the difference between using a laser to reduce wrinkles on the face and doing a chemical peel?  What procedure works best for wrinkles?

A.  The use of lasers and/or chemical peels to reduce fine lines of the face has become very popular in this country.  Both procedures are designed to create a controlled injury to the skin which then stimulates collagen.  The most popular laser that is used to resurface the skin is the fractionated CO2 (carbon dioxide) laser.  In trained hands, this laser offers a safe and predictable method to reduce fine lines of the cheeks and the area around the mouth and eyes.  The laser can be performed under either local anesthesia or general anesthesia.  The choice of anesthesia is often dictated by the severity of the skin damage and the depth of the wrinkles.  The deeper the wrinkles the more aggressive the laser treatment must be, and therefore the greater chance of pain during the treatment.  In patients with significant sun damage and wrinkles, general anesthesia is often preferred for comfort.  The laser will not get rid of all wrinkles, some are just too deep; however, the procedure can make a significant difference in smoothing out the skin and improving texture.  Of course, there is a risk of scaring with any resurfacing procedure, but the risk is very low with the laser.

Chemical peels offer a less expensive option than laser, but chemical peels are typically not as effective as laser.  For this reason, chemical peels are often repeated several times in order to achieve the desired result.  In my practice, I will recommend chemical peels to the younger patients with less wrinkled and less sun damaged skin.  A consultation with a plastic surgeon who specializes in facial rejuvenation will be helpful for you to outline a plan to improve your skin.



William Byron Barber II, M.D. has been practicing plastic surgery in Greensboro for 20 years and is certified by the American Board of Plastic Surgery.  He is Chief of Plastic Surgery for Moses Cone Health System, and is an active member of numerous local, regional and national plastic surgery associations.

Visit his website at: www.BarberPlasticSurgery.com or e-mail him at: AskDrBarber@BarberPlasticSurgery.com

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