Chemical Peels & Shumway Custom Peels

A chemical peel is a body treatment technique used to improve and smooth the texture of the facial skin using a chemical solution that causes the skin to blister and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin. Thus the term chemical peel is derived.

Dr. Shumway also designs Custom Chemical Peels to best suit every patient’s individual situation and goals.

There are several types of chemical peels.

Alpha Hydroxy Acid Peels:
Alpha Hydroxy Acids (AHAs) are naturally occurring organic carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids 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 are used to:
• Reduce fine wrinkling
• Treat areas of dryness
• Reduce uneven pigmentation
• Aid in the control of acne
• Smooth rough dry skin
• Improve the texture of sun-damaged skin
AHA peels may:
• Cause stinging
• Cause skin redness
• Cause mild skin irritation
• Cause dryness
• Take multiple treatments for desired results

Beta Hydroxy Acid Peels:
It is becoming common for the use of beta hydroxy acid (BHA) peels to be used instead of the stronger Alpha Hydroxy (AHA) peels due to BHA's ability to get deeper into the pore than AHA. Studies show that BHA peels control oil, acne as well as remove dead skin cells to a certain extent better than AHA's, due to AHA's only working on the surface of the skin.

Jessner's Peel:
Jessner's peel is a combination of salicylic and lactic acids, and resorcinol. It is thought to break intracellular bridges between keratinocytes.
Retinoic acid peel

Trichloroacetic Acid Peels (TCA):
Trichloroacetic acid (TCA) is used as an intermediate to deep peeling agent in concentrations ranging from 20-50%. Depth of penetration is increased as concentration increases, with 50% TCA penetrating into the reticular dermis. Concentrations higher than 35% are not recommended because of the high risk of scarring.

TCA peels:
• Are preferred for darker-skinned patients over Phenol
• Smooth out fine surface wrinkles
• Remove superficial blemishes
• Correct skin pigment problems
TCA peels may:
• Require pre-treatment with Retin-A or AHA creams
• Require repeat treatment to maintain results
• Require the use of sunblock for several months (this is a must)
• Take several days to heal depending on the peel depth

Phenol Peels:
Phenol is the strongest of the chemical solutions and produces a deep skin peel. Recent studies suggest that phenol is most likely only the carrier for another active component in the solution, namely croton oil. In fact, phenol alone produces only a light peel which is ineffective for restructuring the deeper dermal structures (such as wrinkles). The term Phenol/Croton oil peel has been proposed as a more accurate descriptor, but the established terminology phenol peel continues to be the dominant usage, as the role of croton oil in the mix is not as widely understood.

Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic. A single treatment usually achieves the desired result.

Phenol Peels are used to:
• Correct blotches caused by sun exposure or aging
• Smooth out coarse deep wrinkles
• Remove precancerous growths
Phenol Peels may:
• Pose a risk for patients with heart problems
• Permanently remove facial freckles
• Cause permanent skin lightening by reducing the ability to produce pigment
• Take several months to heal
• Require increased protection from the sun for life

Anesthesia:
With light chemical peels like AHA and glycolic acid peels, there is minimal discomfort so usually no anesthetic is given because the patient feels only a slight stinging when the solution is applied. If a patient were to request something for pain, an oral pain pill like Tylenol with codeine would be appropriate.

Medium peels like TCA are also performed in the doctor’s office or in an ambulatory surgery center as an outpatient procedure and are a bit more painful. Frequently, the combination of a tranquilizer like Valium and a pain pill usually suffice. TCA peels often do not require anesthesia because the solution itself has a numbing effect on the skin. The patient usually feels a warm or burning sensation.

Phenol is the classic deep chemical peel. The application is very painful and most practitioners will perform it under either general anesthesia, administered by an MD-anesthesiologist or nurse anesthetist. Less often, the procedure is done using very heavy sedation, usually intravenous or intramuscular. 

What should you do after a Chemical Peel?
Use a very gentle cleaner when washing your face. Dr. Shumway may ask you to use a prescribed moisturizing cream. Do not apply any glycolic acid product during the healing time. Avoid sun exposure. Do not peel or scratch the skin.

Eyelid Rejuvenation (Blepharoplasty)

Each year thousands of women and men choose eyelid surgery to help restore a more energetic and youthful appearance.  Eyelid surgery or blepharoplasty can correct sagging eyelids, remove fatty pouches beneath the eyes and remove excess skin from the upper eyelids.  Blepharoplasty can be done alone or in conjunction with other procedures such as a facelift, a brow lift or laser skin resurfacing.

The Procedure

Blepharoplasty is generally performed under local anesthesia in our office.  Dr. Shumway places fine incisions in the crease above each eye to correct problems of the upper eyelids.  Then a thin crescent of excess skin and muscle is removed.  The incisions are closed with very fine sutures.  To remove the fatty deposits beneath the eyes, the incisions are place just inside the lower eyelid.  After the fat is removed, the incisions may be closed with absorbable sutures or may be left to heal naturally.  When excess skin and muscle needs to be removed from the lowers lids, the incisions are placed I the natural smile crease below the lashline.  The procedure can take between one and two hours, depending on the extent of the surgery.

Recovery

After the surgery, the area around the eye will be bruised and swollen for about two weeks.  Patients should keep their heads up and place cold compresses on their eyes periodically.  Antibiotic eye drops or ointment may be prescribed.  Patients can’t wear contact lenses for about two weeks, since the eyelids may be stiff and sore.  Make-up may be worn after about ten days.  The resulting hairline scars which follow the natural contour of the eyelids tend to fade in about two months.

After cosmetic surgery, our patients have a softer, more youthful look to their faces.  Many seem to have a new spring in their step after facing fresher reflection in the mirror.

Eyelid 'Rejuventation' surgery can be perfomed very effectively, and is a relatively simple procedure than removes excess skin, muscle, and fatty tissue. Blepharoplasty surgery is often combined with other facial plastic surgery procedures such as browlift, facelfit, or skin resurfacing to further augment the overall result of the surgery.   

Did you know...

Eyelid Surgery is the second most common cosmetic surgery procedure currently being perfomed today!

Facial Fillers (Wrinkle Treatments)

Patients should go into any consultation with their eyes wide open. There can be side effects, like bruising and swelling, so you definitely don't want to get work done the day of a big event. Occasionally there can be infection from the injection, or in the case of some permanent fillers, small bumps called granulomas. (These can usually be treated by a shot of cortisone). The permanent fillers usually have a slightly lumpier feel to them, though this usually isn't visible to the naked eye, while the temporary fillers can have a varying lifespan-usually anywhere from 3 months to a year.

It is recommended that a patients try a temporary filler for their first few treatments, just to make sure it is providing them the results they want. If they are satisfied, they may want to opt for a permanent filler, so they don't have to keep coming back.

Dr. Shumway likes to give his patients choices, because the more they understand about the options, the happier they are with the results

Radiance:

Is a synthetic, man-made, calcium composite that is used to fill lips and facial lines.  Because Radiance contains no animal or human tissues, allergy testing is not necessary, as there have been no reported reactions or rejections.  Radiance keeps its cream-like texture throughout its life after injection.

Like most facial fillers, Radiance is injected into the cheeks, facial lines, lips, or other desired areas to increase fullness and fill in lines caused by aging.  Normally a mild anesthetic is given to reduce pain and discomfort.  Injections take place during an office visit and usually take just a few minutes.  No follow up treatments are required, as the desired effects can usually be reached during one visit.

Results of Radiance injections can be seen immediately.  Minor swelling or inflammation may occur, but usually disappears within 24-36 hours.  Radiance is a long-lasting facial filler that lasts an average of two years, with the effects being sustained as long as three to five years in some cases.

Restylane®:

In the competitive world of injectable dermal fillers, Restylane®, FDA approved for the treatment of facial folds and wrinkles, has been used in more than 1.5 million treatments throughout the world to help both men and women return a more youthful appearance to their face.  Restylane® is made of Non-Animal Stabilized Hyaluronic Acid (NASHA).  Hyaluronic acid is a substance that occurs naturally in the body, and the stabilized version that exists in Restylane® is biocompatible with the human substance.

Determining what areas need to be treated is perhaps the most important step of the Restylane® injections.  Restylane® is used mainly for wrinkles and folds, in particular the nasolabial folds that begin at both sides of the base of your nose and continue down horizontally to your upper lip.  The Restylane® gel is simply injected into the areas in order to increase fullness or create a smoother contour.  Anesthesia is usually not necessary as pain is minimal.  In most cases a cream containing a numbing agent is applied to the treatment area shortly before injection.
Restylane® injections are very quick, but actual duration will differentiate dependant upon the amount of gel that is injected.

The results of Restylane® can be seen almost immediately and there is usually no downtime.  Most patients return to work or their normal activity directly following injections.  At most, you may experience some bruising, redness or skin irritation, but you should begin to see it dissipate within a day or two.  Results will last from between 6 and 12 months.

ArteFill®:

Is the first and only FDA-approved non-reabsorbable injectable filler for the correction of wrinkles known as smile lines. It contains 20% tiny round and smooth particles (PMMA microspheres) and 80% purified bovine collagen gel with 0.3% lidocaine, an anesthetic.

ArteFill is a dual-acting injectable wrinkle filler. First, ArteFill visibly corrects the wrinkle. Then the microspheres provide the permanent support your skin needs for long-lasting wrinkle correction.

ArteFill is injected underneath the wrinkle, just above the skin’s fat layer. ArteFill provides the soft, supportive foundation that your skin needs for long-lasting wrinkle correction.

All temporary fillers are eventually absorbed by the body. That’s why they require frequent repeat injections. ArteFill is different. The unique microspheres in ArteFill are not absorbed by the body. These microspheres provide the permanent support your skin needs for long-lasting wrinkle correction. Now, with ArteFill, you can get the lasting wrinkle correction you want in just one or two treatments. Where the results of temporary fillers end, the long-lasting benefits of ArteFill continue.

CosmoDerm/CosmoPlast:

A collagen-based filler from human skin grown in a laboratory-no allergy test required. CosmoPlast is excellent for lips, while CosmoDerm works on fine lines.  These fillers are great if you don't want a lot of swelling.  They also have lidocaine in them, so patients like them because they are less painful than other fillers.  The products usually last 3 to 6 months.  But even though the product doesn't last as long, it really looks great, especially in the lips.  CosmoPlast is also being used in combination with other fillers to create a more luscious-looking lip.

Fat Injections:

The patient’s own fat is a great filling material. It is soft and can add lots of volume. It can be used in the cheek area, the chin and under the eye. It doesn't work as well in the lips as it moves around too much. In this procedure, intact fat cells with connective tissue are removed from one part of the body and injected in the areas needed. Not all the fat usually takes, however, and sometimes most of it is reabsorbed by the body.

Hylaform:

This is an animal-based hyaluronic acid that is used to fill out wrinkles, fine lines, acne scars and enhance lips. Its effects usually last 3 to 6 months.

Juvederm:

Is nonallergenic hyaluronic acid derived from a non-animal source. It comes in three versions: Juvederm 18 for fine lines and crow's feet, Juvederm 24 for forehead and cheek wrinkles, and Juvederm 30 to fill lips, sculpture cheeks and fill deep nasolabial folds. Results can last 9 months to 1 year.

Perlane:

This is an excellent product for treating the deeper nasolabial folds.  Perlane is a non-animal based hyaluronic acid that is part of the Restylane family. It is used for plumping up wrinkles, frown lines and marionette lines. Results usually last a year or more.

Reviderm:

This filler consists of biodegradable micron-sized beads in a hyaluronic base. Usually two injections are required, the second one coming six weeks after the first, giving time for tissue to form around the beads. Results usually last 6 to 9 months.