Nip This Tuck That

  Did an interesting case today.  Full face TCA chemical peel.  I prefer to use 30 percent TCA….thrichloroacetic acid…say that 5 times really fast.  The TCA at that concentration (30 percent) gives a medium strength peel that will give the entire face a fresh look in about 1 week.

 The chemical is applied to clean skin.  The patient can be awake or under anesthesia for about 10 minutes.  The woman today decided to go to sleep.  The TCA is applied with gauge.  As the chemical evaporates, the skin begins to turn a white color.  This never happens with a single application of TCA and never happens evenly.  On the contrary, mutiple applicatipons are required and the face starts to take on a patch-work of pink with shades of white and off-white.  The trick to doing a great TCA peel is to fan the patien…my scrub nurse does the fanning…as I apply the TCA.  This allows a rapid and accurate assessment of when the skin is peeled just right.  The just-done look is when there is an even white color to the entire face.  You have to watch constantly however because that white color will only last a few minutes and then the skin will return back to the patch-work of pink and off white.  If you’re not paying attention, too much acid could be applied causing a deeper peel then desired.

 After the peel is at just the right depth….this is just into the upper levels of the dermis….I place a layer of super fine petroleum medical ointment and the patient wakes up.  The stinging…yes, there is some stinging with a TCA peel.  I mean, it is a chemical burn after all.  The stinging rapidly subsides after several minutes and the patients face will be slightly pink that night.  Keeping the ointment on for the next few days will allow the burn to heal rapidly and prevent the skin from becoming too dry.  The skin turn dark, like you got a suntan, in about 3 days and peels away in about 5 days.  Makeup can typically be applied at about 5-6 days.  There is no weeping or crusting with this depth of peel.  What’s left is soft, smooth beautiful new skin.  Who doesn’t want that.  I encourage our patients to maintain that beautiful skin with our Cosmeceutical Skin care Products Francis R Beverly Hills(R)…skin care that really works… http://www.frbh.com

Radiesse can be used to shape the Cheeks, Chin and Jawline for aesthetic augmentation.

http://www.drfpalmer.com/radiesse-injections.html

Dr. Francis R Palmer, III