Wrinkles have been the bane of mankind since the beginning of recorded history. It is said that Cleopatra bathed in sour milk because it made her skin look better. While not aware of it, she had discovered a very mild chemical peel to the uppermost layers of the skin.

Hungarian gypsies, noted for their fine looking skin, passed secret formulas for skin peeling from generation to generation. It was not until World War I, that a French surgeon discovered that phenol used as skin disinfectant also erased skin wrinkles.

During the next 80 years, various chemical agents have been used for wrinkle removal ranging from the very mild fruit acids popular today to solutions containing varying percentages of phenol. While good for complextions, the hydroxy fruit acids do little or nothing for wrinkles. The clasical peeling methods are effective for deep wrinkles but carry with them the greater risk of complications.

Exoderm is modified phenol-containing solution developed in 1986 and refined in 1990 by chemists, plastic surgeons and derma-to-pathologists to minimize the complications of phenol while maintaining the beneficial effects of deep-depth peeling.

A variety of oils, alcohols and buffer substances were developed which have almost eliminated the problems of deep peels. New collagen and elastic fibers are formed resulting in a "tightening" effect while a variety of discoloration conditions and pre-cancerous lesions are eliminated. The effects are long lasting for years.

BEFORE	AFTER

PATIENT SELECTION

Generally, the ideal candidate for the chemabrasion is the patient with the minimal facial sag and wrinkled skin that has been exposed to the elements, a patient who desires improvement but is not quite a candidate for a face lift. Light to olive tone skin can be treated since, although exoderm is a deep peel, it is fomulated to not lighten the skin.

PROCEDURE

Chemabrasion is usually performed on an outpatient basis. The skin should be washed oin the evening prior to the procedure and again the next morning to remove all cosmetics. The patient is usually given seditives to take orally one hour before the surgery and is given intravenus sedation during long procedures. If just the skin around the eyes or lips is being treated, the IV sedation may be omitted.

The peel solution is applied to the skin with a cotton application while the patient is in a semi-sitting position. The treated skin is covered with a special dressing, which minimizes pain and promotes even treatment.

The patient returns to the office the following day for removal and cleaning. Instructions for after care are given at this time.

Chemical face peel is an extremely useful tool for the cosmetic surgeon but requires attention to details and a well informed patient. The procedure is carried out by a team approach - the surgeon applies the solution and provides the patient with guidance and instruction, and the patient then becomes part of the team and follows these instructions to the letter to insure the best result. The rewards are a refined and rejuvenated facial appearance which can be enjoyed for years to come.