Reviewed by Varnada Karriem-Norwood on May 25, 2012


Robert Kotler, MD, FACS Cosmetic and Plastic Surgeon of the Face and Neck Clinical instructor, Division of Head & Neck Surgery, UCLA Medical School.

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Video Transcript

Narrator: How wrinkled should I be before I consider a peel?

Robert Kotler, MD: When she looks into the mirror, a lady decides whether she's happy or unhappy with the state of her skin. And when she sees the vertical lip lines and maybe the deep lines around the crow's foot area, and some frown lines here, and some forehead lines, at some point, she's going to ask herself, well should I do something about it? Now, she could use an entry level procedure like botox. That will help the squint lines. It's very good for the vertical frown lines, but it doesn't change the overall characteristics of the skin when there has been a lot of sun damage. That brown color, the kind of an unhealthy look, sun damage, brown spots, age spots, whatever you want to call them. It would take a resurfacing, the removal of that damaged layer of skin, and forcing nature to regenerate fresh new skin. And that's really what the chemical peel or the laser peel does. So, some patients may need a little help with Restylane, a little help with botox, a lot of help with the chemical or laser treatment. When you look in the mirror, you decide what you don't like, and then you have to consult with a specialist who will tell you what the remedies are. And for some people, treatment A isn't proper, and for others it is, and that's the value of the consultation.

Narrator: If you see you're starting to wrinkle, should you rush in, in your 40s and 50s?

Robert Kotler, MD: Only if it's really bothering you a lot. I mean everybody, everybody has kind of a tipping point. There's a point where one day, you look in the mirror and you say, you know what, I know it's not going to get any better, I think I need to talk to a doctor about this. And that age could be 40, it could be 65. And people have come in here to consult for the first time with a cosmetic surgeon at 75 or 80. My first question is where have you been? No, but whatever is right for the patient is what counts. It's all in the eyes of the beholder. We're here to serve when appropriate, at any age.

Narrator : Now does the chemical peel do any kind of lifting?

Robert Kotler, MD : It does. In fact, it doesn't correct the jowls or the sagging neck, but a lift in the sense that it does tighten the skin on the face. It'll make this groove a little better. Not enough perhaps to solve the problem completely, but what it does is it gives you a youthful looking skin, because it's not wrinkled. It doesn't have the age spots,doesn't have the brown spots, doesn't look like you've baked in the sun, and that's something that no other process obtains.