Facial Chemical Peels

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Chemical Peels for Facial Rejuvenation, discussed by Dr. Robert J. Brueck MD FACS

Chemical peels may be used to repair damaged skin. They vary in active agents and strength, with three basic types of peels.

Superficial peels, which usually employ a diluted acid, such as glycolic acid, are the mildest peels and can be used on all skin types.

Medium peels are taken more deeply into the skin, causing a second-degree burn. Trichloroacetic acid, commonly referred to as TCA, is the peeling agent often used in medium peels.

Deep peels penetrate even more deeply into the skin, affecting multiple layers. They also cause a second-degree burn. Phenol is commonly used for deep peels, which are used only on the face. Deep peels risk bleaching the skin and, therefore, are usually not recommended for darker skin.

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I consult with patients to determine the most appropriate peel for the individual, based on:

  • skin type
  • areas to be peeled
  • results the patient desires
  • level of risk the patient is willing to take.

Then, I usually select a small area to test for results.The process starts with cleansing your face twice a day, two to three weeks before the scheduled procedure. A moisturizing cream often is used. Sunscreen is applied each day. Preparing skin this way prepares it for more even results, faster healing and less chance of infection.

Immediately before a superficial peel is applied the skin is cleaned again. The peel is applied with gauze, cotton-tipped applicators or small brushes. After the peel has done what is intended, it may be neutralized with water or alcohol and wiped off. There may a slight burning sensation while the peel is active.

A medium peel will be approached similarly, but the peel will be left on the skin longer. As a result medium peels are more painful. You may elect to have a pain reliever or oral sedative to control pain and anxiety during the procedure. The stinging sensation may be relieved with cold compresses and fans. The procedure takes about 40 minutes. With little or no pain when the peel is finished.

A deep peel is the most painful procedure. More effective pain relievers are indicated. It may oral, a shot or intravenous. In rare cases, we will use general anesthesia. Tape may be used when treating deeper problem areas.

Superficial peels are done to improve the appearance of the skin, mitigate acne scars, treat mild sun damage and smooth fine wrinkles. Medium peels are called upon to treat mild to moderate wrinkles, long-term sun damage, skin pigmant changes and precancerous lesions. Deep peels are applied to treat severe wrinkles, severe sun damage, extensive pigment changes skin lesions and growth.

 Hetter Peels ©

Hetter Peels are a new technique that can be used to treat skin damage. One of the advantages of Hetter peels is the flexibility the procedure offers doctors to be effective with a wide spectrum of skin damage, from mild to moderate to severe. Improvements skin from Hetter peels have been unmistakable.

Skin ages as a result of several influences: time, gravity, exposure to the sun and environmental conditions. As the skin ages, it progressively thins. Lost collagen, tiny scars from repeated facial movements and pigmentation changes take their toll.

For years, I and my colleagues in plastic surgery have searched for procedures to mitigate the effect of aging on facial skin. Facelift surgery does not address skin tone and damage to skin. Hetter Peels succeed at changing the deep structures of the skin and improve signs of advanced skin damage, such as leathery skin wrinkles and lip area smoker’s lines. By combining a facelift with a subsequent Hetter peel, our patients can realize impressive facial rejuvenation.

For all that, chemical peels are not especially “new”. They were a non-medical staple of Hollywood personalities searching for the fountain of skin youth. These early uses of peels, right up through the 90's were often so aggressive in their approach that there were possibilities of residual skin damage.

In the late 1990’s, Dr. Gregory Hetter, MD, developed an approach to chemical peels that became known as the “Hetter Peel”. ©

The new Hetter Peel, while an aggressive procedure that offers dramatic results, is safer and more versatile than previous procedures. There is reduced downtime and less risk of depigmentation. Visible difference between treated and untreated areas are not a problem with the Hetter Peel, as they occasionally have been with earlier peels. Because the concentration of active agent in a Hetter Peel can be modified, the Hetter Peel procedure is more versatile for use with different patient types and on different areas of the body.

What can you expect from a Hetter Peel?

  • Diminished fine lines and facial wrinkles
  • Smoothed and tightened eyelid skin
  • Diminished Crow’s feet at the eyes
  • Smoothed smoker’s lines
  • Smoothed “orange peel” texture
  • Softened frown lines and pucker marks
  • Elimination of brown spots and uneven skin color
  • Flattened facial scars
  • Improvement of depressions and pits from chronic acne
  • Reduction of uneven pigmentation, pre-cancer lesions, and redness

Treatment using the Hetter Peel requires committing to healing time. Phase one of recovery involves facial swelling, sloughing and return of outer skin to the peeled surface, usually completed within 2 weeks. Most patients are able to return to normal social interaction then. Residual redness begins to end during phase two of recovery, while it may last as many as 12 weeks for complete elimination. Make-up maybe used to cover the redness during this time.

We will discuss all these options and variants during your consultation with me. We will have photographs to review and I will be pleased to answer all your questions. My staff is highly trained staff and dedicated to providing patients with the finest in cosmetic surgery and plastic surgery in a responsive and comforting manner, always with a view to the good health of each patient. Sometimes this mean advising a prospective patient that, for various health reasons, he or she should not undergo the procedure at the time. "I have never regretted a case I didn't accept."

My practice provides a wide variety of plastic surgery, cosmetic surgery and reconstructive surgery to patients throughout Fort Myers/Naples and Marco Island in Southwest Florida. Click here for more information about my medical and surgical training.

Dr. Brueck is associated with a number of professional medical societies, including:dr robert brueck fort myers

  • American Society of Aesthetic Plastic Surgeons
  • Florida Medical Association
  • Lee County Medical Society
  • Southern Medical Association
  • American Society of Plastic & Reconstructive Surgeons
  • American Association of Laser Medicine & Surgery
  • Aesthetic Surgery Association

I am a Fellow of the American College of Surgeons and havemore than 30 years of experience in plastic surgery, cosmetic surgery and reconstructive surgery.You may contact Dr. Brueck by telephone at 239-204-5040, through email or through his Aesthetic Co-ordinator, Judy.

Before-and-after photos of Dr. Brueck's work may be accessed via links on each procedure-specific page. Please note: If photos of uncovered body areas offend you or you are under 18 years old, please do not view these pages. To explore links to websites that support Dr. Brueck, click on this Links page.