A Structural Approach to Non-Ablative Rejuvenation
Gary D. Monheit, M.D.
Associate Professor
Department of Dermatology
University of Alabama at Birmingham
Birmingham, Alabama

Facial Rejuvenation today involves a complex of different procedures designed to reverse or correct the degenerative changes that occur on multiple levels of skin and soft tissue in response to the processes of aging. Intrinsic and photoaging processes cause changes in epidermis, dermal structures and subcutaneous atrophy. These lead to the characteristics of dynamic and static wrinkles, redundant skin and surface changes in color and texture. In the past, major innovations involving face lifting techniques and deep chemical peels involved a morbidity and risk of complications as well as significant recuperative down time. The advent of more conservative “lunch time” procedures to correct these changes are the expected norm for most cosmetic patients. Microdermabrasion, light and medium depth chemical peels, chemodenervation with Botulinum toxin, filling injections with collagen and other implants, vascular and pigmented lesions lasers all play a role in reversing discreet lesions of photoaging. The most recent treatment modality is non-ablative resurfacing, allowing the physician to remodel and control dermal collagen without destructive changes or down time. It fits in well with the other procedures currently used for photoaging skin correction. It is up to the physician to fit this into an individual treatment program where each tool can be used to correct the defects present. Any one tool alone will not give the results needed but by combining these procedures together in a structural approach will accomplish these goals with a safe and effective treatment program with little down time.