On energy-based “rejuvenation” technologies

Some stories are too good to be true…
Some are short-lived, like first love.
Still, we hold on to the impossible, our souls will not find peace without tasting it, even if our minds say otherwise.

Medical LASERs, which are the ancestors of energy-based facial rejuvenation applications, were very cool and are still used successfully in many fields of medicine. However, the story in plastic surgery was a little different…

Come and listen to this story from me;
It’s the 1980s, star wars movie series is playing in the cinema, lightsabers, laser guns, everyone is in control of the concept. We don’t know exactly what it is, but we’re sure it’s something very technological, and something technological can’t be bad…

Laser devices took their place in the field of aesthetic surgery in a very short time, in the mid-80s. The skin is treated with laser, a controlled burn is created, and after a few weeks of healing, the skin renews itself, resulting in a refreshed, healthier-looking and wrinkle-free skin. Medical lasers are still one of the most important tools at our disposal in the treatment of spots on the skin, the treatment of unwanted hair, and the treatment of vascular lesions.

However, our experience in facial rejuvenation has not been what we expected in the long run. Over the years, patients began to complain that the skin in the application area became thinner, dry and unhealthy. What happened, in the months and first years following the treatment, when everything was so good, the spell was broken. Patients who were very satisfied with the treatment and had it repeated several times in the same area became more victimized in the long run.

This phenomenon is very important to the prospective patient seeking facial rejuvenation, so focus your attention. Go get a tea. I’ll go into the medical part a little more and try to explain it in an understandable language.

Here’s what we’ve learned in research over the years. The laser beam creates controlled heat damage—that is, a burn—in the deep, vascular and living layer of the skin, which we call the dermis. A healing process begins in this burn area, as we observed in other burns. During the healing process, the blood supply to the area increases, the cell cycle on the surface accelerates, and the healing cells that migrate to the burn area produce the protein we call “collagen” in abundance here. In fact, this tissue production is such that the skin looks thicker, more vibrant and healthier than before during the healing phase. The key point here is: Since recovery is a process that takes a very long time, these effects that we observe from the outside continue for up to 18 months as long as the healing process continues. In fact, when we repeat the application before the end of 18 months, we re-create the damage and rewind the process.

The problems start when the healing process is over. Vascularization decreases, skin thickness decreases, the number of sweat glands and sebaceous glands that regulate the moisture and oil balance of the skin decreases. Most importantly, the protein called “elastin”, which provides the elasticity of the skin, is permanently reduced and the skin permanently loses its elasticity. We mentioned that the body piles the “collagen” protein into the damaged area. However, this “collagen” is not as organized as in healthy skin. If the collagen in a healthy skin is a “lambswool” sweater, the newly produced collagen in the skin in the healing process can be compared to two sweaters left on the table. In the final stages of healing, specialized cells make a coarser and finer weave from this wool ball than the original, but this new weave never reaches the quality of the original. The result, unfortunately, is a skin that has lost its vitality permanently… Loss of vitality is called “atrophy” in medicine.

These are the reasons why I am skeptical and do not include in my own practice laser, radiofrequency, ultrasonic energy, concentrated light technologies and all technological devices that apply “energy” to the skin and thus create “heat damage” in the skin or subcutaneous tissues. This observation, which is the basis of my skepticism, remains valid even in the case of “sunburn”, which is the simplest and most basic example of the heat damage mechanism.

Remember and imagine going on vacation and getting a tan. That summer, your skin shines brightly in the mirror, it looks more tense, bright, voluminous and healthy. This effect is so satisfying that high society beauties of a period used to go to the solarium and continue to tan in the winter months. Studies and observations have shown that the signs of aging appear earlier and the skin damage is more serious in individuals who are exposed to the sun’s rays more during their youth. When two twin sisters, one living in sunny “Miami” and the other living in “London” where the sun rarely shows up, come together at age 50, the more heavily sun-exposed Miami twin will look at least one 10 years older than her London twin sister. .

While plastic surgeons and dermatologists all over the world recommend protecting from the sun and using sunscreen for our face even when there is no sun, I see the cosmetic industry’s effort to rejuvenate the skin with technologies that cause heat damage to the skin as a modern contradiction of aesthetic surgery.
My advice is do not become a candidate for any application whose long-term results have not been filtered by science and for which there is insufficient evidence to show its effectiveness and reliability. Let’s follow the technology a little behind.

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