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Tattooed Face

I was shocked to read this story in the news of a Belgian teenager who was tattooed over her face whilst apparently sleeping through the procedure!

She alleges that she only wanted 3 stars, but ended up with many more.

She and her family are suing the tattoo artist for $18400, the apparent cost of removing the tattoos.

Laser tattoo removal can be performed on a case such as this, and fortunately, for this girl, there are a few things about these tattoos that make it favourable for laser removal;
- It is black – black is one of the better colours to remove as there is a good contrast between this colour and her normal skin. Also the lasers are highly attracted to black. Other colours such as white and green may be harder to remove . We usually use our Ruby laser to remove green tattoos and this works well. White ink on the other hand tends to oxidise and turn black initially, and then takes longer to remove.
- It is on her face - Believe it or not, but the face actually heals better and faster with a smaller chance of scarring than the body when it comes to laser. We find this to be true not only for laser tattoo removal, but also from laser skin resurfacing or laser freckle removal. I recently removed a tattoo from a man’s face, and it was amazing to see how ‘normal’ the skin appeared after it came off.

In the end, this tattoo is likely to take more than one year to remove, and over 10 sessions of laser treatment.

I wish this girl the best for her treatment.

We have been testing the fractional carbon dioxide lasers on a few patients in the past weeks with some good results so far. We have found that the results have been excellent for skin texture / wrinkles and pigmentation and the downtime is usually less than one week. Overall, the results achieved with such little downtime is a testament to the new technology.

I have posted a picture of my hand 6 days after a single shot of fractional carbon dioxide laser. You can see the columns of laser treatment within the square treatment zone. The skin in between the columns is the skin that is unaffected by the laser, and this helps the skin to regenerate faster. I would expect even faster recovery times for the face – the hands usually take about twice as long to recover from laser treatments normally.

A patient recently came to me and asked me ‘Doc, just make me look better…’. This patient just wanted to look refreshed and revitalised, but didn’t really exactly what could be done or what they wanted. I started discussing some ideas including the possibility of some dermal fillers when the patient asked me, ‘but how will this make me look better?’

It was the answer to this question that prompted me to write this blog entry…

So, this is what I told the patient;

Basically, there are a few aspects to facial ageing that should be addressed in order to achieve a more refreshed and revitalised appearance.

Firstly, there is the issue of volume. Volume is gradually lost from our faces as we get older (unlike our bodies which tend to get fatter!). Volume loss can occur in any part of the face, and can be due to reduction in fat in the face as well as bone resorption. We usually see it in areas like the cheeks, lips, and brows. Volume can be replaced in the face through many methods. Dermal fillers are one of the most common and simple methods of replacing lost volume in the face, and this can be done as a simple office procedure. Other alternatives include fat transfer from other parts of the body to the face. This is a more involved procedure as it does require the patient to have liposuction first to harvest the fat for injection, but the longevity of this treatment tends to be longer than most dermal fillers.

Secondly, there is the skin. The skin is the drape that covers the face and its appearance is paramount to someone’s perceived age and appearance. UV radiation from sun exposure or solariums increases the rate of skin ageing, pigmentation problems and wrinkles. To improve the skin itself, there are number of things that can be done. Lasers can be used to remove specific problems such as broken capillaries, sun spots / pigmentation, and wrinkles. Also good skin care including a good topical retinoid and sunscreen are important to maintain the skins appearance. Anti-wrinkle injections are also a good method of helping to stop expression lines and creases such as those around the eyes and between the brows.

Thirdly, there is the effect of gravity on the face, which causes the face to sag. This leads to a descent in the cheeks, jowl formation, the formation of folds from the nose to the mouth (nasolabial folds), and a more square appearance to the face. In most cases, a surgical procedure is required to properly correct this descent. Face-lifting and brow lifting are examples of these surgical procedures.

So it is important to address all of the above three aspects of facial ageing when rejuvenating the face. Addressing one of the three issues without the other can sometimes lead to an unusual appearance. We all know of Hollywood stars who still look their age despite having a facelift (or two). The reason for this is that often the issue of volume loss hasn’t been addressed, so they are tight, but not full like a younger person would be. Similarly, addressing facial sag and volume without addressing the skin can also create an appearance that is inconsistent. Ima1gine a person with a youthful shaped face, with lots of sun spots, broken capillaries, and wrinkles!

Usually a specialised cosmetic doctor is the best person to advise you on what you might need. We can tell you where you are doing well and which parts might need to be addressed. Good facial rejuvenation will make you look refreshed and revitalised … naturally!

The carbon dioxide laser skin resurfacing first emerged in the 1990s and was hailed as a revolutionary means to rejuvenate the face. To this day, it remains as the ‘gold standard’ for facial skin resurfacing, but then why is performed so uncommonly by only a few doctors? Although the results from carbon dioxide laser resurfacing are second to none, the recovery period, especially in today’s society, has been deemed to be unpalatable by most people. Recovery periods after carbon dioxide laser resurfacing can range from weeks to months depending on the intensity of the treatment performed. In today’s society, where time becoming increasingly valuable, people are reluctant to undergo such a procedure. Furthermore, risks such as scarring and hypopigmentation (excessive whitening of the skin) were common.

More recently, fractional carbon dioxide lasers have emerged to help strike a favourable compromise between obtaining results and reducing the recovery period required. You may have heard of lasers such as the Fraxel laser which was one of the pioneer lasers to use fractional technology. Fractional lasers are aptly named as they only treat a ‘fraction’ of the skin. They fire small columns of laser energy into the skin and leave the skin adjacent to these columns untouched, and this allows a quicker recovery whilst still producing good results within the skin.

Fractional carbon dioxide lasers are the latest in the generation of fractionated lasers and will possibly be the new way to resurface skin, reduce wrinkles, and acne scarring.

At The Victorian Cosmetic Institute, we are in the process of evaluating the various machines available and will be getting one in the next few months based on our research.

For more information on skin resurfacing, visit our webpage on this topic by clicking on the link below;
http://www.thevictoriancosmeticinstitute.com.au/skin-resurfacing/