IN FOCUS
COOL REFLECTION ON A HOT TOPIC
This page will be devoted to a discussion of a subject that is currently
in the news or particularly of interest and controversial. It will be
changed regularly and hopefully elicit comments.
LASER RESURFACING
Recently touted as a wrinkle panacea, laser treatment of rhytides is indeed effective at lessening their depth and severity. However, the post-treatment redness can persist for weeks or even months and the treatment is not really any more effective than any a well-performed traditional dermabrasion which possesses the same efficacy without the prolonged erythema or redness. Deep (phenol, tricholoracetic acids) and superficial peels (glycolic, pyruvic acids) are alternative methods of attacking the same problem. The former group lessen the skin pigmentation with a "bleaching" effect while the latter do not affect skin color but are less effective and require repeat application.
LIP ENHANCEMENT
Collagen injections into the muscle are frowned upon by the F.D.A but injection at the vermillion border to alleviate fine smoker's wrinkles (perioral rhytides) and mimic a pouty or "Paris lip" are a dependable although temporary (6-9 month) augmentation. Augmentations with implanted materials such as autogenous tendon (the patient's own), fascia lata (the patient's own or someone else's), gortex or other materials are all too frequently eventually accompanied by problematic skin erosions and scarring. The patient's own tissues are better tolerated than those of others or foreign materials, but areas of active motion and scant skin coverage like the mouth are poor places for long-term survival of implanted materials. Complications of these materials are disastrous and difficult to treat. Permanent enhancement with cheiloplasty, in which the patient's own tissue is shifted outwards to make the lips appear fuller, can reliably effect a modest augmentation in a small procedure carried out under local anaesthesia that may be repeated for greater effect. Injectable elastin is being developed for a more permanent, albeilt still temporary, injectable alternative.
COMMUNICATIONS REFORM ACT
President Clinton has just signed the Communications Reform Act which censors free speech on the internet. Protect your First Amendment rights and oppose the institution of roadblocks and tolls on the information superhighway.
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