Visage®-The New Face of Wrinkle Reduction

Until now, your choices in wrinkle reduction ranged from a light "touch up" procedure like microdermabrasion, to chemical peels, to laser treatments for deeper wrinkles. We now offer another alternative-Visage, a procedure that gently removes damaged skin, allowing fresh, new skin to regenerate. Visage is a proven procedure, cleared by the FDA for wrinkle reduction, that we can customize to give you just the amount of improvement you want. Now, the results you want can be achieved with a single Visage procedure.

Unlike lasers, which work by burning off the top layers of skin, Visage uses the unique "Soft Touch" wand to dissolve away only the skin cells necessary to achieve the results you want. This gentler procedure causes less damage to the skin cells that surround the treatment area which means a quick recovery period-usually 5 to 10 days after the procedure-so you can return to your normal activities sooner.

Visage is performed under local anesthesia on an outpatient basis in our office. The procedure itself takes 15 to 45 minutes depending on the amount of improvement you want and the areas of your face that will be treated-around the eyes and mouth or the full face.

Within a month, you'll see visible improvement in your skin. Within 3 to 6 months, even more dramatic results are seen and many patients report that their results continue to improve, and improvement may continue as time goes on. In clinical studies of patients with fine to moderate wrinkles, both the patients and their doctors have been impressed with the amount of wrinkle reduction. 

If you have considered reducing your wrinkles, but were uncomfortable with the harshness of laser treatments, the advantages of Visage may make it the right procedure for you. Please call our office for a consultation and let us show you the impressive results that other patients have achieved with Visage. 

About wrinkles

Wrinkles form when the internal structures of the skin break down.  The outer layer of the skin is called the “epidermis.” Wrinkles can be seen on the epidermis but they are primarily caused by changes in a deeper layer called the “dermis.”  Certain connective tissues called “elastin” and “collagen” fibers are located in the dermis.  In young skin, elastin and collagen fibers keep the dermis filled in and firm. This makes the epidermis look very smooth.  With time, though, the elastin and collagen fibers naturally break down, resulting in wrinkles.

Causes of wrinkles

Many factors enter into the development of wrinkles, such as:

• Natural facial movements, like smiling, laughing, or frowning
• Genetics. In general the lighter the skin the more rapidly wrinkles form
• Environment. A number of environmental factors can accelerate the breakdown of elastin and collagen fibers. These include:

o        Ultraviolet rays – either from the sun or indoor sources such as tanning booths

o        Cigarette smoking

Reducing wrinkles

Most wrinkles are the result of the breakdown of elastin and collagen fibers in the dermis, or deeper layer of skin. The best way to effectively reduce wrinkles is to cause new growth of collagen in the dermis.  Studies have shown that the only way to effectively reduce wrinkles is to disrupt or damage the skin cells in the dermis.  The skin cells in the dermis respond to the damage by producing new collagen fibers that fill in the dermis more fully, thus reducing wrinkles.

Wrinkles cannot be significantly reduced by using moisturizers or over the counter skin creams and ointments because they only affect the epidermis, and not the dermis.

About Visage

The unique Visage procedure uses a state-of-the-art technology called Coblation®. Radio frequency energy is combined with natural saline solution through the use of a Soft Touch™ Wand.  As it passes over the skin, it gently removes the epidermis. Then, in a very carefully controlled manner damages the skin to start a healing process in the dermis.

Visage can be customized to your own individual needs.  It can be done on your entire face or just in certain areas, such as around your eyes or mouth. Your physician can also vary the energy level of the procedure as well as the number of times the Soft Touch Wand™ is passed across your skin. This will depend on the amount of improvement you want.

Clinically proven wrinkle reduction

In order to determine the effectiveness of this procedure, a six month study with 95 patients was conducted. Some of the most prestigious academic institutions in the United States took part in the study, including the Yale University School of Medicine, the University of California at San Francisco, and the University of Minnesota Medical School. Patients, physicians, and an independent panel of experts evaluated the results.  All three groups reported a significant improvement in wrinkles.  As a result of this study, FDA cleared Visage in March 2000 for the reduction of wrinkles.

Visage vs. laser skin resurfacing

Lasers vaporize skin cells by heating them to very high temperatures (400ºF to over 1,000ºF).  As a result, they can damage the healthy skin cells that are next to the ones being targeted. With Visage, Coblation® technology causes skin cells to gently separate from each other at temperatures much lower than that of lasers (165ºF to 195ºF) with very little damage to nearby healthy skin cells.  Doctors think the heat level applied to the skin directly affects the healing process. While lasers are effective at reducing wrinkles, many patients are not willing to undergo the long recovery period that follows. With Coblation technology, the lower levels of heat result in a quick recovery period as well as effective wrinkle reduction.

Visage vs. chemical peels

Chemical peels employ an acid and work by burning skin cells, which then peel off.  These peels can be effective at reducing wrinkles, but the results tend to be less predictable and can sometimes be uneven.   Also, with some types of peels, the skin can appear as if it had been “bleached” when compared to untreated areas. Visage, on the other hand, creates even results with smooth skin tones.

Candidate Guidelines

Although Visage has been cleared by the FDA for the reduction of mild to severe wrinkles, not everyone is a good candidate for the procedure.  In general, Visage is not for people who: 

§         Have a pacemaker or other electronic device implant

§         Are pregnant or lactating

§         Have a history of hypertrophic scarring or keloid formation

§         Have used Accutane within the past twelve months

§         Have current skin infections in the treatment area

§         Have skin diseases such as psoriasis or autoimmune disease in the treatment area

These are general guidelines.  Only a qualified and trained physician can determine whether or not you are a candidate for the Visage procedure.

The Visage procedure

The Visage procedure is performed in a physician’s office with local anesthesia, that is, medicine to numb the skin in the area to be treated.  The whole procedure usually takes from 15 to 45 minutes, depending on the amount of improvement you want.

Before the Visage procedure

Usually doctors like for their patients to spend about a month preparing their skin for the Visage procedure. This will give you the best possible results. In all likelihood, you will be asked to use the following creams:

§         Tretinoin cream – four times a day to ensure your skin is as clear as possible on the day of your procedure

§         Sunscreen (SPF 15 or higher) – to be used daily

On the day of your treatment, or a few days earlier, your physician will prescribe an anti-viral to minimize any risk of infection or post-procedure skin outbreaks.

After the Visage procedure

Your physician may choose to cover the treated area with a dressing. If so, keep the dressing clean and dry. Do not change it unless your doctor directs you to do so.

Some doctors prefer using an ointment instead of a dressing. Be sure to clean the treated area and replace the ointment frequently so the skin does not become dry.

In addition to taking good care of your skin as it heals, for the first few days after the procedure be sure to:

§         Keep your head elevated with two to three pillows to reduce swelling

§         NEVER scratch the treated area.  If it itches, call your physician who will prescribe medicine to relieve the itching

§         Take recommended pain medicine as necessary

§         Take all of your prescribed medicines

§         Avoid intense sunlight

§         Avoid strenuous exercise, bending, straining, stooping or lifting heavy objects

§         ALWAYS CALL YOUR PHYSICIAN if you experience any problems or have any questions

Healing, Recovery and Results

Quick recovery is one of the key benefits of the Visage procedure.  Typically, the outer layer of your skin, or epidermis, will regenerate within five to ten days, leaving you with a fresh, new layer of skin.  How quickly your epidermis regenerates will depend on the amount of treatment as well as how quickly you typically heal as an individual.

Once your epidermis regenerates, you can use make-up to conceal any residual pinkness you have as a result of the procedure. 

Within a few weeks of the procedure, you will enjoy the benefits of having a fresh, new layer of skin.  Because the healing processes in the deeper layers of skin take time, you will notice the most dramatic improvement in your wrinkles between three and six months after your procedure.  Many patients report that their results continue to improve further as time goes on!

Although you can expect results after a single Visage procedure and the results are long lasting, you may choose to have the procedure again in the future if you so desire.