semisolid food is essential. High-calorie drinks can also be very useful.

60.4.7 Mask Removal on Day Eight (8)

Vaseline should be massaged firmly into the mask hourly five to six times, until it can be peeled off piece by piece. This can be done safely at home as you are not peeling off skin, only the mask. The skin was removed by liquefaction in the first 24 h. This whole procedure takes 6–7 h.

At first there will be many new lines on the skin… “Don’t Panic!” These are not wrinkles, but just indentations from the rigid mask and will resolve completely over the next few days.

The new skin is red initially, but this will pass over the next 8–10 weeks. However, it is a good idea to use plenty of your aqueous cream and consult your beauty therapist immediately for makeup to cover the redness until it resolves. This allows you to get back to a normal life as soon as possible.

Also you should apply the prescription your physician gave to you to prevent unwanted pigment changes and the sunscreen as well. It is important to follow this regime carefully.

In close to 2,000 patients treated over 15 years, we had delayed healing with posterior hyperthrophic scar formation only in two patients. It is interesting to remark technical mistakes that might have contributed to these two complications. Both patients were female. They had past history of previous face-lift. In both there were skin healing problem around the mandible area. In these patients, tumescent solution was infiltrated. This solution is well known by its marvellous effect to promote local anesthesia especially for liposuction. I tried this solution on the face as I thought it could be helpful to avoid local sedation and to reduce the need for postpeeling pain killers. The author feels that the tumescent solution changes local microcirculation and favors deeper absorption with this dangerous consequence. The second conclusion here was to be very careful on patients past facial surgery history as this area around the mandible may be covered by neck skin as the facial surgery lifts and brings up the surround skin. This solution has been used in another case that coincidently had previous mini face-lift, but have had no healing complication by the time of the surgery. This third patient is the only patient who has had discoloration and the skin became much lighter than it was expected.

60.5 Remember

If you have any questions or problems after the procedure or at any time, please contact me or one of our staff.

Dr. ___________________

Dr. Assistant___________________

Nurse:_________________

60.6 Complications

Apart from the excellent and impressive results, the best on Exoderm is the safety. The buffered solution does not penetrate any further than the middermis, so dermatologic side effect reactions like scars or achromia is avoided when the technique is correctly performed. Systemic complications like arrhythmias and organ damage (especially kidneys) are equally not seen here.

60.7 Discussion

Several techniques are available to treat facial aging. Ablative lasers do promote beautiful physical resur-

facing, but in our experience, postop is longer and potential complication like bacterial infection or viral infection is more prone to happen. Ablative laser therapies require antibiotic and antiviral drugs while Exoderm only requires pain killers. The only situation to prescribe antiviral for Exoderm is in case when patient has positive past history for simplex herpes eruption.

Other rejuvenate techniques like botulinum toxin and fillers have a special role in the battle against aging. They can bring patient expressive results but neither of them treats the problem literally speaking, as patients keep inside the same aged tissue.

Exoderm represents an optimal solution to the aging phenomenon. Exoderm is performed ambulatory, under IV sedation. After the eighth day, patient recovery is completed and patient can return to normal activities.

60.8 Conclusions

Exoderm represents the best deep peel solution. The little phenol amount in the formula is not a problem due to the buffer system that autoblocks Exoderm in

the medium dermis. This auto blockage mechanism is responsible for Exoderm security.

Patient satisfaction and long-standing effect have proved the Exoderms goals to be true: preserve long-lasting clinical and histological results (Figs. 60.7–60.9).