Very Thin Skin

Some Ways to Restore Facial Fat

I had erbium laser done 2 years ago by a doctor in California. I'm not happy with results. my skin is so nonexistent thin and just will not rebuild.

I'm 30. I'm a model and trying everything to rebuild my skin or try and get back the layers that have been removed

I am trying to have hope. do you have any knowledge or advice for me?

THANK YOU.

Brandi

I'm so sorry to hear of your problem - especially given your career as a model - although this would be devastating for any woman.

I'm a bit puzzled though because I've never heard of this complication with the erbium laser. In fact the erbium laser resurfacing treatment was introduced as a gentler option to the CO-2 laser.

How Skin Resurfacing Lasers Work

Both the erbium and CO-2 lasers work only on the skin's surface and do not penetrate to the fat pads beneath the skin.

One of the main benefits of erbium laser resurfacing over CO-2 is minimal burning of surrounding tissues, so side effects like swelling, bruising and redness are reduced.

Recovery time is short, usually just a week and the risk of dyspigmentation is also lower, so the erbium laser is frequently recommended for darker skin tones.

According to Dr. Elizabeth Tanzi, Co-Director, Laser Surgery, Washington Institute of Dermatologic Laser Surgery, the "most severe complications of erbium laser skin resurfacing treatment" are "fibrosis [formation of fibrous tissue during healing], hypertrophic [bulky] scarring, disseminated infection, and the development of ectropion [outward pulling of the eyelid so that it no longer rests on the eyeball]."

Notice that every risk the doctor mentions occurs on the skin's surface during re-epithelialization (the replacement of the surface layers of skin). None of the complications result in thinner skin.

Thermage Is Reported to Cause the Type of Complication You Experienced

I have however heard of your type of complication from Thermage. Thermage is the use of radio waves to penetrate to the collagen beneath the outer layer of skin. In experienced hands, the radio waves heat/injure the collagen just enough to stimulate it to grow and repair.

In a cautionary article I wrote about the Safety Profile of Thermage I reported the experience of Dr. Benjamin Bassichis, medical director of the Advanced Facial Plastic Surgery Center and Clinical Assistant Professor at University of Texas-Southwestern Medical Center.

In his practice, he was seeing patients who had been allegedly injured by Thermage.

He believed the gaunt or deformed appearance he was observing had been caused by overaggressive Thermage where the radio waves had penetrated to the subcutaneous fat layer and literally melted away facial fat pads.

The deformities could only be rectified by fillers or surgical implants.

Your Options Now

Have you had other procedures, perhaps even Thermage, which might have caused the loss of tissue?

Have you dieted to the point that every bone in your body shows?

Unfortunately, we all begin to lose collagen as we age (usually around age forty). Being bone-thin to model the latest fashions will make any tissue loss even more obvious.

Are you otherwise in good health? If you have any other health concerns such as fatigue, hot flashes, occasional tingling or numbness, see your primary care physician to evaluate your overall health.

If you haven't had a general health checkup in a while, it might be a good idea to schedule an appointment with an internist. Perhaps he will do no more than recommend that you consume more fat in your diet.

It is important to know what caused your thinning skin so that the best course of action can be prescribed. Assuming you are otherwise in good health, I recommend that you consult at least two new specialists.

Make sure they are Board Certified in Plastic Surgery or Dermatology. Find one who is expert in facial reconstructive surgery and one who is expert in less invasive techniques like fillers.

Ask them to evaluate your condition and recommend a course of treatment.

One of the options s/he may advise is nLite laser treatment, which unlike erbium and CO-2 laser resurfacing treatments, does not work on the surface but penetrates to the collagen layer and stimulates growth.

Another option might be injectable fillers and/or surgical implants.

Good luck. I know much more is at stake for you than "mere vanity".

This article does not purport to offer medicl advice.