Dr Gavin Sandercoe

Croton Oil Peels

Croton Oil Peels in Sydney

 

Patients investigating facial rejuvenation in Sydney should be educated that there are two aspects to facial rejuvenation. The first is reversing the changes of gravity (folds)– most of which can be addressed through surgery. The second aspect that needs to be considered is the fine wrinkles – skin changes caused by the sun, dehydration, smoking, chemicals.


 

A lot of gains can be made through surgically addressing facial ageing – lifting sagging neck & jaw lines through a face lift (also termed a lower facelift, or neck lift), lifting a sagging cheek & lightening a heavy nasolabial fold by a midface lift and or fat transfer, enhancing the appearance of the upper and lower eyelids through blepharoplasty and adjunctive eyelid procedures, lifting a heavy brow through the various browlift procedures that are available. Surgical procedures address gravity related folds, but cannot address the finer wrinkles that will still be present when the post operative swelling resolves. Pulling harder on finely wrinkled skin does not smooth out these wrinkles!

Fine wrinkles that develop with ageing can partially be avoided through good skin care during your life. Staying hydrated, never getting over exposed to the sun, never smoking are all good starts. In the Sydney climate & culture, whom of us manages to stay hydrated and untanned throughout their life? The best that most of us can manage is good skin care, through using quality ingredients and judicious use of topical Vitamin A at night, such as found in the Aspect Dr range.

Some of us have bad luck with our skin, and trial many different (and reputable) brands before settling on a brand that works for our own skin. This trial & error process can be time consuming, and our skin can sometime change on us, such as at times of hormonal influence (adolescence, pregnancy, menopause) or illness, requiring further manipulation and changes of skin care options.
 
Once these fine wrinkles are developed, there are very few options to reverse them easily. High strength Vitamin A creams (to be used at night only) will have some effect. Microdermabrasion and lighter peels will have some changes, but are likely to be short lived and require frequent re-treatment to maintain the improvements.
 
A few options exist to attempt to address these fine skin changes with longer acting results – dermabrasion, laser and peels are the most common. All of these options are technique dependent and big results require longer downtime and greater risks. Disappointed by the variability in results seen with fusion laser (combined ablative and fractional) laser treatments, Dr Gavin Sandercoe attended the Centrofacial Rejuvenation Workshop in December 2016 specifically to learn about croton oil peels from the internationally recognised expert in the field. He was the only Australian Specialist Plastic Surgeon attending this internationally acclaimed course.
 
Deep chemical peeling, such as the Gordon-Baker peel, has been the gold standard in skin resurfacing since the 1960s. This peel formula produced some striking results, but required courage & faith to perform, as it was well known for an ‘all or none’ skin response. Even in experienced hands, it was known to produce hypopigmentation (loss of colour or tan in the skin) and an unnatural waxy skin response in some patients. This wide variability in skin response lead to the peel largely falling out of favour with Plastic Surgeons in Sydney, and mostly being offered only to elderly patients with very sun damaged skin.
 
The loss of the Gordon-Baker peel from the armamentarium of Sydney Plastic Surgeons lead to the expansion of other types of peels and laser treatments in an attempt to deliver similar results.
 
From early 2000, Gregory Hetter (later joined by Richard Bensimon) began analysing the components of the Gordon-Baker peel and identified croton oil as the critical ingredient in peeling and rejuvenation of the skin. The classical Gordon-Baker peel formula created a croton oil concentration of 2.1%, which we now know is too high for a safe peel. Through the application of varying concentrations of croton oil to different areas of skin on the face, a skilled Plastic Surgeon can deliver safe but visible results for patients in Sydney. This type of peel can be applied to a wide variety of ages and skin types.

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