The rehabilitation period for a cosmetology patient

Olga Lukina,dermatocosmetologist, leading specialist at Laura Beaumont (Ukraine, Kyiv)

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Rehabilitation is the most important step, without which the work cannot be completed. Due to damage to the epidermal barrier, transepidermal water loss increases significantly, which leads to a violation of the water-electrolyte balance in the skin and its dehydration. In addition, even with a strictly observed procedure technique, there is a risk of developing a number of side effects and complications, such as persistent hyperemia and desquamation, post-inflammatory hyperpigmentation, seborrhea, exacerbation of herpes infection.

Given the relevance of this point, I propose to dwell in detail on the restorative procedures most often performed by a cosmetologist during the client’s rehabilitation period after plastic surgery and other aesthetic invasive interventions.

Objectives and features of recovery procedures

With the help of rehabilitation the following results are achieved:

• optimal conditions are created for rapid and favorable postoperative tissue healing;
• resorption of edema and hematomas is accelerated;
• discomfort and psychological stress are reduced.

So, the goal of rehabilitation procedures is to reduce the recovery time of the body, prevent and treat side effects, and help the patient return to their normal lifestyle faster.

An important condition for successful skin restoration after damage is the use of products that provide the skin with a protective function during the regeneration period. The ongoing loss of fluid from the surface of damaged skin contributes to its drying, tightening and itching. Dehydration, in turn, prevents normal healing, since this process occurs faster in a humid environment. Not so long ago, recommendations included the use of medical petroleum jelly in the early stages of re-epithelialization, which, by creating a moisture-proof barrier on the skin surface, stops transepidermal water loss, thereby maintaining the necessary water balance. However, this property - to block TEWL - also inhibits the response aimed at restoring the skin. In addition, according to electron microscopy, petroleum jelly penetrates the upper layers of the epidermis and disrupts the structure of lamellar bodies. The latest generation of protective external agents - Moisturizing restorative gels create a physiological “breathing” film on the skin’s surface, which not only prevents water loss from the skin and retains moisture in the upper layers of the epidermis, but also does not disrupt the natural processes of skin restoration.

To prevent the development of pigmentation, it is recommended to avoid exposure to the sun throughout the entire course of treatments and completely avoid visiting solariums. It is necessary to use sunscreens daily, regardless of the season, with a protection factor (SPF) of at least 30. In case of damaged skin, the best option for protection from sun rays is products with inorganic filters based on zinc oxide and titanium dioxide. These substances do not penetrate the skin, are chemically inert, practically do not cause allergic reactions and are able to effectively reflect ultraviolet radiation. In order to prevent hyperpigmentation, it is better to exclude cosmetics containing photosensitizing components from your daily skin care products: bergamot, orange, lemon, bitter orange, cinnamon, lavender, licorice oils, St. John's wort and clover extracts.

Priority actions

The first problem observed after procedures with a violation of the integrity of the skin is inflammation. Remember: rubor tumor calor dolor functio laesa - redness, swelling, heat, pain and dysfunction. To reduce the severity of these reactions, restorative care should include:

• moisturizing,

• restoration of the epidermal barrier,

• prevention of infection.

NB! During the early recovery period, the patient should not use cosmetics containing glycolic acid, as this may lead to deeper damage to the skin.

The treatment is carried out according to the principle of "wet - treat wet, dry - dry".

In the first days, external treatments are prescribed in the form of solutions, liquids, foams, antiseptic dyes, lotions. As soon as epithelialization occurs and the weeping and erosion disappear, we switch to cosmetic preparations in the form of a cream.
Depending on the severity of inflammation, creams may contain steroid hormones, regenerating substances (placenta, panthenol, retinol, bisabolol, zinc, azulene), components that restore the water-lipid mantle (shea butter, phospholipids, ceramides, omega-6, waxes), hyaluronic acid - an indispensable assistant that will moisturize the skin and accelerate regeneration, as well as vitamins and antioxidants that inhibit lipid peroxidation and, as a result, prevent the appearance of post-inflammatory hyperpigmentation. Masks are an excellent means of moisturizing and restoring the skin. They can be based on collagen, kaolin, almond oil, vitamin E (for example, Collagen Mask Laura Beamond, Intense Revitalizing Mask Spa Abyss, Porcelan Mask Сhristina), as well as spirulina, menthol, white clay, which is a natural antiseptic (for example, cryomask Cold Mask Laura Beamont, Cooling Mineral Mask DR. Spiller, Firming Stimulation Algae Mask Сhristina).
Often, if you neglect to conduct an allergy test before peeling, you can get a complication in the form of an allergic reaction. In such cases, antihistamines, calcium preparations, sorbents, external lotions and steroid ointments are prescribed.
If asepsis and antisepsis are violated, wounds may become infected with pathogenic microbes. To resolve such complications, antibiotic-containing medications are prescribed internally and externally.

Hardware rehabilitation

The next stage of rehabilitation is hardware cosmetology techniques and manual massage, which can restore local blood circulation, accelerate the resorption of hematomas and edema, improve lymph flow, and free the body from damaged cells and toxins. Manual lymphatic drainage enhances the effect of facial care procedures, as it stimulates lymph circulation, improves metabolism, and cleanses subcutaneous tissues. Lymphatic drainage provides a modeling and lifting effect, relieves swelling, increases muscle tone, and improves complexion. One of the important advantages of this technique is relaxation. The rhythm and lightness of the pressure characteristic of this technique contribute to the relaxation of not only the face, but the entire body. It is recommended as the main technique for recovery after plastic surgery. Microcurrents and ultrasound are in first place among hardware corrections.

Microcurrent therapy.

The technique is optimal for relieving postoperative pain and reducing swelling. Its essence lies in the complex effect on the body of pulses of electric current of ultra-low frequency. Dermatocosmetologists recommend using microcurrent therapy after any plastic surgery, especially after a circular facelift or blepharoplasty, since in these cases manual massages are contraindicated. The main advantage of microcurrents is the ability to remove toxic substances and excess fluid from the skin. As a result, swelling and bruises decrease and disappear, skin tightness goes away. Due to the increased metabolism, the process of skin rejuvenation is activated and muscle tone improves. This accelerates tissue healing processes, improves metabolism, and restores the physiological activity of damaged cells.
Even a couple of such procedures can reduce the recovery period by about a third, but in general the course involves 7-15 sessions, the frequency of which is selected individually. The simplicity of the method, a small number of contraindications, and high efficiency determined the wide application and great popularity of microcurrent therapy in the field of aesthetic medicine.
Darsonvalization. Darsonval currents - high-frequency currents of weak power - are one of the classic methods of physiotherapeutic treatment. In cosmetology, darsonvalization is used as a rejuvenating, regenerating procedure. Passing through the tissues of the face, Darsonval currents cause improved blood circulation and stimulation of metabolism. Darsonvalization in various areas of the head and neck can help reduce pain and improve blood circulation. Darsonval currents are usually used in combination with other restorative procedures.

Ultrasound therapy

Under the influence of high-frequency sound vibrations, local tissue heating occurs, which causes acceleration of metabolic processes. This provides an anti-inflammatory and analgesic effect, improves peripheral blood circulation and resorption of scars. The procedure takes 10-30 minutes. The course is designed for 12-15 sessions, held two to three times a week.

Relaxation treatments

Any invasive intervention is stress for the body. Relaxing procedures help to overcome the feeling of anxiety, loneliness, and insecurity that can accompany plastic surgery and deep peeling: lymphatic drainage massage, classical massage, stone therapy.

Injection methods and microneedling

2-4 weeks after radical aesthetic procedures, it is time for more global skin restoration using mesotherapy and biorevitalization. Injections of vitamin cocktails and hyaluronic acid-based preparations are needed for rapid tissue regeneration. The desired effect is achieved not only due to the pharmacological effect of the components, but also due to stimulation of the skin by mechanical action with a needle.
At the final stretch of rehabilitation, such issues as correction of scar elements after surgical plastic surgery, removal of skin lesions, laser resurfacing, complications after deep peelings arise. It is very important to explain to patients that it is unacceptable to tear off crusts, as this can lead to the formation of a rough scar.
In case of formation of keloid and hypertrophic scars, cryotherapy is recommended - cryodestruction, which allows to effectively reduce the volume of scar tissue, as well as triamcinolone injections, which are carried out once every 10-14 days, the use of silicone patches, laser correction.
Mesorollers have proven themselves to be excellent in the treatment of hypotrophic scars - a unique medical instrument that ideally meets the requirements of non-surgical and non-ablative (without destruction of tissues or their individual structures) treatment of various skin diseases, as well as in methods of combating age-related skin changes (wrinkles, folds) and for restoring hair.

Clinical studies have shown that the use of a mesoroller is more effective than peeling, CO2 laser, dermabrasion and radiofrequency stimulation methods for reproducing collagen and elastin in skin tissues, allowing you to thicken the skin and thereby "erase" wrinkles, smooth out scars and marks.

The principle of microacupuncture acupuncture is that small needle pricks create localized irregularities in the dermis, which in turn are recognized by the body's defense system, and it sends fibroblasts to them. Fibroblasts secrete precursors of collagen and elastin proteins, are the primary "repair" material of the skin and are always present around various damages and irregularities of the skin, where they are converted into collagen and elastin and ultimately build up a completely new layer at the site of damaged tissue, which "supports" the damaged tissue. skin from the inside, thereby smoothing out wrinkles and smoothing out scars and cicatrices, leveling the surface layer.
The mesoroller has another undeniable advantage over other systems and methods: it creates a large number of microchannels on the skin, through which, bypassing all barriers and obstacles, any active substance can be introduced into the skin. In other words, medications and cosmetics are introduced intradermally with the mesoroller and, thus, act much more effectively than with the usual method of use. Complex cocktails with peptides and oligopeptides (a group of organic compounds consisting of two or more amino acids that are linked together by a chemical bond called a peptide bond and are ideal for the desired DNA - for example, nanospherical mesococktails MesoActive from TM SPA Abyss, glycosaminoglycans from TM Plazan, Meso-Cocktail from TM Hikari), amino acids, hyaluronic acid, enzymes, plant extracts (therapeutic concentrates of Laura Beaumont dermocosmetics), etc. penetrate the dermis much easier, correcting various changes.

Psychological preparation
And finally, perhaps the most important moment of rehabilitation is psychological support for the patient. Of course, the success of a quick recovery depends on the technique, the scope of intervention, the constitutional characteristics of the person, the general condition of the body and preoperative preparation, during which it is possible to correct, reduce and, possibly, prevent various unpleasant components of the rehabilitation period.
Special attention should be paid to the psychotherapeutic preparation of the patient, since any traumatic procedure causes stress. It is necessary to tell the patient as fully and reliably as possible about the upcoming manipulation, about all its features, without saving time on the consultation and without thinking that in front of you sits a person who is unable to understand the terminological nuances. Today, with the richest information base, the patient, as a rule, comes to the appointment quite prepared and informed, therefore the doctor's "arrogance" will only hinder the establishment of contact with him. Positive attitudes, information support, paying attention to positive dynamics, results, efficiency, wishes for a good day and mood - and miracles of transformation of our dear clients will not keep you waiting.

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First published: KOSMETIK international journal, №4/2013, pp. 66-69