Dr. Gregory Branham

Mark Gilliland Photography 314-9

Summer vacation has ended, the kids are back in school and trips to the beach are over. However, those hours spent outdoors under the brutal sun have wreaked havoc on your face, and your upcoming schedule is booked full of events where you want to look your very best. With a variety of skin resurfacing techniques, Dr. Gregory Branham of Washington University Facial Plastic Surgery Center can help you achieve that glow. “We’re ending the season where we’ve done the most damage to our skin, so it’s an ideal time to repair and correct before winter,” Branham says.

While the sun is a major factor, there are a number of contributors to facial skin damage, explains Branham, a facial plastic surgeon who has been in practice since 1990 (and with Washington University since 2004). The sun degrades DNA in your skin, breaking down collagen and elastin. As another factor, smoking deprives skin of oxygen, so the tissue struggles to live. Genetics and the aging process also contribute to fine lines, wrinkles and discolorations, as hormonal changes during menopause or perimenopause influence the state of your skin. “Things sag or shrivel up, we lose volume or texture, and all of those things contribute significantly to how young we look. People underestimate the effect of smooth, clear skin on the overall perception of healthiness or youthfulness,” he says.

Branham is able to combat those factors with treatments appropriate to the level of damage. While basic spa services like glycolic peels can remove the top layer of dead skin and help moisturizers penetrate deeper, “they are not effective enough to affect long-term fine lines and wrinkles,” Branham explains.

Instead, the practice combines a Jessner pretreatment with a medium-depth trichloroacetic acid (TCA) peel that requires five to seven days of downtime, but will provide greater improvement on those lines and wrinkles and rid you of superficial pigment changes.

Those results also can be achieved through fractional laser resurfacing. Branham uses a carbon dioxide (CO2) laser that treats the face, while leaving microscopic islands of skin behind, allowing for quicker healing and less redness. The laser has two components to it, one of which creates tightening and collagen stimulation in the deeper layers of the dermis, while the other affects the superficial elements. “You’re not resurfacing 100 percent of the skin, so there’s less downtime,” he notes. “Also, lasers allow you to tune to specific areas, allowing for better treatment.”

For those with limited downtime available, the practice offers a non-ablative laser that penetrates the deeper collagen level, while limiting the impact on the surface. “We use that option sometimes for patients with acne scarring, or for males who don’t wear cosmetics like women,” Branham says.

The practice also offers fillers and Botox, along with various surgical procedures for facial rejuvenation. However, Branham makes sure his patients approach the process with an open mind. “It’s a complex process and you can’t correct everything with just one tool. It takes a balanced approach to get you looking better for your particular age—you want to look healthy and normal and not operated on.”

In addition, the doctor stresses the importance of a home skin-care regimen, whether you’re trying to prevent the need for skin resurfacing in a younger patient, or maintaining the results in an older patient. Branham can guide patients through the use of glycolic or alpha hydroxy lotions or topical medications like tretinoin or Retin-A to optimize results.

While technology continues to improve the procedures and techniques available to get you ready for the fall social season, Branham takes a wise approach to the new opportunities. “Being in an academic practice, our mindset is to be critical and look at things analytically. We’re not the first adopters of every technology, but we try to pick and choose what is going to give consistent, great results so our patients can accomplish their goals.”