Latest Technology In Surgery
Delving deep into skin, ageing effects of skin such as dryness, dullness, discolouration, age spots, fine lines and wrinkles is due to changes at the DNA level. Interesting research has been done in these areas:
- Growth factors
- DNA repair enzymes
These help skin regenerate and work in conjunction with preventive measures such as a high SPF sunscreen to prevent further DNA deterioration caused by sun damage.
Growth factors were discovered by Stanley Cohen, biochemist and Rita Levi-Motalcini, neurologist, both were awarded the Nobel prize in Physiology and Medicine in 1986.
Growth factors stimulate cell division. They either interact directly with the genes or stimulate the cell’s own growth factors to enhance cell division. One of the desired outcomes in skin rejuvenation is to increase the thickness of the dermis of the skin. In areas of thin skin, such as lower eyelids, dark circles are more obvious when skin is thin. So if the dermis can be made thicker, dark circles would be less obvious and patients would look fresher. Skin care companies are working on delivering high concentrations of growth factors in a form that can be absorbed by the skin. High integrity growth factors are expensive, and safety of the formulations can be checked with the NICNAS (National Industrial Chemicals Notification and Assessment Scheme).
Sun exposure generates free radicals that can damage DNA. DNA is continually undergoing repair, with the help of DNA repair enzymes. One such enzyme is telomerase. There has been a lot of interest in TAM 818, a molecule that activates the enzyme telomerase. Telomerase is able to slow down the ageing process in cells.
Retinol is a vitamin A derivative, was first revealed by Dr Albert Kligman in 1979 and was proven in 1996 as the only chemical capable of reprogramming cells and normalising skin function. New delivery systems are working on minimising side effects of redness, flaking and dryness.
Laser and IPL
Lasers for tattoo removal used to be the ND:YAG Q switch laser, but now the picoseconds laser technology works more effectively using light and sound energy to fragment the tattoo ink so that the body’s immune system can remove it more completely. It is more comfortable and requires less treatment than the Q switch and can handle all colours with less chance of scarring.
It is dangerous to assume that laser and IPL are quick, painless and have little risk. The ARPANSA (Australian Radiation Protection and Nuclear Safety agency) is currently considering submissions to come up with nationally uniform requirements for education, training and insurance for the use of lasers and IPL, with clear regulation by the government.
With the advent of cheaper machines, many operators who are not medically trained have access to machines without the appropriate training, therefore putting themselves and their clients at risk. Moreover, unlabelled or mislabelled machines may mean that operators are not aware of risks inherent in the machines which can lead to burns in the process of removing tattoos
A recent survey of medical practitioners by the ARPANSA’s Radiation Health Committee working group showed there were 62 cases in a 12 month period in which a diagnosis of skin cancer was missed because a pigmented lesion was incorrectly treated with IPL or laser. Of the 62 cases, there were 22 cases where diagnosis of melanoma was missed or delayed.
Plastic surgeon Dr Sawjin Tew has worked on the Northern Beaches since 2001 and has privileges at Manly District Hospital, Mona Vale Hospital, Warringah Day Surgery, Castlecrag Private Hospital and North Shore Private Hospital. Phone 94112266 or visit drtew.com.au