In the more than twenty-five years that I have been a board-certified plastic surgeon, a great deal of my time has been spent dealing specifically with skin. Many of the most popular cosmetic plastic surgery procedures are focused, primarily, on keeping the skin youthful and vibrant looking. We use facial fillers to keep it plump and taut, chemical peels to keep it smooth and even, and surgical procedures like facelifts to keep it lifted and wrinkle-free. But despite being the largest and most visible organ of the body, the skin is often overlooked and poorly understood. Just what is it? What does it do and how does it work? Here are answers to some of the most frequently asked questions about skin.
What is the skin made out of?
The skin is actually very complicated, composed of many different specialized cells and structures. Basically, the skin has three distinct layers: the epidermis, the dermis, and the subcutaneous tissue. The outermost epidermis includes an outer layer of dead skin cells that are constantly flaking off and being replaced as newly formed cells are pushed outward. Facial rejuvenation procedures, like chemical peels, work by gently lifting away these exterior dead cells, revealing newer, fresher looking cells underneath. Beneath the epidermis is the dermis, which contains sweat glands, hair follicles, nerve endings and so on. Most of the useful functions of the skin happen in the dermis. Finally, the deepest layer of skin is composed almost entirely of subcutaneous fat. This fat anchors the dermis to the muscles and bones and helps regulate the body’s internal temperature. Over time, the subcutaneous fat in the face can break down, giving the facial tissues a slack and drawn appearance. Facial fillers, like Juvéderm®, use hyaluronic acid, a substance that occurs naturally in young and healthy skin, to replace this fat, giving the face a more plump and youthful appearance.
How does the skin grow?
A full-sized adult has approximately 20 square feet of skin, and in a single inch there are about 650 sweat glands, 20 blood vessels, more than 1,000 nerve endings, and 19 million skin cells. New skin cells are constantly being formed in the deepest part of the epidermis, starting out as fat and square and slowly flattening out as they are pushed to the surface. Every day between 30,000 and 40,000 dead skin cells flake off from the skin’s surface to be replaced by the ones growing underneath. All the skin that you see now will be completely gone and replaced in about one month.
What gives the skin its color?
Skin color is the result of melanin, a pigment produced in the epidermis to protect your body from the sun’s damaging ultraviolet radiation. While everyone has about the same number of cells that make melanin, the amount these cells actually produce is largely determined your genetic heritage. The more melanin your skin makes, the darker the skin appears. Melanin shields the deeper layers of the skin from ultraviolet light, which can cause damage that eventually manifests as wrinkles or even skin cancer. Because people with darker skin have more melanin, they usually don’t get as wrinkly when they get older and are also less likely to get skin cancer. Unfortunately melanin cannot completely block ultraviolet radiation, so everyone needs to protect their skin when they go outside.
It has always been my philosophy that facial aging, while inevitable, can be managed through the gradual and skillful application of a combination of non-surgical and surgical cosmetic treatments and that taking care to keep your skin healthy and vital is an excellent first step. If you are interested in learning more about any of the various facial plastic surgery procedures that I perform or would like to discuss what approach would be best suited to your specific facial rejuvenation needs, I would welcome you to contact my office and schedule a consultation. Don’t forget to connect with me, Dr. Fernando Burstein, on Facebook, Twitter, and Google+ for the latest facial plastic surgery news.