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The Steering Committee
Alastair Carruthers, MD, FRCP(C)
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Glossary

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

Actinic keratoses (AKS)
Dry, scaly, rough, red-brown patches or lesions that form on the surface of the skin after years of ultraviolet light exposure, such as sunlight. Lesion size ranges from that of a pinhead to larger than a quarter. Occasionally, a lesion grows to resemble an animal horn and is called a "cutaneous horn." Untreated, AKS may become malignant.


B

Beta-lift peel
Lifts the topmost layer of skin by dissolving the "glue" that holds it to the epidermis, triggering a "burst" of cell division, which increases skin cell production and shedding. Salicylic acid peels are often more intense than the glycolic acid peels.
Blepharoplasty
Eye surgery that removes fat, excess skin, and muscle from the upper and lower eyelids. This procedure can correct drooping upper lids and puffy bags below the eyes.
Botulinum toxin type A (BoNTA)
Purified substances from bacteria that block muscular nerve signals. Very small amounts are injected into facial muscle, temporarily weakening the muscle and diminishing unwanted lines in the face. BoNTA is also used to treat hyperhidrosis. See also: Botulinum toxin type B.
Botulinum toxin type B (BTX-B)
Purified substances from bacteria that block muscular nerve signals. Very small amounts are injected into facial muscle, temporarily weakening the muscle and diminishing unwanted lines in the face. BTX-B is also used to treat hyperhidrosis. See also: Botulinum toxin type A.


C

Chemical peel

Resurfacing of the skin with a chemical solution that removes dead skin cells and stimulates the production of new cells for smoother skin.

  • Glycolic acid peel
    Diminishes the cohesion of the skin cells at the innermost levels of the surface. It stimulates this layer of skin, thickening the skin and introducing new epidermis and dermal collagen. This process will result in skin shrinkage, reduced wrinkling, and softening of "crow's feet." It also helps to lighten hyperpigmentation.
  • Salicylic acid peel
    Lifts the uppermost layer of the skin by dissolving the "glue" that holds it to the epidermis, triggering a "burst" of cell division, which increases skin cell production and shedding. Salicylic acid peels are often more intense than glycolic acid peels.

 

Chemodenervation
A process involving the injection of substances into the skin to relax spastic muscles, interrupt nerve impulse pathways, and prevent communication between neurons and muscle tissue.
Collagen
Major fibers of protein found in the skin that give the skin its strength and resilience.
Collagen fillers

Gel-like substances derived from purified human and/or bovine skin that is used as a plastic surgery technique to correct wrinkles, depressions in the skin, and/or scarring.

Columella

A portion of the nose between the nostrils. Fixing a droopy nose, where the columella faces downward, often involves re-orienting the "attitude" and direction of the columella.

Crow's feet
Fine lines around the eyes often caused by sun exposure. Smoking also contributes to their formation.


D

Dermabrasion
A surgical procedure in which scarred skin is frozen and then removed using a high-powered rotating brush.
Dermal fillers
Substances used to "plump" and minimize wrinkles, furrows, and hollows in the face, correct depressions and scars, and enhance the lips. Filler substances include collagen, fat, hyaluronic acid, plastic microbeads, and liquid silicone.
Dermalogen
A product derived from human donor tissue that is used in lip augmentation to produce a look of fuller lips.
Dynamic rhytides
Wrinkles and furrows caused by facial expressions such as frowns.


E

Elastosis
Degeneration of elastic tissue.
Endoscopic thoracic sympathectomy (ETS)
An outpatient surgical procedure that treats hyperhidrosis and is performed under general anesthesia through one or more small insertion incisions.
Eutectic mixture of local anesthetics (EMLA)
A topical anesthetic cream (2.5% each lidocaine and prilocaine) that provides neuralgia pain relief by causing loss of cutaneous sensation through reversible blockade of conduction in nerve fibers.


F

Fat fillers
A plastic surgery technique used to correct wrinkles, depressions in the skin, and/or scarring. Fat is harvested from a patient's thigh or abdomen and then injected to fill or "plump" facial and other body areas.
Fat grafting
A procedure in which body fat is used to augment cheeks, lips, or any body area in which augmentation is desired to correct tissue deficiencies or rejuvenate the face for a more "refreshed" look. Also called fat transfer.
Fitzpatrick Classification System

Thomas B. Fitzpatrick, MD, PhD, developed this system to classify skin types. It is based on a person's complexion and responses to sun exposure. He correlated these three classes with the following scoring system and degree of elastosis:

  • Class I (score 1–3): Mild elastosis is defined as fine textural changes with minimal skin lines
  • Class II (score 4–6): Moderate denotes a yellow discoloration of individual papules (popular elastosis)
  • Class III (score 7–9): Severe elastosis describes marked confluent elastosis with thickened, multipapular, and yellowed skin

The Fitzpatrick classification of skin types and their response to sun exposure are as follows:

  • Skin type I: Very white or freckled, always burns
  • Skin type II: White, usually burns
  • Skin type III: White to olive, sometimes burns
  • Skin type IV: Brown, rarely burns
  • Skin type V: Dark brown, very rarely burns
  • Skin type VI: Black, never burns


G

Glabellar rhytides
Creases in the forehead between the brows. Also called frown lines.
Glycolic acid peel
Diminishes the cohesion of the skin cells at the innermost levels of the surface layer of the skin. It stimulates this layer of skin in its renewal process, increasing skin thickness and promoting the formation of new epidermis and new dermal collagen. This process will result in skin shrinkage, reduced wrinkling, and softening of "crow's feet." It also helps to lighten pigmentation.


H

Hyaluronic acid
Hyaluronic acid is a naturally occurring component of the skin. It can be injected as a dermal filler to improve the skin's contour and reduce depressions in the skin due to scars, injury, or lines such as crow's feet.
Hyperhidrosis
A disorder of the eccrine or sweat glands that causes excessive sweating in the hands (palmar), armpits (axillae), face, and feet (plantar). Causes are unknown and the condition can be worsened by stress, anxiety, a warm environment, and physical activity.
Hyperpigmentation
A skin condition in which there is excessive pigmentation, often seen as dark spots on the skin such as "café-au-lait" spots.
Hypopigmentation
A skin condition in which there is a lack of pigmentation.


I

Intense pulsed light (IPL)
A technique that delivers high-intensity pulses of light that stimulate new collagen growth, resulting in rejuvenated, smoother, healthier skin.
Iontophoresis
A transdermal delivery system that uses water to conduct a mild electrical current through the skin's surface to block the flow of sweat. Once the sweat is interrupted, sweat production is often "turned off."


L

Laser resurfacing
A procedure in which light beams vaporize the top layers of the skin to lessen the appearance of wrinkles, scars, or birthmarks, or to generally resurface facial skin. Also called laserbrasion surgery.
Laugh lines
A loss of volume in fatty tissue between the mouth and cheeks that creates lines or ridges.
Lentigines
Flat, brown marks that usually appear on the face, arms, legs, and hands from chronic sun exposure. Also called freckles, age spots, or liver spots.
Lipoatrophy
Facial lipoatrophy is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes.


M

Marionette lines
Lines going down from either side of the mouth. See also: Oral commissures.
Melanin
A substance that is produced by the cells (melanocytes) that give the skin its color. Melanocytes increase the production of melanin in response to sun exposure to protect against skin damage.
Melomental folds
Folds in the corners of the mouth that produce a sad or negative expression and give the appearance of advanced age. Also called drool grooves.
Mental crease
A deep groove between the lower lip and prominence of the chin.
Microdermabrasion
A mini-peeling with minimal risk of dyspigmentation or scarring that is achieved by projecting aluminum microcrystals onto the skin.


N

Nasojugal groove
A shallow groove in the skin that extends downward and laterally from the medial canthus. See also: Tear trough.
Nasolabial fold
The crease that runs from the nose to the corner of the mouth. It separates the cheek from the upper lip. With time, this fold can become more prominent due to excessive skin, thinning of skin, and ptosis, or drooping of cheek fat. See also: Smile lines.
Non–animal-stabilized hyaluronic acid (NASHA)
A clear gel, consisting of microspheres, that is injected into or below the skin to provide desired augmentation.


O

Oral commissures
Lines going down from either side of the mouth. See also: Marionette lines.


P

Peau d'orange chin
Contraction of the chin muscle producing horizontal and multiple dimple rhytides called "peau d'orange" or "apple dumpling."
Photoaging
Changes that occur to the skin (eg, wrinkles, age spots) due to sun exposure.
Photorejuvenation
Nonablative laser resurfacing that uses light energy to stimulate the new growth of collagen without removing skin tissue and produces new elastic fiber that rejuvenates photoaged skin.
Poly-L-lactic acid
A biocompatible, biodegradable, synthetic polymer from the alpha-hydroxy-acid family that is used as a filler for facial lipoatrophy in persons with human immunodeficiency virus. It may have a role as a dermal filler for other indications in the future.
Ptosis
Drooping of a body part, such as the eyelids.


R

Rhinoplasty
An aesthetic procedure used to enhance or resculpt the nose in which bone and cartilage are reshaped and reconstructed. Commonly known as a "nose job."
Rhytides

Wrinkles and furrows caused by facial expressions such as frowns. See also: Dynamic rhytides.

Rosacea
A skin disease that causes an array of symptoms, including redness and puffiness on several areas of the face, such as the cheeks and nose.


S

Salicylic acid peel
A procedure in which the uppermost layer of skin is lifted by dissolving the "glue" that binds it to the underlying epidermis, triggering a "burst" of cell division which accelerates skin cell production and shedding. Salicylic acid peels are often more intense than glycolic acid peels.
Smile lines
Lines that run between the nose and the outer portion of the lips and are produced by contraction of the zygomaticus muscle. See also: Nasolabial folds.
Soft tissue fillers
Substances that are used to "plump" and minimize wrinkles, furrows, and hollows in the face to give the skin a smoother appearance. Fillers such as bovine collagen, fat, and polymer implants are effective for shaping specific facial areas and correcting depressions and scars.


T

Tear trough
The groove where tears fall down the cheek at the middle corner of the eye. See also: Nasojugal groove.
Telangiectasias
Small red, purple, or blue blood vessels that swell under the skin and can be easily seen anywhere in the body. They are often called thread or spider veins.
Tissue augmentation
Tissue and other materials (eg, bovine collagen, hyaluronic acid) are grafted, injected, or implanted to treat the face or lips to clear wrinkles and scars from the skin.


U

Upper gum show
A short upper lip that exposes the gum line, upper incisors, and canines during a smile.


V

Vertical platysmal bands
Produced when the cervical skin loses its elasticity and the platysma separates into two diverging vertical bands. These bands are visible during speech.