Facial Cosmetic Surgery & Plastic Surgery Overview

At Reynolds Oral & Facial Surgery, we offer a number of different procedures to improve facial features or correct facial abnormalities. Whether you require reconstructive surgery or cosmetic facial procedures, our team of professionals is here for your needs.

Skin Evaluation:

The most common skin complaint is wrinkles, followed by acne, blemishes, and age spots. Two factors are involved in wrinkling of the skin: environmental factors and age. Exposure to the sun and smoking are the most common factors for causing wrinkles, otherwise known as rhytids. Both age and the environment cause loss of collagen and relaxation of elastin which results in loose and wrinkled skin. For many people, years of sun exposure results in premature aging of the face. Skin aging due to ultraviolet light exposure is called photoaging. Patients with fair colored skin are most likely to photoage. Other complications of sun damaged skin are pigmentary changes and rough spots called keratoses. Another change that occurs in skin with aging is telangiectasias development, or, spider veins.

When evaluating the skin, the following two classification schemes are commonly used: The Fitzpatrick Sun-Reactive Skin Types, which classifies skin based on the amount of melanin content, or the Glogau Wrinkle Scale, which classifies skin based on wrinkle amount and offers treatment guidelines.

Fitzpatrick Sun-Reactive Skin Types

Skin Type

Skin Color

Tanning Response



Always burns, never tans



Usually burns, tans with difficulty



Sometimes gets mild burn, average tan



Rarely burns, tans with ease


Dark Brown

Very rarely burns, tans very easily



Does not burn, tans very easily

Glogau Wrinkle Scale

Skin Type


Recommended Treatment

I. No Wrinkles

  • Patient age: 20s or 30s
  • Early photoaging;
  • Mild pigmentary changes
  • No keratoses
  • Minimal wrinkles
  • Sunscreens and education
  • Topical tretinoin
  • Alphahydroxyacid Creams: 15%-30%
  • Glycolic acid peels: 40%-70%
  • Botox®
  • Photorejuvenation treatments

II. Wrinkles in Motion

  • Patient age: 30s or 40s
  • Early to Moderate photoaging;
  • Early smile lentigines visible
  • Keratoses palpable but not visible
  • Parallel smile lines appearing
  • Sunscreens and education
  • Topical tretinoin and AHA creams
  • Jessner’s peel
  • Jessner’s + 35% TCA
  • Superficial laser resurfacing
  • Soft tissue augmentation
  • Botox®
  • Photorejuvenation treatments

III. Wrinkles at Rest

  • Patient age: 50s and older
  • Advanced photoaging;
  • Obvious dyschromia, telangiectasia
  • Visible keratoses
  • Wrinkles even at rest
  • Sunscreens and education
  • TCA chemical peel;: 30%-50%
  • Combination TCA peels
  • Laser resurfacing (periorbital, perioral)
  • Photodynamic skin rejuvenation treatments and long-pulse erbium laser
  • Combination laser resurfacing
  • Soft tissue augmentation
  • Botox®
  • Combination procedures

IV. Only Wrinkles

  • Patient age: 60s or 70s
  • Severe photoaging;
  • Yellow-gray skin color
  • Prior skin malignancies
  • Wrinkled skin throughout
  • Full facial CO2 laser resurfacing
  • Combination CO2 laser and TCA peel
  • Photodynamic skin rejuvenation treatments and long-pulse erbium laser
  • Deep peel
  • Facelift
  • Browlift
  • Blepharoplasty
  • Botox®

Once the skin is evaluated and a complete aesthetic diagnosis has been established, Dr. Reynolds and our team discuss skin care and additional aesthetic options for treating all of your areas of concern.

For optimal skin results, combination therapy is often used. Additional skin care includes Obagi® Nuderm cosmeseuticals, Retin-A, light/medium chemical peels, and laser/light treatments with selected laser resurfacing. For optimal results, surgical options such as rhytidectomies, liposuction, blepharoplasty and brow lift are often discussed in order to achieve the look you want.