Plastic Surgery Santa Fe-Albuquerque-New Mexico

Skin Care Basics: The Facial

Facials offered at Dr. James Green's office will leave your skin refreshed, rejuvenated, glowing, healthy and radiant. Facials deal with aesthetics, and while there is a clinical science behind the process, there's also a beauty to it. In some ways the word facial is a misnomer, because it's also important to treat the neck and décolleté (upper chest). We enhance the experience by playing a range of relaxing music in our treatment rooms, and our state-of-the-art table is designed to offer comfort and support, enabling clients to relax and drift off during the various stages of the process.

Facials can play a critical role in keeping skin vital and healthy. As we age, millions of cells that are supposed to be sloughing off your skin are getting stuck. Environmental exposure and our "Natural Moisturizing Factors" (NMF Levels) drop so the cell turnover rate is slower. These cells become adhered to the skin. If these cells continue to stay stuck to your skin, its ability to protect, breathe and absorb topically applied nutrients decreases. Also as we age, the skin can become dehydrated. The dermal-epidermal juncture (a thin area between inner and outer layers of skin) becomes more flat and less pliable, allowing for more free radical damage. This is what we're here to treat.


We begin each session with a consultation, reviewing the skin and any problems in order to determine what treatments and products to employ. We hear a range of comments from 'I feel old' to 'My skin has aged overnight.' (We hear that one a lot.) It's not that someone truly aged overnight, but all of a sudden they look in the mirror and their skin has changed. We've also hear, "What can I do to stop the aging process?" We don't stop aging, but we can put it at bay, and get cleaner, healthier, and consequently younger looking skin.


After you are relaxed and comfortable, treatment begins with a gentle steam flowing from a wand above the face steam to open the follicles. The amount of steam needs to be monitored. Usually 20 minutes is the maximum amount, after that, the steam may begin to dehydrate the skin. We can use oxygenated steam, which will help destroy any bacteria—ideal for acne. We can also include aromatherapy in the steam, to calm or stimulate cells. Oxygenated aromatherapies have a rice bran oil basis, and can include clove, geranium, thyme or rosemary, while restorative aromatherapies can contain lavender, jasmine or sandalwood.

Using viscose sponges we to start to cleanse the face, neck and upper chest. It's like an elegant massage when you're cleansing the face. The cleansing solution used is tailored for each particular skin type. If your skin is sensitive we use a creamy cleanser, if it's oily, we'll address that too. We're careful to determine who's sensitive and who has allergies, which herbal aspects can be used, and which should be avoided.


After a good cleansing, exfoliation is the next step. One type of exfoliation is a peel, which stays on the skin from two to five minutes. There are different kinds of peels, serving different purposes for each skin type. For example, Glycolic and Lactic acids are best for skin marked by fine lines and photo-damaged, while Salicylic and Mandelic acids are best for problem skin. We can also use enzymatic exfoliants that will continue to work for a few hours even after it's removed from the skin. It's an invisible exfoliation that is perfect for a lot of people, especially those who have sensitivities. We constantly monitor the skin to see if there are any reactions that we want to change. If there is any redness, we take the peel off.

Microdermabrasion is another exfoliating treatment which is used to remove dead skin cells. We utilize a diamond and vacuum system, an effective and sterile process. We can lighten hyperpigmentation with the combination of microdermabrasion and lighteners. You need a skilled person doing microdermabrasion. The sole purpose is to remove the dead epitheal tissue, and not disrupt the healthy tissue beneath. You need to know when to stop. Exfoliation is followed by a skin examination to determine if any extractions are necessary, from blackheads and whiteheads to cholesterol deposits and more.

Serums & Ampoules

After cleaning and exfoliation, your skin is perfectly open to receive important nutrients. First, hot towels are applied to the area below the collar bone, the "portals" that drain the lymphatic system in the face and neck. Later, another hot towel is applied to the rest of the face. Then a serum or ampoule, with a super-high (80%+) level of active ingredients, tailored to the individual skin needs, is applied to the face, neck and upper chest. You can see and feel the change. Applying a serum is one of the most important parts after exfoliation, and there are many options available based on the desired effect. Some serums calm and feed the skin, others stimulate and rejuvenate. A gentle and relaxing massage is done to help stimulate blood flow and lymphatic drainage. Using our sense of touch, we gain lots of information about how thick the dermis is, locate problem areas, and help to determine what types of additional treatments may be needed. Ampoules and serums, when correctly applied, can help transform a dry, dehydrated, sallow skin with less blood flow to a more radiant and active state. The treatments regenerate the skin, creating a newer and fresher appearance. It's like a chemistry kit designed for each patient.

Masque Application

Next, we apply a finishing masque to restore the correct pH to the skin which may have been changed by the previous steps. Our correct pH is not not neutral like water (pH 7), but slightly acidic (pH 5.5), and helps to protect us from everyday environmental exposure. The masque, like the previous ampoule treatments, contains a high concentration of active ingredients designed for each unique skin type. At the appropriate time, the masque is removed with a hot towel.

The eye treatment follows, consisting of an eye cream designed for individual skin needs, whether it's to address fine lines and wrinkles, puffiness, under-eye darkness or signs of stress and fatigue. A lightweight moisturizer or a heavier face cream is designed to either stimulate or calm the skin as required. We also offer eyebrow waxing and shaping, hair removal, and eyelash and brow tinting.


The final, and one of the most critical steps, is applying an appropriate, protective sunscreen. With the fresh skin exposed, it's an extremely important time to take precautions against UV damage, a particularly acute problem at Santa Fe's elevation. There are two main types of sunscreen, UVA and UVB, and you need them both. There's an easy way to remember the difference: UV"A" applies to damage associated with "Aging" (deep wrinkles caused by ultra-violet damage). UV"B" pertains to "Burning" of the skin, which leads to Melanoma. It's imperative that you have a quality UVA and UVB sunscreen. We carry many different SPF's and varieties for every lifestyle.

With the facial completed, clients return to the consultation room, where they receive final advice, including cosmetic and make-up consultations, and frequently leave with samples of products that are going to be particularly helpful for their skin types. Though there are some people that we see twice a month, once every three to four weeks is optimal. We keep detailed charts on all of her patients so that she can follow their progress. The charting of progress is critical to know when we can push the skin a little further. We're never going to do that on a first facial. One needs to know and understand the skin before you can push it to the maximum. Some clients have taken six months to really get them to a place where their skin is healthy and radiant, but most respond much more quickly. We try to ensure that each person walks out of our office with a glow.

Member of the American
Society of Plastic Surgery

Member of the American Society
For Aesthetic Plastic Surgery
The Mark of Distinction
In Cosmetic Plastic Surgery

Our Private Operating Room
Has the Highest Level "Class C"
Accreditation from the AAASF
James Green, MD
Plastic Surgery Santa Fe/Albuquerque, New Mexico

The Physician's Plaza, 1631 Hospital Drive, Suite 150
Santa Fe, New Mexico 87505-7670

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