What conditions are treated with laser skin resurfacing?
Currently the carbon dioxide and erbium lasers are used for skin resurfacing procedures including wrinkle removal, acne scar removal, treating skin discoloration and uneven pigmentation, and for the treatment of sun damaged skin.
What Areas Of The Face Are Most Commonly Treated?
Dr. Weiss most commonly treats the face, particularly the problem areas around the eyes, including the upper and lower eyelids and "crow’s feet" areas, and the mouth, chin forehead frown lines. Although single areas of the face can be treated separately, it is often preferable to treat the whole face as one unit. When the whole face is treated at once, there is very little chance of a noticeable demarcation line between the area treated and the area not treated.
How Does The Laser Remove Wrinkles?
The new development in laser technology (represented initially by the Ultrapulse CO2 laser and then with the newer Erbium lasers) that has allowed the recent advances in skin resurfacing, is the ability to apply the laser energy very quickly before the heat can spread to the underlying tissue and cause thermal damage. The laser target tissue is water, which is the main component of every cell in the body. The laser removes tissue by rapidly heating and vaporizing the water within the cells of the superficial skin surface. The remaining protein of the cell is then precisely removed layer by layer by actually gently wiping the wrinkles away, much as one would wipe away the dead skin off the ankle after being in a warm bath. In addition, laser energy seems to cause collagen shrinkage that actually "tightens up" the skin surface.
What Type Of Lasers Does Dr. Weiss use?
Dr. Weiss’ preferred method in most cases is the combined use of the Coherent Ultra Pulse CO2 and one of the newer Erbium lasers. However, individual cases vary and sometimes either laser alone is used. More recently, a variety of Fractional CO2 lasers can be used without general anesthesia to produce similar results while decreasing the risks and recovery period.
Why Does Dr. Weiss Use Two Lasers?
Here is the theory. The pinkness of the skin during the recovery period after laser skin resurfacing is thought to be due to a thin (80-100 microns or about a tenth of a millimeter) layer of thermal inflammation caused by the CO2 laser, which gradually disappears. The Erbium laser light is about one hundred times more effectively absorbed by water and leaves less thermal inflammation than the CO2 laser, which is why it causes so much less pinkness when used alone (unfortunately, it is also less effective when used alone). Dr. Weiss uses several passes of the Erbium laser immediately after the CO2 laser treatment in an attempt to reduce the amount of residual thermal inflammation present and lessen the total recovery time.
What Is The Recovery Period And How Long Will The Treated Area Remain Pink?
The recovery period will vary from patient to patient and will depend on the amount and extent of treatment performed. Typically, patients will be quite red post-operatively for 5 to 10 days. During that period you will be instructed to keep the treated area(s) well lubricated and moist with cold compresses. The redness will generally fade to light pink within 2 weeks. Because Dr. Weiss uses a more advanced and extensive newer technique first described by an Australian dermatologist which includes the simultaneous use of both the carbon dioxide and the erbium lasers, the pinkness will usually fade completely in 4-8 weeks, rather than the 3-6 month recovery period of older methods. The recovery period is much shorter with the Fractional CO2 lasers.
How Long Will The Results Last?
Based on clinical results thus far and on information gathered from histological studies and experience with similar skin resurfacing methods such as deeper chemical peels, the results will probably last from 5 to 10 years or longer. Results vary between individuals and depend on genetics, age, baseline skin condition, and subsequent skin care and sun exposure.
Will I Need Additional Treatments?
Additional treatments are sometimes required for maximum results, particularly in patients with significantly sun damaged skin. Very deep, stubborn lines may be retreated after approximately 2 months. It is rare to require more than one CO2 laser treatment. Re-treatments may occasionally be required with the Fractional CO2 lasers.
If I Only Have One Site Done Will The Texture And Color Be Even With The Rest Of My Face?
Once the skin is completely healed, the treated area(s) will in the majority of cases blend naturally into the untreated areas. With medium to darker skin types, there does exist the possibility of slight skin lightening in the area that is treated. To minimize this risk, full face resurfacing is often preferred in many patients.
What Kind Of Anesthesia Is Used?
The procedure can be performed with intravenous sedation and local infiltration anesthesia in certain patients, and in others general anesthesia with a board-certified anesthesiologist and a controlled airway is preferred. Fractional CO2 laser treatments can be performed in the office with only a topical anesthetic cream.
Can Men Be Treated With The Laser?
Men are sometimes very good candidates for laser procedures. In fact, men’s thicker skin heals much faster and with less redness than women’s more delicate skin. However, in men, full face treatments are strongly preferred because makeup is usually not an option in the post treatment period.
Are Laser Procedures More Effective Than Dermabrasion And Chemical Peels?
Yes. Lasers allow physicians to selectively peel wrinkles without damaging the area around them, giving the physician more control over the tissue that is being treated. Laser skin resurfacing is much more accurate and precise than other methods. It is also safer and there are not as many side effects. Other advantages include decreased post-operative pain, a decreased rate of infection and often a reduction in operative time.
When Can Makeup Be Worn Again?
Patients can begin wearing makeup to cover the treated area(s) 5 to 10 days after the procedure.
How Long Has Laser Skin Resurfacing Been Performed?
Carbon dioxide lasers have been used in medicine for removing skin lesions since the late 1960’s. The current era of laser skin resurfacing began in about 1994, and was made possible by the advent of the Ultrapulse CO2 laser. Laser skin resurfacing has rapidly achieved widespread use among cosmetic surgeons because of its ability to safely and predictably produce dramatic improvement of skin wrinkling. Fractional CO2 lasers began to appear in 2007.
How Long Has Dr. Weiss Been Doing Laser Skin Resurfacing?
Dr. Weiss has been using medical lasers since 1980, and has been performing laser skin resurfacing since May of 1995. Since then, he has been at the forefront of developing safe methods of increasing efficacy and decreasing the recovery time with various newer modifications of technique.
How Long Do I Have To Stay Out Of The Sun?
Common sense is the rule here. With sunscreen applied to the skin, patients can be in the sun relatively quickly, in most cases by the second week. Of course, sun bathing is strongly discouraged for several months. The treated areas should be particularly well protected with sunscreen until the pinkness is completely gone.
What Are The Possible Complications Or Side Effects?
Possible side effects of the laser include mild skin lightening or darkening, infection, herpetic outbreaks, and scarring. Dr. Weiss has not seen any scarring within his practice. The laser is a tool, and when used correctly in properly chosen patients, the risk of complications is rare. In any case, these risks are less than those associated with dermabrasion and deep chemical peels.
Are There Skin Types That Are Not Ideal For Laser Skin Resurfacing?
Yes. People with darker skin pigment are done with caution. In some cases it is preferable to treat a test area with the laser before proceeding with the full treatment.
Does Everyone Need A Laser Test Before Surgery?
No. Typically a test is only performed on people with darker skin pigment. When a test is performed, it is usually done behind the ear or on the forehead just beneath the hairline.
How Much Does Laser Skin Resurfacing Cost?
The cost for laser skin resurfacing will vary depending on how large the area is being treated, how many areas are being treated, the condition of the skin and the depth of the wrinkles. The total cost to the patient including all pre- and post-operative visits, initial dressings and medications, surgeon’s fee, anesthesiologist fee and facility fee will range from $1200 to $5000.
How Can I Find Out If I Am A Good Candidate For Laser Skin Resurfacing?
If you would like to learn more about laser skin resurfacing and to see how you could benefit from this procedure, please contact an us to schedule a private, complimentary consultation.