Laser Skin Resurfacing

In much of this country we are blessed with sunshine for most of the year. Unfortunately this sun exposure, along with the normal aging process and acquired traits such as acne scars take their toll on our skin.

Laser skin resurfacing, unlike a surgical facelift, seeks to improve facial appearance by targeting the more superficial layers of the skin. Whereas a facelift removes droopy bulges and sagging skin, skin resurfacing procedures improve wrinkles, scars, and uneven pigmentation on the skin surface. Lasers work by removing the outer layer of skin, which includes thickened and dead skin layers. Following this, the laser light causes restructuring of collagen in the dermis, or deeper layer of the skin. The overall effect is a tightening of the skin, with a smoothening out of fine wrinkles and other skin surface irregularities. It is important to understand that each face is different with regard to skin color, texture, and degree of wrinkling, and choosing the best resurfacing option can make a difference. Laser resurfacing has not eliminated other methods such as chemical peels and dermabrasion, which continue to play a role in skin resurfacing, but in many cases the laser has proven to be a superior tool.

Laser resurfacing can be either deep, or superficial in nature:

Deep Skin Resurfacing Options

Patients with deep, static wrinkles, moderate to severe acne scars, or deep hyperpigmentation will generally require deep skin resurfacing. This procedure may involve intravenous sedation anesthesia for patient comfort, or infiltration of local anesthetic (numbing medicine) into the treatment areas. Recovery time for a deep laser peel is generally 7-10 days. Our San Diego cosmetic surgery practice utilizes two laser systems for deep resurfacing: the ERbium: YAG laser and the CO2 laser. The procedure may last approximately one hour. Patients are generally discharged home the same day, and are advised to apply cool compresses to the skin, as well as a moisturizing ointment. Laser resurfacing is generally less uncomfortable than a deep chemical peel, and patients usually have minimal pain after the first twenty-four hours.

Over the first week, it is normal to experience crusting and redness as the outer skin layers become separated and are replaced by new skin. Following this, the skin appears somewhat pink and sensitive for several weeks, however most patients can resume applying makeup at 7-10 days if desired.

Erbium: YAG Laser

The Erbium: YAG laser uses light of a 2940 nm wavelength which is readily absorbed by water in our cells. It treats light-skinned to moderately dark or olive-skinned patients with little to no risk of hypopigmentation (permanent skin lightening) and very little risk of hyperpigmentation (darkening of skin) or scarring in experienced hands. This laser can achieve dramatic results which compare with CO2 laser in many cases.

Carbon Dioxide (CO2) Laser

CO2 laser resurfacing has long been considered a "gold standard" in deep laser resurfacing, due to the impressive nature of results obtained. It uses a 10,600nm infrared beam which is also well-absorbed by water in our cells. Newer CO2 laser "scanning" technology has significantly lowered the risks of adverse effects such as hypopigmentation, or skin lightening. The CO2 laser generally suits patients with fair to average complexions, although new "fractionated" technology allows the laser to be used for most skin types.

Superficial Laser Resurfacing Options

Many of our San Diego patients have only light to moderate sun-damage, scarring, or wrinkling which they wish to address, or do not want the downtime associated with a deep laser peel. Active FX(TM) (utilizing CO2 technology) and Micro Laser Peel (TM) (utilizing Erbium: YAG technology) offer two options for effective superficial skin resurfacing. Superficial resurfacing is generally performed with only a topical numbing cream, and patients can drive themselves home. Recovery time is generally between one to seven days only, with no lingering "pinkness."

Active FX(TM)

Active FX is a fractional laser procedure performed in a single treatment with minimal patient downtime. The fractional technology teats a "fraction" of the skin surface, leaving healthy normal bridges of skin in between. This makes the healing process much faster, and gets you back to your normal activities sooner. The treatment is highly effective in producing skin tightening, reducing wrinkles and fine lines, eliminating hyperpigmentation, and stimulating collagen production. Unlike other fractionated lasers( such as Fraxel(TM)), Active FX requires a single treatment for dramatic results. Recovery varies from several days to one week, with minimal discomfort.

Roy David Amir, MD, FACS
La Jolla Center for Facial Plastic Surgery
(858) 658-0595
http://www.sandiegoface.com

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