Laser Technique

In laser resurfacing, sometimes called "laser peel," a carbon dioxide (CO2) laser is used to remove areas of damaged or wrinkled skin, layer by layer. The procedure is most commonly used to minimize the appearance of fine lines, especially around the mouth and the eyes. However, it is also effective in treating facial scars or areas of uneven pigmentation. Laser resurfacing may be performed on the whole face or in specific regions. Often, the procedure is done in conjunction with another cosmetic operation, such as a facelift or eyelid surgery.

Laser resurfacing is still a relatively new procedure. However, it has been shown that in some cases, this surgical method produces less bleeding, bruising and post-operative discomfort than is typically seen with other resurfacing methods.

We will give you a basic understanding of the laser resurfacing procedure - when it can help, how it's performed and what results you can expect. It cannot, however, provide all the details which may be relevant to your particular needs. Please ask your plastic surgeon if there is anything about the procedure you don't understand.

A word about the laser

Laser resurfacing is performed using a beam of light, i.e. laser energy which vaporizes the upper layers of damaged skin at specific and controlled levels of penetration.

It's clear that laser resurfacing may offer a number of advantages over other resurfacing methods: precision, little (if any) bleeding and less post-operative discomfort. However, laser resurfacing isn't for everyone. In some cases, an alternative skin resurfacing treatment, such as dermabrasion or chemical peel, may still be a better choice.

All resurfacing treatments work essentially the same way. First, the outer layers of damaged skin are stripped away. Then, as new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. Laser resurfacing is a new method being used by plastic surgeons to remove damaged skin. Because it is new, there are no long-term data on this technique. However, a number of studies using microscopic examination have shown that the physical changes that occur to laser-treated skin are essentially identical to those that occur with either dermabrasion or chemical peel. Ask your plastic surgeon about the latest facts concerning long-term follow-up.

For superficial or medium resurfacing, the laser can be limited to the epidermis and papillary dermis. For deeper resurfacing, the upper levels of the reticules dermis can also be removed. Varied penetration allows treatment of specific spots or wrinkles.

It's also important to consider the length of recovery when choosing among the skin-resurfacing alternatives. In general, the more aggressive the resurfacing procedure is, the more prolonged the recovery is likely to be. "Light" resurfacing procedures, such as superficial chemical peels or superficial laser resurfacing, offer shorter recovery times. However, these lighter procedures may need to be repeated multiple times to achieve results comparable to those achieved with more aggressive techniques.

The best candidates for laser resurfacing

In many cases, facial wrinkles form in localized areas, such as near the eyes or around the mouth. The laser can be precisely controlled so that only these specific areas are targeted.

Patients with olive skin, brown skin or black skin may be at increased risk for pigmentation changes no matter what type of resurfacing method is recommended. Your plastic surgeon will evaluate your skin characteristics and make recommendations accordingly.

Also, individuals who have taken acutance in the past 12-18 months or are prone to abnormal (keloid-like) scarring or those with active skin infections on the treatment area may not be appropriate candidates for this procedure.

Remember, having laser resurfacing can help enhance your appearance and your self-confidence, but it won't completely remove all facial flaws or prevent you from aging. Lines that occur as a result of natural movements of the face - smiling, squinting, blinking, talking, chewing - will inevitably recur. Your plastic surgeon can suggest ways to help you preserve your results by protecting yourself from sun exposure or using maintenance treatments, such as light chemical peels or medicated facial creams. Before you decide to have laser resurfacing, think carefully about your expectations and discuss them with your surgeon.

All surgery carries some uncertainty and risk

When laser resurfacing is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. However, because individuals vary greatly in their anatomy, their physical reactions and their healing abilities, the outcome is never completely predictable.

Risks associated with laser resurfacing include: burns or other injuries from the heat of the laser energy, scarring, and obvious lightening or darkening of the treated skin. Also, laser resurfacing can activate herpes virus infections ("cold sores") and, rarely, other types of infection.

Additional corrective measures and treatment may be required if healing seems abnormal or delayed or if there is any evidence of abnormal pigmentation or scarring.

You can reduce your risks by choosing a qualified plastic surgeon who has received special training in laser surgery.

Planning your surgery

Not every practitioner who offers laser surgery has the same level of experience and skill with laser use. That is why it is especially important that you find a plastic surgeon who is adequately trained in the procedure.

One safety measure is to find out whether your surgeon has privileges to perform laser resurfacing with a CO2 laser at an accredited hospital. Even if the operation is to be conducted in your doctor's private facility, the fact that he or she has privileges to use that same laser in a hospital ensures that the doctor has been reviewed by the institution's experts.

In your initial consultation, be frank in discussing your expectations with the surgeon and don't hesitate to ask any questions you may have. Your surgeon should be equally frank with you, explaining the factors that could influence the procedure and the results - such as any abnormal skin condition which has been diagnosed or previously treated, medications you are taking or have taken in the past, previous skin injuries or previous operations.

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