Skin Resurfacing & Rejuvenation
As one of the most exciting and innovative scientific achievements to date, laser technology is being utilized throughout the health care community. Our practice uses a carbon dioxide laser (CO2), to treat sun-damaged skin, facial wrinkles and scars in a procedure called laser skin resurfacing. Resurfacing is like dermabrasion with a laser. CO2 laser resurfacing is considered an invasive laser treatment, however, Non-invasive laser treatments are also available (non-invasive laser therapy). Invasive laser treatment causes changes equivalent to surgery and the patient can expect post-operative discomfort and a healing period.
What is a Resurfacing laser?
The word “laser” is an acronym, which stands for Light Amplification by the Stimulated Emission of Radiation. A surgical laser, such as the CO2 laser, is a beam of light capable of removing unwanted tissue, such as scarred, lined, wrinkled and otherwise imperfect skin. The laser vaporizes skin cells by emitting bursts of light energy that are absorbed by water in these cells. Laser light penetrates to a very precise, controlled depth, making the procedure safe and predictable, while reducing the risk of scarring or pigmentation problems. Laser skin resurfacing is bloodless, and is performed right here in our office under light sedation. As a result of this treatment, you are left with more youthful looking skin.
Prior to surgery, our team will discuss the goals for facial improvement with the patient. After determining the most appropriate procedure to use, we will fully describe the procedure, what results to expect and the costs. The skin is pretreated prior to surgery to improve the outcome with hydroquinone and retin-A.–the Obagi® Nuderm system is a cosmeseutical by Dr. Reynolds for this purpose.
IV sedation and a local anesthetic are often used to ensure that you are comfortable throughout the procedure. The area is cleansed and draped and then Dr. Reynolds will direct the laser beam toward your skin imperfections. The laser quickly and accurately vaporizes the outermost layers of skin just four or five cells in thickness.
What can be expected?
In most cases, only one treatment is needed. The process leaves a denuded area of skin which oozes fibrin and some blood which is much like that of a bad rug burn. The skin reforms in about 7 days but is initially red. The initial redness fades in a few weeks to months to a light pink, which can be camouflaged with cosmetics. The patient must stay out of the sun during this time and not smoke. The goal of laser resurfacing is to enhance facial appearance. Expectations by the patient must be realistic and results should be anticipated as improvements rather than total corrections. Results of the surgery depend on many factors such as the size, shape and location of the imperfection and the patient’s heredity, age and general skin condition.
What areas can be treated through laser skin resurfacing?
The laser is used to reduce tiny wrinkles, acne scars and other minor skin imperfections, especially around the mouth and eyes. It can improve sun-damaged and acne scarred skin problems that often cause concern to both men and women. It can also be used to treat scars from trauma by reducing their visibility and improving their appearance.
Benefits of Treatment
Laser resurfacing can be used as an alternative to chemical peel and dermabrasion. The benefits of using this technique include a faster recovery time, a precisely controlled depth of treatment, ability to vary depth for different areas in a controlled fashion, collagen stimulation, tissue shrinkage and tightening and predictability.
Chemical peels are helpful for wrinkles, light acne scarring and irregular pigmentation such as freckles and age spots. Pre-cancerous conditions such as keratoses (thick, rough, reddish growths) also respond well to this procedure.
There are several types of chemical peels: Light peels (glycolic or trichloroacetic acid peels) remove superficial wrinkles, medium peels (Obagi® Blue Peel TCA) and deep peels are for more severe conditions.
After thoroughly cleansing the skin, a small applicator is used to apply the chemical solution to an area of the face. Excess solution is removed and the procedure is repeated on other areas.
The amount of improvement varies and depends upon the initial condition of the patient’s skin. Significant improvement of damaged skin has been achieved, which can produce dramatic results.
Repeated light chemical peel:
In repeated light chemical peeling, a mild peeling agent, either glycolic acid or trichloroacetic acid, is applied to the skin for short periods of time. The purpose of the procedure is to stimulate new collagen formation in the skin by mild peeling. The goal is to achieve improvement of fine lines and possibly acne scars after repeated peeling at intervals separated by 2 to 6 weeks.
Peels are repeated until the desired effect is achieved. Between peels, a glycolic acid cream (Retin-A may also be used) is used to continue to stimulate the skin and, after the peels are finished, a glycolic acid cream is used for maintenance. Peels may need to be repeated periodically to maintain the desired effect.
The advantage of repeated light chemical peeling is that because minimal actual peeling of the skin occurs as a result of the procedure, “down time” from work or other activities is minimized. Repeated chemical peeling is a program of skin rejuvenation which aims to correct wrinkling over time rather than with one procedure.
Continued protection from the sun and not smoking are important adjuncts to this procedure and this includes the use of sun screens with an SPF of 15 or greater and hats or visors to keep sun off the face. It goes without saying that, once correction of sun damage is achieved, it makes no sense to allow for re-exposure to reverse the effects of the peels.
Dermabrasion is one of the oldest skin improvement procedures. Dermabrasion may be used to treat skin scarred from trauma, acne pox, tattoos, age (liver) spots, wrinkles and certain skin lesions. Dermabrasion is accomplished by using a diamond wheel to abrade away a thin layer of the epidermis (top layer of the skin). This process leaves a denuded area much like a rug burn. The skin bleeds a little and gets a layer of fibrin (clear yellow liquid) that crusts if not kept moist. The post-operative condition is the same as with the laser resurfacing. The patient must keep the area moist until the skin reforms which is about 7 days. As with laser resurfacing the skin is initially red but the initial redness fades over a 3 month period.
Today dermabrasion is still the best technique for certain types of scar revision. Scars resulting in uneven edges or pitting are well treated by dermabrasion. This is because the visibility of scars is increased when a ridge or uneven edge is present. Laser resurfacing is so uniform that it does not change the edge unless used in a particular way that is technically difficult. Dermabrasion is best for smoothing uneven edges.
Obagi Skin Care
A skin rejuvenation program is often used in conjunction with either chemical peels or laser wrinkle removal to reduce the fine wrinkles of the face, lighten areas of hyper-pigmentation and produce a softer texture to the skin. The program can be accomplished separately or in conjunction with the other procedures listed here. It is followed at home by the patient after a consultation and a treatment plan is established for the patient’s cosmetic needs. Our skin care department is dedicated to providing you with the latest and most effective skin treatments available.
We invite you to inquire about laser skin improvement and hope we can help you achieve smoother, fresher, younger-looking skin.
To preview Pre-Operative Instructions, Consent and Post-Operative Instructions along with the scheduled visits, see “Link to Doc’s Orders; Cosmetic Plastic Surgery; Skin Resurfacing and Rejuvenation”
To view our photo gallery see oral-surgery-before-after-gallery.