Laser Surgery And Skin Resurfacing

Neigel Center for Cosmetic and Laser Surgery

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Laser Surgery & Skin Resurfacing

The carbon dioxide (CO2) laser has revolutionized the field of facial plastics.The CO2 laser is a high energy infrared beam of light. The CO2 laser can be used for both surgical incisions and skin resurfacing (wrinkle erasing). The laser was developed in 1964 but it is only recently that computer technology has allowed us to use this laser for wrinkle erasing and aesthetic skin surgery. The laser is used to gently vaporize the top sun-damaged layers of skin resulting in tightening of the underlying skin layers and collagen producing a reduction of wrinkles. The skin is removed layer by layer (like peeling an onion) so there is much more control than dermabrasion or chemical peels. Unlike face lift surgery this procedure is bloodless.

The pulsed laser can also remove scars, blemishes, and growths. This allows the body to generate new skin, produce new collagen turning the clock back without invasive deep surgery. How does the laser work? The laser emits short intense burst of light strong enough to vaporize the outer layer of skin while fast enough to limit heat damage to the underlying skin. The laser penetrates about half the thickness of one hair. It is in contact with the skin for only one thousandth of a second. The laser resurfaced skin is populated by fresh skin regenerating cells. Improvement continues for three to six months after resurfacing.

How long is the recovery period? It takes seven to ten days for the skin to grow back. Usually,the face is covered by a bandage. The first few days the area is crusting and weeping. The bandage helps with the oozing, encourages rapid healing, and keeps you comfortable. At this point, some patients may feel a 'little depressed' or have second thoughts. Relax! This is normal. Just be patient and wait till you see the new skin under the bandages.

How long do the improvements from the laser treatment last? A great deal depends on you. The results appear to be long lasting for many years, usually from five to twenty years depending on the number of wrinkles. The results are enhanced by post-op skin care and also by protecting your new skin from sun exposure.

Good candidates for laser resurfacing include:

fair to medium complexion
good healing qualities (no keloid formers)
no use of acutane in the past year

Poor candidates for laser resurfacing include:

dark complexions
hyperpigmentation in scars
keloid formers (raised thick scars)
cigarette smokers
heavy drinkers
acutane users in the past year
facial radiation

Is it painful? No, because you will be given a local anesthetic and nerve block to the area to be treated. When having the face resurfaced, often an anesthesiologist is used to give intravenous sedation.

Laser resurfacing compared with a facelift:

a facelift is incisional surgery underneath the skin and muscles involving scarring at the incision line, bleeding, bruising and stitches. It does not address the damaged collagen and superficial wrinkles. It does correct sagging of the major facial structures and the effects of gravity.

Complications seen with laser resurfacing include scarring, hyperpigmentation and hypopigmentation (too much or too little pigmentation), infection and possibly eyelid malposition. The risk of these complications is minimized by careful selection of patients undergoing the procedure.

The cost of laser resurfacing varies across the country. Most surgeons charge per facial unit. The face is divided up into six zones or units. A full face resurfacing would consist of all six zones. Insurance will not usually cover any of the cost of a resurfacing procedure.