About Laser Skin Resurfacing
The goal of laser skin resurfacing is simple: replace damaged skin with new, fresh skin. Techniques for skin resurfacing have made enormous advances, allowing nearly everyone to achieve close to flawless complexions. Many systems allow for light, moderate or deep laser resurfacing.
What are the primary targets of laser skin resurfacing?
- Fine lines and wrinkles of the face, especially around the upper lip, cheeks and forehead
- Loose eyelid skin
- Crow’s feet around the eyes
- Pucker marks (smoker’s lines) and frown lines
- Brown spots and splotchy, uneven skin tone
- Scars, especially acne scars
- Loose skin around the neck and jowls
We use the gold standard of laser skin resurfacing systems, ActiveFX, which delivers thousands of tiny laser pulses in a pattern over the skin. Each pulse heats a column of tissue eliminating pigment discolorations at the surface and creating a zone of heating deep in the tissue. Unique to the UltraPulse Encore, these zones of heating shrink collagen immediately*. The CO2 laser also offers the benefits of heating deeper layers of skin tissue, thereby stimulating collagen remodeling the skin further. The laser skin treatments have a 25-year track record of producing dramatic results in the texture, tone and tightness of face and neck skin. Patients can select from a range of treatments depending on the needs of your skin and lifestyle.
What are fine lines and wrinkles?
Fine lines and wrinkles are signs of intrinsic or chronological aging; there’s no way to entirely avoid them. As we grow older, our skin becomes thinner and drier. Weakened collagen makes the skin less elastic. Static wrinkles begin to appear. The rate of intrinsic aging occurs at a variable, genetically determined rate; the process is often first noticeable between the ages of 30 and 35.
We do have control over extrinsic aging, a result of exposure to the environment. Extrinsic aging is the critical element in determining who looks older or younger than their biological age. Over-exposure to sunlight is responsible for the majority of problems associated with extrinsic aging. Sun-damaged skin is photoaged from a decrease in collagen and other dermal proteins. This gradual process results in the appearance of fine lines and wrinkles. Over time, these can progress into deep wrinkles and furrows. Photoaging also causes pigmentary changes; “age spots” (sun-induced freckles), uneven skin tone, spider veins and dilated capillaries.
The simplest way to see the contrast between intrinsic and extrinsic aging is to compare skin commonly exposed to the sun (face, hands, neck) and skin not exposed to the sun (usually on the breasts, inner arms or buttocks).
How does Ultrapulse laser skin resurfacing work?
The gold standard of laser skin resurfacing systems, the CO2 laser delivers thousands of tiny laser pulses in a pattern over the skin. Each pulse heats a column of tissue eliminating pigment discolorations at the surface and creating a zone of heating deep in the tissue. The CO2 laser skin treatments also offers the benefits of heating deeper layers of skin tissue, thereby stimulating collagen remodeling the skin further. Patients can select from a range of treatments depending on the needs of your skin and lifestyle.
Can CO2 laser technology be used less invasively for treating milder indications?
With Lumenis’ CO2 laser technology, skin resurfacing is so precise that you can tailor treatment according to the nature and extent of photodamage, wrinkling, skin type and individual requirements for recovery time. For instance, the Active-FX peel using the unique CO2 Lite feature allows you to achieve a superficial laser peel with just one pass. CO2 Lite utilizes fluences that are below the ablation threshold and with a single pass imparts intraepidermal coagulation that is confined to the epidermis with little to no thermal injury in the dermis. In addition, the CoolScan program on the CPG places pulses in such a manner as to minimize thermal conduction of heat to deeper tissues and reduce the recovery period. The epidermis is typically left intact and serves as a natural wound dressing. The coagulated epidermis sloughs off in 3-5 days. Downtime is typically 4-7 days and offer substantial results. Offering both superior results for treating deep wrinkles and the ability to achieve controlled superficial resurfacing, the UltraPulse Encore is the most logical choice for an “all-in-one” resurfacing laser.
What results can patients expect, and how long will the benefits of treatment last?
Laser skin resurfacing can restore your patient’s skin to a healthy state, similar to that of skin that has not experienced sun damage or scarring. With proper sun protection, results can persist for more than five years. In areas where muscle activity is strong, lines may begin to reappear sooner. After laser eyelid surgery, the cosmetic improvement is usually sustained. Typically, only one blepharoplasty procedure is needed to remove excess skin and fat pads. As skin continues to age at a normal rate, you may advise your patient to maintain results with a ‘touch-up’ resurfacing treatment. In any event, with cosmetic laser surgery you will have definitively ‘turned back the clock.’
What are the advantages of using authentic CO2 vs. erbium lasers with extended pulse widths?
A bilateral study comparing resurfacing with long pulse erbium:YAG followed by traditional short-pulse erbium ablation to UltraPulse CO2 followed by short-pulse erbium ablation (Rostan E, Goldman M, Fitzpatrick R. Laser Resurfacing With a Dual-Mode, Long-Pulse Erbium:YAG Laser Compared to the 950-µs Pulsed CO2 Laser. Am J Cosmetic Surg. 2000; 17(4):227-231.) found that there was no statistical difference in healing between the two sides and in 5 patients (26%), greater clinical improvement in periorbital lines, perioral lines, or both was noted on the UltraPulse CO2 side. (A reprint of this article can be ordered from the Lumenis web site, Lumenis Lit. # 5448).
The value of utilizing authentic CO2:
- When addressing moderate to severe wrinkles, true high-energy short-pulsed CO2 technology has proven to be the superior modality.
- Physicians report that continued, progressive improvement in solar elastosis is seen post UltraPulse CO2 laser resurfacing.
- The hemostatic effect only afforded by CO2 provides superior visualization of clinical endpoints.
- For surgical incisions, the cutting ability of CO2 is unsurpassed.