Resurfacing

Facial wrinkling and other changes associated with aging or sun exposure can be reduced utilizing a laser. The laser has also shown to be effective in the treatment of acne scarring in some patients. It will not necessarily improve those conditions associated with excess skin or extremely deep wrinkles or scars. Laser resurfacing of the skin has also been an important contribution to the treatment of irregular pigmentation and in some cases, may reverse the early precancerous conditions of the skin.

The laser is an optical instrument, which has the ability to amplify and focus a beam of light.  In the case of the UltraPulse Laser, this beam of light is generated with the help of carbon dioxide or C02. It is an extremely powerful beam of light, which works by generating heat at the point of focus. This heat vaporizes the outer layer of skin to a very precise depth. Multiple passes of the laser will enable treatment of each area of concern individually and achieve the desired result. The UltraPulse Laser is unique in its built-in- safety features which help to avoid too much heat being generated at the skin surface.

The procedure is usually done under general anesthesia but in limited areas may be done in an outpatient setting under local anesthesia with intravenous sedation with Valium and Demerol. Depending on the areas to be treated, the entire procedure will take 45 to 90 minutes. YOU WILL NEED SOMEONE TO DRIVE YOU HOME as you will be unable to drive due to the anesthesia or sedation.

The resurfacing of the skin with a laser, although less invasive than many other surgical procedures, should nevertheless still be considered an invasive procedure. There are specific pre-and postoperative guidelines, which MUST be followed if you are to ensure the most rapid and trouble free healing. A skin care treatment plan will be laid out for you prior to your resurfacing. This will consist of agents to pre-peel your skin and may include a mild bleaching medication to help lessen the likelihood of pigmentation problems as you heal. These medications will be continued following the resurfacing for several weeks. AGAIN, IT IS IMPORTANT THAT THESE DIRECTIONS AND MEDICATION PLANS BE FOLLOWED TO LESSEN THE LIKELIHOOD OF COMPLICATIONS FROM THE LASER TREATMENT.

Following the resurfacing procedure, a dressing may or may not be applied to the treated areas.  If there are dressing materials in place, do not disturb these until instructed to do so. Early removal may delay healing or result in thicker scars.  Following the procedure or upon removal of the dressing, the treated areas will appear crusted and quite red.  As new, tighter skin grows it will cover the raw areas and the wounds will have become resurfaced.  This new skin will be tighter and smoother but it will be red or pink in color. THIS DISCOLORATION MAY LAST SEVERAL MONTHS. This coloration indicates adequate depth of resurfacing and effective treatment. Cover-up make-up may be applied following a period of 7 to 10 days after the laser treatment

Complications may occur during or after the laser treatment. Utmost care and the most advanced technologies will be utilized to try to prevent problems from occurring but the risks still exist. These possible complications include:

  • HYPERPIGMENTATION – Darker skin color is the most common complication following laser skin resurfacing. It is more common in patients with naturally darker skin tones. It is usually temporary but may last several months and may be camouflaged with make up until it clears. The chance of this occurring may be reduced by following the pre- and post-operative treatment recommendations and by wearing sunscreen.
  • SCARRING – Because the laser produces a superficial “burn” of the skin, the potential for unsightly scarring exists. The UltraPulse Laser has built in safety features which lessen the likelihood of deeper injury but the characteristics of your skin and the postoperative care are also important factors. IT IS IMPORTANT TO KEEP ALL POST-TREATMENT OFFICE APPOINTMENTS AND NOTIFY THE OFFICE IF YOU SUSPECT ABNORMALITIES IN YOUR HEALING.
  • HERPES INFECTIONS – Cold sores or even Herpes Zoster (chicken pox virus) infections may occur following resurfacing. These infections can occur after any facial surgery, but are more common following laser treatment. Medication will be given to lessen the chance of these infections.
  • TOOTH INJURY – The laser may damage the tooth enamel but care will be taken to lessen the risk.
  • EYE INJURY – Damage to the cornea is possible but again, care will be taken to prevent this.
  • ECTROPION – Pulling of the eyelid away from or downward in relation to the eyeball may result from tightening of the skin following resurfacing of the lower eyelid skin. This is usually temporary, but may require additional surgery to correct.
  • INFECTION – As with any skin “injury” infection may occur following resurfacing with the laser. Antibiotics will be given in most cases to prevent infection.
  • HEAT – The feeling of heat or stinging may be felt following the resurfacing. This will subside as healing progresses.
  • MILIA – Small white cysts may occur and can easily be treated with abrasion or topical medications.

As with any procedure alternative treatments exists. The option of doing nothing and living with the condition the way it exists should always be considered. For facial wrinkling, pigmentation changes or superficial blemishes the optional treatments include dermabrasion (mechanical sanding of the skin), chemical peel or more extensive surgery. You should consider all treatment options, the potential risks of the procedure, the associated costs, and the extensive time of recovery before proceeding with the laser skin resurfacing procedure. If complications occur they may result in additional costs, additional recovery time (including time off work), additional discomfort or surgery and the possibility of emotional or psychological distress.