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Laser Resurfacing

Laser Resurfacing is a treatment to reduce facial wrinkles and skin irregularities.  The procedure uses short, concentrated, pulsing beams of light to remove layers of skin. This can be an effective procedure for reducing the appearance of acne or facial scars and wrinkles.

EVALUATION

Candidates for laser resurfacing are measured based on one’s skin color. Those with
fair skin, light eyes, and that burn easily in the sun have very little pigment in their skin
and seem to respond well. Very dark skinned individuals with a lot of skin pigment run
the risk of developing hypopigmentation and splotchiness and are therefore not good
candidates for this procedure.

Those with fine lines, crepiness of the skin beneath the eyes, mild to moderate lines of
expression, dark spots, freckles, dull appearance of the skin tend to respond well to
this procedure.

Assessing the severity of changes to skin and the specific areas of problems will
determine whether higher density, multiple treatments, and increased power will be
needed.

TECHNIQUE

If one is having a coincident facial plastic procedure requiring anesthesia, then little
numbing is needed for the postoperative recovery. If it is being done as a solitary
procedure, then topical and local anesthesia of the areas being treated will need to be
applied. If desired, IV sedation can be administered to eliminate the discomfort of
local anesthesia.

Once the treatment areas are anesthetized, the laser is set to the appropriate level for
the various areas of the face and the surface is treated sequentially until the entire
area is covered. For areas of denser lines or thicker skin the laser can be turned up or
the number of passes increased.

Once completed, the skin is covered with aquafor and the patient procedure is
complete. Continued application of lubrication will be necessary for the remaining
week until healing has satisfactorily progressed.

RECOVERY

Initial swelling, crusting, and pinpoint bleeding maximizes over the first three days
reducing over the remainder of the week. By seven to ten days the swelling and
crusting will have diminished significantly, but your face will typically remain red for
several weeks. Makeup can be applied once the skin has resurfaced and is dry
(typically 7-10 days). It can take up to six weeks for the skin to return to its normal
coloration.

RISK AND COMPLICATIONS

The most common complication from laser resurfacing is related to pigmentation
problems and prolonged redness. Darker skinned people, with olive skin or creamy
brown skin can get splotchy areas of hypopigmentation (lighter color surrounded by
normal color). The opposite can occur where the skin takes on more pigment
(hyperpigmentation) which is treated with bleaching agents and steroid creams.
Prolonged redness usually resolves in three months but can be hastened with steroid
creams judicially administered. Usually, time will cure this.

Viral or bacterial infections can occur, so every patient is treated with an antiviral and
an antibiotic. Scarring can result if the laser gets too deep, the skin gets infected, or
there is chronic irritation from aggressive cleaning during the healing process.
Multiple small pimples called milia can occur due to the tightening that occurs in the
pores. These are treated with manual evacuation or basic dermatologic exfoliation.

Each patient’s response and recovery is unique. Everyone has different amounts of
collagen in their skin and not everyone responds the same way to the stimulatory
effect of the laser. Since each response is individualized based on a number of
variables, it is not an exact science as to how well the skin will respond. Predicting
outcomes and properly establishing reasonable expectations for each patient is
challenged by the individual responses to the treatment.

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