Resurfacing the skin with laser is accomplished by way of a Carbon Dioxide Laser (Coherent 5000 with a Computer Pattern Generator or CPG) which literally evaporates the first three of the six layers of the skin. This laser, in conjunction with its CPG, affords an extremely precise depth of penetration (75 to 150 microns, with one micron equaling one 1000th of an inch). This in turn allows for more precise and better controlled resurfacing than any other laser on the market. Practically speaking, this translates into better results. The resurfacing removes or reduces fine lines, skin discoloration, acne scars, and other scars and at the same time, tightens the skin. The action of the laser actually causes the collagen to thicken and the elastic fibers in the skin to increase in number. This means that the skin will have properties more similar to an earlier time in your life. Sun damaged, cigarette damaged, and aged skin is rejuvenated in a fashion and to an extent never before attainable with chemical peels and dermabrasion.
This operation is performed under Light Sleep Anesthesia. The procedure takes 30 to 90 minutes. A plastic membrane called Tegaderm is placed over the lasered skin after the procedure.
There's More To It
Laser Resurfacing is a very effective tool in the improvement of aged skin and moderately effective in acne scars and other scars. In aged skin, one treatment will have significant results in rejuvenating the skin. In severely sun damaged and aged skin, a second treatment may be helpful. In the case of significant acne scars, the procedure is often performed twice. In these cases, the first procedure gives about a 20 to 30 percent improvement. The second procedure gives a 30 to 40 percent overall improvement. Unfortunately, there is no way to create a 100 percent elimination of acne scars.
There is generally very little pain after laser resurfacing; however, this is variable from individual to individual. One must protect the skin from the sun for eight to 12 months using total sun block (sunscreens rated SPF30 or greater). One should avoid direct sun exposure during this time. The skin will have a shade of pink to it for approximately two to five months. This is generally not too bothersome, is covered by make-up, and is far outweighed by the benefits of the procedure in most patients' minds. Please note, however, complications can occur. In five to ten percent of patients, darkening or brown discoloration will occur, requiring the use of bleaching creams. This treatment will generally resolve the discoloration in two to three months. Prolonged redness occurs in three to five percent of patients, delaying the return to normal color by about three to five months.
The First Week After Surgery
The patient returns to the surgery center four to five days after surgery for a follow-up visit to change the Tegaderm, which is kept over the skin for four to ten days. Moisturizing cream is to be used for several weeks after the Tegaderm is removed.