Minneapolis Laser Surgery doctors

You have already demonstrated that laser treatment directed at deeper structures unfortunately damages those structures closer to the surface as well; in this case, your hair follicles and skin (causing scar formation).

I have treated true venous malformations for over 2 decades with sclerotherapy (utilizing sotradecol), and use lasers only for those vascular lesions close enough to the surface of the skin for effective laser energy absorption. I have taught laser surgery since 1988, and received my undergraduate degree in Math and Physics, so laser use is something I have always taught on the basis of energy interaction with tissue. Wavelength of laser energy, absorption characteristics at specific wavelengths and by specific tissue chromophores, depth of penetration (dependent upon the previous two items, as well as other factors), and actual efficacy is much more important than the idea that "Laser is high-tech, so it must be the best" for whatever application or medical situation that is at hand. This is a marketer's approach to laser surgery, not a (proper) physician's.

Consider consultation with someone versed in other options before asking "What is the best hammer?" This is not a nail, and a hammer is not the best tool for this situation. Best wishes!

The amount of actual skin tightening by the "best laser and the best laser surgeon" is NOT enough to replace the need for facelift to tighten and lift sagging jowls or to soften deep nasolabial and subcommissural folds, or the need for surgical lower eyelid blepharoplasty (especially if you need fat removal or repositioning, or lid tone and position improved). Let me repeat: No laser will replace plastic surgery for these areas!

However, if your overall skin tone is good in the eyelids and around your mouth, and you are bothered by crepe-like skin and fine lines around your eyes, and/or smoker's lines or lipstick "bleed" lines around your mouth, then laser resurfacing is absolutely appropriate for treating these conditions. In fact, I believe ablative combination CO2/Erbium-YAG laser resurfacing after proper skin preparation with hydroquinone therapy and Retin-A is the "gold standard" for treatment of the most severe cases of these lines. Peels of various types, and fractional lasers (the present"rage") also can make nice improvements with good technique and in proper hands, but can require multiple treatments that in my humble opinion cannot match a single laser resurfacing with this third-generation ablative laser.

The best way to summarize laser vs. facelift is to understand that laser works only on the surface (fine lines, wrinkles, and discolorations), and facelift tightens the deeper tissues and skin from the muscle layer to the fatty layer to the skin itself. Thus, do facial cosmetic surgery first, then undergo laser surgery (if needed) to deal with any fine surface irregularities or fine lines that remain after the swelling goes down. This two-step procedural approach gives the BEST overall results!

Angie, you were 35 years old when you had laser resurfacing and ended up with a life-threatening infection, ICU and respirator for 3 weeks, and now at age 47 you use alcohol daily and smoke 2 1/2 packs of cigarettes daily.

If your health were better, and you weren't a smoker, sagging jowls could be treated by facelift, or perhaps lower facelift. There is no laser that will tighten loose skin, just smooth the surface. Laser treatment would just give you smooth jowls, not wrinkled ones. Seriously. If you have loose skin, you must have a skin-tightening procedure to improve this area. Tightening the SMAS beneath the facial skin can further improve the result and increase the length of improvement.

But, I would really encourage you to stop alcohol use, stop nicotine use, start exercise and diet if you are not at a proper weight, and use the cigarette and beer money for your plastic surgery!

Angie, I grew up in Kansas and went to Medical school in Kansas City; Kansas folks are strong and fine people! I am really concerned for your health and encourage you to seek help with your addictions before considering any kind of elective surgery. Best wishes!