Laser resurfacing and downtime

Hi, Diane,

I would respectfully disagree with Dr. Berkowitz about one aspect. Traditional CO2 laser can indeed give you the best results in terms of tightening of the skin and removal of wrinkles. The downtime, however, is much longer than a week. It can take up to a month of redness and edema, and sometimes patients might stay red for up to 6 months or longer.

Fractional CO2 downtime is much less. The results, are as well, less dramatic, but usually good enough to justify the procedure. We have Active FX which has the ability for superficial and deep treatment, and we have found the results to be fantastic. We can and do adjust it for each patient individually, varying the amount and intensity of both deep and superficial components. Unfortunately, the more intense is the procedure, the longer will be the downtime. We can usually plan the procedure so that the patients don't have to have multiple procedures.

Fraxel Repair is a similar concept fractional CO2 laser. The older Fraxel is much less invasive, therefore requires multiple treatments, again with less results. Other CO2 lasers will usually be the middle of the road, if you will.

The other important question is: why are you considering resurfacing? Is it wrinkles, sun damage, acne scars or other scars, loose skin? This answer will guide the choice of the laser procedure, and in many cases will influence the amount of necessary downtime.

Laser resufacing can be done with as little downtime as you desire to the most downtime and most results. Very simply, more risks can lead to more results and vice versa. For more superficial results, all you have to do is turn down the energy on the laser and decrease the density that the lasers create with their spots that remove skin. 

Lumenis makes the Active FX system and this is the most versatile system out there and can be tailored to fit almost any person. There are an almost infinite amount of combinations that can be carried out to fit the person. Superfiicially, 50-75mj of energy, density 1-3, with cool scanning and one pass can give you a downtime of 2-3 days or less. Turning it up to 80-100mj of energy, with a density of 4-5, and 2-3 passes can give you a downtime of a couple of weeks to months depending what you think creates downtime for you. Redness can occur typically when you get more aggressive and can stick around for months. But severe crusting and swelling usually fades in 1 week with the more aggressive approaches.

Laser resurfacing are great for cosmetic and medical reasons. If you are interested in improving your wrinkles, pigmentation problems (like sun spots, etc), the size of your pores, your skin texture, etc laser resurfacing can be a great option. It can make a huge difference in your appearance for the better. These are things or areas of improvement that really only resurfacing can do in a significant way. Skin care with cosmeticeuticals can only minimally improve your skin. Some skin care lines at the doctor's office can do a little more than the products that you get at the cosmetic counter.

You might not know this but resurfacing can also improve your skin by reducing the number of cells that are bad as well. So from a medical standpoint, it can be beneficial in reducing your chances of acquiring skin cancer. This is done when you remove your more superficial layers of skin through resurfacing and receive more refreshened cells from deeper within your hair follicles when these cells "resurface" the skin that has been removed. These newer cells typically have much less DNA damage and hence less bad mutations that lead to cancer and this has been proven in scientific studies.

Consulting a Board Certified Facial Plastic Surgeon would be something that I would recommend. We specialize in the face and are highly qualified to help you with this.

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