Laser Resurfacing Results Vs. Downtime
- Asked 5 years ago
Hi - I am considering laser resurfacing, and I have a couple of questions:
1) What kind of results can I get for the least amount of downtime?
2) What kind of results can I get if I opt for a laser treatment with the highest amount of downtime?
3) Please give me some examples of lasers that would fall in the ranges described in questions 1 & 2. Also if there are any middle-of-the-road options, please let me know about those as well.
Laser Skin Resurfacing Works Great!
Laser skin resurfacing has been very effective at tightening skin and reversing sun damage. The gold standard is traditional resurfacing with a CO2 (carbon dioxide laser by Coherent , now Lumenis). The downtime can be 7-10 days on average. Most patients have rosiness to their skin for another 8-12 weeks. The results are beautiful causing a major improvement in sun damage and diminishment in wrinkles. (Answer to question # 2)
Since many people do not want to have so much downtime, physicians have been searching for an alternative that can give CO2 results with minimal time off. Other modalities have come about like erbium and fraxel but I have found the best results to occur with CO2. Last year I imported from Italy the Mixto laser. It is fractional, meaning a fraction of the energy is placed upon the skin. This allows the skin to heal much faster and with greater patient comfort. The beauty of it ( as well as some other lasers on the market) is that it can be tuned to your skin. I am able to perform a very light fast healing treatment or a more intense treatment which will have even greater benefit. If someone wants very little downtime they can have a series of treatments which can be additive. (Answer to question #1)
Laser resurfacing downtime
A general rule of thumb is the better the results the longer the downtime. Microfractional CO2 laser resurfacing alone can smooth and tighten skin up to 60% and dramaticaly reduce pigment. Our patients are able to return to work in 7 days with a minimal powder makeup to cover redness. The neck area takes 2 additional days to be presentable and is usually covered by a silk scarf and the chest/decellotage area is covered by a closed blouse until day 14. If a patient needs deeper resurfacing (up to 80% tightening) on the lines aroud the mouth or eyes with Microfractional Plus, (Sanding down ridges with a Scition Erbium laser first and then using the Microfractional CO2 laser to tighten and snooth), they wil need 8 or 9 days before makeup will cover the red. This make up will need to be used 3 to 12 weeks, but you are back at work durin this time
Laser Resurfacing Results And Healing Time Go Hand in Hand
The results you get from any resurfacing procedure will depend on how aggressive the procedure was done. This also directly correlates to healing time. Sadly, this is a very confusing subject for patients becuase there are so many technologies out there along with a lot of mis-information. The newer non-ablative treatments have minimal down time, but create minimal effects. This is great for the 40-year-old who wants to liven up their skin. If your problems are more significant, don't waste your money on non-ablative treatments. Sadly, the physicians and companies that sell these machines are much better at marketing than they are at getting results. Before and after photographs cropped down to small areas of the face and taken with harsh angled lighting in the before and soft straight on lighting in the after should tip you off to phony results. Absolutely nothing can touch the results of a standard ablative resurfacing in the patient who has signicant age and sun related damage.
The best of the new technologies available today are the fractionated CO2 lasers. There are many brands and many of these will give the same results when set to similar settings. These lasers really do open up an in-between world of very nice results with a managable healing course, even for busy people. Don't expect to wipe away deep wrinkles, but here we have something that in one week of healing will provide very demonstrable results especially with sun spots and fine wrinkles. This tends to be the best procedure for the typical mid to late 40-year-old, while conventional resurfacing is usually necessary for the person in their 50's and beyond. The fractionated lasers are also useful on dark skinned people and other parts of the body besides the face. Of course, everyone is unique and needs to be evaluated as such.
Web reference: http://www.dr-apo.com/surgical-procedures/laser-skin/
Recent Laser Resurfacing Reviews
Laser Resurfacing Photos
There are many options you can choose from
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.
Fraxel may offer you what you are looking for
1) Usually, the least down-time procedures involve minimal results but the arrival of the Fraxel Restore laser, has allowed people to have some redness, mild swelling and peeling with some bronzing for three to five days. Most people though, continue to do their normal routine. Fine lines, acne scars, uneven brown discoloration and texture and pores can improve with this technique. IPL light sources, are not lasers, and they can improve uneven discoloration but do not help scarring.
2) There is the best result in diminishing wrinkles and acne scars with laser ablation. Ablation refers to the removal of the top layer of skin leading into the dermis. Recovery can be 12 days and redness lasts for many months. The new Fraxel Repair uses this technology in a shape of many very fine diameter beams that minimally wound the skin. Healing is more rapid and gentle than the old fashioned laser ablation. Portrait plasma energy source can effectively treat wrinkles and scars and discoloration along with providing tightening.
The answer to your questions lie in what your conerns are - are you concerned about wrinkles or age spots or possibly both. The second half of the question is - how much of a result are you looking for versus how much of a downtime can you take. For some people, downtime is the key and even if they don't get the best result possible, they will be happy with some result. For patients with deep wrinkles, often deep laser treatments or at least multiple superficial treatments are necessary. Deeper treatments can increase downtime but increase improvement. More superficial treatments may not cause as much downtime but because of repeated treatments may result in the same overall amount of downtime. The best answer to your question will be attained by visiting with a physician who offers all of the options that you are thinking about - from minimal downtime such as Fraxel to more downtime such as conventional CO2 or phenol peels.
Laser resurfacing and downtime
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.
Usually “low” downtime results in poor long term results (downtime less than 3 days). Longer downtime results in a more profound improvement. The goals and the problem to address must be discussed first. You may not need to have an aggressive treatment. If you have lines present without moving your face, then an aggressive treatment is needed. If your skin is dark, then an aggressive treatment may have a higher risk of pigmentation and scarring. Lasers have options in settings which can be very mild to very aggressive. The lasers to use are usually CO2, Erbium, or YSGG-Erbium glass, in the right hands. The involvement of a Board Certified Dermatologist or Plastic Surgeon experienced in lasers is a vital.*
Web reference: http://www.elitemdspa.com
These techniques improve fine wrinkles, uneven pigmentation, and general sun damage. They act by stripping away the superficial layers of the skin. New skin cells migrate to the treated areas and produce new, smooth, natural collagen.
Chemical peels such as trichloroacetic acid (TCA) can be applied to the entire face and neck (avoiding the eyelids). Dermabrasion uses a spinning wheel with a rough (diamond encrusted) surface to abrade the skin; this is especially good for the pitting of acne scars and vertical lines around the lips. Lasers can also be used to resurface facial and neck skin. It is effective in treating wrinkles, age spots, acne scars, and uneven pigmentation. The laser also causes a mild tightening effect on the facial skin.
These treatments result in redness and peeling of the skin for 5 to 10 days. There will also be some swelling. Most patients can return to work within 2 weeks. The pink color of the new skin may last for several months.
Dr. Wiener now also offers a new Laser Micro-Peel procedure that reduces post-procedure down-time by nearly 50%. Please contact the office for further information.
The degree of effectiveness of laser resurfacing is proportional to the amount of down time.
An easy way to consider my response to these questions is that, generally speaking, the degree of effectiveness is proportional to the amount of down time. The more aggressive lasers, when more aggressive results are desired, generally have greater down time associated with them. I think of down time, as it relates to effectiveness, along a continuum. On that continuum, the least aggressive treatment with the least down time would be a series of light chemical peels designed to address minor skin blemishes, improve pore size, skin tone and texture using a “medium strength” peel – such as a trichloroacetic acid (TCA) peel.
Then, moving into lasers with even greater effectiveness and proportional down time, “fractionated” resurfacing techniques generally are at the lower end of the scale for lasers with regard to associated effectiveness and down time. These treatments are fairly aggressive but with less down time than the truly ablative resurfacing laser procedures such as CO2 laser resurfacing or Erbium: YAG laser resurfacing. The treatment you choose has to be very specifically designed to address your unique concerns while allowing your recovery to stay within your available timeframe for down time.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.