FRACTIONAL CO2 LASER Laser Resurfacing with Faster Recovery




Fractional CO2 laser skin rejuvenation is widely considered to be the current state of the art for improving skin texture/laxity, wrinkles, dermal lesions, photo aging, acne scarring and some dyschromia. In simple terms, this technology for skin resurfacing can smooth and tighten the skin, reduce pores and wrinkles, remove many superficial skin lesions, reduce many of the signs of facial age, improve acne scarring and many skin discolorations. Fractional CO2 laser offers skin rejuvenation which can be quite dramatic with far more rapid recovery than traditional CO2 laser resurfacing. 

Earlier versions of fractionated lasers, especially Erbium, hastened recovery but could not reproduce the effects of the standard CO2 laser. Before the development of fractional CO2 technology, the pain and prolonged healing time for earlier CO2 laser treatments caused many patients to shy away from potentially beneficial treatment for facial aging, discoloration and scarring. At the Plastic Surgery Center of Dallas we offer the SmartXide DOT Therapy Fractionated CO2 laser which we believe offers an excellent balance between maximum skin improvement with minimum down time. Tiny dots of skin are treated with CO2 laser leaving “dots” of normal skin between the lasered perforations which enter the skin, ablate the underlying collagen and initiate the collagen renewal process.  A wide range of settings can be used and, at the more aggressive end of the spectrum, there may be some oozing and surface wound care. At the more conservative end of the spectrum, the healing process usually consists of mild peeling and flaking of the skin while the patient uses physician grade emollients and moisturizers to speed the process.  Older technology CO2 laser resurfacing had dramatic results but essentially blistered the entire facial skin surface, requiring much more comprehensive care and longer recovery with quite a bit of discomfort.  With this newer technology, because of the fraction of normal skin blended in with the treated “dots”, healing is far more rapid with far less discomfort and risk.  The underlying collagen regeneration proceeds as with non-fractional older technology resurfacing, while the surface heals much more quickly, often in as little as four to six days. 

With the exception of relatively aggressive treatments, patients need only topical anesthesia for treatment of the full face and they describe the sensation following the treatment as similar to a sunburn.  Treatment of the entire face can be done in as little as twenty minutes for a single pass.  Immediate skin tightening is seen during the procedure and patients will have mild swelling for a couple of days thereafter. There is a light “glaze” on the skin which peels off in a few days.  Most patients are back in makeup in five to six days with only mild pinkness of the skin, although in some individuals the skin can be quite red especially with more aggressive treatments. Collagen replenishment continues for many months as the CO2 treated collagen is replaced with new, “tighter” collagen fibers. Reports show that this process takes approximately six months to reach its final state.  Sun protection is essential during this time.

The SmartXide DOT Therapy Fractionated CO2 laser is unique in that the intensity of the treatment can be increased or decreased depending on the patient’s need. This also means that patients can choose a more intense setting to get deeper wrinkle or scar improvement, accepting more redness, swelling, peeling and recovery. Lighter settings may be chosen, sometimes as a series of treatments, each with fast healing and recovery. This will be determined during your consultation.  This versatility allows the physician to customize treatments for each patient’s specific desires.  Wrinkles, fine lines, brown age spots, some sagging of the lower eyelid skin as well as acne scars and other facial scars can all be treated with the DOT Therapy Fractionated CO2 treatments. DOT therapy is also effective for reducing the size of pores. 

All treatments result in improvement to some degree, but it is important to understand that nothing can recreate the perfect skin of youth or eliminate all scars.  In some cases patients may opt for additional treatments, especially for deep acne scars. In these cases a period of six to nine months should be allowed between treatments to allow full recovery and evaluation of results.   With realistic expectations, DOT Therapy Fractional CO2 laser resurfacing offers a wider range of treatment options for rejuvenation of the face with the promise of much more rapid recovery and far greater patient comfort.

Article by
Dallas Plastic Surgeon