Robert Pettis, MD

Hello and thank you for your question and for providing a photo.  In our practice, we use the Icon laser system by Cynosure for Scar Reduction.  This is a non-surgical and non-invasive treatment, i.e. no cutting, suturing, etc.  While treating a scar with the Icon system can reduce the appearance, size and thickness of the scar, it is not a "reshaping" or "reconstructive" procedure such as a plastic or reconstructive surgeon would perform in an operating room environment.  That being said, we have seen very good results after a series of treatments, and our patients are very satisfied with their outcomes.  Each treatment is relatively quick, there is minimal discomfort, normal activities are not interrupted, and treatments are spaced about 4 weeks apart.  If you are looking for improvement but are not ready to consider more complex or surgical options, you may want to consider this treatment.  As other responders have advised, be sure that you find a clinician who has proven experience, actual patient photos, and engages in a two way discussion with you to plan your treatments. 

All the best to you.

Hello and thank you for your question.  In our practice we have had some patients see excellent results with PicoSure treatments for melasma.  You usually want to think initially terms of a series of treatments spaced about 4 weeks apart, and then maintenance treatments once every 6-12 months after that. 

With that being said, everyone is different and not all patients respond to melasma treatment in the same way. Melasma can be a challenge to treat and in some cases, heat can make it worse..  For that reason, after a proper consultation where we discuss the procedure, treatment goals, realistic expectations, etc., we usually do a small test spot to start so that the patient can see the process and results that can likely be expected.  Our patients have been very satisfied with the opportunity to "preview" what the likely outcome will be by going through the test spot process.

We recommend a skincare routine that uses SkinCeuticals products and have a few that we recommend specifically for Melasma patients and have seen some great results with.

All the best to you! 

 

Hello and thank you for your question and for providing photos.  We completely agree with the answers and information provided by our highly qualified colleague, Dr. Riehm.  There are excellent alternatives to Co2 to correct color, tone, texture, pigment, and fine lines. 

In our practice we use the PicoSure laser to treat these skin concerns (we have been using PicoSure since it was FDA approved almost 5 years ago), and it is one of our most popular platforms for treating sun damage/brown spots on patients over 35.  One of the great advantages to PicoSure is that there is minimal "down time" and PicoSure is considered a non invasive treatment.  Fall is a great time to begin treatments as you have likely completed your heavier sun exposure activities of the summer.  You will likely want a series of a few treatments to achieve best results, and treatments should be spaced about 3-4 weeks apart.  As previously stated, you will likely want to maintain your results with a follow up treatment every 6-12 months, and use sunscreen to protect your skin always!  

We wish you all the best! 

Hello and thank you for your question.  Tattoo regret is not uncommon, but we always recommend that a patient wait at least 3 months before beginning tattoo removal treatments.  Your body needs time to fully recover from the "trauma" of a new tattoo and you also want to minimize any potential side effects such as hyper or hypo pigmentation as a result of attempting removal too soon after application of new tattoo ink.  Taking good care of the tattooed area to ensure optimal healing will be beneficial when you begin treatments, you are on the right track.  In our practice, we use the PicoSure tattoo removal laser by CynoSure, which shatters the ink into tiny micro-particles which are then naturally eliminated by your body over time. PicoSure is usually more expensive than other laser treatments, but typically requires fewer treatments and is more comfortable for the patient, so keep that in mind as you consult with practitioners.

Stay healthy! All the best to you!

Hello and thank you for your question and providing photos.  PicoSure is not recommended for cosmetic tattoo removal.  There are several reasons for this but the most important is that it is not recommended to use laser energy of this type on or that close to the eye area.  Please be exercise extreme caution and consider other alternatives as this can be dangerous.  Your best option would be to contact the State of CA Medical Board and find a Board Certified Plastic Surgeon to consult with regarding alternatives.

All the best to you.