Difference between plastic surgeon and medical spa? (photo)

I have gotten multiple pixel C02 lasers at a medical spa for scarring on my left cheek (picture attached). They did the laser on the highest setting, and yet the results have been negligible. I am planning on getting fractional CO2 now by a renown plastic surgeon, Dr. Bassichis in Dallas. Can I expect much more significant results now from a surgeon? Also, looking at the picture, does the scarring look like it can be treated to where it is not noticable? Or is it too deep? Thanks!

Doctor Answers 2

Treating Scars with Co2 Laser

The use of fractional CO2 lasers to treat facial scars can be very effective to help improve the contour of the skin. This treatment can be used as a stand-alone or in combination with other treatments for facial scarring. With pitted scarring for example from old acne scars, the use of the Co2 laser can be more measured in the results that one sees. Here is our approach to such cases:

Based on skin color, scar depth, and time from when scarring happened, we make a determination of what laser setting we will use AND what adjunct therapy we will use with the Co2. Adjunct therapies with Co2  can include using steroid injections or topical with new scars, combining the Co2 with TruPRP (platelet rich plasma), injecting the scar with your own fat (Adivive) and PRP (TruPrp), injecting the scar with HA fillers (Restylane, Juvederm, Belotero), combining the laser with focused intra scar deep micro needling therapy (Rejuvapen), and finally using the laser after classical scar removal surgeries.

In our experience, CO2 remains a good baseline treatment but combining it with other things can get one a lot further in improving a scar. 

Phoenix Facial Plastic Surgeon
4.1 out of 5 stars 25 reviews

Acne Scarring and CO2 Laser

The type of scarring you have needs a combination of laser, surgery and fillers.  Typically I will individually remove the scar and suture it closed, then let it heal 4-6 weeks.  After which I do laser treatment to smooth it out, and then fillers to keep it raised (if needed).  You need someone with experience in skin care and acne scarring.  Solely doing co2 laser will only give you modest results at best given the type of atrophic and icepick scars you have.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

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.