Very Deep ProFractional Treatment - Fear

I am scheduled to have a very deep ProFractional treatment for acne and wrinkles in a week and I was told I would only need one very deep treatment ($1600.00). I am terrified of the pain and any possible disfiguration. I was also told that I would look like a monster for a few days, which I can handle as long as my face heals and there is no disfiguration. Is it dangerous to do a very deep ProFractional treatment? The surgeon is doing my entire face and the process will take 2 ½ to 3 hours.

Doctor Answers 3

Deep ProFractional Treatment

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Thank you for sharing your concerns. I understand your trepidation and I agree that you should share these with your surgeon. You should feel comfortable with the procedure and your surgeon before going to the operating room.  Any intervention has inherent risks and complications can and do occur. That said, in capable hands, laser resurfacing is a fantastic procedure with uncommon adverse events. The Sciton profractional laser uses an Erbium laser for vertical wounding of the skin. Erbium's peak energy is absorbed by water causing immediate vaporization of a vertical core of skin reaching the deeper portions of the dermis without transmitting much heat to the surrounding tissues. Injuring the deeper tissues is critical for getting the most improvement in wrinkles and skin tightening. A series of superficial laser treatments will never reach the same benefit level as a single deep procedure. This clean removal of tissue without much heat leaves the remaining skin surrounding the defect uninjured and has a much less chance than traditional carbon dioxide lasers to cause pigment changes or scarring. The precise removal/ablation of the top layer of skin is less deep and allows the remaining skin within the hair follicles to quickly resurface the face with new skin. With good post-operative care and appropriate interventions when necessary, risk is minimal. As for looking like a monster, your post procedure appearance isn't anything you will want to show off for at least a week and maintaining moisture can create a mess for your clothes/sheets. After it is finished, you should be very impressed with your results. I am sorry for my frankness, but I don't believe in any surprises for my patients so I try to lay it all out beforehand. There is no use in sugarcoating the challenges of the healing process.  I hope this helps. Take care.

Dallas Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

You need to discuss your fears of the upcoming procedure with your surgeon

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It is true that the deeper profractional treatments give better results in fewer treatments.  It is also true that it is more painful to have deeper treatments.  Sciton's Profractional is an excellent resurfacing laser, but it is a powerful machine and deeper treatments can potentially have more complications. 

You must also know that no matter how safe the procedure and how experienced and knowledgeable the treating physician, there is no way to guarantee that there will not be any adverse events during or after treatment.  However, you do want a board-certified dermatologist or plastic surgeon with training and experience to do this procedure.

Talk to your doctor if you are afraid of the upcoming procedure.  You should not be uncomfortable.  Ask for before and after photos, ask whatever questions you have regarding the procedure and consider doing several more shallow treatments.  That tends to give you a shorter recovery time and with a number of treatments should give you similar results to one deep procedure.

Emily Altman, MD
Short Hills Dermatologic Surgeon

Deep treatments- risks and fears

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OK, the machine itself does not do the damage, nor expose you to any danger, as with all laser treatments, the biggest factor is the operator. 

To answer your question, if performed correctly, even the deepest setting is safe, however the downtime and time it takes to perform the procedure will be dependent on density and the number of passes. 

The danger as per all laser procedures includes changes in skin colour, scarring (v v rare) and infection. Your Specialist will discuss all of this in absolute detail with you and will or should follow you thru the healing up processes. 

Dr Davin Lim 
Laser and Cosmetic Dermatologist

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.