How Much CO2 Laser Treatment Is Needed On My Face? (photos)

Question

Welcome! How much CO2 laser treatment is necessary to reduce my face scars or to help them disappear? Thank you in advance!

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

I suggest consulting with a board certified cosmetic dermatologist who is experienced in treating acne scars. You would yield the best results by adopting a combination method treatment approach. C02 (if you are a candidate for it - you need a consult to determine this) can provide results relatively quickly when done in combination with a full treatment plan often consisting of additional lasers (customized based upon your specific case), peels, proper skin care, and microneedling w/ prp. See an expert in order to determine what would provide you with the best results.

Nissan Pilest, MD · Answer

Scar tissue with textural differences and density should be treated differently so combining treatments can most definitely help expedite the results, as well as increase you treatment efficacy. Further down you will find the ideal steps on combined these specific treatments to reduce the appearance of acne scars.
Prior to your C02 treatment subcision can be performed on any present boxcar scars to separate fibrotic strands that are tethering the scar to the underlying tissue. 
  Immediately after your subcision, Fraxel Repair (c02) if preformed on the full face, focusing on any dense scar tissue. Due to the intensity of the Co2 patients can expect 5-7 day downtime when paired with PRP. 
  Platet-Rich-Plasma (PRP) (which is your own concentrated growth factors) is then injected directly into the scars, as wells as microneedled on top.
  Result very patient to patient. Always discuss with a Board Certified Dermatologist desired results.

Davin Lim, MBBS, FACD - Account Suspended · Answer

In fact for your first few sessions I would subcise your scars, micro needle manually your forehead, then consider either RF or CO2 fractional laser. 4-8 sessions depending on the degree of sub dermal fibrosis you have. See Dr Emil Henningsen or Prof Tony Chu if you are in Europe. Acne scar revision is a sub-specialised field. For the best results, one should target the acne scar type with ideal treatments methods and not just one device. It is the dermatologist or plastic surgeon and the settings behind a device combined with proper technique that will give you the best results.

For example deep ice pick scars, and narrow box car scars can be treated with TCA CROSS peels, mixed scars, rolling, and atrophic scars treated with fractional devices such as Fraxel, fractional lasers, PRP and INFINI radiofrequency. Atrophic scars (depressions) can be treated with either fat grafts, or with HA dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that we use include punch elevation, surgical elevation, punch excision and traditional excision of focal scars.

The majority of patients will have a collection of different scar types, and hence a tailored treatment METHOD will be best. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. In the majority of patients its finding the correct combination that give you best results, and everyone is unique! All the best,

Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.

How Much CO2 Laser Treatment Is Needed On My Face? (photos)

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