Is there a difference between the UltraPulse CO2 laser and Fraxel or Pixel lasers?

Great question.  There are many laser devices which can be divided into 3 main categories.
1) Fully ablative that includes CO2 and Erbium lasers (not used much these days due to downtime, recovery and risk)
2) Fractional Ablative lasers that include CO2 and Erbium lasers (brand names include Fraxel Repair, Lumenis Total Fx, Pixel)
 3) Fractionated non-ablative lasers (brand names include Fraxel Restore, Clear and Brilliant)
The main differences between these categories are the results and the amount of downtime and risk that goes along with them.  Fully ablative lasers have the most dramatic results but also the most downtime and risk.  Fractionated non-ablative lasers have less dramatic results and also less downtime and risk.  
Please see an expert in lasers to discuss the benefits and risks for your particular concern and lifestyle.
I hope this helps.

Thank you for your question. I regularly use both the UltraPulse Encore and the Fraxel devices in my practice. The UltraPulse can be used for ablative procedures, which work by precisely removing layers of dermal tissue. As the underlying skin heals, it becomes softer, firmer, and more youthful. This procedure requires 1-2 weeks of downtime, which will include redness, swelling, tenderness, flaking, and crusting as the skin heals.

Fraxel lasers provide fractional treatments that create micro-channels in the skin, leaving surrounding skin and tissue intact. This allows the laser to work deeper into the dermal layers with minimal downtime afterward. The micro-channels stimulate collagen production, creating smoother, firmer skin from the inside out. While downtime after this procedure is limited, the results are not as dramatic or long-lasting as an ablative treatment. Many patients also require a series of treatment sessions to achieve the best possible results. I recommend scheduling a consultation with an experienced, board-certified dermatologist for a personal assessment and customized treatment plan that will meet your needs and goals best.

there is no one right answer for laser resurfacing, especially without examining your skin, no doctor can make a recommendation. One would hope that a professional would not do a treatment with a laser if that were not the appropriate laser for your condition and refer you to a colleague that performs the best treatment. In my NYC practice, we have replaced our Ultrapulse C02 (carbon dioxide) with the Fraxel Repair CO2 laser and also do a great deal of resurfacing with Fraxel Dual / Restore, Clear & Brilliant, Permea, PicoSure focus, Infini microneedling and sometimes use multiple lasers on different areas of the face depending on what is needed for that specific patient's condition.

There are many lasers out there as you can see by the many responses. You are also right that most of us own one or two maybe three lasers. So we do often recommend only the ones we have. Most of the lasers have adjustments and settings to become very close to the others. It is only after an honest consultation where you will be able to decide if this is the best for you. I review the reasoning behind my recommendations and I am open to discuss any other lasers. Most laser surgeons become comfortable with their laser and then adjust the settings, power and treatment to each specific patient. Things like age, skin tone and goals of treatment all play into this. 
You just need to find a surgeon you trust and have this honest discussion. 
Hope this helps,
Best of luck, 
DrC

Thank you for your inquiry. There are several lasers available today for facial skin resurfacing. Lasers for skin resurfacing can be divided into ablative and non-ablative. The Ultrapulse CO2 fractional laser has the greatest diversity to treat depth and deliver the greatest energy. The Ultrapulse can be used as a fully ablative CO2, Active FX, Deep FX, or SCAAR FX depending on the patient. The Syneron Candela CO2RE is a great CO2 laser which delivers energy in both superficial, deep, and fusion modes. The Lumenis ResurFX is an Erbrium Glass laser which like the Fraxel are non-ablative. The Pixel is an Erbium-Yag laser which can be ablative or non-ablative. The most important part of Laser resurfacing is the operator and his/her experience with laser resurfacing. 

There are many different types of lasers, some with significantly different properties, and within each type of laser there are multiple brand names that may have slightly different bells and whistles to go with it. It's no wonder that it can be difficult as a consumer to sort them all out, and that's why this is such a great question. Often times, physicians push one laser as the best, because that is the one they have.A great analogy is pants: there are slacks, jeans, suits, even shorts, and within each of those there are an abundance of brands that make them. You are usually looking for a specific kind of pant, usually in a certain color, and you have a unique size and cut that is best for you. Once you're at that point the pockets or buttons or pleats may be slightly different, but at least you are in the right category. The best laser question you can answer is, what are you looking to get out of your laser: wrinkles, pigment, scarring, redness, all of the above?  As an example: for wrinkles, you can do fully ablative, fractionally ablative (CO2 and erbium) or fractionally non ablative lasers. Your downtime is going to vary between each one, and your downtime is going to be directly proportional to your results - more downtime, more results. Your physician should have this discussion with you first and foremost to determine your goals, then start to discuss multiple options with varying downtime and results. Most respectable laser practices will have multiple lasers and multiple options, ask them how many options they have for your particular goal. Seek out a Dermatologic surgeon, oculoplastic surgeon, plastic surgeon or facial plastic surgeon who is board certified and fellowship trained in one of these core four cosmetic specialties. 

Fractional Co2 Laer resurfacing is a popular technology where basically a scanner splits the beam of a 10,600 nm wavelength Carbon dioxide laser to provide a more controlled ablative column (hole) in the skin. Today the technology is rather commoditized, with many manufacturers offering some version of the laser with subtle differences in power, settings, and spot size. Other laser frequencies also have fractionation technology built into them (erbium), but I will focus this answer only on Co2.Having personally trialed many different Co2 fractional lasers, my experience has been that each can obtain a very similar result IF the practitioner has good experience matching the laser settings with the desired clinical outcome. The points of experience that I have found most important is choosing the correct spot size, knowing the depth of the hole in the skin, and finally knowing the density or amount of skin being treated. Experiences laser surgeons usually have some idea in their mind of these three parameters to plan a treatment. If one reviews the data provide by many of these laser manufacturers, the best outcomes shown are often very similar, with the assumption being the physician whose the right treatment parameters for the patient.Finally, one new element that is important in laser resurfacing are the adjunctive therapies being done to achieve better clinical outcomes with less down time. The most significant I have found is the addition of PRP (Platelet Rich Plasma/ TruPRP) with the laser. PRP I have found gives the practitioner more flexibility in the laser settings and the final outcomes. 

There is no "best" C02 laser system.  The key is to understand the technology and how it is being applied to your skin.  There are basically two types of C02 laser technologies, fully ablative and fractionally ablative lasers.  

Fully ablative C02 laser is not used as commonly, but does have a role in specific lighter skin types.  The main issue with this technology is that the downtime can be longer than ideal and the rate of complications, such as hypopigmentation and scarring is higher than most patients and surgeons find acceptable.

Fractionally ablative C02 lasers are the laser technology of choice since they offer many of the benefits of fully ablative lasers without the downtime and the complications.  

 

The results of Fractional CO2 depend less on the brand of laser and more on the assessment of your skin and the settings used to treat you.  I have found that in my Santa Monica plastic surgery practice, there are rarely two patients who will need the exact same settings for fractional co2 laser.  I custom tailor a computer generated laser treatment to your particular situation and requirements.  Fractional CO2 laser is an excellent modality for laser skin resurfacing and can be used successfully on most skin types.  I treat patients in the peritreatment period with Melaquin AM and Melaquin PM to reduce pigmentation from fractional CO2. 

Dear Mrs. Westfall,

The newest, strongest, latest, greatest, coolest lasers come on the market daily...according to the laser companies. Keeping up with the many laser devices on the market is beyond most physicians as well. The fact of the matter is that if you want great results for true facial resurfacing only 2 things really matter:

1. Get the Best Technology. The current leading technology is fractionated CO2. It combines the gold standard results from the traditional CO2 with the improved downtime from fractionation technology. It's like having your cake and eating it too. I happen to have the Lumenis UltraPulse because it is powerful and versatile. I can customize my patients' treatments to exactly meet their treatment on my wife - who loves her results!

2. Who is firing the technology? Go to someone well trained, board certified, experienced, who you TRUST. Have a great doctor-patient relationship to assist you in selecting the best treatment for you, to facilitate a healthy recovery...and to enjoy your beautiful refreshed results with! 

Best of Luck,

Dr. Bassichis