Can you combine Photorejuvenation, TCA Cross and Fraxel laser in a session? (Photo)

Question

I just met with a doctor that proposed to combine photo rejuvenation, TCA cross and Fraxel laser (on top of TCA) during the same session for better improvement. So I wanted to get a second opinion on whether it is effective and not too aggressive for the skin. They use ellipse Nordlys laser. He also mentioned nanofat injections after 2 sessions. I have done e matrix and micro needling in the past but I'm trying to get rid of the pigmentation and enlarged pores. Thank you

Monika Kiripolsky, MD · Answer

Dear Gaelleib,I do often combine treatments for the best overall cosmetic results. However, I'm not a huge fan of the TCA CROSS technique. It occasionally makes acne scarring more prominent if it is not done correctly. Also, Fraxel is the company name that makes several types of lasers (one of which is an erbium - non-ablative - laser, another is a carbon dioxide - ablative - laser, etc). In my opinion, the only one from that company that would give you noticeable improvement would be their carbon dioxide laser. You could benefit from an IPL/photofacial on vascular settings for the redness. Please make sure that whomever you see is well-trained in using these devices/doing these procedures as quite a bit of skill is necessary to achieve great results (and to avoid potential side effects).Hope this helps,Dr. Kiripolsky

Jason Emer, MD · Answer

Thank you for your question!
It is quite common to combine treatments that way, as long as you have an experienced doctor handling your care. I like to give my patients the best results possible, and I find that combining treatments does just that.  
Hyperpigmentation from any type needs a combination approach of peels like cosmelan, lasers like clear and brilliant and aerolase or laser genesis, radiofrequency like venus viva, (RF and microneedling combination treatments like Morpheus) and constant skin care and sun protection. Bi-monthly facials with silk peel dermalinfusion is essential to hydrate, exfoliate and infuse vitamins and antioxidants into the skin. If you have acne you can do additional treatments and peels to get more improvement. 
I recommend getting a formal evaluation with a cosmestic dermatologist. 
Best, 
Dr. Emer

Michele S. Green, MD · Answer

I would be careful to have so many aggressive lasers in one session especially TCA on top of the Fraxel laser.  It would be a very aggressive treatment. I would combine the V-Beam for the redness and the Fraxel for the pigmentation and scarring at the some time. Please consult an expert in acne scars for the best cosmetic results. Best, Dr. Green

Davin Lim, MBBS, FACD - Account Suspended · Answer

As Dr Green has eluded, vascular laser such as the V BEAM will give you more traction than other lasers - given your presentation (red spots, active acne). The combination you describe is absolute safe, however a more targeted approach should give you better outcomes. Video will explain. Kind regards, Dr Davin Lim. Brisbane. Australia.

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