Can someone give me the names of fully ablative lasers?

Question

After all the research I have done I still don't know what laser is fully ablative C02 laser? I thought Lumenis deepFX is but then I read it is fractional laser.

Mark Hamilton, MD · Answer

Thank you for your question. The main wavelengths used for fully ablative laser resurfacing are CO2 laser and Erbium. For CO2 laser Lumenis is the most commonly used device, but the active fx and deep fx technologies are actually fractional applications. That said, by altering the settings, your physician can use the active fx in a fully ablative mode.Hope that helps!

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

David Gilpin, MD · Answer

Thank you for your question.  The 2 types of ablative lasers are typically a CO2 laser and an erbium laser.  At the term "ablative" means that the laser is removing a very thin skin layer of the skin, which is what promotes the rejuvenation and smooths the moderate and fine lines of the skin.  A non-fractional ablative laser will remove this thin layer of skin where ever the laser is used.  A fractional laser, in contrast, ablates the skin in a pattern, and in small points leaving nontreated skin as well.  Therefore, the laser is only treating a 'fraction' of skin with each pass.  The advantage of a fractionated laser, is that the downtime is usually less than its non-fractionated counter-part.I would consult with a board certified facial plastic surgeon or plastic surgeon who has experience with resurfacing lasers for an in-person consultation.  Here you will be able to discuss your goals for the procedure. I hope that this helps!-David Gilpin

Harold J. Kaplan, MD · Answer

Hi Saphire.  "Fully ablative" is what we would describe as "full field", meaning we can resurface 100% of the surface of the skin, vs. a portion of the skin.  When we resurface a portion of the skin, it is called fractional laser resurfacing.  We do not own the Lumenis Deep Fx, but on our laser resurfacing device, the Sciton Profractional, we can use full field (100%) or fractional (5% - 22%).  With fractional, we also use multiple passes to increase the overall % of skin resurfaced.  We wonder what you are considering with full field resurfacing.  Using the full field is an older methodology because the risks are higher, the recovery longer, and requires general anesthesia for deep full field.  It is also not used on darker skin types.  All of these were factors that influenced the development of fractional laser resurfacing.  Fractional can be used for all skin types (at least erbium fractional) and can go deeper with less downtime because we don't treat 100% of the skin.

J. Marshall Green, III, DDS · Answer

Hello, 
  Thank you for your question and I'll do my best to answer it here. Ablative simply menas that the tissue is being removed or destroyed. This can be the case with either CO2 or Er:Yag laser resurfacing. CO2 creates a charing effect while tightening collagen with heat deposition and Er:Yag use results in straight vaporization of the tissue. Certain Er:Yag Lasers like Sciton allow for heat to be "dialed in" but never result in the immediate skin tightening effects of the C02 laser. Now when it comes to the term "Fully Ablative" this usually refers to the amount of skin being ablated through the density setting. When I use the term fully ablative in my practice I am referrring to Active Fx lasering of 80mj or more and a density of 6 on the lumenis ultrapulse. This means full coverage of the face with a high desnity pass at relatively high power. Both the laser power and density can be adjusted to provide a lighter resufacing with less down time. I do hope that clarifies things and doesnt just add to your confusion. There are lots of variables but with the right settings and use by an experienced provider you can have phenominal results with CO2 laser resufacing. Other than facelift surgery laser resurfacing often results in some of the most dramatic results I see in my practice. Hope that helps! 
Sincerely,
  Dr G

Richard Ort, MD · Answer

The two common types of ablative laser are CO2 and erbium.  Usually these are used in fractional mode, which delivers tiny "dots" of injury separated by untreated skin.  The benefit of fractional ablative is faster healing with less risk.  Ablative lasers can also be used in traditional non-fractional mode to ablate the entire surface of the skin ("fully ablative"). This is a more aggressive treatment and might be appropriate for someone with deep wrinkles, but has a longer recovery period and a higher risk of side effects. In my office, we use the Smartskin CO2 laser (also known as SmartXide Dot).  Most of our treatments are fractional because the results are good, pain is mild, and recovery is generallly quick and uneventful.Regards,Dr. Ort

Richard O. Gregory, MD · Answer

What is a fully ablative laser?  There is a great deal of confusion about the term ablative with regard to lasers. This is in part due to the marketing efforts of the laser companies and laser therapists. A common goal is to achieve the optimal result with the least downtime, recovery, pain, cost, etc. A potential patient should set a goal of improvement and then ask which laser would best serve to accomplish that goal. There is a strong correlation between improvement in the skin condition and the following factors: pain, recovery time, redness and crusting or flaking, and even forced. The patient should seek consultation by a surgeon who does several different types of laser resurfacing and can offer the patient a variety of options.  Do not expect the best results with the least consequences.The term ablative relates to tissue disruption. Almost any laser used at high energies can disrupt tissue. The carbon dioxide laser whether fractional or non-fractional is almost always ablative to a greater or lesser degree. Even with the wide variety of carbon dioxide laser treatments available a treatment protocol can be designed which best achieves the patient's goals.

Ahmed Sabet, MBBS · Answer

Thanks for your inquiry.
There are many ablative laser resurfacing technologies available but the most common are CO2 and Erbium Laser resurfacing for facial rejuvenation, acne scarring,...
To find out whether you are suitable for this procedure you must carefully choose your clinic and consult an experienced laser dermatologist to be fully assessed and explained in details about the outcome and side effects, recovery time,etc
Best of luck,

Davin Lim, MBBS, FACD - Account Suspended · Answer

There are many brands of CO2 and erbium lasers, most can do fully ablative or fractional mode. The most important factor behind the laser is not the brand itself, it is the experience of the Specialist. My suggestion is to see 2-3 Board Specialist and find out who you are most comfortable with. Reviews on this site help, but seeing before and afters will also assist. Remember, Specialist before laser brand. Cheers, Dr Davin Lim.Brisbane Dermatologist. Australia.

Sara A. Kaltreider, MD (retired) · Answer

The best approach to resurfacing is the combination of fractional AND ablative CO2. The older CO2 lasers were not fractional - in other words - all of the epidermis was treated and removed. The new skin growth came from the skin appendages - hair follicles and associated glands. Many of the patients treated had a very long and uncomfortable recovery and the end result was smooth skin, but very pale skin tones. Now, there are several good FRACTIONAL ABLATIVE CO2 lasers on the market - a percentage/ fraction (20% - 60+%) of the skin cells are eliminated, but 100% of the dermis is treated with the heat. Translated - that means that new collage is formed, old collage is remodeled, and enough of the skin is ablated so that skin irregularities are corrected - pores, wrinkles, age spots, uneven skin tones - all improve. We don't see the ghost-like complexion that was common with the CO2 lasers in the 1990's. I use LaseringUSA's MiXto because of its Z-pattern computerized hand-piece which delivers the laser in a more comfortable manner, and allows full control of all parameters. It can be used at maximal settings for a particular skin type - or - it may be turned back for a milder "lunchtime" peel. Down time is minimal at 3-5 days. Their website has a directory for MD's in your area who have this technology.Best wishes.

Can someone give me the names of fully ablative lasers?

Answers (10)

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