Thank you for your question. You’ve submitted several photos that describe your CO2 laser procedure which resulted in significant loss of pigment that you feel left a ghostly appearance. You say the treatment left you with acne-like scars, so you’re looking for a solution to help improve skin quality. I can help you with some perspective as a board-certified cosmetic surgeon and a fellowship trained oculofacial plastic surgeon in practice in New York City for over 20 years. I deal a lot with thermal-related trauma due to aesthetic devices.Your situation is a little unusual for CO2 laser. When I trained with the CO2 laser back in the mid-90s, the CO2 laser was very aggressive, ablative, and generated a lot of heat. Since so many people had complications at that time, the CO2 laser was widely abandoned by the majority of colleagues, until the fractional CO2 lasers came in a couple of years ago. In my practice, I use the fractional CO2 laser a lot. However, my approach about how to rejuvenate skin has evolved over time as I’ve developed regenerative medicine techniques to build tissue with your body’s own natural abilities, specifically using platelet-rich plasma (PRP). Platelet-rich plasma is derived from your own blood, and a lot of work about its effectiveness can be found in the National Library Medicine or PubMed. It’s not highly publicized in the cosmetic field, which I believe is due to no big pharmaceutical or medical device company promoting it. Currently, people like you are being overheated by thermal devices which are supposed to create non-surgical skin tightening. However, they soon realize they’re losing skin quality, the skin is getting thinner, scarring occurs, and they’re losing fat under the skin.In our practice we use platelet-rich plasma to stimulate the blood supply and the fat cell layer under the skin. We use PRP on acne scars a lot, and also have a lot of success combining it with hyaluronic acid fillers for more long-term improvement. I’d suggest considering platelet-rich plasma to help improve your skin’s appearance. It’s important to note that PRP is not a onetime treatment- it’s like going to the gym to build muscle - you treat, observe the result, then you treat again. The difference of platelet-rich plasma compared to thermal devices is you’re not heating the skin. PRP stimulates skin quality by increasing blood supply, and by improving and increasing collagen. Basically, you’re leveraging the natural wound healing mechanism of the body to improve skin quality. I’ve consistently seen the benefits of platelet-rich plasma for dark under eyes circles, acne scars, and skin quality improvement like complexion improvement. People who don’t have any problems with skin trauma often come in for skin quality improvement alone. We use PRP to treat their complexion due to the effects of facial aging where there’s loss of collagen and blood supply. PRP gives the skin this remarkable and unique glow.While there are some topicals that may be a value, when there was past ablation, tissue rehabilitation is the way to go. I would avoid any other type of thermal devices, which I don’t think you’d pursue anyway. It’s unfortunate you‘ve had this result, but I think there is value to this. Other ideas also include fat grafting and adipose-derived stem cells, but those are more surgical procedures, while PRP is simply a blood draw and a treatment the same day. If you go with the PRP strategy where you treat, observe, and at some point plateau, then you can consider a surgical option to enhance the benefit. Of course, whenever we do fat grafting we also use platelet-rich plasma to improve those results as well. I hope that was helpful, I wish you the best of luck. Thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
