Is laser resurfacing best performed by a dermatologist or plastic surgeon?

Question

Hi, I asked a prior question if repeat bad results from laser resurfacing (multiple scars, rough waxy texture, blotchy discoloration, minimal tightening) were due to being a poor candidate for laser resurfacing (having fair sensitive skin), or poor technique. Drs. here indicated it was likely due to faulty technique or modality selection. Bad outcomes were by a Dr. who is double-board certified with many years as a Dr. Should laser resurfacing be performed by a Dermatologist instead? Thanks.

Jason Emer, MD · Answer

someone who understands skin, has done a laser fellowship, and has you on pre and post procedural skincare prep like cosmelan peels and enlighten peels (see link).  I suggest you see an EXPERT.  Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hello,
Your experience sounds disappointing.  Unfortunately, we often hear of a lack of improvement by many of those we perform a consultation for.
We believe there are several reasons for this poor track record.  Basically, the one who is performing the procedure is utmost important.  Simply put, Training Trumps Title.  A dermatologist may not have experience with class IV medical lasers.  A plastic surgeon may perform an excellent face lift but may not be well-versed with lasers.  Registered Nurses may spend more time delivering aesthetic treatments than their supervising physician and thus are able to produce consistently good results from performing the majority of treatments.

Although there is no one standard to "certify" or "license" physicians and nurses in laser resurfacing, the practitioners performing these treatments should be able to readily demonstrate their skill level with patient photos and with a background in training through workshops, seminars, round tables, etc.

We encourage consumers to seek out those with a medical license AND have a history of performing lasers for their condition and their skin type.  Before and After photos should speak to their experience.

Lastly, it our professional opinion that the consultation process is lacking.  Realistic expectations should be set to define the patient's stated goals and what laser resurfacing can and cannot do.  Being overly aggressive is not good and delivering underwhelming results is also not good.

We hope this help as you consider a future treatment.  We believe in the technology when used correctly and to its full potential...hence, why the practitioner matters more than his/her title.

Please see below link and video for more information on laser resurfacing.  
Regards.

Andrew Campbell, MD · Answer

The specialty of the provider is not nearly as important as the experience of the provider. Lasers are not something that a provider should be "dabbling" in or performing on an occasional basis. You want to see someone that has extensive experience and performs resurfacing procedures on a regular basis. The Erbium laser is by far the most efficient and safe laser for full field resurfacing.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa

Anshul Gambhir, MD · Answer

Thank you for your question. Whether they are a dermatologist or plastic surgeon shouldn't matter for laser resurfacing; however, you should be picking a provider that has been properly trained and has significant experience under their belt when it comes to laser resurfacing. Make sure you do your research on how experienced that provider is and that they perform laser resurfacing frequently. You may even need to pre-treat your skin to prepare for the laser. Hope this helps!

Leslie Pickens, MD · Answer

123okay,Sorry you have not been having the results you desire from you laser treatments.  The choice should be based on consultation with an experienced and trained physician who has had patients with your similar conditions.  One can not say a particular specialty of board certification will determine your outcome. Your skin should be prepped with a good skin care regimen before applying lasers.  Perhaps you can even do a test spot in a less conspicuous location to see how it heals before going forward. There will be a healing process of varying duration depending on the patient, settings and technique.  Make sure you are given expectations for post treatment care and outcomes.

Richard Sadove, MD · Answer

While it is true that there are qualified and non qualified in both specialties, I would add this consideration.If you plan to have your laser under IV sedation or general anesthesia, the issue of specialty will not likely matter to you as long as the physician is qualified with the laser.However, having performed CO2 laser in my office for decades, I will say that most of the time and effort with the procedure is in preparing the patient. As a surgeon, I perform facial nerve blocks for anesthesia frequently. We also use what we call "tumescent" or local anesthesia administered in a comfortable manner.  An experienced surgeon willing to take the time, makes a big difference for the patient.

Jason Pozner, MD · Answer

There are many specialties who are qualified to perform laser resurfacing including plastic surgeons, facial plastic surgeons, dermatologists, oculoplastic surgeons and even other specialties with extensive experience. Many of us who have interest in lasers are members of the American Society for Lasers in Medicine and Surgery. My answer to your question is that experience is key to great laser outcomes and specialty matters less. I have many friends in different specialties who are excellent laser physicians while other friends who are expert aesthetic physicians (plastic surgeons and dermatologists) who have never touched a laser.

Is laser resurfacing best performed by a dermatologist or plastic surgeon?

Answers (7)

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