Is this the normal result for profractional laser? (Photos)

Question

I had profract laser on 12/28/16. I took a pic of Chelsea Handler's after pic and said I want my skin to look similar to hers. I stressed that my under eye wrinkles, acne scars, & the ruddiness of my skin were my issues. I was assured profract would fix that. 21 wks later & I barely see a diff My under eye lines have softened a tad but my acne scars & texture of my skin look worse to me. At my final consult a few days ago I was told this is as good as it gets. I feel like it was a waste of $.

Harold J. Kaplan, MD · Answer

It's very disappointing when someone does not receive the intended outcome for their financial and time investment.  Based upon your photos, we agree that there appears to very little value for your stated goals.  After 21 weeks, you should have appreciable improvement, and your own assessment seems fair and balanced. We have been using the Sciton ProFractional since 2013 and have not been disappointed.  We find that this technology has exceeded our initial expectations.  With that said, we often hear consumers reporting that their ablative or fractionated version of a treatment did not offer much value.  Although the technology is relatively consistent among the numerous versions and manufacturers, the one performing the treatment makes a significant difference in achieving the best outcomes.  The depth of penetration, density, passes, all work to provide a safe and effective treatment.  Setting correct expectations that are in alignment with the patient's stated goals is also key.  With your history, we would have opted for the pulsed dye laser for facial redness, ProFractional laser for the scarring/texture/wrinkles, and review the benefits of dermal filler under the eye area.Please see the below link for more information on the ProFractional laser with before/after photos.

Carmela A. Pettigrew, MD · Answer

Thanks for your photo and question. The Sciton Profractional  is an excellent laser, but the results with it vary depending on the operator, mainly on depth selection. The laser is nearly infinitely tunable, so if the depth is shallow:not much downtime but not much result. I can see an improvement of your lower lid. You would benefit from another Profractional treatment at a deeper depth. Multiple treatments are commonly needed for acne scars.
Best of luck to you

Marc J. Salzman, MD, FACS (retired) · Answer

Results after aggressive laser resurfacing of any type are strictly related to the depth of the laser and how much heat is added to the skin. The advantage of the site on laser is that both of these parameters can be adjusted independent of each other. The result is greatly tied to the amount of time it takes to heal. Very superficial laser resurfacing procedures usually lead to smaller results. I think that another go round, maybe a little bit deeper especially around the eyes will be beneficial. Hope that's helpful.

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