Combination of Fractional Ablative and Full Non-ablative Laser Resurfacing?

I am a light-skinned Caucasion 33 year old woman. I have troublesome wrinkling around the eyes in particular, medium pores, raised acne scars, and mild skin mottling. I've seen a little bit about a resurfacing technique that combines fractional CO2 with other non-fractionated lasers for less downtime and better results than fractional CO2 alone, but I'm having trouble getting more information about this. Can someone direct me to some good resources?

Doctor Answers 9

To fractionate or not

I love this question because my Laser does this and more. It is the Sciton and is an Erbium powered Laser that can go from a very light micropeel to a very aggressive and deep "CO2" like peel and also has the benefit of the "Profractional", a propriety fractionated system. It is great with acne and deep wrinkles, especially around the lips and eyes. Go to their website to find a Board Certified Plastic Surgeon who has a lot of experience with skin resurfacing. There are other Lasers that treat these problems but I still think the Sciton is the best for this. No other Laser on the market has this felxibility and diversity of resurfacing options in my opinion. It is also how the device is used so there can be some downtime with it. It depends on your goals so be sure the consult is with the doctor. 







go t

Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews

Combination of Fractional Ablative and Full Non-ablative Laser Resurfacing

Laser skin resurfacing is a wonderful treatment to address the concerns you have regarding wrinkling around the eyes, pore size, raised acne scars and mild skin mottling.  The combination of the two treatments(fractional non-ablative and fractional ablative) has the added benefit of significantly decreasing downtime(which can be a major factor when deciding to pursue this treatment). The non-ablative treatment, which is performed first, promotes the production of collagen and stimulates a healing response that yields less bleeding and bruising when followed by the fractional ablative skin resurfacing treatment. Although the downtime is minimal when compared with the traditional CO2 laser, keep in mind that the optimal results yielded from the treatment are expected to be seen 6-8 months post treatment. In addition, you will want to discuss with your physician the appropriate home care regimen that will promote and maintain your desired results. 

Larry C. Leverett, MD, FACS
Phoenix Plastic Surgeon
4.7 out of 5 stars 18 reviews

Fractional Ablative and Full Non-ablative Laser Resurfacing?

Thank you for your question. Fractional Ablative laser resurfacing is a great treatment for wrinkles, pores, scars and uneven skin tone.  There is some downtime depending on the depth of injury. Non-ablative non-fractionated lasers have minimal to no downtime, but also with milder results.  The treatment of choice will depend on your goals and lifestyle.  There are various protocols that a provider may offer depending on their experience and expertise. I would recommend being treated under the supervision of a Board Certified Dermatologist or Plastic Surgeon for safest and best treatment option. I hope this helps.

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Combination Therapy

Sometimes 1+1=4.  Combining multiple modalities can often lead to greater results with less complications than single modality therapy.  I use a combination of full C02, full erbium, fractional erbium, or fractional C02 depending each patient's skin type and allotted downtime.  Patients can have a greater result with less downtime, a win, win.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 166 reviews

Laser treatment for lines around the eyes

The approach to treatment of lines and skin laxity around the eyes as well as scarring requires more than one modality of laser treatment.  You have to be careful that any treatment around the eyes is done carefully and taking into consideration that laxity of the lower lid.  Overzealous tightening can cause the lower lid to be tugged down.  CO2 energy creates more risk for excessive tightening as there is much more heat involved in the injury.  Although I do not have a picture for my input I am certain we could improve all your concerns using two technologies on the Sciton laser platform, namely erbium microlaser resurfacing for the skin laxity around the eyes and Profractional laser for scarring to the skin.  Board certified Dermatologists are also fully competent to perform such procedures.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Resurfacing options and you

Without seeing you in person for a full assessment of your skin type and to discuss at length your desires and expectations for laser resurfacing, it's difficult to determine in this format, what might be your best approach. Contact a reputable plastic surgeon in your area for a full consult.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Downtime Fractional Ablative Resurfacing versus Non-Ablative Laser Resurfacing

Many individuals focus on downtime as the single most important variable in deciding between fractional ablative versus fractional non-ablative lasers. However, the focus is often misplaced depending on the setting of the laser and the total amount of energy delivered. Experienced practitioners will either choose the laser that best suites your aesthetic goals, or combine modalities to achieve certain outcomes. The other issue that must be considered is number of treatments to get a desired result. Again here, practiotioner experience with various platforms is important, as sometimes single treatments with longer downtimes are more desirable than repeated treatments with other platforms. Good luck.  

Farhan Taghizadeh, MD
Phoenix Facial Plastic Surgeon
4.0 out of 5 stars 23 reviews

Every laser "guru" has their "favorite" laser and of course, it's the BEST! (Usually for everything)

My partner and I (2-surgeon practice) own 5 lasers, and routinely use another 2 that we lease as required, so we are in the minority of laser surgeons who utilize what's really the best for a specific patient need, rather than use the (usually) only laser they own for many things. (Sort of like having only a hammer in your tool box, so everything seems like a nail!)

Not that there's anything wrong with fractional/non-fractional laser combinations, but why not use what is truly the best for wrinkle/acne scarring resurfacing--combination Erbium/YAG--CO2 ablative resurfacing? (For more information please click on the web reference link below.)

You should have no problem getting information about any laser technique or specific laser brand that any physician offers--if s/he does not provide the information that is scientific, comprehensive, and fully informative enough to give you a sense that the laser surgeon really knows the laser technology, the biophysics of laser-tissue interaction, and how/why the specific laser is being recommended for your concerns, then run/don't walk away to another laser provider that can fulfill those BASIC requirements, besides showing experience and photographs.

If you can't find out much about what caught your eye in the first place, it's because it's probably marketing blarney by someone who barely knows where the laser trigger is, what the "usual" settings are, and charges as if s/he's an "expert!"

Laser "anything" is meant to convey "latest, greatest, and up-to-datedness" by all too many physicians who are the modern-day equivalent of snake-oil salesmen. Truly, there are many excellent doctors of various specialties who are quite knowledgeable about many different lasers, and even a few who are lucky and busy enough to afford more than the "laser-du-jour" offered by the "ACME Laser Corp."

Remember, every time Wile E. Coyote used an ACME product, he ended up with disaster. That could be you if you seek a machine, a specific type of procedure, or a "brand" rather than an experienced laser practitioner. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Fraxel and CO2 laser

this is one of my favorite procedures to do. u can read more about it on my website: the heading for non-surgical procedures and fractional lasers

Misbah Khan MD, FAAD, FACMS
New York Dermatologic Surgeon
4.9 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.