SmartXide Co2 Laser DOT Treatment - Dallas, TX

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I went in to have the Co2 laser DOT treatment...

I went in to have the Co2 laser DOT treatment yesterday. It started out pretty well, they applied numbing cream immediately after I showed up for my appointment... then they left me in an exam room for nearly two hours but didn't really explain it to me. I thought they forgot about me, so I went looking for someone (also the room was freezing). The numbing cream worked really well, however; as soon as my therapist came in the room she immediately started cleaning my face really well... first with a soap and then with a very strong (it smelled like 90%, which I use at work) alcohol treatment, she said it was to remove all residue of anything on my skin. While she was cleaning it, I felt no superficial sensation whatsoever... just pressure, and it was pretty deep too. 
After she cleansed my skin, she put the protective mask on my eyes and asked if I was ready. I said I was--although I was pretty nervous, I thought maybe I wouldn't jump out of the bed! I have read several of these reviews, so I had expected the sensation of rubber bands being popped every time the laser zapped, and that was spot on. She seemed to be holding the laser wand in one hand, and a vacuum in another, or at least positioned so that it sucked up any skin fragments or smoke. And yes, all the same, I smelled singed hair (probably really singed skin). Not the most pleasant smell, but I had expected that. She was very thorough, and she did stop once or maybe twice to change settings, particularly around the eyes, and she did treat one thin pass under my eyebrows and she got to within maybe 3/4" below my lower eyelid, I'm guessing? She did below my jawline too, although just around the bone (not the whole beck or anything, since I paid for just the full face treatment). I asked her if she did a pretty deep setting and she said "We always do." Maybe they weren't terribly customized then? I have pretty even skin (thanks to a recent round of chemical peels that ended a month ago) for the most part though. 
Immediately after the procedure I walked downstairs and saw myself in the mirror--WOW, I was already swelling and had bulges under my eyes which hadn't been there before. They reassured me that this was completely normal, however. The guy at the front desk said that he had phoned in my meds to the local drugstore near my house (I had driven from San Antonio), although he had not checked to see what time they closed, and when I got home, sure enough they were closed. 
On the way home, I noticed that I was swelled and very red, and I also noticed that the melasma on my forehead, which I had previously managed to erase from using Obagi Clear and orange oil, was now on the surface. Another provider had explained that this was a normal thing, and these dark pigment cells were dead and would fall off in a few days, although they still are apparent. I drove home (it took 4 hours) with the A/C on in my face, and I was careful not to had the sunlight shine on my face, as they had warned against. Once I got almost all the way home, I noticed that my face was very very dry and I re-applied the post-treatment silicone skin lotion (which they had told me I could not apply too much). I noticed throughout the day that the skin seemed to drink that lotion up!! It would only last an hour or less before I needed more. I read on another doctor's website that bacitracin was good too, so I applied that at night. Apparently it is very normal to break out following the treatment due to a lot of open "holes" in the skin, and bacitracin might help retain moisture while keeping down any risk of infection.

Recovery day #1--I awoke the day after the...

Recovery day #1--I awoke the day after the procedure having slept sitting up, as instructed. I normally sleep very very soundly, but this position made it difficult to sleep. Nevertheless, I woke up and was very swelled up, particularly around the eyes, but in the cheek and chin too--pretty much all over my face, and very red too. I saw the marks very well where the therapist had changed the pattern and then treated around the sides of my face, under my chin, and below my eyes, in a horizontal dot pattern.
I kept the moisturizing cream (whose main ingredient was silicone) on and mixed it with some bacitracin (as specified on another doctor's office website) to prevent any infection during the morning. I didn't keep it up throughout the day, however, and later on I developed some pimples on my chin. That evening I went to Walgreens and discovered burn pads--eureka! They worked wonders, keeping my dry skin from drying out even more (even with the silicone moisturizer on my skin was still extremely dry). They kept the skin moist while preventing the moisture from evaporating, which was VERY helpful, especially during the night, when it seemed to dry out no matter what.
Later on in the day, most of the swelling in my cheeks and chin went down for the most part, but the eye swelling remained. Some of the redness went down, too.

Recovery day #2--I woke up after sleeping upright...

recovery day #2--I woke up after sleeping upright again, only with the Walgreen's burn pads covering as much of my face as possible--they only come 4 to a pack, so I was able to cover my cheeks and under my eyes, but not my chin, nose, or forehead. Where I had left them on was beautiful, moist, smooth skin--I highly recommend them! The swelling was pretty much gone too, except for under my right eye (I woke up with my head tilted slightly to the right), and to a lesser extent, just a tad below my left eye. The laser marks on my forehead, around my face and eyes, and under my chin (where they set the laser for a horizontal-dotted line pattern) were still very much apparent, and I could feel the ridges too. The rest of my forehead nose, and chin were generally just very very dry and rough. The skin throughout was still very red too.

Throughout the day I picked up another package of the burn pads, and took a nap with them all over my face. When I woke up, the covered skin (pretty much all over my face, just small sections left uncovered) was all very nice and smooth, less red, and all the swelling was almost entirely gone! Some minor peeling occurred when I washed my face afterwards (like yesterday, although I forgot to mention that the majority of peeling happened yesterday), and I reapplied the silicone moisturizer the doctor gave me.

Recovery day #3--I woke up from sleeping with my...

recovery day #3--I woke up from sleeping with my head only slightly elevated (on a pillow). Before I had gone to bed (the night before), I had applied the silicone cream 15 mins prior (to allow it to soak in) to putting on the burn pads all over my face, with minor patches of skin left uncovered. I woke up with no swelling at all, but still a fiercely red face (like I had fallen asleep in the sun, except without blisters), and plenty of roughness around the edges of my face and a little under my eyes too.

I went to work and washed my face twice during the day: morning and lunchtime--both times a little dead skin came off, mostly from the edges of my face (my cheeks, lower forehead, nose--pretty much all areas the burn pads had covered--were smooth). After lunchtime, pretty much all of the ridges around the edges of my face were gone, and some of the redness went away--but it was still pretty red. Around the evening, more of the redness went away too.

Recovery day #4 (post procedure)--Another day at...

Recovery day #4 (post procedure)--Another day at work, I slept normally that night, without burn pads, because I didn't feel I needed them. By this day, ALL swelling is a distant memory, although there is still redness, albeit much improved. I did not put on any makeup, and people thought I had spent too much time in the sun. There is still residual peeling here and there, mostly on my chin and a little above my lip. The wonderfully smooth skin and tiny (nearly non existent) pores are really starting to emerge from under the flaking/peeling skin. I am only 36, but have had a lot of past sun damage due to a childhood spent in the sun and at the beach, mostly without sunscreen. All the same, I had only fine lines around my eyes and melasma on my forehead. I think my biggest concern was my cheek area where the fat is not 'there', so my cheeks are not as full as they used to be and I have the beginning of expression lines there. I noticed a vast improvement in the condition of the skin as well as in the fine lines being reduced, even around my eyes, in an area that was not even treated. My cheeks seem to be a little fuller, and the expression lines are much less noticeable, although still there. But then apparently full effects are not seen until 2-3 months after the procedure, so I am keeping my fingers crossed.

At this point, I do have to say I am pretty pleased with the results thus far. Apparently some people have to get it done twice, and should that need to happen in my case, I would not hesitate to get it done again. The pain really was not that bad, and the recovery period really has not been bad. I think the biggest concern during my recovery is the redness and the fact that I was advised against cardio exercise for a week afterward--for a runner, that is tough! But strictly sticking to pain during the procedure as well as the recovery period, it has been really quick and very little downtime. Since I work, this procedure works okay on a long (3 day) weekend--by day 3 I was able to return to work because by then the swelling had all gone down. Redness lingers, however, but it appears to others as sunburn.

Today my skin is pretty much recovered for the most part, except for some redness that receded throughout the day, and by night there is only a slight difference in my neck's pigment against the slight redness of my face. Maybe tomorrow it will be gone! Throughout the day I still had flaking skin, and some minor itchiness, but the skin is so sensitive and tender, I dare not scratch with any intensity. Just rubbing my fingernails (without any pressure) is enough to relieve the itching on my cheeks (which have no flaking or peeling skin). Everything is starting to look very good by now! I am pleased and would do it again!


ONE THING THAT I HAVE NOT SEEN ON OTHER REVIEWS... is that I think recovery depends on what kind of procedure is done. For instance, if you have the DOT procedure done, there are settings for depth in nm on the laser machine, I think generally from 50 (which is what I think they call the 'Madonna Lift') all the way to 1000 for a deeper treatment. My understanding is that the superficial (50 nm) setting is good for melasma and uneven pigment, whereas the deeper setting (up to 1000 nm) is more for uneven surface and scarring. Obviously, the deeper setting will likely have a longer recovery than the superficial setting... it might be something to ask about. But then you might also consider how do you recover from burns and scratches? If you tend to heal quickly, this will probably hold true with recovery from this treatment (which is a controlled burn). In my case, I heal quickly, and I think they gave me the superficial setting on the laser, because it seems like I have healed really quickly. These might be some things to consider.

Also--don't confuse the recovery of the CO2 DOT laser with the recovery of the traditional CO2 laser! The two are virtually the same in my understanding, but the recovery isn't! The traditional laser basically burns the entire surface of your skin off (and I know someone who had that treatment--it is VERY effective against scarring, but basically a two week recovery period in which you are confined to your house), whereas the DOT laser ablates (or vaporizes) 'dots' of skin while leaving the surrounding skin unaffected. Obviously the latter treatment is much quicker recovery.
Skin Spa Med (Dr. Kevin Light)

I came in on the weekend, so I never did meet the doctor, though the staff did my treatment. I didn't get the feeling of a customized approach, rather a generic setting and I got the impression that they were trying to sell me skincare products (they steered me away from the Aquaphor from the drugstore, and recommended that I use their $100 kit for recovery, although I'm not convinced it was 100% better) and trying to get me to come back for lots of other treatments.

3 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
3 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
4 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
2 out of 5 stars Wait times
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