Laser Resurfacing After a Facelift 10 Months Ago - Minneapolis, MN

Doing well. Saw Dr. Tholen today and he said it looks like it's supposed to look. Glad it's over. I wanted this done last year at this time...but all the doctors on Realself felt I needed a facelift first ( that was disappointing news...I obviously looked older than I thought I guess).

Glad you are healing well. You will be beautiful in no time. I will be going through a similar process soon. I will have a facelift and eyelid surgery and after 3 months have C02 laser. Dr Tholen do you know about Dot C02 laser?

Hi Teddyjo, What kind of laser did they use on you? I can't imagine having this done when not asleep. I was happy to pay whatever it cost for them to put me out. I think it's easier for the Dr. too if he knows his patient isn't feeling any pain. My routine ( which I was told not to vary from) is cold compresses for 5 minutes, then wash with Cetaphil, then apply Vaseline. Do that 3x a day for 3 days, then 2x a day for 3 days, then 1x a day for 3 days. He said washing too often slows healing. I do not get up during the night. For meds I take, the virus pills, antibiotic, and Celebrex for anti-inflammatory. Sometimes I take Tylenol, but the only pain I really have is when I have to wash my face. Tell me more about you and your procedure. Where are you from. We had our resurfacing done so closely, we really need to stay in touch.

I think it might be a little more invasive, but I was told one fractional laser treatment covers about 15% of your skin and this was 100%. Being in my 60s I needed to go with the big guns or there wouldn't be much improvement. It looks worse than it is. Really.

Looks like you will have a wonderful result. Really interesting to watch your progress. Thank you for sharing it :)

Hi playto, The fully ablative laser I used is a dual-wavelength laser (more accurately, two lasers in one chassis) incorporating both CO2 and Erbium/YAG wavelengths. The brand is Derma-K, made by ESC, which was a company that manufactured these third-generation machines over a decade ago. ESC purchased Coherent Medical Group (makers of the Ultrapulse first-generation CO2 resurfacing laser) in 2001, after which the company was renamed Lumenis. This dual-wavelength laser utilized selectable power and pulse frequency for both Erbium and CO2 portions of each dual laser pulse, and the percentage duty cycle for the CO2 portion of each pulse, which allows the physical effect of the more superficial tissue removal characteristics of the Erbium laser followed immediately (within milliseconds) of a low(er) power CO2 laser pulse that provided collagen remodeling and shortening that tightens the tissues without the higher energies used in the first-generation CO2 lasers. This higher energy is what ultimately led to the hypopigmentation seen with the first-gen ablative resurfacing lasers, but is not seen with the Derma-K laser. Lower CO2 energy was effective because the Erbium/YAG portion of each pulse removed the upper 10-50 microns of tissue first, permitting effective CO2 energies and lower thermal damage to the melanocytes (pigment cells). Being eager to not miss the "bandwagon" of laser resurfacing, very few laser surgeons waited long enough to purchase this best-of-category machine, having spent over $100K on a first-gen Coherent Ultrapulse, or a similar amount on a second-gen Erbium/YAG resurfacing laser (or both!), only to find the first yielded great results but suffered delayed loss of skin pigment (major problem, including crosshatching and visible lines of demarcation between treated and untreated areas of the face), and the second failed to remove wrinkles as well (usually due to doctor failing to treat as many layers as needed, and not a "fault" of the laser or wavelength). So, sometimes over $200K invested in "state-of-the-art" lasers that generated unhappy or dissatisfied patients (and a few lawsuits). Very few "hung in there" long enough to actually purchase the Derma-K, which successfully blended the two wavelengths in one box to create a fully ablative laser that didn't have the pigmentation loss, yet still worked great at removing those wrinkles and sun damage. My partner and I have one of the few fully-functional Derma-K lasers still in use, and that is only because we purchased a second used Derma-K a few years ago for parts! So unless your laser surgeon had the foresight to make a similar investment, you are right--it is usually one or the other, and each has limitations that the dual-wavelength laser surpasses. And that is also why the vast majority of laser companies retooled their machines to perform fractional resurfacing--safer (because it only treats polka-dots of skin), but with less-ideal results and the need for more than one treatment). Thanks for asking, and I hope you don't mind that I answered instead of my patient! Best wishes! Dr. Tholen

I'm glad you did the answering on this one Dr. Tholen. I learned more about the laser you used by reading it. Very informative.

I'm glad Dr. Tholen answered this for you because I didn't totally understand it either. I just knew that the laser he used would work better on the deep wrinkles I have. I consulted with other doctors in the area and they all had fractional lasers. I only wanted to go through this one time, not multiple, which would have been the case with their lasers.

Wow! Thank you for explaining the technology you employ in your practice. There are so many laser modalities that confound consumers and that was very helpful to my understanding. I see through an internet search there is also a similar laser called Cortex. It seems all lasers are marketed to correct every issue WE consumers are looking to correct. I know from personal experience that a patient may be sold a technology that does not produce the desired results because that is the only laser offered at their clinic. Fitting a square peg in a round hole because the square peg has got to pay for itself and its too expensive to also buy a round peg. Anyway, money should never be a motivating factor in determining the correct needs of a patient. Ultimately a patients health and wellbeing should be the only consideration, especially when it comes to their face. I have seen many PS/Derms and not one of them have ever referred me to another doctor due to not having the most efficacious modality. It shouldn't be a big deal in the cosmetic world as I am referred all the time to other doctors by my family doc. I digress... I am willing to spend hard earned money and want positive results in return. My first experience with Fraxel Re:store was broken promises and I actually ended up worse off. I believe much of that was due to unqualified technicians/esthetician. I was very ignorant at the time and drank the proverbial "kool aid". They were not qualified and later determined to be operating out of their scope of license in the state of Iowa. How did an esthetician get their hands on a piece of equipment like that? I digress again.... I am currently being courted by a highly respected PS. He suggest using his Sciton Pro Fractional combined with Contour TRL for optimum correction of my acne scarring, enlarged pores, skin laxity, and fine lines. I have found many negative reviews for the Profractional laser and hardly anything for the Contour TRL. The PS also has the capability of doing fully ablative CO2, but I think he is operating with the 1st Gen as you described. Dermabrasion is something he does as well, but thinks I will get best results with this Sciton laser. I am just very skeptical at this point and laser gun-shy. I am trying to determine what's best: CO2 or Erbium; fully ablative or fractional; and now combination CO2/Erbium? Anyhow, sorry for the rant and I hope I have not made you regret answering my earlier post. That kind of openness and candid discussion is what puts me at ease with a doctor, so thank you.

Oh and I must not forget to thank Ckiesch for the updates! I am pulling for you and hope you have excellent restorative healing. I look forward to following your progress.

How do I see your pictures? Do you have to keep your face covered in vaseline?

Hi there. I just started my review. Maybe just type in Teddyjo. It should pop up.

So the only difference in our 2 procedures is that I also had the erbium laser used along with the co2. So we should be looking about the same. Are you getting any white blotches on areas of your face? When do you go in for your checkup? I go Tuesday. I'm going to try to find the photos you posted. How old did you say you are? I'm 64.

No white blotches, but I do have red blotches. I am 52.