These days, there's more and more "buzz" about laser resurfacing. Jennifer Aniston has openly touted her addiction to "laser porn" - regularly undergoing resurfacing as an important tool to maintain her looks. As resurfacing has become more popular, we're hearing patients with more information, but unfortunately more disinformation as well. We teach the optimal use of this technology for physicians, love it for both ourselves and our patients, and want our patients to really understand what can be accomplished by skilled personnel using the latest in resurfacing tools. At its core, resurfacing is quite simple. It is simply using a laser to re-surface - to remove some degree of the surface of the skin, thus smoothing or improving it and stimulating the body to grow new skin which has never seen a sunburn or other damage. Many problems we hate in our skin reside in the surface layers - little bumps and irregularities of texture, fine lines, age spots and pigment problems. If you simply remove layers until you've removed those problems, when the skin heals in: voila! those problems are gone. If this was as much as you could accomplish with laser resurfacing, it would still be a pretty exciting tool. Unfortunately most lasers aren't very powerful or very refined in what they can do for resurfacing. They're a lot like a low end rental car. You don't have very much "get-up-and-go" on the highway, but in town, you find out you really can't gently accelerate or brake without jerking either.
Many patients who come to us have been to offices already and told they can have a "light-medium laser peel" or a "medium laser peel" - they go by different brand names, but are essentially the same: laser treatments where they can't do anything very light for when you only have a day or two to be out of the public eye, but also where they only have a few limited mid-range options - nothing where they can do deep resurfacing which can address the harder problems - deep wrinkles, scars (especially acne scars) and significant laxity. These patients rarely are aware how infinitely customizable laser resurfacing with the latest technologies can be. The latest lasers can do incredibly gentle laser peels which might take only 12-24 hours for full healing, perfect for a quick refresher or glow for an event. These same lasers can go deep - deep enough to reach the base of even very deep wrinkles and scars and can offer beautiful and very dramatic improvement for those who can invest 7-14 days out of the public eye for healing.
Where it really becomes an art is blending treatments: using light peels over IPL or BBL to improve both color and texture in those with only a few days available for downtime, seamlessly transitioning lighter and deeper treatments in different areas of the face, depending on the patient's needs (perhaps less on a smooth forehead while deeper in areas with more wrinkles or laxity), even carefully planing down individual lines under high-magnification glasses for best effect. Practitioners who have and are comfortable with both full-field and fractional resurfacing can employ both of these in a single treatment as well (link to article here).
In addition, the wavelength used to remove damaged cells is important as well. There are only three wavelengths which ablate tissue. YSSG is almost never used. CO2 was the original ablative laser. It works, but at a price. Full CO2 resurfacing gives the skin that characteristic white, waxy look that many patients are savvy enough to recognize and do not want. CO2 also can't be used off the face in fully ablative mode, leaving a distinctive line at the jawline, and both the procedure and recovery are more painful and more difficult than with newer lasers - full resurfacing can leave patients deeply red for a year or longer as they heal. For these reasons, very few practitioners use them for anything other than light fractionals - stuck in the mid range of treatments like that rental car we discussed with very little power or subtle refinement.
There are a lot of these lasers out there (they've been around longer) and they are far less expensive than erbium models, so they are still quite popular in offices. Although harder to find, erbium resurfacing lasers (of which Sciton makes the only one powerful enough to get impressive results) do allow a full range of treatments from light to very deep as well as the blended treatments mentioned above. It is far less painful - permitting even deep, full resurfacing to be performed in the office with oral medication and blocks unlike CO2 which requires general anesthesia with all its risks. It is also a far safer wavelength for a wider range of skin types.
Anyway, that's a lot of talking, here are some pictures which show what you can accomplish with a deep (10 days out of the public eye) laser resurfacing treatment:
And here's a younger patient with a bit lighter treatment (5 days out of the public eye). She had had multiple IPL treatments at another office without fully improving many of her brown spots and also wanted to improve her skin texture and tightness - especially around the eyes: Most importantly, if you've considered resurfacing, or just have wondered if there is something out there to improve your skin, be aware that resurfacing can be a tool which can be customized to meet a wide range of skin concerns and also adjusted to fit almost any schedule.