Laser Resurfacing

Lasabrasion

Laser Treatments for Wrinkles

Laser resurfacing is one of the most common treatments used for wrinkles and acne scars today. Like many things in plastic surgery, laser resurfacing goes by several names: wrinkle laser, lasabrasion, laser peel, laser surgery, laser vaporization, laser desurfacing, and several others. All of these terms mean the same thing: they refer to the use of the laser to treat wrinkles and acne scarring.

Laser Resurfacing: The Good News

Laser surgery for wrinkles accomplishes improvement in wrinkles and acne scars. Some lasers (the CO2 and erbium) accomplish this by vaporizing superficial damaged skin cells and allowing the remaining collagen to become thicker and healthier. As a result, fine wrinkles will be removed and dynamic wrinkles will be improved (see Wrinkles for an explanation of dynamic and fine wrinkles). Acne scars will appear less obvious. The CO2 laser will also tighten your skin, smooth your skin texture, improve your complexion, and possibly your skin color. The N-Lite laser works by stimulating collagen production alone, rather than by vaporizing superficial skin cells.

Laser Resurfacing: The Bad News

Unfortunately, laser surgery is not a panacea. Your wrinkles and acne scars will improve but will not simply vanish, and several treatments may be required to achieve the result you desire. Also, (in spite of what you may have read elsewhere on the web), recovery from some laser procedures is not a snap (more below).

Laser Surgery: How and Why It Works

To understand why the laser works, you must first appreciate some basics about your wrinkles and acne scars. Wrinkles and acne scars share one very important feature: they are lower than the surrounding skin. Because of this, light casts shadows in them, making them visible. Look in the mirror to convince yourself. You will see that everywhere there is a wrinkle or acne scar, there is a shadow. If all wrinkles and acne scars were flush with the level of the skin, the eye would not see them because there would be no shadow. Laser resurfacing works because it makes the wrinkles (acne scars) less visible by
vaporizing the surrounding skin (as in the case of CO2 and Erbium) and by stimulating collagen production which makes wrinkles less deep (as in the case of the CO2, Erbium, and N-Lite laser). Because your skin is vaporized (due to the CO2 or Erbium lasers), it is like a true burn. Your skin will be oozing and weeping. The deeper your wrinkles and acne scars, the more treatments you will need. Shallow wrinkles and scars may be vanished with one treatment.

The N-Lite laser is slightly different than the other two in several important ways. First, it does not actually vaporize away the top layer of the skin, so there is no open wound and no recovery period. You may put make-up on immediately and return to work. There is also no discomfort of the procedure, so you do not need to be anesthetized. N-Lite works by stimulating collagen formation within your skin, as opposed to CO2 and Erbium, which work by removing the older superficial skin layers.

Carbon Dioxide Vs. Erbium Laser Vs. N-Lite:

Which One is Right for You?

Choosing a laser is a very personalized decision and depends on how much improvement you want and how much recovery time you can afford. In general, carbon dioxide (CO2) laser resurfacing is generally more effective than Erbium and N-Lite (works better on deeper wrinkles and scars), but imposes far greater recovery (plan on 10-14 days with a bag over your head following CO2 laser). Erbium provides more modest improvement, but allows you to get back to work within a week. N-Lite offers less results, but has the huge advantage of imposing no recovery time. After N-Lite laser, you may put your make-up on and return to work immediately. Because N-lite imposes no recovery and is effective for wrinkle reduction in some people, it enjoyed a period of great popularity in 2000 and 2001. However, because some people saw little improvement with the N-Lite, it is considered less predictable, and has lost much of its one-time popularity.

The Following Table will help you understand more of the differences between these lasers.

Preparation for CO2 or Erbium Laser Resurfacing

Preparing your skin for laser resurfacing is critical to optimizing your result and recovery. Retin-A, glycolic acid, and bleaching agents (hydroquinones) available through your plastic surgeon’s office will help prepare your skin for CO2 and Erbium laser resurfacing. (No preparation is necessary for the N-Lite laser). They will reduce your risk of discoloration,
speed healing, and optimize your cosmetic result. You should use these products consistently for at least six weeks prior to your procedure. After your skin heals from the laser, you should resume these skin care products throughout your period of redness.

Recovering From Your CO2 and Erbium Laser Surgery

(N-Lite Laser Recovery is Immediate)

Anesthesia: General or sedation (topical anesthesia may be used for some erbium procedures)

Length of surgery: 15-90 minutes.

Length of stay: Outpatient (home same day).

Discomfort: Anticipate 1-4 days of prescription pain medication.

Swelling: lasts 3 days to three weeks.

Dressings: Treated areas will appear as abrasions or deep burns. They will weep, ooze, and hurt when uncovered.

Healing: Your skin will heal in 4-6 days following erbium laser and 5-14 days following carbon dioxide laser. It will then appear sunburned. The only problem is that this “sunburn” takes awhile to fade. Redness will improve over 1-4 weeks following erbium and 1-4 months following CO2. Once your skin heals you can wear camouflage make-up to conceal the redness. Interestingly, as much as everyone hates to be red, the longer you are red, the better your final result.

Presentable in public: You will be presentable with makeup in 7-14 days.

Sun protection: SPF 15 or higher for 3-6 months.

Resume skin care: You may resume skin care products after your skin has healed.

Final result: Will be seen after your redness has faded, approximately one week to four months.

Next laser treatment: You should wait at least 6 months between laser treatments.