Frequently asked questions about Carbon Dioxide Laser Treatment.
What is the CO2 laser?
A laser is essentially a machine which takes electrical and electromagnetic energy and converts it to a beam of energy. Lasers are defined usually by the type of material or materials which are used to generate its energy. In medicine, and in particular, ophthalmology, several different types of lasers are used, each for a specific application.
How does the laser work?
The new technology associated with the CO2 laser has to do with its use for resurfacing. The problem in the past was that the laser could not be applied without causing heat buildup, which results in scarring of the tissue, instead of simple tightening. With new technology, we are now able to deliver a pulse of energy so fast that heat is not allowed to build up in the tissues. Thus, we are able to remove the top layers of skin and tighten it without causing heat buildup and unwanted scarring.
What does the CO2 laser treat?
The other categories of patients who will benefit from the laser are those with wrinkles of the face or other irregularities from such things as acne scarring or previous trauma. In this instance, the laser is used to remove the top layer of skin, and then to tighten the underlying collagen layers. This is where the tightening occurs, and the reduction of wrinkles or scars..
Are there possible complications?
As with any surgical procedure, there are always risks. Though the risks are low, the most common ones for laser skin resurfacing are infection, activation of herpetic lesions, and scarring. Antibiotics are administered and protective ointments applied to avoid infection. Antiviral medication is given to prevent a cold sore flare-up. Scarring is avoided by careful surgical technique and appropriate expectations
What are the alternative treatments to the CO2 laser?
In considering the laser for skin resurfacing, there exist several other alternatives. When one has facial wrinkles, the traditional approach has been to conceal them by using cosmetics and creams to fill in the cracks and wrinkles, giving a smoother appearance to the skin. With the trend more toward a natural look, people are looking for a more permanent smoothing effect. Chemical peels (acid peels) and dermabrasions (scraping of the superficial skin) are two similar methods, in that they both remove the top layers of skin. However, they are not as precisely controllable as the laser. Also, they do not appear to tighten the skin as well as the CO2 laser.
Probably the most common alternative to the CO2 laser for facial wrinkles is the traditional facelift, or rhytidectomy. This can offer the advantage of removing large amounts of excessive skin from the face, but has disadvantages as well. The incision from a facelift can often be noticeable around the ears and side of the face and it also carries with it the risk of cutting one of the facial nerves during the surgery. The main advantage of the laser to facelift surgery often has to do with the "refreshed" look of the laser patient, versus the "surgical look" of the facelift patient.
Who is a candidate for the laser?
Almost anyone is a proper candidate for the CO2 laser. Lighter-skinned and very dark-toned patients tend to heal the fastest. Those with olive skin will usually have the redness last longer, but are still excellent candidates for the resurfacing. There are some conditions which will preclude the performance of a resurfacing operation. Medical conditions such as keloid formation or other autoimmune disease must be approached with extreme caution.
What should I expect before, during, and after the laser resurfacing procedure?
After your initial consultation with the physician, you will be given several papers with which to familiarize yourself. These include consent forms, and pre- and post-operative expectation forms. If you then decide to schedule a laser procedure, you will need to come in to the office to finalize your pre-operative preparations. At this time, you will also consult with our esthetician and receive several necessary prescriptions.
A few days after the procedure, and while the skin is rebuilding from the bottom up, some weeping will occur as new collagen is formed by the dermal layer. Minimal to moderate postoperative swelling will occur. Dressings or ointments are used to cover the treated areas and speed the healing process. As the skin heals, the fresh new skin will have a pink quality which will fade over a period of several months. This is easily camouflaged by makeup which can usually be applied in 6-10 days, depending upon your skin’s response to treatment. All laser resurfacing procedures are performed under local anesthesia on an outpatient basis.
How long does it last?
Laser Skin Resurfacing is a relatively new technology, with only five years of clinical follow-up. And while we know that it is a safe procedure when performed by experienced hands, the long-term results are not known. The estimate that seems appropriate is that it should last ten years, depending on the care and protection your new skin receives in the coming years. Many patients say that they look like they did TEN YEARS before the procedure!
Can other areas be resurfaced, such as the neck or chest?
No. The necessary skin elements for proper regeneration after resurfacing are abundant on facial skin. However, the neck, chest, and other areas of the body do not have the ability to heal properly. Scarring will likely result if these areas are lasered using current resurfacing technology.
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