First Quarter 2011, Volume 25, Number 2

Knowing the laser language and the different types. Which one will work for you?


Are you feeling the pressure to look younger? You’re not alone

Knowing the laser language and the different types. Which one will work for you?

Ask the Surgeon / Health Tip / What’s New

Innovative ways to optimize your healing

Lasers – light amplification by the stimulated emission of radiation – provide an excellent option for helping you achieve a younger, more vibrant you. How do lasers work? What procedures use lasers? How can I benefit from lasers? Find out more information about what your facial plastic surgeon has available so you can discuss your optimal choices at your next consultation.

Laser introduction
A laser is a beam of light that can selectively transfer its energy into tissue to treat the skin. The light beam can be varied in its intensity and pulse duration. The wavelength and power output of a particular laser determines its medicinal application. Many procedures can be performed with different lasers. The choice of the laser depends upon many factors, including the surgeon’s experience, the size of the area to be treated, skin type and color, and the expectations of the patient.

Lasers can be used to reduce wrinkles around the lips or eyes, even the entire face, softening fine wrinkles and removing certain blemishes on the face. This type of resurfacing may be referred to as laser skin peeling.

The appearance of birthmarks and skin lesions can be improved by laser resurfacing. Port-wine stain birthmarks respond remarkably well to laser treatment. The abnormal blood vessels that cause these marks are reduced in size by the laser. This results in a lightening of the treated area. Skin growths, facial “spider veins,” warts, and some tattoos respond to laser surgery. Most situations take more than one laser treatment, but some respond to a single treatment.

Technological advances will lead to new applications and new generations of lasers. Talk to your facial plastic surgeon to see what is available.

How it works
There are two types of lasers that work very differently on your skin, ablative and nonablative. Ablative (skin removing) lasers produce a powerful beam of bright light that heats water within the surface layers of the skin causing both the water and the tissue to vaporize. The depth of laser resurfacing is dependent upon the light wavelength, power utilized, and pulse direction. The carbon dioxide laser (CO2) and the Erbium YAG laser are examples of commonly used ablative lasers.

Your skin is made up of the epidermis (outer layer) and the dermis (underneath). Within the dermis are two levels, the papillary dermis and the reticular dermis. Superficial wrinkles and slight pigmentation problems generally originate in the epidermis. Scars and deep wrinkles involve the papillary and reticular layers. Ablative laser resurfacing can remove the epidermis and penetrate into the papillary dermis; this eliminates the superficial wrinkles and blotchy pigmentation.

Extensive scarring and wrinkles in the reticular dermis can be made less noticeable with resurfacing, but not eliminated entirely. After resurfacing, during the repair process, your skin rebuilds the tissue allowing a fresh new layer to become the skin surface. You may experience some swelling and redness for several days. Antibiotic ointments may be used during the healing process. Be sure to follow all the postoperative directions of the surgeon, especially using sunblock and avoiding sun exposure.

The full impact of the laser may not be apparent for a month or two, especially with vascular deformities. Additional treatment sessions will not be scheduled until the healing process for a particular treatment is complete.

Nonablative or fractionated lasers, conversely, have lower energy levels than ablative. The heat of the laser stimulates collagen production in the dermal layer with little damage to the epidermis layer. The collagen growth may improve skin tone, texture, and fine wrinkles. These lasers usually require multiple treatments-with little or no recovery time – to bring about the desired results. Light – based devices, e.g., Intense Pulsed Light (IPL), use flashes of light (technically not a laser) to stimulate the dermal tissues. These nonablative treatments may be referred to as photo rejuvenation.

Although there is little or no downtime after treatment, your facial plastic surgeon will still provide postoperative instructions to maximize your results, such as moisturizing the area and using sunblock.