Finely-etched wrinkles on the skin are known as “atrophic rhytids”. While it is easy to assume these are changes on the outer surface of the skin, in reality, they are caused by changes happening in the under-surface of the skin – a supportive layer known as the dermis.
People develop fine wrinkles on their skin because their skin’s dermis layer has thinned and undergone changes. These changes include loss of strength and the ability to stretch and recoil due to loss of collagen and elastin in the dermis, as well as permanent changes in architecture of the dermis. This is why any meaningful therapy to restore the skin’s texture and appearance has to involve treatment at the under-surface of the skin to induce repair and remodeling of the dermis.
How Do You Choose Which Laser Therapy is Right for You?
The fundamental decision process for selecting the type of laser therapy should be based on efficacy-to-risk ratio for the treatment of skin texture and wrinkles. Simply stated, the more aggressive the laser treatment, the more likely that you will have noticeable improvement. But it also means a higher risk of complications such as scarring or skin pigment changes.
There are many different types and brands of laser devices available today. A simple way to think about various lasers is to put them into one of two categories: ablative vs non-ablative. Non-ablative lasers are generally considered gentler, and therefore, safer lasers. It also means that the outcome may not be as noticeable, but recovery time is generally shorter. Newer laser devices tend to be based on non-ablative lasers to emphasize safety and a quicker recovery.
From an efficacy standpoint, ablative lasers based on CO2 or Erbium remains the gold standard. However, first generations of CO2 and Erbium lasers had a high-risk profile due to significant collateral heat damage to the surrounding skin. The subsequent generation of CO2 and Erbium (or a combination of the two) lasers are in fractionated mode to reduce the risk profile. Fractionated means that a precise pattern of laser delivery is performed by the device to preserve surrounding tissue to enhance recovery and repair. The specific pattern of a fractionated laser also allows maximal time for cooling to prevent collateral heat damage to surrounding skin.
In experienced hands, a fractionated ablative laser delivers superior outcomes for deep wrinkles and sun damage while managing the risk of side-effects compared to non-ablative laser therapy.
What is the Recovery of Laser Skin Resurfacing?
In our practice, we utilize the ablative fractionated CO2 laser to improve skin texture and restore skin wrinkles from aging and sun damage. While the energy setting is adjustable depending on the individual patient’s outcome expectation and recovery time, typical protocol involves a recovery of 7- 10 days. If full face resurfacing is planned, then most patients will benefit from conscious sedation. Treatment itself takes 30 minutes or less. If partial resurfacing is planned (around the mouth or eyes), light sedation may be sufficient.
What is the Downtime for Laser Skin Resurfacing?
Based on our typical protocol, patients are expected to have a downtime of about 7-10 days. During this time, meticulous care of the resurfaced area is very important to ensure optimal outcomes. It is not a painful recovery, but the treated site will look impressively raw and covered in emollient. After the initial 7-10 days of downtime, your skin should have completed its initial repair. The redness of new skin will persist for several weeks, but at this stage, patients can cover with light make up, which our staff can demonstrate in the clinic. Patients are expected to avoid sun for the first 3 months. About 6 weeks after, patients will be advised to resume their maintenance skin regimen such as tretinoin and neuromodulator injection.
Double Board-certified Facial Plastic Surgeon Dr. Sang W. Kim at Natural Face™ Clinics specializes in aesthetic enhancement of the face, head, and neck, exclusively. Patients come to see us from the Syracuse metropolitan area and Central New York area, including Ithaca and Rochester. At Natural Face™ Clinics, we specialize in restoring the youthful neck contour, tired appearance of the brows and eyes, and skin laxity. We offer customized treatments, both surgical and non-surgical. Find out more by scheduling your personal consultation today.