Laser Resurfacing Surgery
Qualitative aging changes to the face occur with the cumulative effects of ultraviolet light from the sun. This results in the development of wrinkles due to a loss of elasticity in the skin. Wrinkles most commonly occur at right angles to muscle contraction forces but can also be seen to occur in areas of chronic folding, as in creases that occur due to sleeping in a certain position chronically over a long period of time. Surgical procedures which are highly successful at correcting quantitative aging changes such as puffy eyelid fat, sagging neck skin and the like, are not nearly as effective at correcting skin wrinkles, or qualitative aging changes. By the same token, laser resurfacing is no substitute for facial aesthetic surgery – the two types of treatment are mutually exclusive.
Controlled burning of the skin has been used for decades to smooth the skin. By removing the outer layer of the skin (epidermis) and the superficial layer of the deep layer of the skin (dermis), and allowing the skin to heal from the deeper skin appendages such as the hair follicles and sweat glands, the appearance of the skin is smoothed and a varying degree of improvement in the texture, pigmentation, and tightness of the skin is obtained. This has been historically done using the methods of dermabrasion (sanding), salabrasion (salt abrasion), and chemical peeling (with various acids, or a phenol mixture). These methods, though often effective, lack the degree of control with regard to the depth of penetration of the desired burn, and are often exceedingly painful. Because of the lack of control over the depth of the peel, the risk of complications, specifically scarring, is not insignificant (though in very experienced hands is usually very safe).
The introduction of the carbon dioxide ultrapulse laser for use in skin resurfacing in the early 1990s brought a significant diminution in the degree of variability of depth of penetration in the skin and thus brought down the degree of physician experience, the degree of risk, and the level of pain of skin resurfacing. This is not to say that no experience with use of the laser is necessary, but without question laser resurfacing is a superior modality for smoothing skin wrinkles than anything previously available. Dramatic results are achievable with the laser in the properly chosen, properly prepared, properly treated patient. Two dominant types of lasers exist, the CO2 (Carbon dioxide) Ultrapulse Laser, and the Erbium Laser. The CO2 is used for most wrinkle treatment, but the Erbium Laser is used for milder degrees of wrinkling, as it penetrates the skin to a lesser extent. In general, the degree of smoothing of a wrinkle is directly proportional to the depth of tissue removed. Dr. Parson will suggest the appropriate type of treatment after he examines your skin and takes your medical history.
Laser resurfacing is not for all types of skin, for all ages, nor is it suitable in terms of the length of recovery for all lifestyles. It is not risk-free, but the risks are acceptably low to justify its use for the treatment of skin wrinkling in selected instances.
Laser Resurfacing Surgery Consultation
Dr. Parson will take a medical history and do a directed physical examination of your skin and other facial features during your visit. This will involve identifying functional issues as well as cosmetic issues of concern to you. It is important for you to provide us with any history of skin sensitivity, previous skin peels or laser peels, history of acne particularly if you have been treated with the acne drug ACCUTANE. You should inform the doctor of any history of cold sore problems that you have had. If you have skin that is olive or darker in color, this is not a procedure that you should consider because there is a significantly higher risk of pigmentary changes (darkening or bleaching of the skin) following laser resurfacing.
It is not uncommon that adjunctive procedures are performed prior to resurfacing, such as a brow lift, eyelid surgery (blepharoplasty), or a facelift. You may wish to visit those sections of the website prior to your consultation to familiarize yourself with the effects achieved with these procedures. If Dr. Parson feels that you would benefit from another procedure other than the laser resurfacing, he will tell you during the consultation as part of a comprehensive facial esthetic evaluation. Laser resurfacing cannot be done safely at the same time as a facelift is performed. The doctor prefers to wait at least 3 months between a facelift and laser resurfacing.
It is very important for you to consider whether your particular aging is quantitative or qualitative, as the treatment of each is different.
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