Facial Plastic Surgeon / Procedures / Skin / Skin Resurfacing
Laser skin resurfacing using our top-rated Sciton Laser targets the skin to improve its quality and appearance, correcting many years of sun damage. Specifically, it can improve the appearance of fine lines, remove superficial blemishes, correct many pigment problems, and provide a smoother texture to the skin.
In general, the deeper the resurfacing or peel, the longer the recovery, but the better the results. There are a wide range of resurfacing methods available using various chemicals, lasers, or dermabrasion. Excellent results can be obtained using many of these methods.
The key is that your surgeon or physician is well trained in skin resurfacing and explains to you the actual risks, benefits, recovery period, and expected results with his method of choice. Although this may seem like a simple procedure, severe complications can occur in the hands of a poorly trained individual.
All resurfacing treatments, whether using a laser, dermabrader, or chemical like phenol or TCA, work essentially the same way. The outer layers of damaged skin are stripped away and as the new skin heals in, a smoother, tighter, more uniform skin surface appears. The deeper the resurfacing treatment, the better the results. However, deeper treatments are associated with longer recovery and higher risk. A properly trained physician should have a firm understanding of all.
Skin resurfacing can be applied to a small region of the face like the upper lip or lower eyelids or to the entire face and sometimes the neck. This all depends on your goals and the method of treatment chosen. Resurfacing can also be combined with other procedures like a facelift to enhance the results. Although the whole face cannot be resurfaced with a facelift, target areas like the lower eyelids and lips can be treated. Since a facelift does not address fine wrinkles in these areas, adding resurfacing will provide a better overall result. Less commonly, resurfacing can be applied to the hands and décolletage as well.
For a chemical peel, a thin layer of TCA or phenol is applied to the skin and when the desired depth of penetration is obtained, the chemical is neutralized. Often little anesthesia is required as the chemical itself provides an anesthetic effect.
Depending on the areas treated, this procedure can take 15 minutes to 1 hour. This is usually an outpatient procedure and can be done in the surgeon’s office or an ambulatory surgery center. An antibiotic ointment type dressing may or may not be required.
For laser resurfacing, a precise depth of injury is obtained by programming the laser to the appropriate settings. These settings are varied depending on the goals of treatment. The laser is then carefully passed back and forth over the skin until the desired protocol is completed. The quality of laser used also has a big impact on the result. We use the highly advanced, top of the line Sciton laser for our resurfacing procedures.
With dermabrasion, the upper layers of skin are precisely stripped away using a rotating diamond burr until the proper depth is reached. This is also a short outpatient procedure requiring local anesthesia with sedation.
Initially you will be swollen, but there is little pain associated with recovery. Depending on the surgeon’s preference, a dressing may or may not be used. If no dressing is used, a scab will form and should be allowed to separate on its own revealing the healed pink skin below. This usually takes about 5-10 days; the deeper the injury the longer this takes.
If your surgeon wants you to apply an ointment, minimal scabbing will form and the skin will also heal in 5-10 days. The new skin will be pink for several weeks to months until it returns to your natural skin color. Once the skin is healed, camouflage makeup can be applied to cover the redness.
Most patients are able to return to work in 1 to 2 weeks. It is critically important to apply sunblock at all times until the redness is gone. If this is not done, blotchy irregular skin pigmentation may result.
As mentioned previously, the deeper the resurfacing, the better the results, but the higher the risk. Very deep resurfacing can lead to prolonged healing and scarring. Infection or the activation of a herpes outbreak (“cold sores”) can occur. If you have a history of frequent cold sores, you should inform your doctor. These patients are pretreated with antiviral medications.
The new skin after resurfacing is pink or red in color and eventually fades to your usual skin color. However in some patients, especially those who undergo deep peels, this redness can take up to 3 months to resolve.
Some patients also suffer from increased or decreased pigmentation of the treated skin after resurfacing. This can depend on the resurfacing method chosen. For instance, phenol is known to predictably cause lightening of the skin. Thus this would be inappropriate for dark skinned individuals.
In general, darker skin types have more problems when resurfacing is done. The key to preventing problems is to make sure your doctor is well trained in resurfacing techniques.
You should be warned that in some states a medical degree is not required to perform chemical peels. Disastrous complications can occur when inadequately trained individuals perform these procedures.