Laser Resurfacing

The aim of skin resurfacing is to remove the superficial layers of the skin, producing a ‘wound’ which then heals with better skin surface quality and in the process becomes smoother, firmer and less pigmented. Full facial resurfacing as a rejuvenation measure has applications in the treatment of acne scarring, blotchy pigmentation and the physical signs of age.

Chemical peels have been the traditional way of achieving this. Dermabrasion (mechanical sanding of the skin) is an alternative.

With the advent of laser technology in the 1980’s, use of laser resurfacing was dominant, driven as much by the laser companies as the surgeons.

However, full face laser treatments became associated with possible complications of pigmentation and scarring. In response to this, microdermabrasion has now become the popular new technique for those wishing to refresh their skin, and these days laser is used more judiciously in association with other appearance medicine and surgical techniques.

Today, the best application of the laser technique is considered to be in the treatment of acne scarring and upper lip resurfacing.

Resurfacing of full faces is carried out using carbon dioxide or Erbium: YAG lasers, to produce a more youthful skin. The process usually involves a general anaesthetic before treatment of the face. Appropriate power settings are defined to produce an improvement in contour of the facial tissue and the area is treated. After treatment, dressing to treat the face are applied over the healing period of seven to ten days.

This is not a procedure to be undertaken lightly and leaves large wounds which are susceptible to infection with the cold sore virus or other bacteria. There is a significant incidence of scarring, especially if an inexperienced or untrained practitioner performs the procedure. For this reason, apart from very strong indications, full facial resurfacing has become less popular and few practitioners will have any real recent experience of carrying out many of these procedures.

Great results can be achieved, however, in the use of resurfacing lasers to treat the skin of the upper lip.  For vertical lip creases the alternative treatment – dermal fillers – does not produce particularly satisfying cosmetic results. Furthermore, the need for repeat treatment to sustain a result makes fillers and extraordinary expensive exercise.

Laser resurfacing of the upper lips is a simple local anaesthetic procedure taking 15-20 minutes. This incidence of complications such as infection is very low, particularly when treated with preventative medications.

It is difficult to deal with the wound during the immediate post-operative period, but the results are gratifying for the patient. It takes a short period of time to do and has a healing period of about seven days. There is an incidence of pinkness or erythema on the lip which may last between three to four weeks depending upon the laser used, the problem being less likely with an Erbium: YAG laser.

Generally, the results are good and associated with a very small incidence of scarring in the hands of an experienced practitioner, although de-pigmentation of the upper lip skin, leading to a degree of whitening, is relatively common.

In the treatment of acne scarring with laser resurfacing you can expect a 50 per cent improvement in the depth of contour irregularity.  Under no circumstances should facial resurfacing for acne be carried out in the presence of active disease.

Another use of both Erbium: YAG laser and the carbon dioxide laser is the treatment of creasing in and around the lower eyelids.

However, experience shows that the healing of lower lids in particular is unpredictable, and although very gratifying immediate results may be obtained, there is also a significant incidence of scarring. There can also be a significant incidence of loss of substance in the lower lid skin leaving it lax and crepe-like. This is not necessarily predictable in the preoperative period. For this reason, lower lid resurfacing with lasers is used with extreme care nowadays.

Alternatives to Laser Resurfacing

• For fine lines and wrinkles, Rejuvenation Treatments, Chemical Peels, Microdermabrasion

• Iinjectable Derma Fillers like Restylane, Juvederm and Collagen fillers.

• For more severe lines and wrinkles cosmetic surgery procedures such as Facelift Surgery, Browlift Surgery and Eye Lift Surgery