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Laser Resurfacing
Changes associated with ageing and sun exposure, such as fine lines, wrinkles, and uneven texture and pigmentation, are all suitable for treatment with the carbon dioxide or erbium laser. The most commonly treated areas are around the eyelids, mouth, forehead and cheeks.
You should think of laser resurfacing as an improvement, not an elimination of all lines. Adding Botox™ before laser resurfacing will reduce muscle action (creating dynamic lines) and allow the lasered areas to heal with a smoother result.
Other conditions that can be treated with laser resurfacing are acne scars, chicken pox scars, and superficial scaly lesions called keratoses.
Planning
Procedure
Recovery
Procedure Costs
Diary of a laser patient
Planning
Before meeting with your surgeon, you may want to take the opportunity to discuss your concerns and expectations with one of our specialist nurses. She will give you information about this procedure and discuss what is involved in detail.
Certain conditions may require special precautions, or may not be suitable for laser resurfacing. These include:
1. Past treatment by dermabrasion, laser resurfacing or chemical peel.
2. Taking certain drugs at present or in the past, such as Roacutane for treatment of acne, the contraceptive pill, and certain antibiotics.
3. Previous removal of facial hairs by electrolysis.
4. Darker skin types.
5. A history of keloid scars.
6. A history of oral herpes.
Your surgeon will assess any of these conditions and advise whether you can proceed with the treatment.
Photographs will be taken before and after your surgery to plan the procedure and to record your results.
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Procedure
For laser resurfacing, carbon dioxide or erbium is used to produce light energy that is absorbed by water.
Because the skin is 70 percent water, the carbon dioxide or erbium laser beam vaporizes the epidermis or top layer of skin. Subsequent passes of the laser beam will vaporize deeper layers (or papillary dermis).
As the depth of the laser treatment progresses, the collagen and elastin fibres that have become disorganized and stretched by photoageing will undergo a reformation process with shrinkage and reorganization.
By controlling power, spot size, and the dwell time of the laser beam, ablation of the skin can be controlled precisely with minimal heat injury to surrounding skin, little or no bleeding, and minimization of risks or complications.
Either local anaesthetic with sedation, or general anaesthetic, should eliminate pain or discomfort during the procedure.
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Recovery
Immediately after treatment, your skin will start to swell. After the anaesthesia wears off, there is usually a slight burning or stinging of the skin that can be managed with mild analgesics.
In the first 24-48 hours the area will weep like any burn. If a sticky dressing has been used, this may need to be replaced after the first 24-hour period. Subsequent dressing changes may be necessary until the area heals.
If ointment only has been applied to the treated area, you will have to clean and replace this frequently (every 3-4 hours) to prevent scab and crust formation.
With either postoperative treatment, it generally takes about 5-7 days for the skin to heal, depending on the depth of treatment and your healing response.
After healing is completed, the skin is usually pink to red and sometimes quite dry. On average this takes 6-8 weeks to settle, but occasionally the pinkness can last for many months. Because altered, blotchy pigmentation can be a problem during this time, it is essential that you wear a quality sunblock.
You may be able to return to work after two weeks, but some makeup will be necessary. If pinkness of the skin persists, then “anti-red” or camouflage makeup can be used once the area is healed. Our staff can assist with the application of this makeup if necessary and also provide you with a cream to treat any post-laser pigmentation.
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Procedure Costs
Please ring the Institute for an up-to-date estimate. A more accurate costing will be made after the first consultation.
Laser treatment for biopsy proven superficial precancerous lesions (keratoses) and other conditions may be covered by your healthcare insurance.
This page provides an overview. More detailed information can be obtained during a consultation with one of our plastic surgeons.
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Diary of a laser patient
Laser surgery is a procedure that I had contemplated
having for a couple of years. At around 20 years, I
began to get acne after having reasonably trouble free
skin during my teenage years. I eventually went to a
specialist who prescribed Roaccutane but unfortunately
the damage had been done. Now, almost 30 years old I
decided to bite the bullet and have laser surgery to
reduce my scarring.
The most important consideration when facing surgery
is to choose the best surgeon you can find. I now
live in Europe but coming home for this procedure was
the best thing I could have done. Although a costly
decision, it is one that I will never regret as some
days that was what got me through - knowing that
Stephen is one of the best and his team of staff,
particularly Karen and Angela, are truly fantastic
people and whom I trust implicitly.
Karen will drum into you what to expect after surgery
("expect your face to look like a baboon's bottom"), I
laughed and didn't take much notice as I thought I was
a reasonably strong individual and I really wanted
this procedure. My advice: "Listen to what she
says".
Here is my diary.
Day One:
I arrive at Ascot at 7am and go through the procedures
pre-op. I am still not particularly nervous as I
really want this surgery. Stephen does his thing and
I awake in recovery. I am asked if I am in pain, I
actually don't think I was, but at this point any
drugs I get are only going to help I figure so I
accept.
A silicone mask has been applied to my face and the
skin beneath feels quite tight. I find it difficult
to have a drink even when using a straw.
My mother collects me and I must congratulate her on
keeping things together. At this point I haven't seen
my face and it can't be a pleasant thing for a parent
or caregiver to experience.
We stop at Dr Gilbert's rooms just to ensure that
everything is ok and get some instructions on how to
care for my face.
I arrive home early afternoon and continue taking
medication (stuff to prevent cold sores, antibiotics
and pain relief). Unfortunately I wasn't interested
in eating and soon after looking at my face for the
first time, I start to feel quite faint. I sit on the
edge of the bath which was not very clever as I 'come
to' lying in the bath.
I try to sleep for the rest of the afternoon. The
best way to describe how you will feel is
uncomfortable, it is not painful but you will look
like a burns victim and wonder how you could have
inflicted this on yourself.
Day Two:
Still not interested in eating but I attempt some
yogurt just to avoid fainting again. You will need to
tend to your own face, cleaning with cotton buds and
applying a vaseline type substance. If you have a
carer, fantastic, let them do it and don't look at
your face otherwise prepare to get strong as this is
the part I probably struggled with the most.
Day Three:
Pretty much the same as Day Two. Feeling a little
anxious and can't wait to see Karen to make sure all
is ok and that I am making a "normal" recovery.
Day Four:
My mask is removed which is fantastic but I am told to
prepare myself as my face still has a lot of healing
to go. Once again, I pay little attention and imagine
how I expect my face to be - a bit pink at worst.
Wrong. My face looks like it has been slashed and it
is quite swollen. At this point I really was
questioning my sanity. I am told to go home and have
a shower, running my face under the water for as long
as I could, then wiping it gently with gauze pads. I
am told to repeat this procedure often. It is the
last thing I feel like doing but the results are
amazing. I see a 30-50% improvement each time -
almost like I just wiped away the slashes. I regain
my appetite slowly and start to eat lots of salmon
which is meant to be very good for the skin. It is
also important to drink loads of water.
Day Five, Six, Seven:
I can't believe how quickly my face is starting to
heal. I have been taking quite a bit of arnica to help
with the swelling and am feeling loads better. My
wrinkles have also disappeared and I look like my face
has been botoxed. The botoxed look is temporary
however and my face loosens up day by day.
Day Eight:
Today I visit Angela for a skin consultation and an
application of make-up to reduce the pinkness in my
skin. I leave feeling great and expect in a few days
I will be ready to face the world.
Day Nine:
I am still feeling a little self-conscious but can't
hide any longer. We have a dinner for twelve people
and nobody seems to notice.
From Day Ten:
It all just gets easier. The biggest
thing is how conscious of the sun you become, even
when behind glass. I am now looking after my skin the
way it should have been looked after for the past 29
years.
The funny thing for me is that I use to have freckles
and thought everybody would notice something different
about me however the common reaction I receive is that
I look great and Europe must agree with me.
I would certainly recommend this procedure, with the
right surgeon, however there were days that were
pretty tough and you really need to be prepared for
it.
Things you will need:
Cotton Buds (200-300)
Gauze Strips (Heaps)
Soft Foods - soup, yoghurt, scrambled eggs, stewed
apple, mince, salmon, mashed potato.
Pick up your script prior to surgery if you can.
Hope this is of useful information to other clients who are
considering facial resurfacing by laser.
Kind regards
P.W |
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