Facial Resurfacing

Individuals with facial wrinkles, superficial scars, uneven pigmentation and other cosmetic skin problems may consider facial laser resurfacing to regain a more youthful appearance. Individuals with lighter skin tone, and have limited sun exposure after treatment, typically achieve the best results. Patients with a darker skin tone may be more susceptible to skin pigmentation changes after treatment. Individuals with a history of abnormal scarring, such as keloid or hypertrophic scars, have had bacterial or viral infection of the skin, or have special conditions that could impede the healing process may not be good candidates for facial resurfacing procedures. Patients considering facial resurfacing should be in good general health, both physically and emotionally before pursuing treatment.

a) CO2 laser facial resurfacing entails the delivery of intense busts of high-powered laser energy to undesired skin tissue. The unwanted skin is vaporized one layer at a time to reveal the fresh, healthy skin underneath. This procedure has a low risk of scarring, causes mild to moderate discomfort, and requires about 2 weeks of recovery time.

b) Erbium laser facial resurfacing delivers a less intense laser energy (compared to the CO2 laser) to the unwanted skin tissue, which minimizes damage to the surrounding skin and reduces the recovery time to about 1 week. The wavelength of light that erbium laser emits gently penetrates the skin, is readily absorbed by water, and reduces the extent of thermal damage created by laser treatment. This method is suitable for patients with mild to moderate facial wrinkles, scars and/or skin discolorations. More severe cases will achieve greater results with CO2 laser resurfacing.

On your initial visit, your physician will review your health history and any daily medications you are taking. Individuals who have special conditions such as bleeding disorders, healing disorders, diabetes, or have had radiation therapy must disclose this information to their physician. If you are a smoker, you should quit for 1 month prior to treatment to minimize the risk of infection. In addition, it is prudent to quit smoking for 6 weeks following treatment to promote the healing process. Individuals considering facial resurfacing should not take Accutane, a strong acne medication, within 18 months of treatment and should make sure that their skin is free of active infections before treatment. You should be prepared to follow strict limitations that are provided by your surgeon, to minimize potential risks and maximize the benefits of facial resurfacing. Finally, you will need to arrange for a friend or a spouse who can take you to and from the treatment facility and care for any small children who may need to be lifted since you should not do any bending, lifting or straining the first week following surgery.

If your facial resurfacing procedure requires general anesthesia, you must take several precautions prior to surgery. First, you will have to avoid eating and drinking after midnight on the day before surgery. This precaution ensures that your stomach is clear of digested foods that could potentially be aspirated into your lungs during induction of anesthesia. Since, you will have anesthetic medications administered throughout the case; you will remain groggy for several hours and will require a ride to and from the treatment center.

Most patients are extremely satisfied with the significant improvement in the quality of their skin and rejuvenated appearance. Patients benefit from smoother, more evenly colored, and brighter skin as a result of facial resurfacing treatment. Facial resurfacing results generally last for several years, varying upon each patient’s diligence to protect their skin from the sun and maintain a healthy lifestyle. Over time, natural facial movements and expressions will also cause wrinkles to reappear. Patients may require additional facial resurfacing procedures in the future to maintain their rejuvenated appearance.

Depending on the severity of the treatment and type of anesthesia required, facial resurfacing can be performed at a physician’s office-based facility, outpatient facility or at a hospital. If your case requires general anesthesia, it must be performed in an operating room that is part of a hospital institution or outpatient surgery center. Less frequently, patients may be operated on in an in-house office based operating room, but it is of utmost importance for patients to make sure that the office facility is accredited by a surgical accreditation body such as AAAASF. Cases that do not require general anesthesia are usually performed at a physician’s office-based facility.

For small areas to be treated, patients are usually administered a local anesthetic that is sometimes combined with an oral sedative. For facial resurfacing of the entire face, patients are either administered intravenous sedation or general anesthesia.

Recovering from anesthesia, patients will be wearing a soft head wrap around their head to minimize swelling after surgery. Patients usually experience mild swelling and skin redness for the first few days. Patients may also notice some bruising and feel that they have a “surprised look” due to the swelling which temporarily elevates a patient’s eyebrows. Patients will use antibiotic ointments and/or wear occlusive dressings to retain moisture, prevent infection and promote the healing process. Most patients claim to feel mild to moderate discomfort after procedure due to sensations such as numbness, itching and/or tightness around the treated area. Appropriate amounts of antibiotics and pain medication are prescribed by your physician and you should only take pain medication as needed.

Patients are able to bathe immediately after surgery as long as they can keep their head dry. Patients should sleep with their head elevated and avoid bending, lifting or straining within the 1st week following treatment. Since there may be some crust over the treated areas in the first 10 days, patients will need to gently wash their skin several times a day to prevent infection. Patients can usually resume normal activities and return to work within 2 weeks after treatment. Your new skin may remain pink or red for 3 to 8 weeks following treatment and it may take several months to one full year for patients to fully recover achieve their desires results.

Patients can usually return to work within 2 weeks after CO2 laser resurfacing. However, it is important for patients to continue wear a strong sun block after treatment. Patients may also want to wait an additional week before returning to work if they are concerned with privacy because mild swelling may persist. Individuals undergoing erbium laser resurfacing usually have a shorter recovery time and may be able to return to work between 7 to 10 days after treatment.

a) Redness: Patients may experience redness for several weeks, or longer, depending on the size of the treated area and method of treatment. The redness will become pink and gradually lighten to your natural skin color over time.

b) Crusting: Immediately after treatment, the skin may appear red or pink and be covered with a fine layer of crust. The crusting usually subsides within 1 to 2 weeks and protective sun block should be worn at this time.

c) Mild swelling: Mild swelling may occur after treatment and usually subsides within a few days.

a) Infection: Infection may occur after treatment, but is generally avoided by rinsing the skin several times a day with cool tap water. Applying an ointment to the skin or using occlusive dressings to retain moisture in the skin also promotes healing and minimizes the risk of infection.

b) Irregular pigmentation: Some patients may experience hyper-pigmentation (darkening of the skin) or hypo-pigementation (lightening of the skin) as a result of skin resurfacing. However, skin discoloration has treatments available. Skin discoloration after facial resurfacing may be permanent in some cases, especially when deep laser treatment is required.

c) Burns: Heat from the laser power may cause burns. To minimize the likelihood of burn injuries, patients should follow their physician’s special instructions, such as avoiding unsafe sun exposure before and after treatment.

d) Scarring: Although scarring may occur in some cases, the risk of scarring is very low for facial resurfacing procedures. Furthermore, the appearance of scars can be reduced with skin medication.

Facial resurfacing is a laser surgical procedure that is used to remove the outer layer of the skin and eliminate skin imperfections such as acne scars, blemishes and fine lines and wrinkles to achieve smoother, brighter skin and a more youthful appearance.

CO2 lasers are typically used to perform more thorough skin resurfacing procedures, such as the removal of moderate to deep facial line and wrinkles. Due to the extensiveness of CO2 laser treatment, the recovery time takes 2 weeks and the damage to surrounding skin tissue is more pronounced than erbium laser surgery. Erbium laser surgery is more suitable for patients with mild skin problems that can be treated with a gentler laser power. The recovery time for erbium laser surgery is only about 1 week.

No, facial resurfacing is only used to change the texture and coloration of the skin and cannot successfully lift sagging skin. Excess skin can only be removed by facelift and/or browlift surgery.

Yes, facial resurfacing is frequently performed with a facelift and/or browlift to eliminate sagging skin and imperfections at the skin surface concurrently.

Yes, facial resurfacing can be performed on any skin type and skin color. However, individuals with lighter skin tone, and have limited sun exposure after treatment, typically achieve the best results. Patients with a darker skin tone may be more susceptible to skin pigmentation changes after treatment. Changes in skin pigmentation can be treated with bleaching creams and agents. To minimize skin problems after treatment, patients should avoid the sun and wear a strong sun screen after treatment.

Most patients report that facial resurfacing leads to mild to moderate discomfort, mostly due to the mild swelling, bruising, redness and crusting of the skin that occurs within the first few weeks after surgery. However, antibiotics and pain medication will be prescribed by your surgeon to minimize the discomfort and promote the healing process. Patients usually claim that the amount of pain they experienced was much lower than expected.

The side effects of facial resurfacing such as crusting, swelling and redness usually subside within 2 weeks after treatment. You are able to apply make-up on the treated site about 7 to 10 days after treatment to cover the pink skin that could remain for several weeks to a few months after surgery. Most patients are extremely satisfied with their appearance at 3 months, although it may take 1 year for their skin to fully heal and reach the desired results.