The photo above shows the result of a full face CO2 Laser Resurfacing for wrinkle removal done 10 years ago using the Ultrapulse CO2 laser, a revolutionary advance in 1995. While the wrinkle removal results were stunning, CO2 laser resurfacing created a “burn wound” that took months of recovery and after a year often left the skin white or hypo pigmented. Because of the prolonged recovery, the need for general anesthesia, and other side effects most people today do not choose to have this effective wrinkle removing procedure.

Over the past three years the concept of Fractional Skin Rejuvenation or fractional laser skin resurfacing has evolved. With Starlux Fractional Skin Rejuvenation the laser beam, an erbium laser beam, is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. (See Figure Below.)

The small areas treated by the Starlux and Fraxel fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production to replace collagen damaged by aging and sun exposure. The new collagen produced by the laser injury “plumps” skin wrinkles. The intact skin between the micro treatment zones allows for much more rapid healing-3-4 days as opposed to 2-3 weeks for the older CO2, and enough pigment cells are left intact that hypo pigmentation does not occur.

The diagram above shows the progression of laser skin rejuvenation technology from the older CO2 on the left to the newest Starlux fractional ablative lasers which have just been released. The Fraxel laser and the Starlux 1540 are depicted in the 3^rd illustration under Non ablative fractional laser resurfacing.

Starlux Fractional Non Ablative Laser Resurfacing

To ablate means to “surgically remove”. The Fraxel and Starlux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of the Starlux 1540 non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are less dramatic than with ablative lasers.

However, the new Starlux 1540 fractional lasers are able to penetrate much deeper than traditional non fractional ablative lasers and we are discovering that deeper penetration of the laser produces a much more dramatic stimulation of new collagen formation which translates into a plumping effect on the skin. This is particularly useful in treating depressed acne scars.

Another diagram which helps explain the Starlux 1540 effect is the microscopic section of skin that has been treated with the Starlux fractional laser below.

In summary, the benefits of Starlux fractional non ablative laser skin treatments are:

1. Less down time- only pink skin for 1-2 days and a day or so of bronzing that can be covered with make up
2. Better new collagen production in the deeper skin layers causing skin plumping especially of acne scars
3. Fewer complications like hyper pigmentation (although with Fraxel there is a 15% incidence of hyper pigmentation (darkening of treated areas) especially in dark skinned people, but it is temporary.
4. Improvement in skin texture and possibly enlarged pores
5. Improvement in wrinkles (See Photos below of Lux 1540 Results)

Above-Before and after Starlux 1540 non-ablative fractional laser skin resurfacing, treatment-Photos courtesy of Palomar and Dr Dwight Scarborough

The Future-Starlux Fractional Ablative Laser Resurfacing

Recently several new fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. The Starlux fractional ablative lasers are depicted in the last or 4^th picture in the first comparative fractional laser diagram above.

The fractional ablative lasers remove the tissue in the micro treatment zone rather than just heating it as is done with Fraxel and the Starlux 1540.

The benefit of ablation is that more sun damaged, wrinkled skin is removed than with the Starlux 1540 or Fraxel, and better wrinkle removal and skin surface smoothing and textural improvement is achieved. This however comes at the price of some recovery time, redness and pinkness for 4-6 days. The Starlux fractional ablative lasers however require much less recovery time than the traditional non fractional erbium and CO2 ablative lasers which required weeks of recovery. Reliant, the company that makes Fraxel has released a new CO2 fractional laser called the Repair, Lumenis has released a CO2 fractional ablative laser called ActiveFX and DeepFx for Bridge Therapy, and Palomar has released the Starlux 2940, an Erbium fractional ablative skin resurfacing laser.

Impressive wrinkle removal and improvement in skin texture is achieved with the Starlux 2940 fractional ablative laser (see Photos of my patients Below).

Above: Before and after Starlux 2940 fractional laser skin resurfacing.

Above: Before and after Starlux 1540 and 2940 combined fractional laser skin resurfacing.

Above: Before and after Starlux 1540 and 2940 combined fractional laser skin resurfacing.

The first non ablative fractional laser on the market was the Fraxel. The Starlux 1540 and 2940 are newer and improved fractional laser skin resurfacing technology.

The field of laser skin rejuvenation is advancing rapidly and new technological breakthroughs occur frequently. The benefit to you is that better wrinkle removal results are possible with less down time and fewer potential side effects.

The applications of fractional laser technology are expanding to other fields like skin tightening and eventually to fat and cellulite removal.

For further information on the Starlux fractional erbium laser skin resurfacing laser for skin rejuvenation and facial aging read Save Your Face or contact me. In my practice I use the new Starlux 1540 Fractional Non ablative erbium laser and the Starlux 2940 ablative fractional laser for skin rejuvenation.

Be sure to sign up fro my free email newsletter to keep up on new developments.

Dr Seckel
978-369-4499

Concord, Massachusetts

Boston, Massachusetts

]]> http://drseckel.com/fractional-laser-skin-resurfacing/starlux-1540-and-starlux-2940-fractional-laser-skin-resurfacing/feed/ 0 http://drseckel.com/fractional-laser-skin-resurfacing/fractional-laser-skin-resurfacing-is-best-cosmetic-laser-skin-rejuvenation-treatment/ http://drseckel.com/fractional-laser-skin-resurfacing/fractional-laser-skin-resurfacing-is-best-cosmetic-laser-skin-rejuvenation-treatment/#comments Sun, 01 Feb 2009 16:27:49 +0000 drseckel http://drseckel.com/fractional-laser-skin-resurfacing/fractional-laser-skin-resurfacing-is-best-cosmetic-laser-skin-rejuvenation-treatment/ Most of us over 30 are seeing skin aging changes when we look at our face in the mirror. Brown spots, dry skin, and wrinkles or crow’s feet around the eyes, frown lines and loose cheek skin are signs of facial skin aging. Today, new laser skin rejuvenation methods have made it possible to remove or reverse early facial skin aging changes and restore our skin to a fresh youthful look. Fractional laser skin resurfacing, starting with the introduction of Fraxel and the Starlux 1540 and 2940 fractional lasers, has emerged as the safest and best alternative for laser skin resurfacing and cosmetic laser skin treatments.

Fractional laser skin resurfacing was developed to eliminate problems associated with traditional old time laser skin resurfacing. Traditional laser skin resurfacing was very effective at wrinkle removal, but recovery was long and difficult and the skin was left white or hypo pigmented. Fractional laser skin resurfacing was developed to remove wrinkles and rejuvenate the skin with minimal downtime, quick recovery and normal skin texture and color after the cosmetic laser skin treatment.

Recently, a new cosmetic laser skin treatment called combined fractional laser skin resurfacing has been developed to improve wrinkle removal and skin rejuvenation results achieved with fractional laser resurfacing. Combined fractional laser resurfacing provides much better wrinkle removal and skin rejuvenation than previous fractional laser resurfacing treatments, but also plumps and improves the texture of aging skin much better than old time CO2 cosmetic laser skin resurfacing. See before and after pictures of Starlux 2940 fractional laser resurfacing superficial cosmetic laser skin peel below:

Above: Befofre and after StarLux 2940 fractional laser skin resurfacing treatment to remove pigment, fine wrinkles and dyschromia. Skin has also been tightened-note skin around mouth and eyes.

How Does Fractional Laser Skin Resurfacing Remove Wrinkles and Rejuvenate the Skin?

The basic cause of skin wrinkles and skin aging changes is loss of collagen in the skin. Collagen in the deep layer of our skin, called the dermis, provides moisture, nutritional support, skin plumping and elasticity which is the firmness and skin tightening component of our skin. As we age, exposure to years of ultraviolet (UV) radiation from sunlight, toxins in our diet and environment, and unhealthy lifestyles such as smoking and tanning all contribute to the destruction of collagen in our skin. When collagen is lost, our skin looses texture, elasticity and fullness, and wrinkles and sagging skin result.

For an analogy, think of a plump juicy plum with smooth skin. Place the plum into the sun for a period of time, water (like collagen in the skin) is lost and the plum turns into a wrinkled prune.

In an effort to protect itself, our skin surface responds to these aging changes by producing pigment to block the UV sunlight, and our skin thickens with extra layers of dry old looking skin, called hyperkeratosis. the visible aging skin changes are called dyschromia.

All cosmetic laser skin rejuvenation methods attempt to restore skin to a youthful state by stimulating the skin to grow new collagen to replace lost skin collagen to plump and tighten loose skin. In addition, many cosmetic laser skin rejuvenation methods strip away the damaged surface skin cells to remove pigment and dead thickened skin and stimulate new healthy looking skin cells to grow.

Above: Before and after combined fractional laser skin resurfacing to remove dyschromia, pigment, wrinkles and to plump and tighten skin around the mouth and cheek.

Fractional laser skin resurfacing is a cosmetic skin rejuvenation treatment which removes dead surface skin cells and pigment and stimulates the deep layer of the skin, the dermis to produce new collagen to replace the collagen that has been lost by facial aging changes. In summary:

Skin aging is results in:

• Loss of collagen in the skin=wrinkles and loose skin
• Skin surface changes=dry, pigmented, course skin with dyschromia

All cosmetic laser skin resurfacing methods rejuvenate skin by:

• Removing aged skin surface cells and dyschromia and promoting new skin cell growth
• Promoting new deep skin collagen to plump wrinkles and tighten skin

Why is Fractional Laser Skin Resurfacing Better?

Older cosmetic CO2 laser resurfacing, called flat beam laser resurfacing produced excellent wrinkle removal and skin tightening, but recovery was very difficult, requiring weeks for the skin to heal. In addition, traditional cosmetic laser skin resurfacing damaged pigment cells in the skin which caused the skin to turn white. These problems were caused by the fact that the older lasers treated the entire surface of the facial skin, thus healing required new skin cells to be produced by hair follicles and sweat glands in the skin. This was a very slow process requiring up to two weeks for new skin cells to cover the surface of the face.

Above: Before and after cosmetic laser skin resurfacing with the flat beam CO2 laser. Results are excellent but makeup is required due to lightening of skin color or hypo pigmentation caused by the older CO2 laser resurfacing technique.

New cosmetic fractional laser skin resurfacing is effective but much safer than traditional CO2 resurfacing. The fractional laser resurfacing beam is broken up into many small beams so that the laser affects only small focused areas of the skin. Fractional laser resurfacing leaves skip areas on the skin that are left normal and undamaged.

These untreated skin cells are able to rapidly heal the treated skin with new skin cells. The treated areas, called micro treatment zones are healed in 6 hours with the Starlux fractional Lux2940 Erbium laser. CO2 fractional lasers like the Fraxel Repair and Lumenis ActiveFX and DeepFX take longer, up to 48-72 hours.

Fractional lasers are also able to penetrate the skin into the dermis much deeper than older CO2 flat beam cosmetic laser skin resurfacing treatments. Deeper penetration causes more effective new collagen production. This characteristic results in improved skin plumping and better skin texture.

Fractional laser skin resurfacing is better than old time flat beam laser resurfacing because skin healing is much quicker, and the risk of white skin, hypo pigmentation is much less.

The benefits of cosmetic fractional laser skin resurfacing are:

• Quicker skin healing
• Deeper penetration for better collagen production
• Less risk of hypo pigmentation
• Improved skin texture
• More gentle, quicker recovery
• Improved wrinkle removal, pigment removal and skin tightening

What Is Non-ablative Fractional Laser Skin Resurfacing-Fraxel, Starlux Lux1540, Affirm

The first fractional lasers were introduced 3-4 years ago and are non-ablative 1450nm and 1540nm (nm=nanometers or one millionth of a meter, and are the units used to measure the wavelength of a particular laser) Erbium lasers. Non-ablative laser skin treatments go deep into the dermis of the skin to promote new collagen, but non-ablative lasers do not ablate or remove the surface skin cells.

Thus the non-ablative fractional skin resurfacing lasers remove wrinkles by building new collagen in the skin, but do not remove the surface aging changes of the skin. The benefit of the non-ablative technique is that there is less recovery time for healing as the skin is not broken. You are pink after a treatment, but can wear makeup and no recovery time for skin surface healing is required.

Because non-ablative treatments are weaker, you need 4 treatments scheduled 4-6 weeks apart for a good result. I use the Starlux Lux1540 non-ablative fractional laser; other models are the Fraxel and the Affirm. The best applications are acne scar removal, scar improvement, skin plumping, pigment removal and mild to moderate wrinkle removal.

Because the skin surface is not ablated, wrinkle removal is less effective with the non-ablative lasers, thus new ablative fractional laser resurfacing technology has been developed in the past year and a half.

What Is Ablative Fractional Laser Resurfacing?

For ablation, different laser wavelengths, the 2940nm Erbium laser and the CO2 laser are used. These laser wavelengths are more powerful and vaporize the skin cells on the surface as well as causing inflammation deep into the dermis.

Because surface skin cells are removed, the ablative fractional lasers are more effective at removing wrinkles, pigment, dyschromia and old dead skin cells. The downside is that some recovery is required for skin healing, however the down time is much less, about a third of the time required recovering from old time flat beam laser skin treatments. The other benefit is that ablative fractional laser skin resurfacing requires only one treatment, as opposed to the 4 treatments required for non-ablative techniques.

I use the Starlux lux2940 fractional ablative laser resurfacing method. The Starlux Lux2940 is an Erbium laser and heals faster than the fractional CO2 lasers, the Fraxel Repair, the ActiveFX and DeepFX ablative machines.

What is Combined Fractional Laser Skin Resurfacing and Why is It Better?

The newest and most effective cosmetic laser skin rejuvenation treatment is combined fractional laser skin resurfacing. After two years of research and over two hundred treatments, we have learned that combining the Starlux Lux1540 non ablative treatment with the Starlux lux2940 ablative treatment provides the most effective wrinkle removal and skin rejuvenation treatment.

Above: before and after combined fractional laser skin resurfacing. Note dyschromia is removed but skin texture and color are normal after treatment.

The Starlux Lux1540 and Starlux Lux2940 are done in the same treatment session. The results in terms of wrinkle removal, skin plumping, improved skin texture, pigment removal and general skin rejuvenation are excellent and better than either treatment done alone. This is a very new technique; I just presented our findings in Dallas, Texas at the Palomar Medical Advanced laser seminar on January 24, 2009. We have been working on this project for over two years.

How Is Combined Fractional Laser Skin Resurfacing Done?

The combined fractional laser skin resurfacing treatment is done in my office with a topical local anesthetic cream. Your face will be cleansed and a topical numbing cream applied. I also give you a tranquilizer and an analgesic to help you relax and be more comfortable during treatment.

The Starlux Lux1540 treatment is done first by my medical aesthetician and takes about 30 minutes. Numbing medicine is re-applied, and I or my plastic surgeon associate do the actual Starlux Lux2940 ablative treatment.

After your treatment we apply cold wet compresses to the skin. Then a soothing ointment will be placed on your skin, and you will go home. During the first 24 hours you will place soothing soaks on your skin and apply ointment every few hours. By day 2 or 3 you will finish the soaks and only apply ointment as you need it. You will be given analgesic tablets in case you need them and Valtrex to protect you from a Herpes skin outbreak. We also give you prophylactic antibiotics to protect against skin infection during healing.

What Will I look Like After Treatment and How Long Is Recovery?

Your skin will be pink to red after treatment. The first 24 hours your skin will be moist and old skin cells will peel off and be removed by the soaks.

Your new skin will cover your face in 2 to 3 days, very different from the 2-3 weeks required for skin healing after the old time float beam laser treatments.

Your face will remain pink for 5-7 days, but you can wear make up by day 3 or 4. This is about a third or fourth of the recovery time from a deep chemical peel or an old time flat beam laser treatment.

When Do I See My Final Result?

You will see a remarkable improvement in wrinkles and skin texture with fresh new skin starting at 10 days and for the first 3 weeks. However, new collagen production, the main goal of this treatment does not begin for 6 weeks and continues for one year after treatment.

The initial benefits are due to swelling of the skin which subsides at about 3-4 weeks so expect to see your wrinkles return initially. However at 3 months you will really start to see the improvement in your skin and at 6 months results are very dramatic.

In my experience, wrinkle removal, skin tightening and improvement in skin plumping and skin texture are most obvious at one year following treatment.

How Do I Find A Doctor Who Uses This Technique?

Board certified plastic surgeons and dermatologists are the experts at cosmetic laser skin rejuvenation treatments. Ablative laser resurfacing is more commonly done by plastic surgeons because of the complexity of skin care after the procedure. The new combined technique is so new that it will be some time before it is widely practiced, so you may have trouble finding an expert on combined fractional laser skin resurfacing.

Be certain that your physician is board certified and has experience in laser surgery-there are many new users of lasers who simply do not have the experience required for these advanced cosmetic laser skin treatments.

Check the websites of the organizations below for credible information and guidance:

American Board of Plastic Surgery
American Society of Plastic Surgeons
American Association of Aesthetic Plastic Surgeons

For more information on fractional laser skin resurfacing, cosmetic laser skin treatments or non-surgical facial rejuvenation call 978-369-4499 or email me. Read my free newsletter to learn about the newest anti-aging and skin rejuvenation techniques. Read Save Your Face to learn how to prevent facial aging and skin aging.

Dr. Seckel
Concord, Massachusetts
Boston, Massachusetts

However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three weeks, prolonged facial redness that can last three months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring.

During the past three years new technology called fractional laser resurfacing has been developed which has dramatically shortened recovery time and lessened the occurrence of complications.

With fractional laser resurfacing the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production and resultant facial skin rejuvenation. ( See Diagram Below)

In the above skin diagram, the first red area on the left represents traditional non fractional ablative CO2 and Erbium laser resurfacing. To ablate means to surgically remove and the skin tissue is removed by the heat of the CO2 or Erbium laser. Since these lasers were not fractional, all of the skin in the treated area is removed creating an open wound that takes a long time to heal.

The second drawing is the Lumenis® ActiveFX fractional CO2 laser which fractionally ablated the surface of the skin down to a depth of 70-100 microns. This laser is fractional and the skin heals much quicker, but depth of penetration is not deep enough to produce substantial wrinkle removal, skin tightening and skin rejuvenation.

The third red areas represent the non ablative fractional laser technologies which heat but do not ablate the skin. These lasers use an Erbium laser to heat small columns of the deep skin layers to promote new collagen production and plump the skin and skin wrinkles. Recovery time is much less than with traditional ablative CO2 and Erbium lasers. Examples of the non ablative fractional lasers are the Fraxel® and the Palomar® Lux1540 fractional non-ablative lasers. These lasers are excellent for improving skin texture, plumping wrinkles and acne scars, and shrinking pores, but multiple treatments are required.

More recently several new fractional ablative lasers (ablate means to surgically remove-see last column on right in diagram below) have been developed which actually remove the heated column of skin tissue and provide more substantial wrinkle removal and superficial skin tightening than the non ablative fractional lasers (See Last Figure on Right in Above Diagram). The Fraxel® Repair laser and the Lumenis® Bridge laser are ablative fractional CO2 lasers and the Palomar® Lux2940 laser is an ablative fractional Erbium laser. These new ablative fractional CO2 and Erbium lasers have the advantage of producing better wrinkle removal and skin rejuvenation than the non-ablative fractional lasers, the Fraxel® and Palomar® Lux1540 with less down time than the traditional non fractional ablative CO2 and Erbium lasers.

These fractional ablative CO2 and Erbium lasers reach much deeper into the skin, 600 to 1000 microns, and can produce much more effective wrinkle removal and skin rejuvenation with significantly less down time and recovery than traditional CO2 and Erbium non fractional ablative laser resurfacing. The Erbium laser produces less heat than the CO2 laser and traditionally recovery time, the time for redness of the skin to go away, has been less with the Erbium laser than with the CO2 laser.

The photo below shows the wrinkle removal results achieved with the new Palomar® Lux2940 micro fractional ablative Erbium laser with only 4-6 days of down time as compared to 3 weeks of down time and 3 months of redness with a traditional CO2 laser resurfacing.

The new micro fractional ablative Erbium and CO2 laser resurfacing techniques are very exciting advances in the field of non surgical facial rejuvenation and wrinkle removal. Many new applications are being developed which will likely improve our ability to rejuvenate the skin and possibly improve scars, stretch marks, and remove pigment.

To learn more about non surgical facial rejuvenation, read Save Your Face or contact me.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

978-369-4499

However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three weeks, prolonged facial redness that can last three months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring.

During the past three years new technology called fractional laser resurfacing or fractional skin rejuvenation has been developed which has dramatically shortened recovery time and lessened the occurrence of complications.

With Fractional Skin Rejuvenation the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production and resultant facial skin rejuvenation.

The first fractional laser made by Reliant the Fraxel laser and subsequently Palomar Medical’s Lux1540 have produced excellent results treating acne scars and facial pigmentation and have improved skin texture and facial rejuvenation. They have not however achieved the same degree of wrinkle removal and skin tightening as the traditional ablative CO2 laser resurfacing technique.

To ablate means to “surgically remove”. The Fraxel and Lux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are much less dramatic.

The results achieved by ablative CO2 resurfacing are more significant because ablation removes damaged, aged skin as well as heating the deeper skin layers to promote new collagen production.

Recently several new micro fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. The diagram below shows how this new technology works in comparison to previous laser methods.

The first on the left is traditional CO2 and Erbium laser resurfacing. Next is the Lumenis CO2 ActiveFX which fractionally ablated the surface of the skin down to a depth of 70-100 microns. Next are the non ablative fractional technologies which heated but did not ablate the skin. More recently the Palomar Lux2940, the Sciton Profractional, the new Lumenis Bridge Therapy and Reliant’s FDDA or Repair lasers have all developed new ablative or microablative fractional laser systems that reach much deeper into the skin, 200 to 1000 microns, and can produce much more effective wrinkle removal, new collagen production and skin rejuvenation with significantly less down time and recovery than traditional CO2 ablative laser resurfacing.

The photo below shows the wrinkle removal results achieved with Palomar’s new Lux2940 micro fractional ablative laser with 4-6 days of down time and a week of redness as compared to 3 weeks of down time and 3 months of redness with a traditional CO2 laser resurfacing.

The new Fractional Skin Rejuvenation lasers are a very exciting advance in the field of non surgical facial rejuvenation and wrinkle removal. Many new applications are being developed which will likely improve our ability to rejuvenate the skin and possibly improve scars, stretch marks, and remove pigment.

Another very exciting aspect of Fractional Skin Rejuvenation is that unlike older ablative laser resurfacing techniques, the new Fractional Skin Rejuvenation lasers appear to be safe to use on darker skin for Asian Skin Rejuvenation and African American Skin Rejuvenation. This will make the latest skin rejuvenation techniques available to millions of people with dark skin who could not be safely treated with previous skin rejuvenation techniques.

The patient below was treated with the Lumenis ActiveFX fractional ablative CO2 laser by Dr Bosniak in NY:

To learn more about non surgical facial rejuvenation and Fractional Skin Rejuvenation, read Save Your Face or contact me.

To stay current on the exciting new advances in Aesthetic Laser Technology sign up for my email newsletter.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

978-369-4499

The photo above shows the result of a full face CO2 Laser Resurfacing for wrinkle removal done 10 years ago using the Ultrapulse CO2 laser, a revolutionary advance in 1995. While the wrinkle removal results were stunning, CO2 laser resurfacing created a “burn wound” that took months of recovery and after a year often left the skin white or hypo pigmented. Because of the prolonged recovery, the need for general anesthesia, and other side effects most people today do not choose to have this effective wrinkle removing procedure.

Over the past three years the concept of Fractional Skin Rejuvenation or fractional laser skin resurfacing has evolved. With Fractional Skin Rejuvenation the laser beam, an erbium laser beam, is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. (See Figure Below) The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production to replace collagen damaged by aging and sun exposure. Damage to collagen in the skin is a cause of skin wrinkles. The new collagen produced by the laser injury “plumps” skin wrinkles. The intact skin between the micro treatment zones allows for much more rapid healing-3-4 days as opposed to 2-3 weeks for the older CO2, and enough pigment cells are left intact that hypo pigmentation does not occur.

The diagram above shows the progression of laser skin rejuvenation technology from the older CO2 on the left to the newest fractional ablative lasers which have just come out. The Fraxel laser and the Lux 1540 are depicted in the 3^rd illustration under Non ablative fractional laser resurfacing.

Fractional Non Ablative Laser Resurfacing

To ablate means to “surgically remove”. The Fraxel and Lux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of the Fraxel and Lux 1540 non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are less dramatic than with ablative lasers.

However, the new fractional lasers like Fraxel and the Lux 1540 are able to penetrate much deeper than traditional non fractional ablative lasers and we are discovering that deeper penetration of the laser produces a much more dramatic stimulation of new collagen formation which translates into a plumping effect on the skin. This is particularly useful in treating depressed acne scars. Another diagram which helps explain this is the diagrammatic representation of the Lux 1540 below.

In summary, the benefits of fractional non ablative laser skin treatments are:

1. Less down time- only pink skin for 1-2 days and a day or so of bronzing that can be covered with make up
2. Better new collagen production in the deeper skin layers causing skin plumping especially of acne scars
3. Fewer complications like hyper pigmentation (although with Fraxel there is a 15% incidence of hyper pigmentation (darkening of treated areas) especially in dark skinned people, but it is temporary.
4. Improvement in skin texture and possibly enlarged pores
5. Improvement in wrinkles (See Photos below of Lux 1540 Results)

Above-Before and after Lux1540 treatment-Photos courtesy of Palomar and Dr Dwight Scarborough

The Future-Fractional Ablative Laser Resurfacing

Recently several new fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. Fractional ablative lasers are depicted in the last or 4^th picture in the first comparative fractional laser diagram above.

The fractional ablative lasers remove the tissue in the micro treatment zone rather than just heating it as is done with Fraxel and the Lux 1540. The benefit of ablation is that more sun damaged, wrinkled skin is removed than with Fraxel or the Lux 1540 and better wrinkle removal and skin surface smoothing and textural improvement is achieved. This however comes at the price of some recovery time, redness and pinkness for 4-6 days. The fractional ablative lasers however require much less recovery time than the traditional non fractional erbium and CO2 ablative lasers which required weeks of recovery. Reliant, the company that makes Fraxel has released a new CO2 fractional laser called the Repair, Lumenis has released a CO2 fractional ablative laser for Bridge Therapy, and Palomar has released the Lux 2940, an Erbium fractional ablative laser.

Impressive wrinkle removal and improvement in skin texture is achieved with the Lux 2940 fractional ablative laser (see Photo Below).

The first non ablative fractional laser on the market was the Fraxel. The Fraxel has been improved and many new improved fractional devices have been released since Fraxel appeared on the market three years ago. The field of laser skin rejuvenation is advancing rapidly and new technological breakthroughs occur frequently. The benefit to you is that better wrinkle removal results are possible with less down time and fewer potential side effects. The applications of fractional laser technology are expanding to other fields like skin tightening and eventually to fat and cellulite removal.

For further information on the skin rejuvenation and facial aging read Save Your Face or contact me. In my practice I use the new Lux 1540 Fractional Non ablative erbium laser for skin rejuvenation.

Be sure to sign up fro my free email newsletter to keep up on new developments.

Dr Seckel
978-369-4499

Concord, Massachusetts

Boston, Massachusetts

However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three weeks, prolonged facial redness that can last three months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring.

During the past three years new technology called fractional laser resurfacing has been developed which has dramatically shortened recovery time and lessened the occurrence of complications.

With Fractional laser resurfacing the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications. The small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury to promote new collagen production and resultant facial skin rejuvenation.

The first fractional laser Fraxel and subsequently Lux1540 have produced excellent results treating acne scars and facial pigmentation and have improved skin texture and facial rejuvenation. They have not however achieved the same degree of wrinkle removal and skin tightening as the traditional ablative CO2 laser resurfacing technique.

To ablate means to “surgically remove”. The Fraxel and Lux1540 are non ablative lasers which mean that when the laser beam strikes the skin the skin is not removed immediately, rather the laser beam heats the skin to cause inflammation and new collagen production. The benefits of non ablative laser skin treatments are dramatically reduced recovery time, but the results in terms of wrinkle removal and skin tightening are much less dramatic.

The results achieved by ablative CO2 resurfacing are more significant because ablation removes damaged, aged skin as well as heating the deeper skin layers to promote new collagen production.

Recently several new micro fractional ablative lasers have been developed which have the benefits of fractional treatments, less down time and complications, as well as the benefits of ablative skin resurfacing, better wrinkle removal and facial rejuvenation. The diagram below shows how this new technology works in comparison to previous laser methods.

The first on the left is traditional CO2 laser resurfacing. Next is ActiveFX which fractionally ablated the surface of the skin down to a depth of 70-100 microns. Next are the non ablative fractional technologies which heated but did not ablate the skin. More recently the Palomar Lux2940 fractional laser has been developed to provide fractional ablative laser resurfacing treatments that reach much deeper into the skin, 200 to 600 microns, and can produce much more effective wrinkle removal and skin rejuvenation with significantly less down time and recovery than traditional CO2 ablative laser resurfacing.

The photo below shows the wrinkle removal results achieved with Palomar’s new Lux2940 fractional resurfacing laser with 4-6 days of redness as compared to 3 weeks of down time and 3 months of redness with a traditional CO2 laser resurfacing.

The new Lux2940 fractional ablative laser resurfacing technique is a very exciting advance in the field of non surgical facial rejuvenation and wrinkle removal. Many new applications are being developed which will likely improve our ability to rejuvenate the skin and possibly improve scars, stretch marks, and remove pigment.

To learn more about non surgical facial rejuvenation, read Save Your Face or contact me.

Dr. Seckel

Concord, Massachusetts

978-369-4499