Boston Plastic Surgery, Cosmetic Plastic Surgery, Dr Seckel, Boston Massachusetts, Concord Massachusetts

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 aging. Today, new laser skin rejuvenation methods have made it possible to remove or reverse early facial aging changes and restore our skin to a fresh youthful look. Fractional laser 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 treatments.

Fractional laser skin resurfacing was developed to eliminate problems associated with traditional old time laser skin resurfacing. Traditional laser 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 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 resurfacing. See before and after pictures of Starlux 2940 fractional laser resurfacing superficial cosmetic laser peel below:

before and after fractional laser skin resurfacing cosmetic laser skin treatment with Starlux2940Above: 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 Face?

The basic cause of wrinkles and skin aging changes is loss of collagen. Collagen in the deep layer , 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. 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 changes are called dyschromia.

All cosmetic laser rejuvenation methods attempt to restore skin to a youthful state by stimulating the growth of 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.

before and after picture of fractional laser skin resurfacing to remove dyschromia, pigment, wrinkles and to improve skin texture, using combined fractional techniqueAbove: 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 resurfacing is a cosmetic skin rejuvenation treatment which removes dead surface 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 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.

before and after cosmetic laser skin resurfacing with the CO2 laserAbove: 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.

before and after pictures of combined fractional laser skin resurfacing to remove wrinkles and skin aging changesAbove: 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.

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

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