How Cosmetic Laser Treatment Can Tighten Skin, and the Importance of Controlling Heat Output

How Cosmetic Laser Treatment Can Tighten Skin, and the Importance of Controlling Heat Output

Thank you for your question. You’re 44-years-old
and you have several dermatologists about helping the fine lines and wrinkles. And you’ve
been advised that CO2 laser will work wonders for you but you have a couple of concerns
including the prolonged healing process and whether comparable results can be accomplished
with microdermabrasion and peels. And you’ve also expressed a concern of loss of facial
fat from the use of heat. Well, certainly I can give you guidance with
this type of question. Although there is no photo submitted and the absence of physical
exam but I can share with you my experience in how I counsel my patients. I’m a board
certified cosmetic surgeon and a fellowship trained oculofacial plastic and reconstructive
surgeon, practicing in Manhattan and Long Island for over 20 years. My experience with
lasers begins first with chemical peels and then started in the mid 90’s with the original
CO2 lasers. I have several lasers in my practice and I offer a wide variety of solutions to
help people like you. So to help you understand a little bit of
the science of why dermatologists are sharing with you this enthusiasm for the CO2 laser,
you have to understand that prior to the CO2 laser, the gold standard was always chemical
peels and still chemical peel is the gold standard by which lasers are compared. There
is a difference. However, the biggest difference is with chemical peels whether superficial,
medium, or deep chemical peels, it’s about ablation of certain levels of skin and the
body generating new skin with the certain amount of collagen that is greater than what
is previously and improvement of texture, skin quality and color. That being said, when
lasers came a long, there was one more thing that can happen that was better compared to
the chemical peel and that was tightening and the tightening effect of thermal energy
has resulted in an almost infinite variety of technologies that have propagated since
the mid 90s. And certainly consumers are overwhelmed by every year by the greatest laser, the greatest
radio frequency device since the last greatest laser, greatest radio frequency device so
it is understandable. In fact, we see a lot of patients who basically bought into the
one of the popular radio frequency devices and who have experienced what you are afraid
of. They experienced fat loss. What was once aggressively hyped turned out to be a procedure
that’s extremely painful and caused a lot of fat loss. So to help these patients, we
are doing platelet-rich plasma (PRP) injections and we’ve been trying to work helping them
get back some tissue volume. When we look at what can help someone like
you, you have to understand that when you do light peels or microdermabrasion, you can
only go so deep and you are not going to get the collagen response you want with or without
thermal energy. So in our practice to help you patients like yourself who is hesitant
about the level of thermal energy as well as the downtime associated with fractional
CO2 which I will tell you that fractional CO2 version of CO2 laser and the science has
advanced significantly and the amount of redness and prolonged healing is considerably less
than we experience in the 90s. We actually have a device in our practice photo dynamis
laser and it is a combination technology of Erbium and ND Yag technology. What this company
did is figure out what is the closest that one can get to the gold standard of CO2 but
at the same time minimize the downtime of the patient as well as carefully manage the
amount of thermal energy. We do use this device not only for resurfacing, for wrinkle treatment
but we also use this for non-surgical fat reduction and it is unique and that we are
able to apply the heat in a very specific way and still protect the skin effectively.
So certainly, there can be a program where you get the benefit of thermal delivery up
to a point but limited so you don’t have heat transfer to the fat and still get the
benefit of CO2 or fractional type of laser benefit which would be better than micrdermabrasion
and light chemical peels. And the way we do this, we will have a patient to come in for
one procedure and they typically heal in 24-48 hours and they will come back 2 weeks to a
month for another treatment. Cosmetic dermatology or cosmetic laser treatment
is more often than not, is a treatment and observation. Certainly you do have other options
but get some realistic understanding from the doctors about what to expect. I know that
from myself, with fractional CO2 laser, I do even with deeper lines, I tend to dial
it back a little bit because I want to heal faster. The modern world people don’t have
time and because collagen remodeling goes on for month to a year, they can continue
to see improvement. Clearly there is more than one way to address fine lines, wrinkles
and skin tightening. So finding a doctor that you can trust and you feel gets what your
concern is and can assure you that fat volume loss is not likely, I think is the key to
your journey and hopefully you will be able to get distinction because a lot of times
doctors advocate laser they own for a variety of reasons including which they felt at the
time when they got this laser that this is the best thing. I think everyone goes in with
the best intention in mind but when you have a variety of options, then the doctor like
a surgeon who can do many things can offer you different options and that’s what we
do in our practice. We have everything from minimum invasive to very aggressive technologies
as well as procedures. So take this information and use it to help you find a doctor that
you will be comfortable with. So I hope that was helpful, I wish you the
best of luck and thank you for your question!

About the Author: Earl Hamill


  1. Excellent information. I am researching Fotona laser in Houston, but very few have it. Is it because it's so new?

  2. I’m forty six years old, I have olive skin and been dealing with persistent melasma for years. I recently had a PICOSURE laser treatments treat my melasma but now I’m looking for laser to tighten my skin, especially around my mouth and neck. My question is, should I make sure that when considering laser treatments they should not use high heat due to possibly worsening my melasma? PICOSURE didn’t really leave my skin hot, no downtime either!

  3. i am 35 and indian (asian)there is very little sagging on my face can l use microcurrent and rf device at home at very low level

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