Laser, light and energy-based treatments have significantly changed the landscape of facial cosmetic procedures. We are better able to treat a wider variety of skin concerns more effectively and efficiently than ever. Like many things in cosmetic medicine, lasers have become a commodity with many facilities offering treatments, some of whom do not have proper physician oversight. This is further complicated by the fact that many of the companies now do direct to consumer marketing in magazines, television, and social media. It is truly overwhelming as a patient to try and figure out what may be a good treatment to consider. At the end of the day, lasers are simply a tool and if the individual operating the laser has a limited knowledge or only a few options to offer, patients may find themselves undergoing procedures that may not be appropriate for a specific patient’s need. In this blog, I’ll share the best laser treatments for a few common skin concerns, from sun damage to scarring.
This is a broad topic, and many conditions can be lumped under this term. In general, devices that treat sun damage are going to address pigmentation, redness, and roughness of the skin. When you come to see us in our Dallas or Frisco Plastic Surgery office, we will assess your skin and ensure you are on a good skin care program. Our aestheticians and I will review your current regimen and/or start you on one. It does not have to be complicated and can ensure that you will be able to maintain the results of any treatments you have. To compliment your skin care program, we have several lasers and lights that can accelerate the improvement of your skin.
Intense Pulsed Light (IPL or BBL) – this is a broad-spectrum light that addresses reds and browns in your skin and generally makes your skin texture better. Most patients undergo 3-5 treatments initially and then a couple of treatments a year for maintenance. There is minimal downtime.
Moxi – This laser is a bit more effective at treating pigmentation of all types and can be used in darker skin colors safely. Patients begin with two treatments separated by a month in combination with good skin care. Maintenance treatments a few times a year are required. Patients may experience a mild flaking and swelling for a few days. It may be combined with IPL in some cases.
Halo – This device is often combined with IPL. It will improve the color of your skin as well as your texture. It stimulates your skin to turnover and build new collagen. Patients have a few days of swelling and mild to moderate flaking. This device is better for skin texture and roughness.
Wrinkles have as many treatments as causes these days. Decisions regarding ideal treatment depends on several things including goals and acceptable downtime. Botulinum toxin (BOTOX) and fillers can treat certain types of “lines” or wrinkles. Other choices when a bit more downtime is acceptable:
Microneedling – this procedure is done by our aestheticians and is an office-based procedure done with a topical anesthetic. It involves the use of a handheld device with rotating, fine needles. Most patients require 3-4 treatments done 4-8 weeks apart. Each treatment is associated with several days over peeling and mild swelling. In some cases, a series of needles are tied to radiofrequency energy to increase to localized injury and generating a more significant response. This may require a few more days of downtime.
Full Ablative Erbium Resurfacing – this is the most aggressive procedure for the treatment of skin and wrinkles. Ablative Laser Skin Resurfacing is performed in the operating room with the patient asleep. The recovery is significant with the peeling process taking about 10 days. Patients experience a more intense redness for about a month followed by a mild pink color for another 2 months. Makeup can be worn once the peeling is complete. The results are worth it with years of improvement in moderate to deep wrinkles.
This type of scarring is challenging to treat. Most importantly the patient’s acne must be well controlled. Once that happens, patients have several options to improve the color, texture, depth, and consistency of their acne scars.
Fractionated Erbium Laser – This laser puts very tiny, deep holes in the scar. This stimulates the skin to heal with collagen and improve the depth of the scar. It is associated with about a week of peeling and then some discoloration that takes another 4-6 weeks to resolve. Makeup can be worn after the first week. Results take six months to finalize.
Microfat injections – Our research has found that taking one’s fat and breaking it up and then injecting it back into the skin helps improve acne scarring. This requires a procedure to remove fat from one area of the body and then inject it after it has been prepared. This results in a week of swelling and possibly bruising. This done in combination with laser seems to compliment laser treatment.
There are many devices that claim to be “skin tightening” devices. We currently have three in our practice. They use either ultrasound or radiofrequency energy to create tiny areas of injury to the skin and rely on the recovery process to help improve the skin’s collagen and elastin. Some require a couple of treatments. Recovery is only a few days and activities are not limited. The devices are limited with what they can accomplish and who may be a candidate. Patients early in the aging process with good skin quality are the best candidates for the procedures. The results are far from what we can achieve with surgery and certainly less predictable.
We have several devices in our Dallas and Frisco facial plastic surgery practices that can help patients with the changes seen with sun exposure and aging. It is important that patients are seen and evaluated first by our team, including myself and our aestheticians. (Danielle and Wendy in Dallas, and Melissa in Frisco). Once evaluated we can identify what your goals are and how best to treat them. To schedule a consultation with Dr. Kenkel please click here or call our office at 214-645-3112.