Laser skin resurfacing is a more aggressive treatment approach to skin damage or scars. Some parts of the skin will be completely renewed and this requires some downtime or a visible healing process.  Laser resurfacing has advanced in recent years using fractional technology.  Now only a portion of the skin receives the energy, sparing islands of normal skin around the treated area, allowing for quicker recovery and safer results.   At Cahaba Dermatology, we take a global approach to your skin rejuvenation.  Many times we will combine resurfacing technology with fillers, neuromodulators and tightening procedures to maximize your natural looking results.

DIFFERENT KINDS OF LASER RESURFACING: Ablative, non-ablative and sublative

  • Co2RE (ablative fractional resurfacing)
  • ResurFX (non-ablative fractional resurfacing)
  • Ematrix (sublative fractional resurfacing)

Co2re

Co2Re Laser resurfacing is the gold standard in skin rejuvenation. It treats wrinkles, discolorations, sun damage, pre-skin cancers, deep and fine lines, and laxity. In this procedure, the laser is used to remove the damaged outer layers of the skin, which is then replaced by fresh new cells in the healing process. This procedure offers a controlled depth of penetration of the skin surface, allowing treatment of even the most delicate facial areas.

What Conditions Can Laser Resurfacing Treat?

Laser resurfacing is performed only by Dr. Groysman in our office. It is used to:

  • Erase fine lines and wrinkles of the face
  • Soften pucker marks and frown lines
  • Remove brown spots and splotchy, uneven skin color
  • Improve and flatten scars
  • Repair smoker’s lines

What Device is used?

The CO2RE (by Candela) Carbon Dioxide (C02) Fractional Laser Resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed, leaving the skin surrounding each column intact to aid in healing) to help reduce “age-spots” (also called sun freckles, liver spots, and lentigines), fine lines, wrinkles, scarring, uneven coloration, skin laxity, textural irregularities, dull tone, and a thinned collagen layer of the face, neck, and chest.

Who will perform my laser surgery?

Dr. Vlada Groysman is a board certified dermatologist who has extensive experience with laser surgery and specifically micro-resurfacing.

What can be experienced before and after treatment?

Dr. Vlada Groysman is a board certified dermatologist who has extensive experience with laser surgery and specifically micro-resurfacing.CO2RE is the best treatment if you wish to get the most results in a few treatments as possible. Most of the time,
one treatment will help you achieve your goals. If you have the ability to take some time to heal (7-14 days), having this one treatment is like having multiple other non-invasive treatments at once. It is also the best single treatment for advanced skin damage and wrinkling.

CO2RE is an in-office procedure that requires pre and post-treatment medications to ensure proper healing and comfort during the procedure. Discomfort varies on the depth of the treatment. For your comfort during the treatment, we will apply topical anesthesia for 1 hour. We also prescribe an antibiotic, anti-viral medication and pain medication. After the treatment most patients describe the post-procedure feeling as a bad sunburn for about 12 hours to 2 days. We also recommend pain or relaxation medications prior to treatment therefore you will need to have somebody drive you home after treatment.

Occasionally, in an area that cannot be treated aggressively, we may need to do more than one treatment to optimize results. Optimally 2 treatments are recommended. This depends on the depth of the treatment. Maintenance treatments may also be necessary to maintain results, especially if sun is not avoided or proper skin care used.

How will I look and feel after my treatment?

After the treatment, you will go home and rest most of the day. After the first day your skin will be raw and you will follow the instructions as to how to keep it healing maximally. We usually see you in the office on the 48-72 hrs after treatment and one week and 3 weeks after procedure. These visits are free of charge. By the 7th day you can usually apply mineral makeup or venture out in public, but your skin will still be pink and will be very sensitive for the 30-60 days.

Strict skincare regimen and sun avoidance is recommended for best healing and optimal results for a period of 6 months following treatment. Failure to do so may result in sub-optimal results or side effects such as listed above. Your initial skin care products will be provide to you.

Your skin will continue to age as time goes on due to sun exposure, environmental stress, overall health and lifestyle choices such as smoking. To maintain your results we recommend a healthy skincare routine including cosmeceutical products, medical grade facials, and other procedures as directed by your provider.

Are there side effects or complications?

Each year thousands of laser resurfacing procedures are performed successfully. Significant complications are rare, and the risk of scarring is low. Some patients may be at risk for varying degrees of pigment loss or infection. Common side effects may include crusting, mild swelling, and brown discoloration at treatment sites. These risks are minimized by careful surgical techniques and the proper pre- and post- procedure regimens.

The main negative of the CO2RE is the downtime. Depending on the area and the aggressiveness of the treatment, it will take 7-14 days for the skin to heal. This downtime will include significant redness crusting (possibly minor bleeding and oozing depending on treatment depth), dryness, and peeling and flaking (it is important to keep the skin moist after treatment). This does mean that social and work activities will have to be curtailed during this time, although you should be perfectly capable of working from home after the first day or two. Other potential side effects may include but are not limited to: skin wound, infection and scarring, hypo and hyper-pigmentation. These are minimized with following instructions. Prior to treatment all potential risks and side effects will be discussed with you by your medical provider and medical assistant.

What are the limitations of laser resurfacing?

Laser resurfacing is not a substitute for a facelift, nor can the procedure eliminate excessive skin or jowls. However, by tightening loose skin, laser resurfacing can improve certain folds and creases. In most cases, wrinkles will improve significantly, but will not be removed completely. The goal is to improve the appearance by giving a smoother, tighter, and more even-toned complexion. If necessary, specific areas can be retreated, as skin continues to improve for up to 12 months after the procedure. Genetics, sun exposure, diet, and smoking also influence the degree and duration of improvement. As always, we recommend the daily use of sunblock and a skin care program to prolong the results of laser resurfacing. Laser resurfacing can also work beautifully in conjunction with other cosmetic procedures such as fillers, Botox® and photofacials.

RESURFX

Lumenis ResurFx is the latest in non-ablative fractional laser resurfacing of the skin.  With little to no downtime, the ResurFx makes fine micro-canals in the skin to stimulate collagen and elastin to soften scars and wrinkles.  This unique technology requires only one pass versus older technologies that require several.

What condition can resurfx treat?

  • acne scarring
  • textural irregularities
  • fine lines and wrinkles
  • lax skin
  • surgical scars and stretch marks

What do I prepare for my procedure?

Preferably, come to your appointment with clean, dry skin.  Avoid using your retinols for 3 days prior and after procedure.  Tell your doctor if you have a history of cold sores so prophylactic Valtrex can be prescribed.  Avoid tanning before or after the laser procedure in order to minimize the risk of post-inflammatory hyperpigmentation (unwanted darkening of the skin after the laser procedure).  Cessation of smoking can aid in quicker healing.  Tell your doctor if you have been on accutane in the last 6 months or have a history of keloids or sun-sensitivity disorders like lupus.

What can I expect in terms of healing after the treatment?

You can expect up to 24 hours of mild redness and swelling.  You may have a fine rough texture to the skin for 1-2 days.  You can apply make-up the following day of the procedure.  Please also begin application of a broad spectrum SPF of 30 or higher on the day following the procedure.  Sun should be avoided before and after treatments by 4-6 weeks when doing laser procedures.

What can I expect during the treatment?

We will apply a prescription topical anesthesia. The treatment itself takes 15-30 minutes.  There is minimal pain during the treatment.  Usually people relate the feeling to a mild sunburn.

eMatrix™: Sublative Fractional Resurfacing

The eMatrix™ is a new fractional skin rejuvenation device for the treatment of sundamage, wrinkles and scars that uses a process called Sublative Rejuvenation. After a series of 4 treatments performed at 3 to 4 week intervals, patients see an improvement in the overall texture and tone of their skin, along with a reduction in fine wrinkles and scars. This laser is improves scarring from acne better than any other laser on the market.

What is Sublative Rejuvenation?

Unlike our other fractional systems which use laser light to either heat or remove microscopic bits of skin — a process called ablation — the eMatrix™ uses bipolar radiofrequency energy to heat and ablate below the skin surface, producing new collagen and revealing smoother, brighter, tighter-appearing skin.

How does it work?

With Sublative Rejuvenation, the injury produced by the bipolar radiofrequency removes microscopic bits of skin beneath the skin surface, with minimal damage to the epidermis. The recovery time is therefore short, and there are no open, healing wounds.

Is there any downtime after the procedure?

The recovery is quick because most of the injury occurs beneath the skin surface. Treatment consists of 3 treatment sessions at 3 to 4 week intervals. There is minimal discomfort after a topical anesthetic is applied, and the procedure takes minutes. The microscopic injury produced in the skin creates a sunburn-like redness, for 2 to 3 days, without visible wounds, and most patients are back at work the next day. All skin types can be safely treated with this technology.