Skincare

Laser Skin Resurfacing / Wrinkle Reduction
Time, gravity and excess sun exposure can cause deepening of facial lines and uneven pigmentation.  This gives an older, tired look to an otherwise youthful complexion.  Laser skin resurfacing can reduce, and often remove, much of this damage to the skin and literally “turn back the clock”.  A tired looking, sun damaged face can obtain an entirely new, fresh look with healthy, glowing smooth skin.  This is the goal of laser resurfacing.

There are different levels of laser resurfacing available, depending on the patient’s condition, the level of “down time” or recovery period a patient can tolerate, and cost.

Laser Skin Resurfacing FAQs

What areas can be treated with laser resurfacing?
Laser resurfacing effectively and safely reduces, and in many cases, removes wrinkles and uneven pigmentation and tightens the skin around the lower eyelids, upper eyelids, forehead, cheek, and jowl region.  It is quite common for patients to have full face laser resurfacing and obtain fresh, new, unblemished skin giving a remarkably natural and more youthful complexion.  It can also be used for acne scarring or scarring from accidents or surgery on almost any part of the body.

How does laser resurfacing work?
The most effective laser for facial resurfacing is the CO2 (carbon dioxide) laser.  This laser is capable of minimizing wrinkles of the facial skin, especially around the mouth and eyes.  It is also highly effective in balancing out pigment irregularities of the facial skin and minimizing facial scars from trauma or acne.

This is often referred to as ablative laser resurfacing, meaning that the laser actually removes (exfoliates) the outer dead layer of skin, the epidermis, as well as a limited amount of superficial part of the next skin layer, the dermis.  The depth of resurfacing is controlled by the type of laser used, the setting parameters & number of "passes" made over the treatment area. The laser beam removes the outer layer of skin (epidermis). Then, at lower power, the laser heats the underlying skin (dermis), which stimulates the growth of new collagen fibers. As the wound heals, new skin forms that is smoother and tighter.

Ablative laser treatment will dramatically smooth skin surface irregularities such as mild to moderate wrinkles, acne scarring & remove patchy discolorations as well.  In addition, thermal heating of the deeper layers will begin an increased production of collagen.  Collagen production will further diminish fine to mild wrinkling and tighten mild sagging of the skin. This is a delayed benefit that continues for 4-6 months after treatment.

Can I treat certain problem areas or do I need to treat the whole face?
Laser resurfacing can be used to treat the whole face or simply specific “problem areas”, like isolated scars or cheek acne scarring.  Usually, it is preferable to treat the face in “aesthetic units”, such as the lower eyelids or around the mouth.  Most often, however, sun damage, wrinkling, and uneven pigmentation affects the whole face and better results are obtained when the entire face is treated.  As it heals, it looks like a sunburn, as opposed to patchy, isolated pink areas of the facial skin.

Also, CO2 laser resurfacing is frequently combined with other cosmetic procedures such as facelifts and lower eyelid surgery.  It is Dr. Guida’s opinion that tightening the lower eyelid skin with the CO2 laser is much more effective and safer than trying to tighten the skin by surgically removing skin.  The laser gives the skin a fresher, smoother appearance with less little risk of scarring or changing the position of the lower eyelid.

How is the procedure performed?
Usually CO2 laser resurfacing is performed in Dr. Guida’s AAAHC accredited office operating room utilizing a board certified anesthesiologist for intravenous sedation.  If isolated, smaller areas, such as the lower eyelids or individual scars, are being resurfaced alone, local anesthesia with no sedation, works very well.

Dr. Guida will mark the face into a series of aesthetic units and while you are sedated, he will use a long-acting local anesthetic to make the face numb during the procedure and for several hours afterwards.  Several passes with the laser will be performed.  The first pass removes the dead, outer layer called the epidermis and subsequent passes with the laser heat up the outer layers of the dermis, which tightens the skin long term.  Dr. Guida uses his judgment and experience to determine how many passes to use with the laser.

When the procedure is done, a healing ointment is placed on the treated area and you are brought to the recovery room.

How is the recovery from laser resurfacing with the CO2 laser?
Most people describe the discomfort after laser resurfacing as a sensation similar to a sun burn.  Cool compresses, generous application of healing ointment, and necessary pain medication will make the recovery comfortable.

This resurfacing provides the most immediate and dramatic results in terms of removing wrinkles and sun damage, but there is a recovery period and some downtime.

Typically, after CO2 laser resurfacing, the face will need to be covered with an ointment for 1 week.  After one week, light cover up or make up can be applied to the skin.  The skin may be light pink for several weeks and gradually fade over this period of time.

How will I feel after laser resurfacing?
Most people describe the discomfort after laser resurfacing as a sensation similar to a sun burn.  Cool compresses, generous application of healing ointment, and necessary pain medication will make the recovery comfortable.

How is CO2 laser resurfacing different from other type of skin resurfacing?
Dr. Guida has experience with deep chemical peels, dermabrasion, and other lasers for skin resurfacing.  He has over 10 years experience with the CO2 laser and believes it is the most effective way to obtain immediate, significant, and safe resurfacing of facial lines, wrinkle, uneven pigmentation and scars.

CO2 laser resurfacing allows for more control over how deep the treatment penetrates your skin, as opposed to other treatments.  It allows for more precise treatment of delicate facial areas, such as those around your eyes and lips.  CO2 laser resurfacing also causes less bruising, bleeding, and post operative discomfort than the other methods, such as dermabrasion.

CO2 laser resurfacing sounds great, but I do not want long down time.  Are there simpler options?
Yes, there are a variety of other options with varying downtime.  The simplest way to achieve resurfacing of the skin with no downtime is by maintaining a daily home care regimen of facial cleansing and exfoliation.  Dr. Guida and his aesthetician will be happy to discuss this with you and achieve a sensible plan that fits your lifestyle.

A step beyond home Skincare is having Dr. Guida’s aesthetician provide a series of in office treatments, such as light, medium or deeper chemical peels, microdermabrasion, and facials that are tailored to your skin type and needs.  This is highly individualized and Dr. Guida and his aesthetician work together to select the best option.

Finally, there are nonablative lasers and intense pulsed light therapy that are effective in rejuvenating the skin with no down time.  These have significantly less or no down time, but may require multiple treatments for more subtle results.

How do I set up an appointment and begin a treatment?
Dr. Guida would be happy to meet with you personally to discuss this laser treatment in detail.  Please feel free to call the office at 212-871-0900 or schedule an appointment on line.  We are here to help you.