Over the last five to ten years the use of lasers in plastic surgery has greatly enhanced the surgeons ability to remove many of the unwanted signs of aging and environmental damage to the skin. Lasers can be used for a variety of skin conditions, including the treatment of wrinkles, pre-cancerous (actinic) lesions, uneven surface texture, scars, facial spider veins, age spots, freckles, tattoos, birthmarks, portwine stains, hemangiomas, moles and warts. Lasers are now given FDA approval for permanent hair removal. Research and production of lasers for skin resurfacing and other applications remains one of the hottest areas of technology in plastic surgery. There are basically two types; those that burn the skin in a very precise fashion (ablative) and those that are designed not to burn the skin but induce new collagen formation by dermal heating (non-ablative). Ablative Lasers - those that remove the surface Ablative lasers (CO2, Erbium:CO2 lasers) are very effective in removing sequential layers of the skin precisely and cleanly. The lasers use a very high energy beam of light to vaporize the surface of scars, lines and wrinkles, and other skin defects. The heating both smoothes the surface and induces new collagen formation in the deeper layers of the skin. The light penetrates to a very precise controlled depth, making the procedure safe and predictable, and reduces the risk of scarring or pigmentation problems. Laser skin resurfacing is bloodless, and can often be performed in the office for smaller areas with oral sedation thus eliminating the costs of hospitalization or anesthesia. Larger areas are more comfortably performed under general anesthesia. Non-ablative Lasers - those that do not remove the surface This type of laser (Erbium, Erbium:YAG, diode laser) is designed to not burn the surface of the skin, but delivers its energy to the deeper layers of the skin (dermis) and induces new collagen formation, thereby reducing wrinkles by "filling the skin" with less downtime and healing required. At the time of treatment you will receive a light oral sedation, topical anesthesia and possibly a local nerve block. This will alleviate any discomfort during the procedure. Generally patients enjoy a short recovery time after the CO2 laser skin rejuvenation, with minimal disruption of their routine. Dr Ptak will prescribe an ointment to keep the healing areas moist, especially during the first 48 hours. The initial redness fades in a few weeks to light pink, which is easily camouflaged with cosmetics and disappears completely in one to nine months. Some swelling may occur, particularly around the eyes. It is important to use a sunscreen with SPF 15 protection against UVA and UVB rays, and to avoid sun exposure for several months as this can cause changes in pigmentation. Some patients may experience transient spots of hyper- or hypo- pigmentation (coloration or discoloration); these conditions usually resolve in four to twelve weeks. It is Dr. Ptak's feeling that although these lasers may serve their purpose for very nice short term results, they have not been shown to produce the long term results that the CO2 lasers are known for. In general very similar results can be accomplished by chemical peeling at a lower cost. Pigmented Lesion Lasers Lasers used to treat pigmented lesions and tattoos include the YAG, Alexandrite and the Ruby laser. Pigmented lesions include age spots (liver spots) and freckles. The tattoos which clearly respond the best to the lasers are those applied with black and deep blue pigments, especially amateur tattoos. Multicolored and professional tattoos are more difficult to totally remove, and all tattoos require multiple treatments. These treatments occur on an average of every six to eight weeks. The type of lesion/tattoo you have will determine the number of treatments you will need. Depending on the age, type and color of the pigmented lesion or tattoo, complete clearing may not be possible. All of these factors will be discussed with you at your initial consultation with Dr Ptak. Vascular Lesion Lasers Pulsed dye lasers can effectively be used for the treatment of hemangiomas, port wine stains, vascular lesions, capillaries, and telangiectasias of the face, neck and chest. The pulsed dye lasers have also proven very effective in the treatment of warts. The side effects of pulsed dye lasers include bruising of the treated area for 1 to 14 days. CO2 Laser Skin Resurfacing: About Your Skin We are all born with smooth, baby-soft skin. Throughout the years none of us can escape the environmental damage we are exposed to, some more than others. Think about the sun exposure, air pollution, smoking, alcohol use and improper diet. All of these factors contribute to free radicals that attack our once healthy skin cells. This damage to our skin leads to a significant acceleration of the natural aging process. These hazards, combined with time, heredity and gravity will create fine lines and wrinkles and thinning of the collagen and support layers of the skin, especially around the mouth and eyes. Other surface imperfections, such as moles, warts, superficial skin cancers and actinic keratosis may also develop over time to mar the skin. We are now able to remove surface imperfections and dramatically reduce lines and wrinkles with a new procedure called laser skin resurfacing. Using the CO2 Laser, we can gently remove sun damaged, aging skin, layer by layer, helping to protect and stimulate the regeneration of the deeper, healthy skin. Unlike dermabrasion, the CO2 laser uses a very high energy beam of light to vaporize or "paint away" scars, lines, wrinkles and other skin defects. Laser skin resurfacing is bloodless, and can usually be performed in the office with oral sedation thus eliminating the costs of hospitalization or anesthesia. After CO2 Laser resurfacing you should have improvement of your wrinkles or scars. Fine to medium depth wrinkles are often eliminated. Deeper wrinkles can be softened. We invite you to inquire about CO2 Laser skin resurfacing, and how it can help to give you smoother, fresher, younger looking skin.