My goal with any procedure is a happy patient. I want you to love how you look. Delivering an exemplary aesthetic result is a given. But believe it or not, this isn’t always enough. Managing a patient’s expectations can be just as important as my skill as a surgeon. Let’s take laser skin resurfacing as an example. If you think that a single laser treatment is going to wipe out 25 years of baking in the sun then you are going to be unfortunately disappointed. So, I am always honest about what can and cannot be achieved with any laser skin resurfacing procedure. Part of this means understanding the different types of energy based treatments:
- Ablative laser
- Non-Ablative laser
- IPL (Intense Pulse Light)
- Radio Frequency
Laser Skin Resurfacing with Ablative & Non-Ablative Lasers
The first rule of thumb when it comes to managing expectations is to match the right procedure for the right patient. With laser skin resurfacing, it’s important to choose a laser that is going to address your individual needs, but also your lifestyle. For example, an ablative laser like the CO2 or Erbium is hands down the best choice for reversing serious sun damage. But it’s also the most aggressive. It basically removes the top layer of your skin where the damage resides and stimulates the underlying tissue. As new skin cells emerge, your skin will appear firmer and more youthful. However, you will look like you’ve had a serious burn to your face for at least a week. And your skin will be pink for probably another week. Not every patient can commit to this amount of downtime.
A non-ablative laser often referred to as “Fraxel”, can also address sun damage, fine lines, textural issues and pigment issues. But it will take a series of treatments, based a month apart, to achieve optimum results while the ablative laser only requires one treatment. And you will still be red and swollen like a bad sunburn for at least 24 hours.
Is IPL the Right Choice for You?
Most patients today are really well informed so they’ve heard of IPL or intense pulse light. Often referred to as a photo facial, an IPL procedure can address a myriad of issues such as brown spots, overall redness and the tiny broken blood vessels that come with age and sun exposure. The nice thing about an IPL treatment is that there is really no downtime. You can have it done during your lunch hour. But it’s also not going to deliver anywhere close to as much bang for your buck as either a non-ablative or ablative laser procedure.
I like to think of the IPL as a “starter” facial treatment. It’s good for younger laser treatments Boston patients who are just beginning to see some signs of aging but is probably not the best choice for older patients whose issues are more intense. However, I will often combine IPL with an ablative laser to treat red scars, and for patients with multiple issues in facial aging. They’ve always been something that’s been hard to improve, but this combination is proving to be quite effective.
RF is Not a Laser
One of the latest innovations to hit the marketplace is RF or radio frequency procedures. A lot of patients are confused and think that RF is a laser. It’s not. Like a laser, it produces controlled heat. But an RF procedure like Pellevé is not so much about improving skin tone and texture. Instead, it delivers skin tightening in patients who have mild to moderate sagging. It’s not going to improve “bat wings” in a massive weight loss patient or heavy jowls in an aged patient. But it can improve fine lines around your eyes and help tone those wrinkles around the knees that may be keeping you from wearing the clothes that you’d like. I find a treatment called Profound, which combines RF with microneedling, to be really effective at addressing the “crepey” skin on the inner thighs, neck, lower face, arms and knees that drive so many of us crazy. But again, this is not going to be on par with the kind of result you’d get from a facelift, tummy tuck or arm lift, for example.
So, when making your decision about laser skin resurfacing and energy based skin treatments, look at before and after photos of patients whose issues are similar to your own. Think about whether or not you’re the kind of person who would rather be “one and done” or are you willing to commit to more treatments if it means less downtime? And make sure to see a plastic surgeon who has a lot of experience. Not only will this help to ensure a great aesthetic result, but an experienced plastic surgeon will really understand the limitations of each different laser and can better guide you towards the right choice for you.