About our Lasers and Laser Procedures

There are 3 different types of light devices that are used today by the cosmetic laser surgeon:

• Lasers
• Intense Pulse light Devices
• Light Emitting Diodes
  

LASER is an acronym that stands for:

    Light Amplification by the Stimulated Emission of Radiation

What is really crucial to understand is that each laser emits a unique wavelength of light. Traditionally, the primary targets for cosmetic lasers have been either water, hemoglobin (blood) or melanin (pigment). Lasers used for the treatment of acne use a unique target related to the bacteria that causes acne. There is much work being done today on lasers that can be used to reduce fat which is the primary target.

The laser surgeon may not be able to manipulate the wavelength of the light emitted by the laser, but he can control the power (also called fluence) and duration of each pulse of laser light (the pulse width).

INTENSE PULSE LIGHT devices differ from lasers in that they emit a band of light instead of a single wavelength of light. This band of light includes all the wavelengths within the limits of the band. As with lasers, the surgeon is able to control the power and pulse width of the band of light.

LIGHT EMITTING DIODES (LED) are a new class of light devices that use a low level of light to modulate activities within cells and can be used to decrease pigment (brown and red), reduce inflammation, soften wrinkles, and increase collagen. Other uses for LEDs include improving acne; investigations are underway to see if it is possible to stimulate the growth of hair on the balding scalp.

Aesthetic lasers can be used to complement plastic surgery procedures and help the patient achieve a more natural and youthful appearance by improving the appearance of the skin of the face and neck. This is achieved by:

• Improving the color of the skin by eliminating abnormal pigmentation
• Improving the texture of the skin
• Softening or eliminating wrinkles
• Tightening of the skin
  

More than a decade ago, cosmetic laser surgeons used a CO2 laser to improve the appearance of a patient’s face. This type of treatment is called ablative resurfacing because all of the epidermis (outermost layer of the skin) was removed. The deeper layer of the skin is called the dermis. During deep ablative resurfacing, the upper part of the dermis might also be removed. It is a procedure that is used to achieve results that in the past could only be done with deep dermabrasion or chemical peels.

These lasers were excellent devices in both eliminating wrinkles and tightening skin. Today, the results obtained with the CO2 laser represent the gold standard by which the results of all other lasers are measured. Unfortunately, these lasers were also associated with a long period of healing and redness, as well as with a high incidence of changes in the pigmentation of the skin.

Another type of laser also used for ablative resurfacing was the erbium laser. Lasers operating at this wavelength of light were good for eliminating wrinkles; however, they did not achieve the skin tightening seen with the CO2 Laser. In addition, they could not be used for deeper wrinkles because they are not hemostatic; that is, they were associated with bleeding from the skin.

The current generation of the lasers employed for skin resurfacing use a type of technology known as FRACTIONAL RESURFACING. In fractional resurfacing, the skin is not treated evenly over its entire surface; instead, it is done in a polka dot fashion. The affected areas are treated in deep columns that go down much deeper into the skin than was possible when all the skin was treated. In fact, these columns may extend up to 4 times as deeper than traditional ablative resurfacing. This is possible because the skin in between each “polka dot” is untreated and enables rapid healing of the skin.

There are two types of fractional resurfacing:

1. Non-Ablative
2. Ablative
   

As previously described, the epidermis is intact after treatment with non-ablative lasers and is removed after treatment with ablative lasers. After a non-ablative fractional laser treatment, the epidermis is intact and there are columns of coagulated or treated tissue below the epidermis that is surrounded by normal tissue. After an ablative fractional laser treatment, the epidermis and the entire column of tissue are removed.

Fractionally non-ablative lasers can be used to improve brown pigmentation of the skin and to improve the texture of the skin, as well as the appearance of scars.

Fractionally ablative lasers are used to not only improve pigmentation, but to also reduce the appearance of wrinkles and to achieve skin tightening.