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David W Kim M.D. | Rhinoplasty Specialist

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Laser Skin Resurfacing

I am a facial plastic surgeon and many patients come into the office thinking that surgery is going to fix all of their problems and make them look younger.  So people come in looking for facelifts, rhinoplasty, eyelid surgery to try and create overall rejuvenation for the face.  Sometimes what people don’t remember is that surgery sculpts and repositions soft tissue but it doesn’t do as good of a job of taking care of surface changes and the surface is very important.  The surface is our interaction with the rest of the world.  When someone looks at you they see your skin.  They see pigment issues, they might see wrinkles, they might see lines and that has to be youthful in order for a total rejuvenation to occur.  Laser skin resurfacing has been around for a long time.  It’s just something that not a lot of people have been excited about because it takes so much recovery.  It is a procedure that creates significant thermal damage to the skin surface and historically patients have to go into recovery or hiding for about three weeks.   People today don’t want to tolerate that amount of down time.  So FX resurfacing is a new type of technology that has emerged.  This is a technology that we have in our office and is called the Lumenis FX system.  This basically uses laser energy that is passed through a filter and delivered through discrete columns of energy.  This circle represents the deep FX setting of our laser.  In this setting these very narrow but deep columns of energy are treated to the skin so that they stimulate collagen production, eradicating fine lines and wrinkles.  In the active setting, wider columns of energy are delivered, encompassing a greater surface area but these columns do not go as deep.  These columns are better for treating problems such as photo damage or pigment issues like brown spots.  When both technologies are applied to the same area, we have improvements in contour as well as skin surface texture and color.  The energy of laser basically removes or belates this damage to tissue.  So it basically gets rid of sun damaged and age damaged skin.   There is also a residual treatment area.  So this thermal damage extends beyond the immediate interface of the laser and the skin.  This area creates collagen remodeling and wound healing which does wonders for fine lines and contour problems.  This demonstrates the ablative portion which removes the damaged skin and the residual thermal zone stimulates the deeper area to create new collagen.  So a combination of these two creates total rejuvenation of the skin surface.  This sequence of photos demonstrates the immediate recovery period after the FX.  That is one of the benefits that the recovery happens much quicker.  This patient before the laser has mainly complaints of pigment issues.  Immediately after the FX setting, the area can be seen as been treated with these little dots around the face.  In the upcoming hours the face becomes a little swollen and red and a day later there is the fine crusting that happens.  Three days later the skin is significantly improved and by five days the skin is healed enough so that makeup can be applied.  This is a typical post procedure result.  This patient has significant improvements in skin contour as well as pigment issues after the active Fx.  When the Deep FX is applied there is more eradication of wrinkles and lines throughout the face.  When both technologies are applied it gives improvement of both skin texture and color as well as contours of the lines and wrinkles.

In summary, laser resurfacing is a very important compliment to surgery to give a total rejuvenation to the face.  A facelift and an eye lift can create structural improvement but those textural improvements are very important for color, tone and eradication of wrinkles.  The FX is our version of the fractionated system.  It’s safer, its effective and it requires much less down time and recovery than the traditional methods of laser resurfacing.  If you are interested in learning more visit my website https://www.drkimfacialplastics.com/laser_skin_resurfacing.php