2) What's the difference between laser,
dermabrasion, and chemical peel?
Chemical Peels
Applying acid solution removes the top layers
and allows smoother regenerated skin to emerge. Chemical peels, which
can be used alone or in combination with other skin resurfacing, can be
effective on fine wrinkles caused by sun damage, superficial skin color
changes such as age spots and signs of premature aging such as the fine
lines around the eyes. Chemical peels can be used alone or in
combination with other skin resurfacing techniques.
Chemical peels offered range from mild no downtime peels to moderate
TCA (trichloroacetic acid peels).
Dermabrasion
Dermabrasion is a facial sanding technique used
to treat deep scars and wrinkles, raised scar tissue, and some severe
cases of cystic acne. Top layers of skin are "sanded" with a high-speed
rotating brush or a diamond-coated wheel.
Sometimes people get confused between dermabrasion and
microdermabrasion. Dermabrasion, which is considered a surgical
procedure, is typically more effective on raised scar tissue, acne and
chicken pox scars and some of the deeper forehead wrinkles. Dermabrasion
can be used alone or in combination with other skin resurfacing
techniques.
Microdermabrasion is a mini-peel achieved by projecting aluminum
micro-crystals onto the skin. "Power Peel", "Euro Peel", "Parisian Peel"
and "Derma Peel" are all forms of microdermabrasion. Microdermabrasion
is safe for all skin types.
Laser Resurfacing
A laser is a high-energy beam of light that
selectively transfers its energy into tissue to treat the skin. Laser
light beams vaporize the top layers of skin to lessen the appearance of
wrinkles, scars and birthmarks or to generally resurface facial skin.
Laser resurfacing can be used alone or in combination with other skin
resurfacing techniques.
Lasers make it possible to change tissue without making an incision.
Lasers can be used to vaporize tumors, close blood vessels, selectively
reduce pigmentation, or even treat skin wrinkles. Dr. Lopez can treat
birthmarks or damaged blood vessels, remove port-wine stains, and shrink
facial "spider veins" without major surgery.
After Dr. Lopez has indicated that a laser can be helpful in the
surgery, he will explain the laser of choice and what can be
accomplished. Dr. Lopez will decide on the appropriate method, dictated
by the nature and extent of the surgery. Dr. Lopez will give you his
best judgment for the particular procedure.
3) Are there different kinds of lasers?
Yes. It is important for you to realize that lasers have specific
applications. The choice of the laser depends upon many factors,
including the surgeon's experience, acceptable healing time, the size of
the area to be treated, and the expectations of the patient. Dr. Lopez
will decide if a laser is appropriate, and which laser is best for the
situation.
4) Which laser is best for me?
The only way to know for sure is a consultation with a board certified
facial plastic surgeon such as Dr. Lopez that specializes in all of the
above skin resurfacing techniques. It is not uncommon to use a
combination of approaches to achieve an optimal result. At the time of
your consultation Dr. Lopez will examine your skin to assess factors
that could affect the outcome of the surgery and to determine the proper
procedure for your condition.
For example, a patient who wants improvement in the lines around the
lips might benefit from a simultaneous procedure of laser resurfacing
and dermabrasion. A patient with acne scars may achieve the best result
with optimal blending from a full-face laser combined with dermabrasion
of the deepest acne scars and a TCA peel of the neck. The choice of
which approach is right for you depends on many factors including the
nature of the defect (traumatic scar, premature aging, pigmentary
changes, acne scarring, etc.), the anatomical location, skin type,
medical history and more.
5) What can you treat with laser surgery?
Facial plastic surgeons are experienced in the use of the laser and are
the best source of information as to whether laser surgery is
appropriate for your condition. Here are a few applications for lasers.
Laser Skin Peeling
Lasers can be used to reduce wrinkles around the lips or eyes, even the
entire face, softening fine wrinkles and removing certain blemishes on
the face.
Laser Removal of Birthmarks and Skin Lesions
Port-wine stain birthmarks respond remarkably well to laser
treatment. The abnormal blood vessels that cause these marks are reduced
in size by the laser. This results in a lightening of the treated area.
Skin growths, facial "spider veins," warts and some tattoos respond to
laser surgery. Most situations take more than one laser treatment,
however some respond to a single treatment.
Dr. Lopez often uses the minimum laser intensity
possible. The low intensity requires many treatments. However, the low
intensity also preserves as much of the healthy tissue as possible. This
produces an aesthetically pleasing result and minimizes the recovery
time.
6) Why isn't all surgery performed with lasers?
Many procedures can achieve the best results only with the use of laser.
Likewise, some procedures are better performed without the laser. The
laser is not always the best tool for surgery. The choice of using a
laser or other surgical methods is carefully made Dr. Lopez, who has to
consider the results, the possible complications and the alternatives.
Always remember that there are very few "right" and "wrong" answers with
laser surgery.
7) Will laser skin resurfacing help with my deep,
pitted acne scars?
It depends on the scars. Sometimes combining a full face laser
resurfacing with dermabrasion of the deepest acne scars is the best
approach. Other times, resurfacing by itself is not enough. Preparatory
surgery such as scar excision or the use of fillers such as fat
injections prior to dermabrasion may be needed to achieve an optimal
result. Excision of multiple deep, pitted acne scars may be performed
over several sessions. These must be evaluated on an individual basis.
8) Will laser surgery lift my sagging skin?
Laser and all skin resurfacing techniques are employed to change the
surface texture. Laser resurfacing is not performed to correct sagging
skin.
9) What kind of results can I expect from laser
resurfacing?
It depends on what we're working with and what the patient is trying to
achieve. Laser is not a perfect science. Even in the best of hands, one
can not expect 100% improvement. However, after reviewing realistic
expectations, most surgical outcomes make patients very happy.
10) When will I look "normal" after laser
resurfacing?
You will be presentable at one to two weeks. You may put make-up on two
weeks following laser surgery and resume most all daily activities. The
lasered areas are quite pink and this pinkness lasts for eight to twelve
weeks. You will look great at three months and even better at six
months. Your final result is evaluated at one year.
11) Does my history of a cold sore on my lip
affect my laser resurfacing?
Cold sores are actually a viral infection. All patients are pretreated
with an antiviral medication to prevent the recurrence and spread of
cold sores while the lasered area heals.
12) Can you laser all skin types?
Yes! However, careful selection for blending reasons must be done. Some
patients can very easily be more prone to post laser hyperpigmentation
(variations in skin color). This can be managed with bleaching creams
and agents, however, sun avoidance and judicious use of sunscreen is
most important.
13) Will I still look like "me" after surgery?
Many of my patients report that when they return to their normal life,
their friends comment, “You look great. Are you getting more sleep?" or
"You look less stressed and tired”. Dr. Lopez will not change the way
you look, just enhance it.
14) Will laser resurfacing get rid of these deep
frown lines between my eyes?
Several modalities exist to treat frown lines, one of which is laser.
Some patients opt for a less invasive treatment such as Botox or
fillers, which achieve temporary results. Other patients want more
permanent correction such as a browlift with permanent treatment of
those muscles that cause the deep frown lines.
15) Will I be awake during laser resurfacing?
For most patients, a limited anatomical area such as around the mouth
(perioral) or one or two scars, patients remain awake. For full-face
skin resurfacing, patients are generally asleep.
16) How much pain will I have with laser
resurfacing?
Understandably, after any surgical procedure, some discomfort can be
expected. All patients are provided with prescriptions for pain
medication. Pain is well managed with medications. Patients who undergo
full face skin resurfacing complain much more about wanting to have a
clean face and keeping the face moist with ointments or dressings than
they do about pain.
17) What does it feel like after surgery?
It depends on the amount of skin resurfacing you have done. Lasered skin
is covered with a moist jelly-like dressing. Patients complain more
about wanting to wash their face than discomfort. If you are asleep for
the procedure, our nurses will be right by your side as you wake up to
attend to any needs you have.
18) Do I go home after surgery?
Skin resurfacing is done on an outpatient basis. Because you will go
home after receiving sedation, you will need to make arrangements for a
responsible adult to drive you home, to stay with you overnight and to
drive you to our office for your first postoperative appointment.
Patients having surgery must stay in the immediate San Antonio area
overnight.
19) How long will pinkness and swelling last?
Postoperative swelling begins to resolve at the end of the first week.
Full resolution of swelling may take two to three weeks. The pinkness
associated with skin resurfacing can last six to eight weeks. For that
reason, patients use make-up to camouflage the pinkness until it
settles.
20) How long should I stay in San Antonio
following surgery?
Most patients stay in San Antonio about seven to ten days following
surgery. After that it's ok to fly or travel long distances.
21) When can I return to work?
Most of Dr. Lopez’s patients take about two weeks off of work. After two
weeks, most of the residual bruising and swelling can easily be
camouflaged with make-up.
22) When can I exercise?
Dr. Lopez prefers that aerobic activities be avoided for two weeks after
surgery. In addition, heavy weight lifting or more strenuous workouts
should be avoided for three weeks postoperatively. It is extremely
important to avoid bending, lifting or straining during the early
postoperative period as these activities can increase swelling and delay
healing.
23) Will I bruise and swell afterwards and how
long will it last?
Unfortunately it is impossible to do surgery without causing swelling.
Dr. Lopez does everything possible to minimize the amount of swelling
that occurs. Generally, postoperative swelling begins to resolve at the
end of the first week. Bruising is extremely variable. Patients that
have a tendency to bruise will generally bruise for about 10 days.
Patients that don’t tend to bruise may have minimal if any bruising.
Complete resolution of bruising and swelling may take two to three
weeks. However, bruises may be camouflaged fairly easily at seven to ten
days with a concealer stick.
