Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.

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Deep Facial Rhytids

Deep static wrinkles, particularly around the mouth (perioral) and eyes (periorbital), represent a structural breakdown of the collagen matrix. These etched-in lines persist even when the face is at rest. They are often resistant to injectables or superficial treatments.

Ablative laser resurfacing is the primary intervention for these deep rhytids. By vaporizing the damaged tissue and stimulating massive dermal remodeling, the laser essentially erases the memory of the wrinkle from the skin. The new regenerating skin is smoother and structurally denser.

  • Vaporization of deep dermal fractures
  • Stimulation of type I and III collagen
  • Smoothing of perioral vertical lines
  • Tightening of the periorbital skin
  • Restoration of skin surface topography
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Vascular Malformations

PLASTIC SURGERY

Vascular lesions, such as port-wine stains, hemangiomas, and telangiectasias (spider veins), are caused by abnormal blood vessels. These vessels are often dilated and clustered, creating visible red or purple discoloration on the skin.

Pulsed Dye Lasers (PDL) and Nd: YAG lasers are used to treat these conditions. The light energy is absorbed by the hemoglobin in the blood, heating the vessel wall until it collapses and seals shut. The body then reabsorbs the non-functional vessel, clearing the discoloration without damaging the overlying skin.

  • Coagulation of dilated capillary walls
  • Clearance of port-wine stains
  • Treatment of facial telangiectasias
  • Reduction of hemangioma volume
  • Removal of cherry angiomas
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Hypertrophic and Keloid Scars

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Pathological scarring, including hypertrophic and keloid scars, results from an overactive healing response characterized by excessive collagen production. These scars are raised, red, firm, and often itchy or painful. They can restrict movement and cause significant distress.

Fractional ablative lasers and Pulsed Dye Lasers are used in combination to treat these scars. The PDL targets the blood vessels feeding the scar, reducing redness and growth. The fractional laser drills holes in the dense scar tissue, physically breaking up the collagen bundles and triggering a remodeling process that softens and flattens the scar.

  • Reduction of scar vascularity and redness
  • Physical disruption of dense collagen bundles
  • Softening of scar texture and pliability
  • Flattening of raised scar tissue
  • Relief of pruritus and pain symptoms

Benign Pigmented Lesions

Sun spots, age spots (solar lentigines), and freckles (ephelides) are accumulations of melanin caused by UV exposure or genetics. These lesions reside in the epidermis and the dermal-epidermal junction.

Q-switched lasers and Intense Pulsed Light (IPL) devices target the melanin within these spots. The energy shatters the pigment melanosomes, initially darkening them and then causing them to flake off or be absorbed by the immune system. This restores a uniform, even skin tone.

  • Fragmentation of epidermal melanin
  • Clearance of solar lentigines
  • Reduction of ephelides and freckles
  • Treatment of seborrheic keratoses
  • Homogenization of skin tone
PLASTIC SURGERY

Unwanted Hair Growth

Laser hair removal targets the melanin within the hair shaft and the hair follicle. The goal is to deliver enough heat to the follicle to destroy the stem cells in the bulge and bulb regions, preventing future hair growth.

Because the laser targets pigment, this procedure is most effective on dark hair, modern long-pulse lasers allow for the safe treatment of all skin types by adjusting the pulse duration to protect the epidermis while still heating the follicle to the point of destruction.

  • Thermal destruction of follicular stem cells
  • Targeting of melanin in the hair shaft
  • Reduction of terminal hair density
  • Prevention of ingrown hairs (pseudofolliculitis)
  • Long-term suppression of hair growth

Tattoo Pigment Fragmentation

  • Tattoos consist of large ink particles trapped within the dermis. The immune system cannot remove them because the particles are too large for macrophages to engulf. Tattoos are permanent because the body encapsulates the ink.

    Q-switched and picosecond lasers deliver energy so rapidly that they create a photoacoustic shockwave. This mechanical force shatters the large ink particles into microscopic dust. The immune system can then recognize these small particles and clear them through the lymphatic system.

    • Photoacoustic shattering of ink particles
    • Clearance of pigment via the lymphatic system
    • Treatment of professional and amateur tattoos
    • Removal of traumatic tattoos
    • Layer-by-layer fading of ink.

Active Acne and Bacteria

  • Acne vulgaris involves the colonization of the pilosebaceous unit by Cutibacterium acnes bacteria. These bacteria produce porphyrins as part of their metabolic process. Inflammation and sebum overproduction further exacerbate the condition.

    Blue light lasers and photodynamic therapy activate these porphyrins, causing a chemical reaction that kills the bacteria. Additionally, infrared lasers can shrink the sebaceous glands, reducing oil production. This dual approach addresses both the infection and the environment that supports it.

    • Photo-excitation of bacterial porphyrins
    • Reduction of C. acnes population
    • Thermal atrophy of sebaceous glands
    • Decrease in sebum excretion rate.
    • alleviation of inflammatory papules

Onychomycosis (Nail Fungus)

  • Fungal infections of the nail plate and nail bed are notoriously challenging to treat with topicals because the nail is impermeable. Oral antifungals carry risks of liver toxicity.

    Nd: YAG lasers can penetrate the nail plate to heat the nail bed. The fungus is heat-sensitive and killed at temperatures tolerable to the patient. This sterilizes the nail unit, allowing a new, healthy nail to grow out over time.

    • Trans-lingual delivery of thermal energy
    • Fungicidal heating of the nail bed
    • Sterilization of the nail matrix
    • Promotion of clear linear nail growth
    • Avoidance of systemic antifungal side effects

Body Contouring (Lipolysis)

  • Laser lipolysis uses fiber-optic lasers inserted beneath the skin to melt fat cells directly. The heat from the laser liquefies the adipocytes, which are then suctioned out or metabolized by the body.

    Beyond fat removal, the laser’s heat is applied to the undersurface of the skin. This stimulates a profound tightening effect, making it superior to traditional liposuction for areas with mild skin laxity.

    • Thermal liquefaction of adipocytes
    • Sub-dermal heating for skin retraction
    • Coagulation of small blood vessels
    • Sculpting of small fat deposits
    • Tightening of the overlying skin envelope

Vaginal Atrophy and Laxity

  • Changes in hormonal status (menopause) or childbirth can lead to thinning of the vaginal mucosa and laxity of the canal. This results in dryness, pain, and stress urinary incontinence.

    Fractional CO2 or Erbium lasers are used to treat the vaginal walls. The laser creates microscopic channels that stimulate mucosal regeneration and collagen production. This thickens the vaginal wall, restores moisture, and improves support for the urethra.

    • Regeneration of vaginal mucosal epithelium
    • Stimulation of sub-mucosal collagen
    • Restoration of natural lubrication
    • Improvement in tissue elasticity and tone
    • Reduction of stress urinary incontinence symptoms

Rhinophyma

  • Rhinophyma is a severe manifestation of rosacea characterized by the overgrowth of sebaceous glands and fibrous tissue on the nose. This leads to a bulbous, distorted, and enlarged nasal tip.

    Ablative CO2 lasers are used to sculpt the nose back to its standard shape. The laser vaporizes the excess tissue layer by layer, allowing the surgeon to contour the nose precisely. The heat also provides hemostasis, making the procedure nearly bloodless.

    • Vaporization of hypertrophic sebaceous tissue
    • Sculpting of the nasal alae and tip
    • Hemostatic removal of excess bulk
    • Restoration of normal nasal contours
    • Resurfacing of the underlying skin

Actinic Keratosis

  • Actinic keratoses are rough, scaly patches on the skin caused by years of sun exposure. They are considered precancerous and can progress to squamous cell carcinoma if left untreated.

    Laser resurfacing removes the entire epidermis, effectively eliminating these superficial lesions. By removing the field of damaged cells and forcing the skin to regenerate from the healthy follicles, the risk of skin cancer in the treated area is significantly reduced.

    • Ablation of dysplastic epidermal cells
    • Removal of precancerous lesions
    • Regeneration of healthy epidermis
    • Reduction of skin cancer risk
    • Treatment of field cancerization

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FREQUENTLY ASKED QUESTIONS

Can lasers remove stretch marks?

Lasers can significantly improve the appearance of stretch marks, but they cannot completely erase them. Fractional lasers stimulate the production of new collagen to thicken the skin and improve texture, while vascular lasers can fade the redness of new stretch marks.

No. Lasers target melanin (pigment). Gray, white, and blonde hair lacks sufficient pigment to absorb the laser energy. Electrolysis is the only effective permanent hair removal option for non-pigmented hair.

Tattoo removal is uncomfortable, often described as feeling like hot grease splattering on the skin or a rubber band snap. We use chilled air and topical numbing creams to make the process manageable.

Melasma is very sensitive to heat and can actually get worse with aggressive laser treatment. We use specific low-energy lasers or non-thermal treatments with extreme caution to break up the pigment without triggering inflammation that causes rebound darkening.

Laser treatment destroys the existing problematic veins. However, it does not cure the underlying genetic predisposition or venous insufficiency. New veins can form over time, so maintenance treatments every few years are often necessary.

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