Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Deep static rhytids are wrinkles that are visible even when the face is entirely at rest. They are most common around the mouth (perioral) and eyes (periorbital). These lines represent a fracture in the dermal collagen matrix that cannot be corrected with Botox or fillers alone.
Laser resurfacing is the most effective treatment for these structural defects. By vaporizing the shoulders of the wrinkle and stimulating new collagen in the valley of the line, the laser smoothes the skin’s topography. It erases the etched-in memory of the wrinkle.
Acne scarring, particularly boxcar and rolling scars, creates an uneven skin surface with depressions and shadows. These scars result from tissue loss during the healing of cystic acne. Fibrous bands tether them down.
Ablative fractional lasers are highly effective for breaking up the scar tissue and stimulating volume restoration. The laser columns penetrate the scar, reducing tension and triggering the formation of healthy tissue to fill the depression. It remodels the irregular architecture into a smoother surface.
Solar elastosis is the medical term for severe sun damage characterized by thickened, yellow, leathery skin. The elastic fibers in the dermis become disorganized and clumped. This condition is prevalent in patients with a history of high sun exposure.
Laser resurfacing removes the damaged epidermal layer and the elastotic material in the upper dermis. It forces the regeneration of a fresh, healthy epithelium. This dramatically improves the color, texture, and pliability of the skin, reversing years of environmental aging.
Hypertrophic scars are raised, red, and firm scars that remain within the boundaries of the original incision. They are caused by excessive collagen production during the healing process. They can be itchy and unsightly.
Fractional lasers are used to drill microscopic holes into the dense scar tissue. This physically removes excess collagen and alters the mechanical tension in the scar. The heat also helps to shut down the blood vessels feeding the scar, reducing redness and flattening the elevation.
Lentigines, or age spots, are flat brown lesions caused by an accumulation of melanin. They are a common sign of aging on the face and hands. Seborrheic keratoses are raised, waxy, barnacle-like growths that are also common with age.
Laser resurfacing effectively vaporizes these superficial lesions. Because the pigment resides in the epidermis, removing this layer eliminates the spots. The new skin that grows back is free of the accumulated pigment, resulting in a clear, even skin tone.
Rhinophyma is a condition associated with rosacea where the nose becomes bulbous and enlarged due to tissue overgrowth. Sebaceous hyperplasia involves enlarged oil glands that appear as small, donut-shaped bumps on the face.
Ablative lasers serve as a sculpting tool, removing excess tissue from the nose to restore its natural shape. For sebaceous hyperplasia, the laser flattens the bumps and shrinks the oil glands. The heat provides hemostasis, allowing for precise contouring without bleeding.
Mild to moderate eyelid laxity (dermatochalasis) can sometimes be treated with laser resurfacing rather than surgery. This is often referred to as a “laser blepharoplasty” or “Madonna lift.”
The fractional laser tightens the skin of the upper and lower eyelids, lifting the brow and reducing the crepey texture. While it cannot remove fat pads like surgery, it significantly improves the tightness and quality of the eyelid skin, opening up the eye area.
Syringomas are benign sweat duct tumors that appear as small bumps around the eyes. Xanthelasma is a yellow cholesterol deposit found on the eyelids. Both are cosmetic nuisances that are difficult to treat with creams.
Lasers can precisely vaporize these lesions layer by layer until they are flush with the surrounding skin. This removal is often permanent or long-lasting, avoiding the need for excision and sutures near the delicate eye structures.
Enlarged pores and rough skin texture contribute to a dull, aged appearance. Pores often appear larger due to a loss of collagen support at their openings.
Laser resurfacing stimulates collagen production around the pores, tightening the support structure and reducing their visible size. It also removes the rough outer layer of dead skin cells (stratum corneum), revealing a smoother, softer surface that reflects light better.
Scars from accidents or injuries can be irregular, indented, or discolored. They often trap dirt (traumatic tattooing) or have uneven edges that catch the light.
Laser resurfacing planes down the elevated edges of the scar to blend it with the surrounding skin. It can also help bring pigment back to white scars or remove excess pigment from dark scars. The goal is to minimize the scar’s visibility by improving its texture and color match.
Melasma is a hormonal pigment condition that causes dark patches on the face. While lasers can be used, they are used with extreme caution. High-heat lasers can worsen melasma by triggering inflammation.
Specialized low-energy fractional lasers (such as the thulium laser) are used to gently create channels in the skin to help clear transparent pigment without generating excessive heat. This is often combined with topical brighteners to safely manage this chronic condition.
Stretch marks are essentially scars in the dermis caused by rapid stretching of the skin. They can be red (striae rubra) or white (striae alba).
Fractional lasers are effective for improving the texture and thickness of stretch marks. They stimulate new collagen production in the thinned, atrophic skin of the stretch mark, making it look more like the surrounding normal skin. Vascular lasers can also be used to fade the redness of new stretch marks.
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Lasers can remove flat, benign moles by vaporizing the pigment cells. However, raised moles or moles with deep roots often require surgical excision to ensure complete removal and to allow for a biopsy to rule out cancer.
Some lasers can reduce active acne by heating the sebaceous glands to reduce oil production and killing acne bacteria. Resurfacing is typically reserved for treating the scars left behind after the active acne is under control.
Laser resurfacing tightens the skin over the bags, which can camouflage them and make them look smoother. However, it does not remove the fat pad that causes the bulge. If you have significant fat bags, a surgical blepharoplasty is usually required.
Yes, laser resurfacing can treat acne scars on the back and chest. However, the skin on the body heals more slowly than the face, so the settings must be gentler, and the recovery time will be longer.
Ice-pick scars are deep and narrow. While laser resurfacing helps, it often cannot reach the bottom of these pits. We usually combine lasers with a technique called TCA Cross (chemical peel in the scar) or punch excision to get the best results for ice-pick scars.
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