Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The initial consultation is a critical medical assessment designed to ensure patient safety and optimal outcomes. The surgeon evaluates the patient’s skin quality, history of scarring, and specific aesthetic goals. It is a diagnostic session to determine whether the patient’s anatomy and lifestyle align with the requirements for laser surgery recovery.
During this phase, the surgeon differentiates between issues that require resurfacing (texture/pigment) and issues that require lifting (surgery). The goal is to formulate a comprehensive treatment plan that may include laser alone or in combination with other modalities.
Determining the patient’s Fitzpatrick Skin Type is the most crucial safety step in laser surgery. This scale classifies skin from Type I (very fair, always burns) to Type VI (very dark, never burns).
Patients with darker skin types (IV-VI) have more melanin, which competes for the laser energy. This increases the risk of burns and hyperpigmentation. The surgeon uses this classification to select the appropriate wavelength and energy settings to ensure the laser targets the water in the cells, not the pigment in the skin.
Modern clinics employ advanced digital imaging systems, such as VISIA, to analyze the skin below the surface. These systems use multi-spectral imaging to reveal UV damage, vascularity, and pore size that are not visible to the naked eye.
This objective data provides a baseline for the patient’s skin health. It allows the surgeon to track progress precisely and show the patient the underlying damage that the laser will address. It transforms the consultation from subjective to evidence-based.
A thorough review of the patient’s medication list is mandatory. Many common medications, such as antibiotics (tetracyclines), diuretics, and antidepressants, can make the skin hypersensitive to light (photosensitive).
Treating a patient on these medications can lead to unexpected burns or blistering. The surgeon identifies these drugs and determines if a washout period is necessary. A history of autoimmune diseases or keloid scarring is also reviewed to assess the healing potential.
Laser resurfacing, particularly around the mouth, can trigger a reactivation of the herpes simplex virus (cold sores). The thermal stress on the skin can wake the dormant virus, leading to a widespread outbreak on the raw, healing skin.
To prevent this potentially scarring complication, patients with a history of cold sores are placed on antiviral prophylaxis (valacyclovir) starting one day before surgery and continuing until the skin is re-epithelialized.
To optimize results and reduce the risk of post-inflammatory hyperpigmentation (PIH), patients are often placed on a pre-treatment skincare regimen for 2 to 4 weeks before surgery. This typically involves the use of retinoids and hydroquinone.
Retinoids thin the dead outer layer of skin, allowing the laser to penetrate more evenly. Hydroquinone suppresses the pigment-producing cells (melanocytes), keeping them quiet during the inflammatory phase of healing. This “priming” is essential for darker skin types.
Recent sun exposure or an active tan is a strict contraindication for laser resurfacing. Tanned skin has activated melanocytes and increased melanin in the epidermis. This extra pigment absorbs the laser’s heat intended for deeper tissues, causing surface burns.
Patients must strictly avoid the sun for at least 4 weeks before the procedure. The surgeon checks for tan lines and uses UV photography to ensure the skin is at its baseline color. Treating untanned skin is the safest way to deliver adequate energy levels.
Laser resurfacing involves a significant recovery period. The surgeon educates the patient about the stages of healing: initial oozing, peeling, and residual redness. Visual aids are often used to show the day-by-day recovery process.
Setting realistic expectations regarding social downtime prevents post-operative anxiety. Patients need to plan for time off work and social engagements to allow their skin to heal without pressure or stress.
For patients with darker skin or those undergoing aggressive settings, a test spot is performed. The surgeon treats a small area in front of the ear with the proposed settings and observes the healing response for a week or more.
This safety check allows the surgeon to verify that the settings are effective without causing hyperpigmentation or scarring. It provides a real-world preview of how that specific patient’s skin will react to the laser energy.
Wound healing places a metabolic demand on the body. Nutritional status is assessed to ensure the patient has adequate protein and vitamin stores to support skin repair. Hydration is also critical, as the laser targets water in the tissue.
Patients are encouraged to hydrate well in the days leading up to surgery and to consume a diet rich in vitamins A and C to support collagen synthesis. Smoking cessation is strongly advised to optimize blood flow and healing.
Undergoing ablative resurfacing can be physically and emotionally taxing. The initial appearance of the treated skin can be shocking. The surgeon assesses the patient’s psychological readiness to handle the recovery process.
Ensuring the patient has a support system at home to help with wound care and emotional support is vital. A prepared and supported patient experiences less anxiety and is more compliant with the critical post-operative care instructions.
Send us all your questions or requests, and our expert team will assist you.
Please arrive with a clean face if possible. While we can remove makeup, having clean skin allows us to see the proper texture, pore size, and pigment depth, which helps us provide the most accurate assessment and treatment plan.
You must reschedule. We cannot safely treat tanned skin. The laser cannot distinguish between the tan and the target, which puts you at high risk of burns and permanent white spots. It is not worth the risk.
Yes, you usually stop using Retin-A about 3 to 5 days before surgery. At the same time, we use it to prep the skin weeks in advance, stopping it just before the procedure, which prevents the skin from becoming overly sensitive or irritated on the day of treatment.
If you are having deep resurfacing with oral sedation or nerve blocks, yes, you must have a responsible adult drive you home. Your vision might be blurry from ointment, and your coordination could be affected by the medication.
For non-ablative treatments, you might need 1-2 days. For deep ablative resurfacing (CO2), plan for 7 to 10 days off. Your face will be red, peeling, and covered in ointment, so most people prefer to stay home until the skin has healed over.
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