Facial Laser Resurfacing

Aging, sun exposure, heredity and lifestyle factors including nutrition, alcohol consumption and smoking all may contribute to facial wrinkling.

Pigmentary changes of the skin, such as blotchiness or brown spots, may also occur with age or as a result of birth control pills, pregnancy or genetic factors. Prior acne may have made the surface of your skin uneven. These problems, as well as certain other skin conditions, may be improved by skin resurfacing.

Your Personal Consultation

During the consultation, you may be asked to look in a mirror and point out the specific areas of your face that you would like to see improved. This will help Dr. Moliver to understand your expectations and determine whether they realistically can be achieved.

Am I a good candidate for skin resurfacing?

You may be a good candidate for skin resurfacing if you have one or more of the following conditions:

• Wrinkled or sun-damaged facial skin
• Vertical wrinkles around your mouth, such as those that cause lipstick "bleed"
• "Crow's feet" lines around your eyes and perhaps some skin laxity in your lower eyelid area
• Fine wrinkling of your upper eyelids
• Brown spots or blotchy skin coloring
• Certain precancerous skin growths
• Acne or chicken pox scars
• Superficial facial scars from a past injury

Patients may have their skin resurfaced at almost any age. You may have certain characteristics that make you a better candidate for one technique rather than another. The amount of time you can allow for recovery also may be an important factor in selecting a particular resurfacing method or determining the extent of treatment. All resurfacing techniques can be performed to varying depths.

A more superficial treatment will require less healing time, but you may need to have the procedure repeated more than once to achieve the same results as a deeper treatment. If you are having aesthetic (cosmetic) surgery, such as a facelift or eyelid surgery, you may be able to have a skin resurfacing procedure performed at the same time.

How will I be evaluated for skin resurfacing?

During your consultation, Dr. Moliver will carefully examine your skin to determine which resurfacing technique, or combination of treatments, will provide you with the best results. Your skin type, the severity of any sun damage, the extent of uneven pigmentation and the depth of skin imperfections will be evaluated. With fine lines, coarse wrinkling or deep acne scarring, each condition may require a different approach to treatment.

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. Be sure to tell us if you have ever had X-ray treatments of your facial skin such as those used in the treatment of acne or if you have had a prior chemical peeling procedure. Current or past use of AccutaneT™, as well as Retin-AT™ and other topical skin preparations, must be reported. For your safety, it is important that you provide complete information.

Skin Resurfacing Techniques

Chemical peels, microdermabrasion and laser skin resurfacing all achieve results in basically the same way. Layers of your skin are removed and, as the healing process progresses, a new, healthier-looking skin emerges. What differentiates the various resurfacing methods is the way in which the skin's layers are removed. Chemical peels involve the application of a caustic solution, microdermabrasion utilizes micro crystals, and laser resurfacing uses a laser beam.

Our Aesthetician performs all of the chemical peels and micro dermabrasion procedures. For more information, please see the Medical Spa Services section.

How is laser resurfacing performed?

Skin resurfacing, using a carbon dioxide (CO2) laser, is the gold standard for laser resurfacing. Several other techniques and machines have come on the market in the past several years. These include ablative (CO2), ER:YAG, etc. and non ablative techniques. Non ablative techniques include Thermage and others that heat the underlying skin elements to promote collagen growth. Also fractionated lasers like Fraxel have become popular.

Dr. Moliver has performed hundreds of laser resurfacing procedures with the Ultapulse 5000C laser. It's still the gold standard because the procedure only requires one treatment and the results are often dramatic.

Like the other resurfacing methods, the laser is effective in treating wrinkles, blotchiness or age spots, and scars from acne or other causes. It can be used on the entire face or specific areas. Certain other characteristics of your skin, such as its thickness and texture, may influence whether you are a good candidate for laser resurfacing. Some patients may benefit from the laser's mild "tightening" effect on the skin, particularly in the lower eyelid area where the skin often becomes somewhat loose as a result of aging.

There is a newer breed of nonablative devices that produce varying degrees of improvement with the potential for reduced recovery time. There are benefits to these techniques like less or no downtime. However, our experience using these technologies (and so far abandoning them) is that patients are more often than not disappointed with the results.

Understanding Risks

Every year, many thousands of patients undergo successful skin resurfacing procedures, experience no major problems and are pleased with the results. Anyone considering treatment, however, should be aware of both the benefits and risks.

I understand that every medical procedure has risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of skin resurfacing is best discussed on a personal basis between you and your plastic surgeon, or with a staff member.

Skin resurfacing procedures are generally safe when performed by an experienced board-certified plastic surgeon. Infection or abnormal healing are infrequent but may occur with any of the treatments. If you are prone to skin disorders including allergic reactions or herpes, skin resurfacing can cause eruptions of these conditions. Even an AHA peel, which is the most superficial of the resurfacing techniques, may occasionally produce temporary minor skin irritation. Tiny whiteheads may develop on the skin following some procedures. These usually disappear with use of a mildly abrasive cleanser, but occasionally may require removal by your surgeon or a staff member in your surgeon's office.

Some individuals have a tendency to form raised or thickened scars, and this may be unpredictable. Medications are available to treat such complications, but in rare cases some degree of scarring may be permanent. While the bleaching effect of a phenol peel is to be expected, other types of peels, dermabrasion and laser skin resurfacing sometimes may produce unanticipated color changes or skin blotchiness.

Following all resurfacing treatments, it is important that you avoid direct or indirect exposure to the sun until all the redness or pinkness of your skin has subsided. Even after that, it is advisable for you to protect your skin by regular use of a sunblock and, whenever possible, a wide-brimmed hat. If the area around your eyes has been treated, you should wear good quality sunglasses when outdoors. After some types of skin resurfacing treatments, you may need to be careful about exposing your skin to chlorinated water.

You can minimize certain risks and help to maintain the results of your skin resurfacing treatment by following the instructions of your plastic surgeon.

Your Resurfacing Treatment

How should I prepare for skin resurfacing?

Prior to a laser resurfacing procedure, Dr. Moliver may place you on a pretreatment program during which you will apply special creams, lotions or gels to your skin for a few weeks or longer. We always pre-treat patients with antibiotics and antivirals starting a few days before laser resurfacing and continuing for about a week after. All of this is reviewed with you at your preoperative visit.

Your skin resurfacing treatment will be performed at our accredited office based facility and under anaesthesia. You should arrange for someone to drive you home after the procedure and probably assist you for a day or two.

How will I look and feel initially?

Laser resurfacing produces an open wound that will weep serum for about a week. You will be instructed on special cleansing and application of healing ointments. It is messy. In the case of men who have undergone resurfacing procedures, shaving must be delayed for a while. It is essential that you follow our instructions and avoid doing anything that might interrupt the healing process.

About 7 to 10 days after your skin resurfacing procedure, a new skin will have begun to form. After the initial redness subsides, your skin may be pink for several weeks to months. Camouflage makeup usually can be used within a couple of weeks, but your plastic surgeon will advise you.

Results of Skin Resurfacing

Because of the persistence of skin pinkness following many types of resurfacing procedures, it may take months before you can fully appreciate your new look. Most patients feel that the results are definitely worth waiting for and, in the case of deeper treatments, the benefits are relatively long-lasting.

Your skin will, of course, continue to age. Also the type of wrinkles caused by movement of your facial muscles will eventually reappear. Some wrinkles may recur sooner than others, depending on their location as well as the type and extent of your resurfacing treatment. Despite this, you can expect that improvements in skin quality and texture achieved by resurfacing will make your complexion appear younger and fresher for many years to come.

When can I resume my normal activities?

Depending on the type and depth of your skin resurfacing, straining, bending and lifting should be avoided during the early period following your procedure. For deeper resurfacing, you should be able to return to work within a week or two.

How much will a facial laser resurfacing cost?

Cost is always a consideration in elective surgery. Please see our Payment Options page under About Us.

We always present our plastic surgery consultation patients with a "fee quote." This fee includes:

• Surgeon's professional fee
• Laser fee
• Facility fee
• Anesthesia fee

It does not include any laboratory tests, preoperative examinations, garments or postoperative prescriptions.

Maintaining a Relationship with Your Plastic Surgeon

You will return to our office for follow-up care at prescribed intervals, at which time your progress will be evaluated.

Please remember that our relationship with you does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us.

Complimentary Consultation

For more information about our facial surgery procedures near Houston, go back to the top and follow the links. When you are ready to talk with Dr. Moliver in person, you can request a complimentary consultation online or call 281.282.9555 to schedule your visit.

See examples of facial laser resurfacing in our Photo Gallery.

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