Laser Resurfacing; At A Glance
- Best Results1 treatment
- Treatment Recovery7-12 days
- Procedure Time60 min +
- Skin SpecialistDavin Lim
- Duration of Results5-10+ Years
- AnaestheticSedation, gas, blocks
- Back to Work7-14 days
Erbium Laser Resurfacing
Fully ablative erbium & CO2 resurfacing gives your skin a second chance. This procedure resurfaces the skin to the mid dermal layer, removing wrinkles, sun damage, pigmentation & textural irregularities. It can potentially reverse your skin’s age by over two decades.
FactsFacts on laser resurfacing with Erbium & CO2 lasers
- Lasers can address a multitude of skin issues
- Fully ablative laser resurfacing is referred to when the entire surface area of skin is treated
- Ablative laser resurfacing is performed with 2 types of lasers, Erbium & CO2
- Healing times range from 7-12 days
- The procedure is conducted under partial sedation in a laser theater
- Lasers are best for improving skin quality including deep wrinkles, sun damage, pigmentation & scarring due to acne, trauma or surgery
How is erbium ablative laser resurfacing different from Fraxel & fractional lasers?
Erbium Laser Resurfacing
Fractional lasers treat only parts of the skin’s surface, typically between 10 to 40%. The untreated ‘fractions’ of skin, enables faster healing times. Because some areas of the skin are sparred, most people undergo several laser treatments over a course of months.
Fully ablative lasers remove all of the skin’s surface. I manually control the depth of ‘ablation’ and how deep lasers go. Whilst fractional lasers have their use, the outcomes are limited by the device & operating protocols. In contrast, ablative lasers are manually controlled.
What types of lasers do I use to perform fully ablative laser resurfacing?
In the majority of cases I use 2 laser wavelengths to achieve the desired goal.
I combine fully ablative Erbium Laser, with fully ablative CO2 laser. Depending on the task, I may use Erbium as a fully ablative laser, then swap to CO2 as a fractional laser. In other cases, I use CO2 fully ablative and then combine Erbium as my last pass.
The ideal combination depends on factors such as your skin’s natural color, thickness, depth of wrinkles, degree of sun damage, downtime & expected outcomes.
Watch my YouTube videos on laser resurfacing to gain some understanding of the complexity of choosing what lasers to use in particular locations.
Who is the ideal candidate for fully ablative erbium / CO2 laser resurfacing?
The ideal candidate will have moderate to severe wrinkling. They may also have extensive sun damage, sunspots, pigmentation, open pores & scarring. Ablative laser resurfacing is best applied to patients with extensive photodamage.
Photoaging accelerates one’s chronological age. This presents as poor skin quality, excess wrinkles, laxity & dull skin.
For mild to moderate cases, 1927 & CO2 fractional lasers will give an excellent result, without the prolonged downtime or cost associated with fully ablative procedures. To see if you are a good candidate for fractional lasers, book an obligation free consultation with my nurses.
What results can I expect from erbium / CO2 laser resurfacing?
Laser resurfacing can produce outstanding results that will transform your skin texture & tone.
Lasers can reduce eye bags as well as tighten the skin around the eyes– without the need for antiwrinkle injections. It can also provide skin tightening to lift eyelids by up to 1.8 mm (laser blepharoplasty).
Resurfacing is also the best way for reduce smoker’s lines surrounding the lip. Erbium laser can also improve your skin’s texture, markedly removing scarring from acne, surgery or trauma.
Raised lumps & bumps including age warts, syringoma & cholesterol deposits can also be treated with lasers. Depending on what I am treating, I will give you a realistic & accurate expectation of the outcomes following resufacing.
View our Treatment Gallery
Do lasers provide a degree of face lifting?
Laser resurfacing using a combination of erbium and CO2 lasers can achieve a significant improvement in skin texture and tone.
Laser provides an excellent way to rejuvenate skin when there is moderate laxity, and skin textural changes. Face-lifts do not address factors such as static wrinkles, sun damage, loss collagen and volume, whilst laser resurfacing can address all these changes. The lifting one gets from laser is due to contraction of collagen.
For people with moderate to severe laxity, a face lift provides better & longer lasting outcomes. True surgical lifting addresses the deeper SMAS layer of tissue.
How long will I take to recover following laser resurfacing?
7- 12 days. Recovery time is variable, as my laser treatments are tailored according to the skin condition and your goals.
- Deep laser resurfacing with erbium and CO2 will have a downtime of at least 10 days. You will be able to wear make up by day 12, however you will be red for at least 4-8 weeks. Medium depth resurfacing will heal up 2-4 days earlier.
- Acne scar laser resurfacing recovery will depend on the depth of your scars- shallow scaring will heal up within 6 days, deep scars will take 10 days before your skin reforms.
- Laser blepharoplasty healing times range from 7- 9 days. For the first 2 days your eye lids will be extremely swollen & your activities will be limited. Redness around your eyes will persist for 3-5 weeks, but makeup can hide this.
- Surgical and traumatic scars will take 7- 10 days to heal up, once again this is depth dependent
- Laser treatment of age warts, age spots, wrinkles, spots and dots will take 5-8 days to heal up.
- Post laser skin darkening may take 6- 8 weeks to resolve. This is more common in darker – Ethnic skin types, or those who see a lot of sun.
Is the treatment painful?
Laser treatment is well tolerated. We use the following combination to numb the skin and place you under sedation during the procedure-
- 23/ 7 numbing gel one hour before the procedure
- Key local anaesthetic blocks to nerves
- Sedation with an injection or IV
Post-operative pain is well controlled with just paracetamol.
How do I look after my skin after resurfacing?
Rest assured we provide specific post resurfacing instructions to hasten skin reformation after resurfacing. Patients are seen by our laser nurses 24 and 72 hours after the procedure. During your visits your skin will be washed, and healing balm applied. Follow ups are essential as this provides an extra layer of safety.
You need to –
- Wash your skin twice a day with a bland cleanser
- Moisturize 3-5 times per day for the first 3-5 days
- Change moisturizer at day 4-6
- You can use a special make up called Lycogel to hide the redness
- Sunscreen and make up can be worn as soon as your skin
Sounds complex? Rest assured we make things easy with follow up checks and written instructions.
Why is volumetric correction important & can it be addressed with lasers?
Skin rejuvenation involves addressing all 3 factors, namely improving skin quality or texture, skin tone (tightness) & importantly volume. Lasers can markedly improve skin quality & in most cases tighten the skin, thereby improving skin tone. They do not address volume changes.
Volume replacement can only be achieved with dermal fillers or fat transfer. By addressing all 3 factors, a balanced, natural outcome is achieved.
Can resurfacing be done on other areas, like the chest & neck?
Yes, erbium & CO2 can be conducted on areas such as the decolletage, neck & chest areas. Resurfacing can also be conducted on the hands. The healing time for extra-facial sites will vary from 10-14 days.
Can Asian and dark skin types undertake laser resurfacing?
Yes, however, the risk with darker skin types is a condition known as PIH or post-inflammatory hyperpigmentation. This means lasered skin can turn dark. PIH can be reduced by-
- The use of Erbium laser without CO2
- Conservative fractional CO2 lasers
- The use of sunscreen, hats, & UV avoidance for 6 weeks post laser
- The use of bleaching creams, & Vitamin A before & after laser
- The passage of time
- Pico lasers can reduce PIH
In some cases of acne scarring, PIH is inevitable as scars lie so deep in the skin. All cases of PIH settle with time and sun protection.
Risks will be discussed in detail according to the condition/s I am treating (eg. Acne scars, scars, wrinkles, skin rejuvenation, or medical conditions such as syringomas.)
What type of acne scaring responds best to laser resurfacing?
Most forms of acne scars respond to laser resurfacing. Box car scars & shallow rolling scars respond exceptionally well to fully ablative laser resurfacing with Erbium and CO2 combined. If scars reside within a certain depth of the skin, often one treatment of laser is needed.
If you have a mixture of scars, I will always tailor a regime based upon your scar type and skin type. For example, I may elect to treat icepick scars and enlarged pores with TCA CROSS prior to laser resurfacing.
Atrophic scars respond best to dermal HA Fillers, whilst tethered scars are best treated with surgical subcision.
What should I consider before undertaking laser resurfacing?
Deep laser resurfacing in one of the most complex procedures we perform. This also applies to the post-operative period. Recovery times for patients is the major issue, however my staff and I will guide you accordingly.
Things to ask yourself before you consider laser resurfacing include-
- Can I have downtime?
- Do I have transport for the day of the laser and the day after? Patients undergo sedation and must have help to get home. Follow up the next day will require help as well.
- Are you willing to comply with strict instructions regarding skin care? The use of moisturizers 4-5 times a day post laser is essential.
- Are you willing to restrict UV – Sun exposure for 4-6 weeks after laser? If not, post laser darkening can occur.
- Are you realistic with your expectations?
- Financially this procedure cost between $5500 to $7500 depending on the depth of ablation & associated post laser treatment.
What are the potential side effects of laser resurfacing?
Side effects are very rare following laser resurfacing, they include-
- Infection- less than 2% of cases
- Skin color changes- more common in Ethnic skin
- Patterning and demarcation lines- rare side effects, and reversible
- Delayed healing- uncommon side effect
- Scarring- extremely rare; less than 0.1% of my cases
- Dry eyes- very common after lower eyelid laser, resolves with ointment
- Recurrence or partial improvement- for skin conditions such as syringomas.
- Persistent redness- this can be a side effect to your benefit as more collagen stimulation occurs with increased blood flow. Easily treated with V Beam vascular laser. Expect to be red for 2-4 months post laser.
How much does laser resurfacing cost?
Cost will vary depending on the complexity and time taken for the procedure, as a guide-
- Deep erbium / CO2 Laser Resurfacing- $5500 upwards
- Acne scar *treatments- $,3490 to $5,500 depending on area*
- Traumatic* & surgical* scar treatments – $2550-$5500 depending on area*
- Medical conditions such as syringomas, sebaceous hyperplasia, angiofibromas – $ 2,900*
*Medical conditions such as acne, surgical & traumatic scars, as well as skin tumors are partially covered under Medicare.
Laser lifts and laser eye surgery is considered as cosmetic and not covered by Medicare- Health Insurance.
Is this procedure covered by Medicare or Private Health Insurance?
In medical cases laser resurfacing is partially covered by Medicare. Examples include-
- Treatment of acne scars
- Treatment of scars caused by trauma, or surgery
- Treatment of pre-cancerous sun damage, such as solar keratosis
- Treatment of skin cancers such as BCCs or Bowen’s disease
- Treatment of dermatological conditions such as syringomas, adenexal tumors, angiofibromas
- Treatment of rhinophyma from rosacea
- Treatment of birthmarks such as epidermal and sebaceous naevi
Cosmetic cases are not covered by Medicare nor Private Health Insurance, however, in many cases, there is an overlap between Medical and Cosmetic. Examples include full-face resurfacing for a surgical scar and pre-cancerous sun damage.
Want to know more on laser resurfacing & skin rejuvenation?
Book an obligation FREE assessment with my procedural nurses. The majority of patients do not require such an extreme procedure such as erbium or CO2 fully ablative laser resurfacing. In most cases, simple 1927 -CO2 hybrid resurfacing will give excellent results.
If you would like an opinion whether a deep ablative resurfacing treatment is right for your skin concerns, book an appointment with myself (standard consult fee applies).
Davin’s viewpoint on laser resurfacing using erbium and CO2 lasers
Even with the event of fractional lasers, fully ablative laser resurfacing using combination CO2 & Erbium lasers can deliver far superior results with only one treatment. By using both lasers, I can choose the amount of collagen stimulation in key areas- such as under the eyes and in front of the ears. This gives a laser lift due to collagen contraction.
This procedure can give up to two decades of rejuvenation. The flipside? Downtime ranges from 7 to 12 days, even longer. Redness is often persistent for a few weeks to months. Resolution can be sped up with vascular lasers.
Most frequently the skin rejuvenation journey involves volume replacement, usually at week 4-8 with dermal fillers. It is important to understand that lasers markedly improves skin quality, however optimal & balanced rejuvenation addresses volume deficits. This can be achieved with dermal fillers, or fat transfer.
If the patient has darker skin, a more conservative approach is taken. This includes fractional CO2, often in combination with pico laser resurfacing.
For conditions such as Rhinophyma, the CO2 is a must- this laser delivers heat as well as ablation to stop the bleeding associated with lasering this condition.
In summary, laser resurfacing can be conducted for all sorts of skin conditions including medical resurfacing- scars, benign skin tumors such as syringomas, skin cancers, rhinophyma, and sun damage. Conversely, laser resurfacing can also be used to treat cosmetic concerns such as sagging skin, loss of tone, wrinkles, upper lip lines and poor skin texture. The flexibility of using BOTH types of lasers for different applications, combined with the skill level of the operator can result in a remarkable transformation. See the before and after gallery for more information.
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