Laser Rejuvenation Essentials At A Glance
- Best ResultsTreat all layers of the skin
- Skin Texture ImprovementsLaser & Peels
- InjectablesHyaluronic acid, collagen stimulating injections
- Skin TighteningHIFU, RF, PDO vectors
What is the role of lasers?
Lasers are an integral part of skin rejuvenation. Their role is to-
- Reduce pigmentation & sun damage by removing old skin cells. This allows for new cells to populate the skin’s surface. The result? Glowing, luminous & radiant skin.
- Reduce fine, medium depth & deep lines & wrinkles in key areas such as around the eyes, mouth, cheeks, neck & decolletage.
- Remove imperfections such as acne & traumatic scarring.
- Tighten lax skin on the face, neck & chest.
What can’t lasers do?
Lasers cannot replace volume. Though it can generate collagen, in patients over the age of 40, volume supplementation may be required (for optimal balance). Collagen depletes at a rate of 1% per year, starting in your early 20s. Volume replacement is either with soft tissue fillers or fat transfer.
What is the best laser to improve skin quality & texture?
Fractional lasers are employed to improve skin quality, luminosity & reduce fine lines & pigmentation. Cutis Dermatology Brisbane has a dozen different fractional lasers, ensuring that you will get the best results from the latest & most advanced systems available.
What is the best laser to remove wrinkles?
Ablative lasers are used to correct deep wrinkles, severe sun damage & skin laxity. These lasers penetrate the deep dermal layer of skin & work by replacing old cells with new skin cells. The depth of ablative lasers can be controlled to 1/100 of a millimetre.
Correction of mild skin aging. In summary-
- Downtime: 5-10+ days
- Pain relief: Numbing, local & sedation
- Cost: $1790 +++
- Number of sessions: 1
- Best for: Deep wrinkles, extensive sun damage, deep pigment, skin laxity
- Done by: Dermatologist, senior nurses
- Examples: eCO2, Hybrid, Ultrapulse, Mixto, CO2RE
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What lasers do we use to treat ethnic & darker skin types?
Darker skin types are treated with special lasers to reduce the chances of PIH or post treatment skin darkening. These include-
- Picosure Pro: fractional picosecond laser
- Picoway: picosecond laser
- CO2 lasers with small spot size; eCO2, Mixto, Alma Hybrid
*Darker skin types require 2-4 sessions for best results.
What lasers are employed to tighten skin?
High powered ablative lasers are used to tighten skin. These lasers reach the base of the second layer of skin, known as the dermis. Skin tightening follows a complex algorithm & often involves other methods to address all levels of laxity.
What is the healing time following laser resurfacing?
Healing time is proportional to the depth & extent of laser resurfacing.
What effective options do I have if I can not have downtime?
Options for those who have limited recovery time is-
- Picoway or Picosure Pro + Profhilo biostimulatory injectable. 3 sessions spaced monthly.
- Low power Fraxel + Profhilo biostimulatory injectable. 3 sessions spaced monthly.
- Hybrid resurfacing + Profhilo biostimulatory injectable. 3 sessions spaced monthly.
The above algorithm will give modest to good results for those who have mild to moderate photoaging & fine wrinkles.
Who performs the procedure?
Level 1 to 4 lasers are performed by our nurses. Deeper resurfacing with CO2 & Hybrid lasers are performed by senior nurses who have at least 5 years of experience in laser resurfacing. Level 5 lasers are performed by myself or my colleagues.
What treatments can be performed at the same time as laser resurfacing?
Depending on the level of resurfacing, deep dermal fillers, RF microneedling, HIFU & PDO vector treads can be performed at the same time as laser. These procedures act on different levels of the skin, & aid in skin tightening.
What treatments are not performed at the same time as laser resurfacing?
What is our point of difference with Fraxel lasers?
We practice Fraxel HD (high density). This treatment uses Fraxel Dual in the 1927 wavelength to resurface skin at a higher-than-normal density. This means-
- Less downtime overall
- Better results
- One session (in most)
- Significant cost savings as only one session is required
For extreme sun damage & or wrinkles we use CO2 laser with Fraxel. This is termed Hybrid laser resurfacing.
How much does laser resurfacing cost?
Cost varies depending on who performs your procedure & the complexity of resurfacing.
A cost-effective program that will address most concerns is;
High Density 1927 Thulium Fraxel in combination with CO2 + Hybrid resurfacing. In summary-
- Downtime: 4-7 days
- Pain relief: Numbing cream
- Cost: $1990 to $2790
- Number of sessions: 1
- Best for: Lines & wrinkles, sun damage, mild to moderate skin laxity, scars
- Done by: Lead nurses
Both my clinicians & I practice tailored treatments. This means a far better outcome as we apply different lasers based upon your concern. We don’t follow the conventional cookie cutter approach as in most cases, only ONE laser session is required.
How to maintain my results from laser resurfacing?
Once your goals are reached, maintaining your results is important. Skincare is easier & more cost effective than you think. A simple program is as follows-
AM: Antioxidants vitamin B, C, ferulic acid, tocopherol, sunscreen.
PM: Retinol, or retinoids. AHA cycled every 10-14 days.
Every 4-6 months: Clear + Brilliant laser.
*Skin care consults take around 30 minutes to complete. Our dermal therapist provide this free consultation.
What are the potential complications of laser resurfacing?
Fortunately, with timely follow ups, complications are rare. The incidence is proportional to the depth & extent of laser resurfacing. In order of common to rare-
- Prolonged post laser colour changes- 5%
- Infection- 3%
- Prolonged wound healing-2-3%
- Scarring- less than 1%
What types of lasers are employed proportionate to my age?
The list below is a general guideline, it varies depending on your skin health & ethnicity.
- 20-30s: Clear + Brilliant, Pico lasers
- 30s-40s: Fraxel, HALO, Hybrid
- 40s-50s: Fraxel + Fractional CO2, Hybrid
- 50s & beyond: Ablative CO2, erbium. Ultrapulse, eCO2, Hybrid
What are substitutes for lasers if I don’t have downtime?
It depends on your skin quality, turgor, luminosity, ethnicity, aims, & expectations. My team & I employ other methods to improve your skin without down time. Examples include-
- AHA glycolic acid peels (5-6 sessions)
- RF microneedling with Genius or Morpheus8
- Collagen stimulating injectables like Profhilo (12-hour recovery)
- Dermal fillers (no downtime)
- RF devices
*You have to be realistic with things. If you have severe wrinkles & photodamage, these treatments can improve your skin, however they may not give you as good an outcome compared to laser resurfacing.
What can chemical peels do?
Chemical peels are an excellent way to rejuvenate your skin. Depending on the clinical features we employ superficial to deep peels. The deeper the peel depth, the longer the recovery.
- Downtime: 0-2 days
- Examples: Retinoic acid, Glycolic, Lactic, BHA
- Cost: From $95
- Number of sessions: 3-6
- Best for: Fine wrinkles, mild sun damage, pigmentation
- Performed by: Dermal therapist, nurses
Medium depth peels
- Downtime: 4-8 days
- Examples: TCA, Jessner
- Cost: $390 upwards
- Number of sessions: 1-3
- Best for: Pigment, medium depth wrinkles, sun damage
- Performed by: Nurses & dermatologists
Deep chemical peels
- Downtime: 8-14 days
- Examples: Deep modified Jessner TCA, Phenol
- Cost: $ 2190 +++
- Number of sessions: 1
- Best for: Deep wrinkles, laxity, sun damage
- Performed by: Davin Lim
What do we have over 40 lasers & devices?
Cutis Dermatology has the most number of lasers of any clinic in Australia. We get one new system every 4 to 6 weeks. Why? Because we are at the cutting edge of technology.
Lasers are merely instruments, much like how an artist uses many different brushes & paint colours. Our ethos is to match the best possible device based on your clinical examination, ethnicity, downtime & budget. My staff & I are at the forefront of laser development & research. This translates into the best treatments for you, the patient.
How do we differ from other clinics?
Cutis Dermatology is the leading laser clinic in the southern hemisphere. We have over 40 lasers & energy devices & we are the hub of laser research in Australia. This means patients are receiving the most technologically advanced laser systems available. We are constantly replacing old tech with new.
Our senior nurses have been trained by me, & have over 6 years of experience in the use of advanced systems including Hybrid & ablative laser. Our approach is to tailor each treatment based upon clinical findings & patient goals.
Davin’s viewpoint on lasers
Lasers are an essential part of skin rejuvenation. They work by targeting chromophores in the skin. They include melanin (pigment), haemoglobin (redness) & water (lines, wrinkles, pores & scars). Within each wavelength there are properties that make each laser system unique. That’s why we have over 40 laser & energy devices.
As a guide, more ‘intensity’ is required to rejuvenate aging skin. In this situation lasers are used to remove older, dull, & damaged skin cells, allowing new cells to repopulate the skin. New cells regenerate from the hair follicles. These cells are protected from UV & environmental damage. Conducted with care & precision, one can achieve over 20 years rejuvenation. 10-year flashbacks are for amateurs.
Limitations: lasers don’t provide a reproducible & predictable increase in volume. Dermal collagen in your late 40s is around 60-75% of what it was in your 20s. Though some collagen is regenerated (about 0.3 to 0.9 mm in total), the displacement in volume is not enough to replace age related volume loss of collagen & fat. This is where soft tissue fillers come in handy. Fillers can replace volume (Juvederm, Belotero, Restylane, Radiesse, Sculptra) or injectables such as Profhilo can stimulate collagen production. Profhilo is a new injectable. Even though it has hyaluronic acid as its main ingredient, it is very different in the rheology or properties. This injectable accelerates & amplifies collagen production.
Lasers & skin tightening skin tightening should be performed in all layers of the skin to be effective. Lasers tighten the upper part known as the papillary dermis. For superficial wavelengths that only affect the upper layer or epidermis (Fraxel, Frax Pro, LaseMD, Clear + Brilliant, Moxi), there is some collagen remodelling due to cytokine (growth factor) release & cellular cross talking.
Deeper lasers such as CO2 & erbium penetrate to the lower dermis, namely the reticular dermis. This tightens both dermal layers. For the fibrosepal layer (one layer beneath the dermis), PDO vectored mono threads, RF, RF microneedling, collagen stimulating dermal fillers & HIFU are used. These treatments tighten the fat layer by increasing contractility of collagen in the network of fat.
The deepest layer of ‘skin’ is the SMAS. This layer is tightened by HIFU or Ultherapy as well as slow heat RF devices such as Tempsure, Pelleve or NuEra. I don’t use fast heat RF devices like Thermage anymore as results are not predictable. Combinations: depending on the clinical scenario we combine 2-4 different treatments in the one sitting. This gives much better results than monotherapy.
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