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Laser Skin Resurfacing

• Indications for Skin Resurfacing
• Lasers used
• Pre Operative Procedure
• The Procedure
• Post Operative Care
• Follow Up
• Complications
• Other Information
• Graphic examples
• Prices

Indications for Skin Resurfacing

Treatment of ageing and sun-damaged skin / Treatment of mild to moderate acne scarring.

This operation has many different applications in the Head and Neck area. Whichever reason you are having the operation performed, the preoperative and postoperative care is the same unless informed otherwise by a surgeon from the LLC. (Only inactive lines which are present when the area is at rest can be treated successfully with this technique)

Lasers used

Flashscanned or short duration high energy pulsed CO2 laser.

Pre operative procedure

Try to get your skin as un-tanned as possible before surgery. Therefore do not sunbathe etc. once you have made the decision to go ahead.

Use the skin creams as provided for 4 weeks prior to surgery, to prepare the skin. Sometimes slight blistering/redness occurs with Retinova, if this happens stop the Retinova until you have discussed this with your surgeon/nurse from the LLC.

Apply the cream once daily, preferably at night after you have washed and/or removed any make up. Spread the cream thinly and evenly to the treatment area and adjacent skin - use it over a margin of at least 3cm, the best results are achieved if the whole face is treated, even though only a small area may have the laser procedure. The function of Retinova is to remove dead and dying cells from the skin surface, and also to stimulate the underlying collagen. Removal of old dead skin means that the effect of the laser is more predictable, pre-stimulation of collagen may also improve the final effect, in which a great deal of new collagen is laid down. Initially this cream should be used only every third day, only tiny amounts are necessary. After 1 week, use every other day, after the second week, use every night, again maintaining the application of very small quantities of the cream. Too much and the skin may redden or even blister, although with no long term damage.

Zovirax antiviral tablets are routinely given for 5 days during the period in which the treatment is carried out. This is to prevent cold-sore formation. Remove all make-up prior to surgery, and wash your face with simple (non-perfumed) soap and water a few minutes beforehand. Men should close shave the area to be treated. Those having sedation should have had nothing to eat or drink for 4 hours, those having general anaesthesia should be 6 hours from eating or drinking. Local anaesthetic cases can eat or drink what they like.

The procedure

If you are having treatment around the eye, eye protectors are used. If treatment is not around the eye, wet gauze swabs will be placed over the closed eyes. The procedure will be painless once the anaesthetic has been delivered. After each pass with the laser (there may be up to 4), the skin will be gently cleaned with antiseptic solution (painless!).

Post Operative Care

We have tried many different types of skin dressing - Vaseline remians the best. Initially, the skin will look fairly normal, and there is little pain. Over the next few hours, usually at home, the skin that has been treated will start to swell, redden, become slightly tender (painkillers will be supplied) and leak fluid - rather like when falling off a bicycle and scraping your knee on the road. This fluid should be cleaned off the skin every 2 hours during the day. The Vaseline should then be re-applied to prevent scab formation, which will otherwise delay healing. During the night set your alarm clock for one cleaning at around 3 a.m. The cleaning can be performed with a soft flannel, or gauze. Use simple soap solution or salt water solution (approx. 1/2 tsp. salt in 1 cup of water) or white wine vinegar solution (1:8 dilution). If slight scab formation occurs, soak the skin for longer. This "washing" stage lasts for between 5 and 10 days.

(The reason this cleaning is recommended is that if the skin is left to dry at this stage, it will scab over a natural dressing. This is perfectly reasonable in terms of healing, but does not look particularly nice and lasts for 3 or 4 weeks - better 7 days of washing).

Once the skin has stopped needing cleaning, the underlying redness can be covered with your usual foundation (if you do not use make up, it is advisable to visit a beautician prior to treatment, explaining what you need. You can return to work at this stage, although if possible 14 days total off work is optimal. Men should avoid shaving the treated area until cleaning has been stopped, then shave only gently with an electric razor for the next 4 weeks, before returning to a wet shave. The redness persists usually for between 1 and 3 months, fading gradually. As it fades to a healthy pink (at about 4 weeks) it becomes easier to cover up with thinner and thinner make up (foundation) during that time. Between 2 and 4 weeks post-op, apply Hydrocortisone cream as supplied to the treated area every night. This helps accelerate healing by reducing inflammation. It will also help to reduce itching, which can be a nuisance. Persistant redness is uncommon, but has been known to last for up to 12 months.

Follow Up

You will be contacted 3 and 7 days after treatment to check that the dressings are being applied correctly, and that you feel confident that the treatment is progressing as expected. At all times your nurse and/or surgeon will be available for questions as and when they arrive. The final check with your surgeon will usually be 4 weeks postoperatively, when the effect will be established, any potential complications or problems can be dealt with then. The final effect is complete once the redness/pinkness disappears - at around 3 months.

Complications

Those patients with no history of Keloid scar formation or Accutane /Ro-Accutane treatments in the proceeding 48 months are very unlikely to scar in any way. (Those having been on Tetracycline antibiotic treatment should wait for 12 months before having this procedure.) Pigmentation changes in the treated area (skin lightening or darkening) are a rare occurrence in Caucasian people (less than 10%), although quite common in those from Asia or with darker types of skin. Hyperpigmentation (skin going darker) usually lasts for around 6-12 months. Hypopigmentation (skin going lighter) is more of a problem, and may on occassion be permanent.

Sunbathing on the treated area is not allowed for the first 12 months after surgery. If going out into bright sunlight during this period, factor 30 sunblock, which incorporates Titanium Dioxide if possible, should be used over the treated area, and adjacent skin (otherwise this will tan and make the treated skin look pale by comparison).

Other information

Pre- and Post- operative photographs will be taken. These remain the property of the LLC. They may be used for publicity purposes with the patient's consent.

Only those patients with unreasonably high expectations of the end result will be in any way disappointed with this treatment.

Graphic Examples

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Pre-operative 1

Pre-operative 2

Post-operative 1

Post-operative 2

Pricing:

To view pricing information for this procedure, click here.