Lasers In Plastic Surgery
Several years ago, I began a manuscript for a lay press book. One of the chapters was "Gimmicks In Medicine," in which I addressed the laser as an advertising gimmick. In some cases, this may very well be, however in Plastic Surgery (especially with some recent developments) there is definitely a place for laser treatments.
Lasers In Facial Resurfacing
Many advertisements cloud the issue here purporting that the laser has replaced the Facelift or the Blepharoplasty. The resurfacing laser (usually a modified CO2 laser) may indeed be an adjunctive procedure to either (or both). Laser treatment addresses fine wrinkling of the skin. Popular areas include around the lips (to lessen the "pursed" appearance about the lips) and the region around the eyes. Fine wrinkling of the skin in these areas (as well as the whole face) is treated by vaporization with the laser. The skin regenerates in a more orderly layered pattern (microscopically) leaving a softer less wrinkled surface. There is also some shrinkage of the skin which loosens to an extent over the course of several months. The degree to which this shrinkage occurs is debatable.
The procedure does leave the area swollen and red for weeks. Sunlight needs to be avoided and moisturizing creams are applied. There can be some pigment changes (for this reason many surgeons will not do the procedure on darkly pigmented skin). Overall, if anything is to be replaced by this re-surfacing laser, it is the deep facial chemical peel. The laser may very well give a more controllable result, as the depth of penetration is controlled somewhat. Laser treatment is at present more expensive than chemical peels however.
Surgery for the eyes (Blepharoplasty) aims at removing redundant eyelid skin (upper) and fat (both upper and lower lids). This reduces redundancy and "puffiness." The laser does not address the fat and only minimally addresses the excess of skin. Therefore, for people with significant fat and/or redundant skin, laser treatment alone will not suffice. Now for the patient with fine wrinkling of the skin and little fat/redundancy, the laser alone may fill the bill. Of course, it follows for those people with wrinkling and extra skin/fat that both procedures may improve an individual's ultimate appearance. It is debatable as to whether it is safe to do both of these procedures to a patient simultaneously.
FULL FACE CO2 LASER RE-SURFACING BY EXAMPLE
Here we see the improvement from facial CO2 laser re-surfacing in 3 weeks. The redness in the skin fades, but takes time to do so (weeks to months). This patient is not wearing make-up although make-up can help make this redness less apparent.
Please note that this information (as well as that on all my pages) is offered freely to individuals considering cosmetic surgery. No rights are granted and it is not to be reprinted or copied without the author's prior written consent. Beware that although efforts have been made to assure accuracy, many of the issues discussed here are a matter of professional opinion. Consultation with a qualified Plastic Surgeon should be obtained to answer more detailed and potentially personal questions.
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©1996-2004 John Di Saia, MD... an Orange County
California Plastic Surgeon 
