PLANNING

For most laser treatments, Dr. Kolker recommends that your skin is optimally prepared prior to your treatment; preparation before laser is integral to the safest, most effective treatment. For non-ablative laser skin resurfacing using the Fraxel Dual 1550/1927 laser platform, all skin types can be treated. Sun tanning before Fraxel laser resurfacing should be avoided and broad-spectrum sun protection should be used when possible. Otherwise, prep time before Fraxel laser skin resurfacing is minimal. With ablative CO2 treatments, including the Active FX, Deep FX and Total FX fractional laser treatments, the pigment within your skin should be more effectively minimized before laser treatments. Avoiding a tan and sun protection including a UV-A and -B sun block with an SPF of 30 or greater is strongly recommended prior to the laser resurfacing procedure. Prior to facial ablative fractional laser resurfacing, a skin care regimen that includes sun protection and that may also consist of a lightening cream and a retinol (such as Retin-A) will often be recommended to give you the most balanced, natural, beautiful results.

FRAXEL LASER RESURFACING

Non-ablative fractional laser skin resurfacing is ideal for those who seek effective improvements in skin tone and texture with minimal downtime. The Fraxel re:store® Dual 1550/1927 platform is the preeminent Fraxel system and the gold-standard for non-ablative skin resurfacing and skin rejuvenation. Unlike the original ablative lasers, the Fraxel non-ablative fractional laser skin resurfacing system treats microscopic regions of skin with every pulse, leaving the surrounding area intact for more rapid healing. The Fraxel re:store® Dual 1550/1927 employs non-ablative Erbium and Thulium laser fibers, which promote safe, effective treatment with minimal downtime. Fraxel laser resurfacing with 1550 and 1927 nanometer wavelengths are FDA cleared for the treatment of photodamage, mild to moderate periorbital wrinkles, acne scars, surgical scars, melasma, and actinic keratosis. One of the great advantages of the Fraxel laser, relative to ablative laser resurfacing, is the increased comfort, reduced downtime, rapid healing, and quick recovery. "Social" downtime is approximately 1 to 3 days after Fraxel laser skin resurfacing using the 1550 nm wavelength, and 3-4 days after Fraxel laser resurfacing using the 1927 nm wavelength. With Fraxel laser resurfacing, results can be anticipated after a series of treatments. In general, an average of two to four sessions may be required to achieve your goals. Many notice improvements in skin tone and texture after one or two Fraxel laser treatments, however the number of laser resurfacing treatments that each individual requires must be tailored to their specific skin condition, anatomy, and desires. Fraxel laser resurfacing can be used to treat all areas of the body. Fine lines and wrinkles around the eyes and lips, dyschromias and other pigment abnormalities of the face, neck, and dècolletage, textural irregularities of the cheeks and forehead, and discolorations of the hands, forearms, back, and legs can all be targeted. Non-ablative fractional laser resurfacing in New York is performed in Dr. Kolker's Park Avenue office. Topical anesthetic only is applied for 30-60 minutes prior to Fraxel laser resurfacing, and is very effective at minimizing any discomfort. The laser resurfacing procedure takes approximately 20 minutes. Fraxel laser resurfacing may be performed alone, or in combination with other surgical procedures such as autologous fat transfer, facelift and blepharoplasty.

CO2 LASER RESURFACING

CO2 laser resurfacing is ablative, meaning portions of the skin are ablated or vaporized by the laser pulse rather than the deep thermal "heating" that is achieved with non-ablative laser treatments. The ablative laser resurfacing procedures are used to treat more substantial textural changes of the skin, more severe wrinkles and deeper, more diffuse pigment changes. Albeit more effective in a shorter period with fewer laser resurfacing treatments required, understandably there is more downtime compared to the non-ablative laser therapies. Ablative CO2 laser resurfacing requires anesthesia (most often local anesthesia or local anesthesia with sedation), and can be used to treat specific areas of the face such as the eyelids, the upper lip, or the entire face. Laser resurfacing can also be used to treat pigment changes and fine wrinkles of the neck and dècolletage area of the chest. Dr. Kolker favors CO2 laser resurfacing, and when indicated will suggest a fractional photothermolysis laser treatment plan. With fractional laser therapy, using Active FX, Deep FX, and Total FX, only a portion of the surface of the skin is treated with laser energy, leaving "bridges" of untouched skin to aid in the regeneration process. With ablative fractional laser resurfacing, recovery is more rapid than with "full CO2" laser resurfacing, but is more significant by comparison than the non-ablative Fraxel laser resurfacing. "Full" CO2 laser resurfacing, i.e., non-fractionated ablative laser resurfacing, is now performed extremely rarely, and only in cases of the most severe skin textural conditions. Dr. Kolker performs fractional ablative laser resurfacing in Manhattan in his office based surgical suite, accredited by the American Association for the Accreditation of Ambulatory Surgery Facilities (AAAASF). Ablative laser resurfacing may be performed alone, or in combination with other surgical procedures such as autologous fat transfer and transconjunctival blepharoplasty.

RECOVERY

Following non-ablative Fraxel laser treatments, depending on the intensity of your treatment, you can expect redness and swelling for approximately 1-3 days, and most are comfortable returning to work after 1-3 days. After the pigment-reducing Fraxel 1927 nm wavelength laser resurfacing treatments, flaking or peeling may be present for 4-5 days. After ablative fractional laser resurfacing treatments, most often recovery is 4-7 days. After non-ablative laser skin resurfacing treatments, light aerobic activity (elliptical, walking, bicycle) may be resumed as early as two days following, and more strenuous activity is begun at five days. After ablative fractional laser skin resurfacing treatments, light aerobic activity may be resumed after 3-4 days and more strenuous activity is begun at 7-8 days. Your relationship with Dr. Kolker does not end after the laser procedure; he will see you often through the first weeks and months following your laser treatment, and will advise you on all matters in your recovery.

Fraxel laser resurfacing treatments and ablative fractional laser skin resurfacing are often performed as isolated procedures. Laser resurfacing procedures can be performed alone, or can be combined with other procedures. When combined with other plastic surgery procedures, Fraxel laser treatments and ablative fractional laser resurfacing with CO2 are most commonly combined with autologous fat transfer, eyelid lift (blepharoplasty), and face lift procedures.

If you would like to learn more about laser skin resurfacing in New York, and about the laser resurfacing techniques that will suit you best, we invite you to meet with Dr. Kolker for a private consultation at our office, located at Park Avenue and 70th Street, by calling 212-744-6500, or by scheduling an appointment online.