21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

The key to any successful laser skin rejuvenation is choosing the right laser treatment.

As someone who loves the science behind medicine, I was drawn to lasers during my dermatology residency training because I was fascinated by the complex interaction laser light has with the skin and skin components. This quest for deeper knowledge is why I completed additional training in laser surgery and cosmetic dermatology during a 2 year fellowship at Harvard Medical School, Massachusetts General Hospital and the Wellman Center for Photomedicine. This is the place where pretty much every groundbreaking laser used today was developed including Coolsculpting and Fraxel. Since then, laser skin rejuvenation has become one of my specialties, and I am a recognized expert in the field. I love lasers because they can address the complete spectrum of your skin tone and texture issues including:

  • Fine lines & wrinkles
  • Sun spots
  • Hyperpigmentation
  • Redness
  • Broken blood vessels
  • Scars, including acne scars
  • Uneven or “crepey” texture
  • Mild to moderate sagging

I will also use lasers on younger patients as a form of prejuvenation in order to delay the onset of aging skin and the need for more invasive treatments. The key to any successful laser skin rejuvenation result, however, is choosing the right laser treatment for your individual skin type, needs and desired outcome.

Laser Skin Resurfacing Consultation is Crucial

It is critical to schedule an in-person lasers consultation with an experienced Board-Certified dermatologist or plastic surgeon. One of the great things about coming to the Boston Center for Plastic Surgery is that myself, Dr. Miller and Dr. Doherty are all Board-Certified so you know that you are in very qualified hands. During your consultation, I will listen closely to what is bothering you about your skin. I will ask about your medical history, any other procedures that you may have had in the past as well as your tolerance for downtime. Though a laser procedure is a non-surgical procedure, some do require time for recovery. The amount of time is going to depend on which laser we use to address your skin tone and texture issues.

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Lasers 101 — Ablative vs. Non-Ablative

All lasers use energy to promote skin rejuvenation. However, there are two different categories of lasers:

  • Ablative
  • Non-Ablative

The former is the more aggressive of the two. Ablative lasers actually remove skin, either in small columns or microscopic layers. This “injury” to the skin stimulates healing in the deeper tissues as well by promoting your body to produce fresh collagen and elastin. These are your skin’s fountain of youth, helping to diminish fine lines and wrinkles, remodel skin texture and soften imperfections. I use our Ablative Fractional CO2 laser to address:

  • Lip lines
  • Crow’s feet
  • Crepey skin texture on the upper and lower eyelids
  • Fine lines, wrinkles and mild drooping in skin on the face and neck
  • Mild to moderate sagging in the upper and lower eyelids

Using an ablative laser to address aging in the upper eyelids is actually my favorite procedure to perform because it can deliver a truly “Wow” result. Patients who have it say that they feel more energized, vital and confident.

Non-Ablative Lasers

Non-ablative fractional lasers, such as Fraxel, deliver heat in small columns to the deep layers of the skin without removing skin from the surface. This is why they require less downtime. I use these types of lasers to:

  • Prevent aging issues (Prejuvenation)
  • Minimize fines lines & wrinkles
  • Diminish scars, including acne scars

A non-ablative laser such as the Clear + Brilliant or PicoSure is also fantastic for addressing brown spots, hyperpigmentation and poor texture. Sun damage is something that everyone experiences as they age. These areas of discoloration and uneven skin tone may make you look older which is why a laser procedure can deliver such an overall rejuvenating effect.

Excel V for Redness

The other very common side effect of sun exposure and age is redness, rosacea and broken blood vessels. I will typically use the Excel V to address these kinds of problems as I find it to be the most effective. Most patients of a certain age, however, present with a range of issues. This is why I will often recommend a combination of lasers as what works best for brown spots, for example, is not the same as what works best for redness or fine lines and wrinkles.

Laser Skin Rejuvenation Recovery

The other important consideration when coming up with the right treatment plan for your unique needs is your tolerance for downtime. This is the amount of time that it will take for you to heal and look like yourself again. An ablative laser procedure is going to deliver a serious rejuvenating result. It is also a procedure that only needs to be repeated once every 3-4 years. However, you may want to postpone social actives for about 5-7 days.

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With a non-ablative laser procedure, you will look red and slightly swollen, as if you have a sunburn, for anywhere from 24 hours to 3-4 days. Most patients feel comfortable returning to their normal routine the next day. But this is a procedure that will require anywhere from 3-4 treatments, spaced a month apart, to deliver the best results. Some patients like the idea of a one-and-done laser procedure while others are willing to wait longer for their results if it means that they can return to their normal lives faster. Luckily, at the Boston Center for Plastic Surgery, there are laser skin rejuvenation options for everyone.

To find out more about laser skin rejuvenation at the Boston Center for Plastic Surgery, contact us today or call (617) 735- 8735 to schedule a consultation.

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