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

Every Treatment is Customized

Skin aging is about more than fine lines and wrinkles. Texture irregularities like brown spots, melasma, redness and broken blood vessels can make your skin look dull. This can begin to occur as early as your 20’s if you don’t take proper care of yourself. Thankfully, there are a lot of effective, non-surgical modalities, including microneedling and lasers, for giving your skin that youthful looking glow. And the added benefit of plump, radiant skin is that it can also make you feel more energetic, vital, and confident. It’s one of the things that I love so much about my job: how changing the outside has a direct, positive impact on my patient’s insides as well. The only downside with so many viable options is that it can be hard to know which direction to take. So, microneedling or lasers — which is right for you?

Problem with Web is It’s Too One Size Fits All

We are living in an era where most of us get our information online, oftentimes from social media. Like any woman of my generation, there are things that I love about social media and there are things that I don’t. As a Board-Certified dermatologist, one of the really problematic aspects of the web is that it can be too homogenous. I can’t tell you how often a patient will come in wanting a specific laser to treat her broken blood vessels because she has seen someone online who got it when this is not actually the right treatment for her concerns. This is why those of us here at Boston Center for Plastic Surgery always encourage our patients to schedule an in-person consultation. Allowing me to assess your skin’s texture and tone for:

  • Fine lines & wrinkles
  • Brown, sun spots
  • Hyperpigmentation (Melasma)
  • Redness
  • Broken blood vessels (Spider Veins)
  • Uneven, “crepey”, dull appearance
  • Loose, sagging skin

This is the best way to devise the correct treatment plan for your specific concerns.

Every Treatment is Customized

Every treatment plan that I design is completely customized to an individual patient’s needs, anatomy and lifestyle. This is imperative as no two people are alike. Furthermore, skin aging is multi-factorial, meaning most of us have more than one issue that is contributing to our skin not looking and/or feeling as good as we’d like. For example, excessive sun exposure can cause brown spots, but it can also contribute to overall redness, broken blood vessels and sagging skin. This is why I will often recommend a combination of non-surgical procedures. Determining whether microneedling or lasers is right for you is going to come down to your underlying issues. However, here are some broad strokes.

Laser Skin Resurfacing for Skin Texture Issues

Laser skin resurfacing, which is the overall term for laser procedures, is great for addressing skin texture issues. As a laser expert, I have deep experience with the full range of lasers that we offer our Boston area patients. Like everything, each has its pros and cons. In general, I tend to use the Excel V to treat redness as I find it to be the most effective. For fine lines and wrinkles, I gravitate towards the:

  • 1540
  • CO2

The latter is an ablative laser so it does require a commitment in terms of downtime. But the results can be seriously powerful. In fact, my favorite procedure to perform is a CO2 laser to rejuvenate the upper eyelids. Patients are thrilled with the end result, and it always feels good to help someone else feel like the best version of themselves.

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Brown Spots Require Combination Approach

Brown spots caused by sun damage typically require a combination approach. If you look closely at your skin, you will see the brown spot. But it is often surrounded by some hyperpigmentation, and there is usually also uneven, “crepey” skin texture thrown into the equation. The right laser combination for you will depend on your anatomy. However, I like both the Clear + Brilliant Perméa and PicoSure laser for addressing these issues. Both require minimal downtime, and can be performed during your lunch hour making it easy for patients on-the-go. Clear + Brilliant Perméa is almost like the laser equivalent of a facial. It will take more than one treatment of either, spaced about a month apart, to achieve your desired outcome.

Microneedling & Microneedling RF

Microneedling can also address skin texture issues. But the real difference between microneedling and lasers occurs when you combine microneedling with radiofrequency (RF) energy. We offer our patients two microneedling RF options:

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  • EndyMed Intensif
  • Profound

I don’t tend to use the former, but Profound can be a real game-changer. While it is not a treatment for skin texture and fine lines, it is a procedure that remodels collagen. This, in turn, both lifts and tightens the skin in the treatment area. And since Profound induces your own body to produce more collagen, one of the two pillars of youthful looking skin, your results will continue to improve with time.

To find out more about Profound and 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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