Thank you for your question!
You submitted a single photo and you described in your question that you had a Matrix CO2
Laser treatment done and that your concern that the treatment may not have been as deep
as you would expect.
And that you’ve done some research and you saw how many people were raw or red after
treatment and in your situation within about 2 to 3 days, you only look pink or like you
described having too much sun.
And you are asking me if you got ripped off and you were explaining in your question that
because of your Latin background that they stated that the doctor or the people who did
the laser stated that they need to go light on you.
So certainly I can understand your concerns and a little bit background, I’m a board
certified cosmetic surgeon and fellowship trained oculofacial plastic surgeon I’ve
been in practice for over 20 years in Manhattan and Long Island.
I actually have been using CO2 laser since 1995 and in my practice, we have a similar
laser.
They mixed off fractional CO2 laser and so I can certainly give you mu experience in
how I approach situation like yours and give you a little bit of guidance to what your
physician might have been thinking in terms of your treatment.
So to understand a little about laser, first we need to understand what the problems we
are trying to solve.
The term laser is very often used and abused and unfortunately perceived as high-tech and
as a method to erase everything that you don’t like.
However, when you really understand what laser is it’s basically a conversion of light
energy into heat.
And with laser, basically there 3 targets: there is water, blood or red and pigment or
brown.
CO2 laser has been around since the mid 90’s and was first very aggressive and when I say
aggressive, basically we are ablating the top layers of skin very aggressively and to
restore new skin that would be smoother.
Now at that time, people with any tendency to tan easily would not be treated with this
laser because of the pigmentation.
Now move the clock forward give or take 15 to 20 years, fractional CO2 laser came to
the market and for me it’s been a great tool because essentially I was getting the
best of both worlds, the depth and thermal energy delivery that I want with the CO2 laser
but with less down time because of the fractional delivery.
Now people like yourself come into my practice, what I do is first talk to them what are they
trying to do.
Are they trying to improve pigmentation, are they trying to improve fine lines, are they
trying to refresh their skin and are we dealing with something more evolve like acne scars.
So my approach especially with people with darker skin is to be conservative but I don’t
usually use CO2 laser as my first line of treatment.
What we do in our practice is we tend to use a lot of platelet-rich plasma (PRP).
Platelet-rich plasma (PRP) is a concentration of growth factors and healing factors from
your blood and when injected in your skin with a certain way and a certain level, we
are able to actually improve pigmentation in people who are at risk of hyperpigmentation
from thermal devices.
So I think one issue that you may have is you may not have got clear understanding of
a full treatment plan.
When I talk to my patients about treatment and when it comes to skin, it’s rarely ever
one off or a single treatment and they are good forever.
A lot of times, it has to be a plan as well as a strategy.
So with someone like yourself, I can understand why they’re being conservative because they
are concerned about issues with anybody with pigment which is hyperpigmentation or hypopigmentation
too much pigment or too little pigment, neither of which is very good.
Now it could be that your doctor wanted to do a limited test to see how you would respond.
I think it’s a very tricky thing to use thermal devices on people with darker skin
and that maybe the basis of why you look what you do at this point.
I would not say you got ripped off but I think you are clearly in need of is an understanding
as to the plan and expectation.
CO2 laser delivers energy in a fractional way to the deeper levels of the skin.
The benefits of that can go on for months to a year and that’s what it takes to get
the full benefit.
So although you may not be raw, you have to understand that the deeper levels of the skin
the collagen remodeling part that occurs at the dermis level that is still ongoing.
A lot of times from my patients, what I will do is I will do platelet-rich plasma (PRP)
treatment first and then I will do a very limited light laser for just the top layers
of the skin.
I tend to be much more conservative when it comes to darker skin a lot of people come
to me because they have darker skin and they have been frustrated with going from one laser
to another to try and treat acne scars and fine lines.
And although a lot of these lasers including the fractional CO2 laser are considered safe
for dark skin, it doesn’t mean in any way that these modalities are free of complications
or undesirable results such as pigmentation issues.
So understanding that I think that you should allow for the full healing of your skin and
talk to your doctor about what your goals are and what you want to see as an output
come.
It might be that your doctor suggested that this laser would be the only thing you need.
I see this all the time particularly to patients who come for acne scars.
I always tell them that acne scar treatment requires a lot more complicated or I should
say a lot of different levels of treatment that is just not going to happen with one
laser treatment but that being said again, you have to define for your doctor are you
looking for pigmentation improvement, skin glow improvement, texture improvement, fine
line and wrinkles and acne scar.
The more clear you are and you have to see what can the doctor offer you.
It’s very important in our practice that we develop a relationship with our patients
and we have a plan and I’m very straightforward with them.
I tell them if they are going to do one thing just don’t do anything.
If I’m recommending that a procedure for optimal results requires 2 to 4 treatments.
There is no value in just doing one approach.
I think it is important not to bounce from doctor to doctor find someone that you like
and you trust and understand what the limitations are.
Every procedure has risks, benefits and other options and that’s what informed consent
is all about so that’s something that you should revisit with your doctor.
So I hope that was helpful, I wish you the best of luck and thank you for your question!