Thank you for your question.
You're asking is the risks of fully ablative CO2 laser greater than other types of lasers.
And certainly, it’s an interesting question because there is – there’s a lot of confusion
in the modern world of lasers.
There’s a proliferation and has been for a number of years of lasers that claim similar
outcomes.
And of course doctors always have their particular preference.
I can certainly give you my perspective of ablative lasers and various other modalities
that I have experienced with.
I’m a board certified Cosmetic Surgeon and fellowship-trained Oculofacial Plastic Surgeon.
And I have been in practice for over 20 years in Manhattan and Long Island.
I could tell you that since the mid-90s when the first ablative CO2 lasers arrived, I used
them.
I have had the opportunities, a lot of different lasers along the way.
And I can give you certainly some perspective.
So to begin with, you have first have to define the solution by defining the problem first.
When people want to have a dramatic improvement in their skin – well, before there were
lasers, there were chemical peels.
There’s still chemical peels.
That’s still the gold standard on how lasers can be compared to in terms of outcomes.
Chemical peels fall in to basically three categories: superficial, medium depth, and
deep.
Now, the golden rule is very straightforward; the deeper you go, the more dramatic and significant
your results will be.
But with that correlation is the deeper you go, the higher risks for complications and
problems.
So it is always important to have a balance.
Now there are certainly many arguments that can be made and you will certainly get a lot
of opinions when you do your research meeting with doctors about what results are best.
And I think that there’s no question that an ablative, and relatively, a deep CO2 laser
will probably give you the most quote benefit in terms of addressing the common problems
that a CO2 laser is used for such as the treatment of lines, wrinkles, etcetera.
But what I can tell you is that in practical terms, the difference of between a laser and
a chemical peel should also be defined.
A laser – a chemical peel, once you’ve applied it, it reaches a certain depth and
that’s it.
That’s true for medium depth or deep peel.
And a certain physiological response commonly referred to as a frost from medium, deep peels
that you see when you are doing this.
With the laser device, you can reach those depths but there’s also an advantage of
a little bit of thermal – or a lot of the thermal energy delivery which has its value
in terms of contraction.
The reality in the modern world and this in my practice in Manhattan and Long Island is
that people don’t have time.
And prolonged growth of healing process is virtually unacceptable.
You want to improve things but you also want to return back to work or your normal activities
within a week or within, at least, two weeks.
So what I’ve done in my practice is I’ve combined modalities.
I’ve taken the benefit of an ablative CO2 laser.
But instead of a fully ablative, I used fractional CO2 laser.
Now fractional means that there were skip areas between the little dots that are made
when we do a laser.
And the idea is that because there’s more intact skin between, you can get better healing
and faster healing.
Now, of course, when you repeat passes, then it becomes less fractional and more ablative.
But you can also control the depth and the energy delivery.
So I’ve always been able to customize that and I find that that’s a way to balance
that – the time of recovery and the results.
Sometimes, you can also repeat which is also has its own value for a specific focal areas.
I also combine my fractional CO2 laser with platelet-rich plasma.
Platelet-rich plasma is derived from your own blood.
And if the goal is to improve your skin, well, platelet-rich plasma has the ability of stimulating
blood supply and collagen.
And so, when you think about it, if we can do something where you're a little bit less
invasive from the laser perspective and you are using a stem cell – well, let’s just
say your body’s own adult stem cell a response to stimulate collagen, then you get the best
of both worlds and you diminish the risk.
Now for some very deep lines, so it’s a little vertical lines around the lips, you
have to be aggressive and you have to be ready for that healing process.
But for most of my patients who come for facial aging related issues, I do this kind of balanced
approach and I’ve had a lot of high satisfaction and people are able to get back to normal
life sooner rather later.
So you have to ask yourself these questions.
There are many of my colleagues and I – and I visited a lot of my colleagues who I know
and respect and I’ve watched them do facelifts and I’ve seen them do lasers and they believe
strongly of fully ablative CO2 laser and they get very, very nice results.
I think it comes down to who you are and what you're willing to tolerate.
What your risk tolerances and what kind of outcome you’ll looking for.
I think that for my practice and the type of people that I take care of, many of whom
are extremely successful, busy people who don’t – or very time-crunched or have
very busy personal lives and family lives.
There’s just not a lot of time.
So we find that the strategy of smaller procedures with quicker recovery ultimately is more easy
to fold into their lifestyles and still get really great results.
So I hope that was helpful.
I wish you the best of luck.
Thank you for your question.