Lasers are of many types and serve many purposes. The laser used by Plastic Surgeons for facelifts and skin resurfacing emits a powerful beam of a specific wavelength of light. The beam is strong enough to heat the surface of the skin, causing a superficial burn of the tissue. This removes the surface layer, including nearly all the dead cells, and some of the living cells, and also causes the underlying collagen to tighten up somewhat. When the skin surface regrows, the skin is smoother and tighter than it was.
A Laser Facelift is a treatment for the surface of the skin only. It can tighten the skin somewhat and reduce fine lines and wrinkles, but it cannot remove folds of loose skin. If there is a considerable excess of skin present, then a regular facelift is needed, in which the extra skin is surgically removed. (The laser can be used for this procedure also, but that is not what is generally termed a laser facelift.)
There are similarities and differences between laser treatments and chemical peels. The similarity is that both are types of superficial burns of the surface of the skin. The difference is that the laser gives Dr. Dowden a greater degree of control over the depth and position of the resurfacing than was possible with the chemical peel. Also, in addition to removing the older skin layer from the top, the laser actually tightens the underlying collagen dermal tisue, which helps smooth out wrinkles. The laser can be used more effectively for the wrinkles and skin creases than the chemical peel can.
Virtually any area with an excess of fine wrinkles can be helped, including the forehead, the eyelids, the cheeks, around the mouth, the hands, and to a lesser degree the neck. If there is a great excess of skin in these areas, then Dr. Dowden may recommend more extensive surgery, such as a forehead lift, eyelid lifts, face lift, or neck lift. Sometimes these are done at the same time, and sometimes they are done at separate stages.
There is no type of skin treatment that can stop the aging process, and so no treatment is permanent. But there is a permanence in a sense, and that is that the skin will always appear tighter than it would have at the same age without treatment. One can compare it to turning back the hands of a clock: eventually the hands will again be back where they were, yet will always show an earlier time. After a few years, the appearance will again be back to where it was, yet the person will always appear younger than they would have without the treatment.
If only very small areas are being treated, it may not be necessary to be under general anesthesia, as sedation and local anesthetic can be enough. But if a large area or multiple areas are to be done, Dr. Dowden will arrange for general anesthesia. Most patients prefer general anesthesia.
It is usually outpatient surgery, but Dr. Dowden can arrange accommodation in the overnight suite. Patients from out-of-town often choose to stay in one of the nearby hotels.
The costs, of course, depend upon the size of the area treated, and how many areas are to be treated. The fees for a laser treatment of the entire face by Dr. Dowden include: pre-operative examination and testing, operating room, anesthesiologist, recovery room, medical supplies and dressings, surgeons fee, the laser, and checkups for twelve months. If the treatments are done in conjunction with other operations, there can be slight reductions in the costs.
One can find surgeons offering lower fees for this surgery, and although lower fees do not necessarily mean that the surgeon is not experienced, there are several questions to which prospective patients must learn the answers:
Virtually all cosmetic surgery is prepaid, but various financing options are available. It is not appropriate for health insurance to cover cosmetic surgery, and Dr. Dowden will not participate in attempts to submit cosmetic surgery to insurance companies.
For the most current cost information, link to the cost page.
There is enough pain to require pain pills, often mild narcotic such as something similar to codeine. Patients generally say that their skin feels "sore" or "irritated". After a few days, over-the-counter, non-prescription pills are usually enough.
For the first several days, there is weeping and crusting of the treated area. After about a week, the skin stops weeping, and becomes a bright pink color, which then fades to light pink over the following weeks. At this point Dr. Dowden permits his patients to use makeup to camouflage the light pink color. After several months, the pink color is gone, and the skin color returns toward normal, or may be somewhat lighter than normal. There are differences in the skin texture between treated and non-treated areas, with treated areas thinner and smoother than untreated areas.
This depends upon the specific activities in question. Light exercise and swimming can be resumed in about a week, progressing to normal physical activity quickly thereafter. However, the light pink appearance may restrict social activities and return to work for two weeks or more. Activities should be planned in order to avoid exposure to strong sunlight, which can leave abnormal discoloration.
Laser treatments can tighten and smooth wrinkled skin, particularly of the face, the forehead, and around the eyelids. They are less effective for neck skin. Laser treatments cannot correct very deep creases, nor can the laser take up very large amounts of excess skin, for which Dr. Dowden may recommend more extensive surgery. Also, like any plastic surgery for aging or sun-damaged skin, the improvements can not be considered permanent. It is not possible to recreate young skin or prevent continued aging. The hands of time continue moving on, and realistic expectations are the key to success.
Every type of surgical procedure has the possibility of complications, and that is true of laser treatments as well. Possible complications can include infection, permanent discoloration or scarring.
Dr. Dowden's staff will assist the patient in making arrangements for any pre-treatments. Patients who have a problem with the cold-sore virus will need pre-treatment with an anti-virus medication. To facilitate healing, it is preferable for patients to stop smoking. After the laser procedure, additional skin treatments may be recommended to maintain the results.
Yes, once the skin is healed, the laser treatment can be applied again. Usually, patients tend to want to repeat the treatment after several years. Occasionally an earlier second treatment is advisable.
Usually, health insurance does not cover the cost of laser treatments, because that is usually cosmetic surgery. Dr. Dowden will not participate in submitting claims for cosmetic surgery to insurance companies.
Someone hoping to solve personal problems through plastic surgery would not be a good candidate. There is less improvement in individuals with thick coarse skin. Laser treatments are not good for darker-skinned individuals because of the slight discoloration which can occur.
No, there is no involvement of, or exposure to, radioactivity or microwaves. It is a surface treatment with infra-red light, a type of heat.
If you are interested in laser skin resurfacing and want to find a board-certified Plastic Surgeon in your area who is qualified to do it, call the referral service of the American Society of Plastic Surgeons at (800)-635-0635, or check http://www.plasticsurgery.org. Alternatively, one can ask the local plastic surgery society, or the plastic surgery department of the nearest medical school. To find out if a surgeon whose name you have been given is truly a Board-Certified Plastic Surgeon, put the name into the search engine at http://www.abms.org to find out.