Dr. De Silva uses a combination of state-of-the-art technology and techniques to enhance skin tightening and reducing recovery time. Dr. De Silva imported a state-of-the-art Combined CO2 and Erbium laser from USA, which works to tighten skin on two separate levels. The CO2 laser targets tightening the deep layers of the skin and the erbium laser targets tightening the superficial layers. Depending on your ethnicity and degree of skin quality the settings are adjusted to ensure maximal tightening with reduced recovery time.
Laser resurfacing of the skin can be uncomfortable with local and topical anaesthesia alone, as most of the sensory nerves of the skin are located superficially where the CO2 laser tightens skin. For some patients Dr. De Silva provides sedation anaesthesia, this results in the laser treatment being both a comfortable and relaxing experience. See this link for further information on Sedation Anaesthesia.
Dr. De Silva utilises a U.S. State-of-The-Art Advanced CO2& Erbium Laser
In the past, it was thought that ageing of the face was an inevitable normal process over which we had little control. Scientific research has shown that up to 90% of skin ageing is a consequence of exposure to the sun. Sunlight accelerates the ageing process through photoageing that is preventable through sun avoidance and the use of sun protection agents. The other 10% of skin aging is considered intrinsic and more difficult to influence. There is cumulative damage to the skin that occurs with sun exposure, the damage may go unnoticed until many years later, and is why it is important to take precautions from the sun from childhood.
Fractionated CO2 Laser resurfacing may be used to remove or improve the appearance of:
Combined CO2 & Erbium Laser Skin Resurfacing.
Combined CO2 & Erbium Laser Skin Resurfacing with Upper Blepharoplasty.
Depending on the size of the area of the face being treated is a guide to the anaesthesia required. Local anaesthesia with or without sedation is all that is commonly required, general anaesthesia is not usually required. Eye shields or goggles are placed over the eyes to protect them and the laser is passed over the skin, sending out pulses of laser. The treatment takes between 30-60 minutes depending on the facial area and once the treatment is completed, the skin is covered with an antibiotic ointment and a cold compress placed over the area to reduce swelling. All patients are able to go home approximately 30minutes after the procedure.
Single areas of the face, such as around the eyes or lips, can be treated with local anaesthesia only, a combination of topical numbing creams and local anaesthesia. Treatment of the entire face can be completed with local anaesthesia with or without sedation.
How long does the CO2 laser take to work?
You will see some immediate results from the CO2 laser resurfacing and the final result is at 6 months after treatment. The Cortex combined CO2 and Erbium laser is customised to an individual patient, treatments that are deeper are more effective however associated with more healing and downtime. Your skin heals between 5-days and 2-weeks depending on the depth of the laser resurfacing, and there may be a period of 4 to 6 weeks after that when your skin might be slightly pink. During this period, your skin will feel smoother and looks less blotchy. During the first few weeks you will see fewer lines, less blotchiness, more even colour and more glow.
How long does the CO2 resurfacing laser last?
The laser skin resurfacing lasts for many years, the effectiveness depends on how well you protect your skin from the sun and other factors that including your genetics, ethnicity, smoking, changes in weight, etc. To maintain the appearance of your rejuvenated skin Dr. De Silva recommends you apply sunscreen (of SPF 30 or above) and wear brimmed hats, generally the good effects of the CO2 laser treatment lasts for more than 10 years.
Most patients return to full social and professional activities between one and two weeks.
The time needed for healing and recovery after laser resurfacing varies according to the size and depth of the treated area and the patient’s skin type. In general, the younger fresher skin replaces the older sun damaged skin between 1 and 2 weeks. Cold packs and analgesia are used to reduce swelling and discomfort. The skin may occasionally remain red for several weeks, and this can be masked with cosmetic concealer after 1-2 weeks. Some patients may have darkening of the skin at approximately 1-month after surgery, this is temporary and resolves (termed post-inflammatory hyper pigmentation), and can be covered with cosmetic concealer if required. Most patients return to full social and professional activities between one and two weeks.
Care of the treated area of the face while the skin is healing is important and includes:
Laser skin resurfacing is an effective technique for rejuvenating the skin for treating:
There are some considerations when Dr. De Silva uses laser resurfacing:
After laser treatment the older skin will become dry and peel off, during this time it is important to keep the skin lubricated. To care for the skin after resurfacing:
After laser resurfacing it is important to keep your skin moisturized. I provide my patients with a prescription for bactroban (Mupirocin 2%) ointment after laser resurfacing procedure, this both lubricates the skin and protects against infection (about 5-7days). Vaseline is an alternative that can be used to lubricate the skin.
After this time a light moisturiser (both creams and lotions are fine) are recommended, a hypoallergenic moisturiser such as Cetaphil moisturiser, your skin can be more sensitive at this time and for some people using a regular moisturiser can irritate the skin. If your skin is more sensitive it is fine to continue with Vaseline as this generally very well tolerated.
Cleaning your skin
Cleaning dried and flakey skin appear after several days and it is important to gently cleanse and to clean away debris. You can then complete this with sterile (boiled water) and gentle patting (avoid rubbing your face at this time).
Dr. De Silva uses an erbium laser that tightens superficial skin and reduces the amount of peeling that is seen after CO2 laser resurfacing.
After 2 weeks you can return to the use of your regular moisturizer and it is important to both avoid sun exposure and use a sunblock (of SPF 30 or above) for 3 months.
Before laser treatment it is important to avoid sun and avoid tanning your skin. For some patients Retin A and hydroquinone can be used for two weeks before laser.
Other treatments have been also used in laser after care including vitamin C, Green Tea, glycolic aced and retinoids, however their effectiveness in healing has not been proven.
After laser treatment the older skin will become dry and peel off, during this time there are steps that can be taken to speed up the recovery:
Depending on the type of laser resurfacing the downtime can vary, most patients are able to return to work with in 7-10 days.
Although a lighter laser resurfacing can be completed with faster recovery, if the treatment is too light it will be less effective. In the same way a spa may offer a “lunchtime peel” with immediate recovery, the results are also likely to be difficult to see. Sun exposure should be minimized for 3-months after laser resurfacing to ensure a fast recovery.
Redness is dependent on patient and treatment characteristics including skin type, type of laser and depth of the laser treatment.
Redness is a common immediately after laser treatment and for the first week after laser. Occasionally there can be redness for up to six weeks and rarely for six months. To reduced the chance of redness several measures can be taken during your laser treatment:
If you have redness after laser, skin creams can be prescribed that will reduce the redness faster, these include moisturisers, sun block and anti-inflammatory creams. Sometimes your own skin creams including moisturisers can irritate your skin as it can be more sensitive after laser treatment, it may be important to stop using all your regular creams for a period after laser treatment and use hypoallergenic products.
Lines around the mouth are often deep and a difficult area to treat. Dr. De Silva considers the following characteristics for treatments around the mouth:
With taking steps to modify the treatment around the mouth, the lines around the mouth can be softened with a combination of deep and superficial laser resurfacing and adding volume to the lip area.
The cost of laser resurfacing is dependent on the type of laser, the equipment that is used to complete the procedure, the location and the doctor’s expertise and form of anaesthesia. Modern CO2 and Erbium lasers are advanced machines that use state-of-the-art technology to treat “fractional” areas preserving natural skin that enhances recovery. Dr. De Silva uses dual technology CO2 combined with erbium to target superficial and deep skin. CO2 laser is advanced technology that is only completed with trained doctors, the treatment cannot be legally administered by other practitioners in the UK. As a consequence, the total cost varies depending on the technology used, the equipment and the number of treatment sessions.
Fractional laser resurfacing is an effective treatment for acne scarring. Acne is not cured by laser treatment.
Key to an effective laser treatment are these considerations in acne:
Laser resurfacing is an effective treatment in improving the appearance of the skin and it requires a comprehensive assessment to evaluate the type and severity of acne scarring and if additional treatments are required to enhance the results, and a discussion about expectations from treatment. If you have active acne, prescription medicines may be needed to control acne. It is important to have acne controlled with medications before laser treatment for scars.
Acne scarring can be a distressing condition, whilst there are a multitude of treatment options available, there are patients who have tried everything including combinations of lasers, peels, retinoids and needling, but are still searching for a solution. No single treatment is able to completely correct acne scarring, each different treatment has a role in improving scarring.
Older CO2 laser were effective however had longer recovery and downtime with greater chance of redness and pigmentation after treatment.
Fractionated laser are more modern lasers than enhance recovery by sparking portions of the skin to laser. A fractionated laser can be either an Erbium or CO2 laser. Both are effective, the physician who is using it is more important then the actual laser. Fractionated technology is aimed at achieving similar results to standard “resurfacing” with less downtime. Dr. De Silva prefers to use a combination CO2 and Erbium laser, as CO2 laser tightens deeper skin and the Erbium laser tightens more superficial skin.