Laser Skin Resurfacing

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There are essentially two types of laser categories: non-ablative (no-downtime) and ablative (removal of old skin and a week or so of downtime). Dr. Lam offers both services. His non-ablative laser is akin to an IPL or “photofacial”. However, since his is truly a laser (actually two lasers: a KTP and Nd:YAG) it works far better at removing red blotches, rosacea, and also at tightening and reducing pores. There is almost no downtime in the majority of patients but in those with extensive rosacea there can be some mild swelling for a day or so. Dr. Lam uses two ablative lasers: the Cortex (fractional carbon dioxide and erbium) and the 2940 nm (a non-fractional erbium). He finds the Cortex to be ideal for lighter problems of skin aging; whereas he uses the 2940 nm primarily for deeper wrinkle problems, especially those around the mouth area.

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Key Points:

The non-ablative KTP is a truly “no downtime” procedure that can be done as a lunchtime treatment. Dr. Lam’s staff performs this procedure rather than Dr. Lam. Because it can take up to 45 minutes to perform, this procedure needs to be scheduled in advance. It can help with rosacea, redness, uneven color, pores, and mild skin texture problems. It is best advised to have this procedure performed every 6 weeks to 3 months if possible, or before a special event for which you want to look good.
The Cortex is a very good laser to treat mild to moderate skin damage like fine to moderate lines, sun damage, and uneven color and texture. The Cortex is a dual laser employing both fractional carbon dioxide and non-fractional erbium. Fractional laser is defined as a laser that skips areas of the skin using a computer program to permit improved healing. The 2940 nm is more powerful to correct the same problems as the Cortex and works exceptionally better at managing wrinkles and texture problems around the mouth. It uses a more powerful non-fractionated ablative erbium laser and also possesses a lighter fractional erbium head as well. Dr. Lam mainly uses the non-fractionated head. Because the resurfacing does not go as deep as the Cortex, it does not need to be fractionated and works better to improve textural issues and wrinkles of the skin. For both lasers, the downtime is typically several days to a week where there is obvious peeling and some swelling making it hard to go to work or be in the social spotlight. Even though some mild color changes may persist for even several weeks, Dr. Lam uses Oxygenetix makeup that can actually be used immediately after an ablative laser session without risk. In fact, Oxygenetix, which is color matched to your skin type, can actually facilitate more rapid healing of your skin, and at the same time cover any mild, remaining discoloration.

Laser Skin Resurfacing

FAQs

What are my restrictions following a 2940 nm or Cortex treatment?

Dr. Lam does not like you to be in a lot of direct sun for a period of 4 to 5 weeks to minimize the chance of hyperpigmentation, which is a temporary darkening of the skin. He also would like you to stay away from submersing your face in dirty water like tub bathing (showering is fine), swimming pools (whether private or public), or saunas for a period of three weeks.

Are there times when Dr. Lam would consider me a poor candidate for a 2940 nm or Cortex laser treatment?

Yes, there are a few conditions that would make you a poor candidate. First, in the very young patient who may not need these lasers, he or she could have the KTP instead as an alternative. Second, if someone is a darker Fitzpatrick IV skin (darker Hispanic or Asian) or anything darker (Indian or African), these lasers would not be suitable. However, for fairer-skinned Hispanic or Asian or lighter-skinned individuals, this laser is not only appropriate but can be highly beneficial. Third, if someone is a smoker or has uncontrolled diabetes, he or she may not heal well. Talking with Dr. Lam can help determine whether you would be a candidate based on these criteria. If you have a history of keloid scarring or significant hypertrophic scarring, you would not be a candidate. If you have had overly treated skin from prior lasers or received high-dose facial radiation, then it may be unsafe to perform the procedure. Finally, the use of isotretinoin (Accutane) during the year prior to the laser would also make the procedure unsafe and may lead to scarring. In general, these lasers are very safe in Dr. Lam’s hands, and he performs all ablative lasers personally himself.

How do I decide whether I should have a 2940 nm or a Cortex laser treatment?

This is a discussion you should have with Dr. Lam in person. He will help tailor the right laser for you based on your skin condition, recovery window, and budgetary concerns. He can in many cases do partial facial treatments or full facial treatments also based on the above criteria.

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Your Laser Skin Resurfacing will be performed by Dr. Lam's surgery center located in Plano, TX.

I highly recommend Dr. Lam. He is a perfectionist and took the time to listen to my concerns and explain the procedure in detail. His staff has always been warm and welcoming from the day of my consultation, throughout the procedure and follow up appointments. I am very happy with the results of my procedure! Thank you Dr. Lam! – See more Testimonials here.

Comparison Chart between Lasers

Deciding which laser would be better for you may be confusing. Dr. Lam has put this chart together to explain the differences between the lasers he uses to help guide you in your decision-making. In every case, however, a consultation with Dr. Lam will help determine which laser would best suit your needs based on budget, recovery time, intended benefits, and communicated limitations. For all three lasers, Dr. Lam can treat a skin type from Fitzpatrick I (very fair skin) all the way to a Fitzpatrick IV (medium Hispanic and Asian skin) but cannot treat Fitzpatrick V (Indian or light-skinned African-American) or Fitzpatrick VI (Central African, very dark skin).

	Gemini Laser	Cortex	2940 nm Contour TRL
Type of Laser	Dual KTP/Nd:YAG	Fractional CO₂/Erbium	Non-Fractionated Erbium
Category	Non-Ablative (does not remove any outer skin layer)	Fractional Ablative (partially removes outer skin layer, making small tiny holes)	Fully Ablative (fully removes outer skin layer)
Type of Anesthesia	None (can drive home)	Topical + Injectable Anesthesia + Oral Sedation but can use IV Sedation upon request (Should Uber/taxi home or have companion to drive you home)	Topical + Injectable Anesthesia + Oral Sedation but can use IV Sedation upon request (Should Uber/taxi home or have companion to drive you home)
Recovery	None or only mild swelling for a day or so (typically, no downtime)	A few days of swelling and peeling up to a week (Oxygenetix makeup can cover any residual redness typically by day 5 to 6)	A few days of swelling and peeling up to a week (Oxygenetix makeup can cover any residual redness typically by day 5 to 6)
Cost	$350 (Partial Face) \| $500 (Full Face)	$1,500 (Partial Face) \| $2,500 (Full Face)	$2,500 (Partial Face) \| $4,000 (Full Face)
Frequency	Every 2 to 4 months (as needed)	Once (repeat only for added benefit or when more sun damage arises)	Once (repeat only for added benefit or when more sun damage arises)
Benefits	Great for broken blood vessels (or rosacea), enlarged pores, mild texture improvement, and superficial brown spots like freckles Typically, no downtime (like an IPL or “Photofacial” but more targeted in its benefits) Can be used as a maintenance laser after a Cortex or a 2940 nm laser treatment a few times a year as needed	Very good for wrinkles around the eyes and can be used just for this one area to complement Botox and filler treatments Good for mild to moderate sun damage Good for acne scarring when there is residual scarring left after fillers have elevated the tissues	Very good for moderate to deeper wrinkles around the mouth and cheeks (although may not entirely eliminate wrinkles). Can be used just around the mouth for these wrinkles Good for moderate to significant sun damage (‘the gold standard’) Can be good for some types of rolling acne scarring but Dr. Lam more often uses the Cortex
Limitations	Does not have significant correction of aging because it does not actually remove any skin (non-ablative) Better to be performed every few months for maintenance	Does not effectively address moderate to deeper wrinkles of the face, in particular around the mouth or the cheek areas Requires downtime	Does not eliminate all sun damage but does better than the other two lasers Requires downtime