The underlying science of the laser was discovered by no less a luminary than Albert Einstein. Every since their first days, lasers have held an outsize place in our minds. The very word connotes highly advanced technology for most of us. Lasers come in many types, from the tiny one inside your DVD player to the biggest laser in the world at the Lawrence Livermore National Laboratory. For plastic surgeons, lasers offer an excellent tool to provide highly customized solutions for many different types of problems. At UT Southwestern, we have the largest collection of medical lasers in the US, with a wide variety of available options.
There are four main uses of medical lasers in plastic surgery:
Hair reduction
By tuning the appropriate laser, energy can be transmitted safely through the skin and into the hair follicles underneath. This turns off the hair follicle’s activity, preventing it from growing new hairs. Not all hair follicles are active at any given moment in time. As a result, laser treatments for hair removal have to be repeated several times at regular intervals. This can more effectively deactivate most of the hair follicles in an area. The resulting hair reduction is long-lasting, and often permanent. It is most effective in patients with dark hair and light skin. This allows the laser to preferentially target the hair and ignore the skin. The treatment is not very painful and is performed in the office without any need for anesthesia or sedation.
Skin resurfacing
Lasers can be used to perform the equivalent of a chemical peel – i.e. remove the entire uppermost layer of skin to reveal fresh, smoother skin underneath. This can be used to treat deeper, “static” wrinkles (unlike the “dynamic” wrinkles that can be treated with Botox®). Dr. Nagarkar most commonly uses the Erbium laser for this purpose.
Lasers can also be used to stimulate the deeper layers of skin to produce more new collagen and increase the elasticity and plumpness of the skin. This can very effectively treat fine lines and wrinkles without removing the upper layers of skin. These are fractionated lasers.
Photorejuvenation
Sun damage can cause distressing signs of aging at a relatively young age – irregular pigmentation, large pores, or flushed and reddened skin with unsightly small veins. By choosing different lasers than those used for hair reduction or skin resurfacing, the skin can be rejuvenated and many of these effects reversed.
Vascular
Abnormal blood vessels often form with age and sun exposure. These can be prominent veins or capillaries, and can appear on the face and legs. Varicose veins and telangectasias are two common examples. Large varicose veins can be treated with a laser – however, this usually requires a more invasive procedure where the laser device is inserted into the vein. Smaller vein and capillary lesions can be treated in the office with lasers that specifically target these vessels.
The engineering and physics of lasers is endlessly fascinating to me. The best part about lasers is that they can be finely tuned for each patient and each purpose. This fits right in with my overall philosophy on plastic surgery – customizing the solution for each individual patient.
Who is a good candidate for laser treatments?
Since there are many different types of lasers and laser treatments, there are different types of patients who are good candidates for each type of treatment. Dr. Nagarkar will discuss your particular skin type and goals with you to ensure that you can get a great result from laser treatments.
What to expect after your treatment:
Hair reduction, blood vessel treatments, and photorejuvenation are performed in the office and are minimally painful. A topical numbing cream may be used to keep you comfortable before the laser is used. You should be able to return to every day activities immediately afterwards.
Laser skin resurfacing is a bit more intensive, requires some type of local anesthesia or sedation, and may even be carried out in an operating room setting. The length of your recovery depends greatly on how extensive the treatment was.
It is very important that you avoid unprotected sun exposure for several weeks after being exposed to lasers. Ultraviolet radiation from the sun can add to the effects of the laser, causing sunburns. The results of laser treatments tend to be long-lasting, whether it is hair reduction or improvement in skin color, texture, and tone.