Charles Perry, MD, Plastic Surgeon
For an appointment, call (916) 248-4447
July 1, 2009

Fractional CO2 versus Profractional Laser Resurfactional Resurfacing in Sacramento

Posted by Dr. Perry in Laser Resurfacing

Laser resurfacing is used to remove wrinkles, reduce scaring and brighten your skin. In Sacramento the sun exposure and the great outdoors activity leads to solar elastosis of the skin and loss of the dermal papillae over time. This causes thinning and wrinkles that have been treated successfuly with laser resurfacing. Older generation lasers used to do this in a blanket fashion which took a long time to heal. Newer technologies have allowed lasers to create small little areas of resurfacing which heal much quicker. The small dots or mtzs (Micro Thermal Zones) of tissue injury or heating stimulate the skin to grow new beautiful fresh looking skin. The MTZ heal from the surrounding injured tissue so that you get a smoother, tighter more uniform appearance of the skin. Before fractionated or Profractional laser the whole skin needed to heal from the bottom up which could take up to six months. With fractionated lasers healing can be much quicker while the depth can be similar. With less down time it is easier to fit into your schedule. Certainly a full resurfacing gives a more dramatic result in one session and is still considered the gold standard, however ProFractional treatments can be combined with micropeels and give a great result as well in one session. You can always do more.
ProFractional lasers utilize an erbium laser that is very specific for water at 2940 nm. With this laser you can remove or vaporize a specific amount or depth of tissue giving your skin a beautiful resurfacing. You can also add heat to the columns of tissue or not depending upon what your doctor and you are trying to accomplish. Heat causes the surrounding collagen to contract. These treatments can be added to additional micro peels or non- ablative treatments as well. They can also be repeated if you desire further enhancement.
CO2 fractional lasers utilize CO2 which has a higher wavelength of light in the Infra red spectrum. Like Erbium it also uses water as a chromophore. However it is not as specific so the thermal relaxation time isn’t reached as quickly and the tissues surrounding the MTZ absorb the excess heat. This allows for collagen contraction and again can gives the skin a nice uniform color and texture. The difficulty with the heat for both lasers is that this can cause hyperpigmentation in darker skin types or long term hypopigmentation. Certainly repeat treatments can be done as well.
CO2 has been considered the gold standard for full facial resurfacing in the past. Fractionated CO2 and the ProFractional Erbium Sciton Laser with its ability to deliver prescribed depths of tissue ablation and heat may give your provider a little more control. Remember when choosing a physician for cosmetic needs, it is not the tool that matters but the person using it that makes the difference in the end.

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