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Fractional Non-Ablative Skin Resurfacing
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New! Little to No Downtime Skin Rejuvenation Delivers Non-Ablative Skin Resurfacing with High Efficacy and Comfort for a Real "WOW" Result!

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Sample Treatment Photos
photos courtesy Palomar Medical

Our Fractional Non-Ablative Skin Resurfacing delivers penetrating uniform microbeams in a simple treatment approach, without the need for time-consuming and costly preparation and clean-up.

At Dr. Lille’s practice, we now have the Palomar 1540 Fractional Laser for facial resurfacing. It is FDA approved for “soft tissue coagulation & skin resurfacing” and, to my knowledge, is the best available treatment for skin rejuvenation without significant “down time.” This is the “next generation” fractional laser, a new laser delivery process based on the erbium laser used in the late 1990s for resurfacing. Targeting the dermis and collagen, a tiny grid of laser beams penetrates the skin, heating the water of the deeper skin to cause inflammation and tightening. By shooting laser beams through very small holes in a grid, a “mesh” of laser beam skin damage is created, allowing several important advantages over all previous skin lasers. Most of the laser energy is delivered to the dermis of the skin, below the surface epidermis, allowing heating of the skin without removing its protective layer.

Patients rightly ask, “So what, how does that help me?” The advantages are significant. First, the discomfort is mild, and requires no anesthesia. Those of us who have had both the IPL and the fractional treatments usually think that the IPL is more uncomfortable. The laser tip is water cooled, and an entire face is usually treated in one session. The skin changes are not as dramatic as those following CO2 laser treatment, but most of the possible complications of CO2 laser use are also minimized or eliminated.

Second, the “downtime” is very minimal, with 3-4 hours of initial redness, then pink skin for 36-48 hours, as if you were at the beach a little too long. This pinkness is easily covered with make-up. Many patients can, and do, return to work the same day, or the next. Some will wait for 1-2 days before returning to work. I (Dr. Ehrlich) have worked the day after my first three treatments, with very few comments from patients. Most of them don’t even notice.

Although the post-operative changes are much less than those after CO2 laser resurfacing, the healing process must still occur. While the CO2 laser causes a 2nd degree burn which must heal from the outside in, the fractional laser causes heating below the skin, which must heal from the inside out. Therefore, instead of occluding the skin as with the CO2, the pores should be kept open, so that the damaged portions can “work their way out” to the skin’s surface. This is why it is important to use only water based cream, lotions, and cleansers after your treatment.

After 3-5 treatments, wonderful changes in the skin are possible, including smoothing of wrinkles, decreased discoloration, and improvement of acne scarring and pore size. We usually recommend 3 to 5 treatments spaced 3-4 weeks apart for maximal improvement. The final skin improvements will not be visible until at least 6-8 months after the last treatment is completed, a very subtle, but very significant change in the skin texture.
We are delighted to offer Fractional Laser resurfacing to our patients, and our initial results have been wonderful.

Frequently Asked Questions

Is the treatment painful?
There may be some mild discomfort during the procedure in some areas of the face, the lips, near the nose, and the lower eyelids. Applying numbing cream and cold to the skin minimizes discomfort. You may also take either 600 mg. of ibuprofen (Motrin) or 1000 mg. of acetaminophen (Tylenol) one hour before your treatment. Most patients who have had an IPL treatment believe that the fractional laser is more comfortable.

Will I need more than one treatment?
Yes, if you want to be happy with the results. For maximal effect, 4-5 treatments spaced at least 3 to 4 weeks apart are recommended. A mild change of the lip line and eyelids may be present after 1-2 treatments, but this is unpredictable. The final changes in skin collagen will take 6 months to develop. In other words, your results are not instantaneous, the skin will continue to improve for at least 6 months, slowly and subtlety.

What is the “down time” involved?
As outlined above, you will be mildly swollen and red for 4-6 hours, then pink for the next 36-48 hours. You may apply make-up after 18-24 hours. Unless you cannot or will not allow other people to see your mildly pink skin, you should be able to do almost everything that you normally do.

Are there any “long term” side effects?
Almost always, the only long-term effects are those that we all want, an improvement in the skin. Rarely, there may be some increased pigmentation in a treated area. This can be treated with creams and IPL.

How do I care for my skin after the procedure?
You may apply cool, moist washcloths when you get home, use cool packs, frozen peas, or frozen corn in a baggie. There is aloe cream with lidocaine (sunburn cream) available in many stores. After 4-6 hours, you may wish to apply a water- soluble moisturizer every 1-2 hours while awake. Gently cleansing once or twice per day with a water-soluble cleanser will also help the inflamed areas and pores clean themselves.

The FRAXEL laser is very painful. Is this the same thing?
No, it is not at all the same. The discomfort is minimal, the heat is decreased, no markings are needed, and the results should be as good or better.

How is this different from the IPL machine that you use to treat blood vessels and pigment?
This laser will not improve facial vessels, but the IPL does. This is a laser, not intense pulsed light, and will tighten the skin and wrinkles much more than the IPL, especially after 4-5 treatments. If the facial pigment is significant, we may recommend IPL prior to the fractional treatment. By itself, the fractional laser will also lessen pigment.

Will the fractional laser treat acne scars?
Yes. In fact, it may be the best available treatment for acne scarring. It is better than the CO2 laser, because it can get the deep portions of the pits and scars without causing a 2nd degree burn and changing the skin pigment. By causing the acne scars to heal from the inside out (instead of the outside in, which causes very little improvement), a much better skin appearance is created.

I don’t want anyone to know that I had this done. Is that possible?
The initial redness and swelling is moderately noticeable up close for the first 24-48 hours, resembling sunburn, or after a mild skin peel. Without cover-up make-up, people will know that your skin is pinkish red for some reason, but it is not horribly messy.

Do different areas of the face respond differently to the laser?
With almost any superficial skin treatment, the thinner the skin, the more the wrinkles will improve. The lower eyelid skin respond the fastest, and have the most noticeable changes.

If I have one or two treatments, will I still see changes?
You may notice some improvement, particularly in the eyelid and lip area. It should be obvious that 3-5 treatments will cause much greater changes. We suggest that you consider 3-5 treatments to achieve the full benefit of the fractional laser.

How much skin improvement can I expect?
The improvements are subtle, but very nice. Fine lines and wrinkles may improve 30-50%, while larger creases and deeper wrinkles may improve 10-25%. This depends upon your skin type, where the wrinkles are on your face, and whether or not you are willing to change how you care for your skin. If you smoke, drink, sunbathe, eat poorly (or all of these), do not expect as much improvement as you might have if you cared for your body and skin. For a treatment with virtually no “down time,” the results are usually very gratifying. Please do not expect significant improvements with 1-2 treatments. Even CO2 resurfacing or very deep peels cannot “erase” facial lines.

 
 
Sean T. Lille, MD, PC • 10210 N 92nd Street • Scottsdale, AZ • 85258 • 480.661.6197
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