What is Fractional CO2 Laser Resurfacing?

CO2 Laser resurfacing has been called the anti-aging breakthrough of the 21st Century. Fractionated carbon dioxide (CO2) lasers are one of the latest advances in non-surgical skin rejuvenation treatments. The CO2 has the longest wavelength of all the lasers on the market and can be used safely on darker skin types with appropriate adjustments in the settings. It is called Fractionated because the depth of the laser can be precisely adjusted with a technologically advanced computer integrated into the laser system. Plastic Surgeons call fractional CO2 laser the gold standard for skin rejuvenation.

Fractionated CO2 lasers excel at treating deeper wrinkles, more severe textural changes from sun damage, wrinkles, blotchiness, acne scars, and surgical, or traumatic scars. It can be used on the delicate eyelid skin and around the mouth. It is also a very effective treatment for sun damage and precancerous growths (i.e. actinic keratosis). In addition, patients can expect a dramatic improvement with  skin tightening, reduction of pore size, and collagen production.

What does it NOT do?

It does not take care of redness including dilated blood vessels (telangectasias) or that reddish blotchy discoloration on the neck (poikiloderma). Temporarily, it can even make these problems look worse because the laser treatment itself causes some redness. For problems with red and veins the Excel V laser is more effective.

There are different types of CO2 laser. At Estetica Institute we use the Deka Smartxide “DOT” system because it easily facilitates customizing each treatment for individual patients and particular sites of the body.  This modality has one of the best “microdot” sizes, which helps to optimize results which leaves micro amounts of normal skin which greatly expedites the healing process.

How Does Ablative Fractional Laser Resurfacing Works?

Also known as fully ablative fractional laser resurfacing and fractionated or pixilated carbon dioxide (CO2) laser treatments, ablative laser therapy essentially resurfaces the uppermost layer of the skin. It works by actually evaporating the water molecules in the upper layers of the skin and removing the aged, undesirable layers. An ablative laser delivers a more intense light beam than a non-ablative laser. Treatment generally requires anesthesia or sedation. After an ablative laser treatment, you will need approximately 7-10 days of downtime to give the skin a chance to recover. Ablative laser therapy is considered an outpatient surgical procedure.

How long do the effects of a fractional CO2 resurfacing laser treatment last?

The length of effectiveness depends on how well you protect your skin from the sun and other factors that cause aging like your general health, smoking, changes in weight, etc. If you apply sunscreen and minimize your sun exposure, you can maintain the beautiful results of your CO2 laser treatment for many years.

When will I see results?

At Estetica Institute the medical provider will customize the fractional CO2 laser treatment.  Fractional CO2 laser treatments can be deeper, with more healing and downtime, or shallower, with less healing time. The deeper the treatment, the better the results generally. But some patients prefer to have two treatments that aren’t as deep. This alleviates a significant amount of downtime.

Patients can expect to see some immediate results, but full results may take 3-6 months. After the skin heals, which may take up to 3-10 days, there will be a period of 4 to 6 weeks after that when the skin might be slightly pink. During this period, the skin will feel smoother and look less blotchy.

How much do fractional CO2 laser treatments cost?

The cost varies by location and the size of the area being treated. Full-face treatments are between $1,500-3,000 while smaller areas such as around the mouth are $750.

What will I look like right after the treatment and what is the healing time?

During the first 24 hours after treatment, your skin may feel and look as though you are severely sunburned. Ice packs/frozen peas are used 5-10 minutes per hour for the first 5-6 hours after the treatment.

Your skin will peel for 2-7 days and will be pink for 3 to 6 weeks. This healing all depends on how deep your treatment is. After a week or so, you can wear make-up to cover the pink. Allow 2-4 weeks for weddings, reunions, family pictures, etc. just to be safe. Allow longer for body sites like arms or legs.

Can I go back to work and activities immediately?

No, you will need to take the rest of that day off to ice and care for the treated area. For the lighter fractional CO2 treatments, you will need 3-5 days of downtime. For the deeper treatments, plan on 7-10 days of healing before you can go out in public.

How many treatments will I need?

The number depends on the extent of your sun damage, scarring or wrinkles, and on how much downtime you can accept. If you can tolerate 7 days of downtime, you would generally need only one fractional CO2 treatment.

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Dr. Gregory S. DeLange at Estetica Institute of the Palm Beaches

Dr. Greg DeLange is a highly trained and experienced Board Certified Plastic Surgeon. He graduated from the University of Miami School of Medicine and then completed his Surgery Residency at the University of Texas. After completing a year as Chief Resident, he followed his General Surgical training with an additional two years of Plastic Surgery Fellowship at the prestigious University of Florida Shands Hospital. Dr. DeLange has performed over 20,000 Plastic Surgical cases and is certified by the distinguished American Board of Plastic Surgery.