Skin resurfacing with a fractional laser

Smooth, radiant skin with just a click of a laser sounds like a dream come true for many people. But how many sessions does it take to get results and how long do you have to hide from your friends? Skin resurfacing with a fractional laser will be discussed by leading experts at the Annual Meeting of The American Society for Aesthetic Plastic Surgery (ASAPS), being held at the San Diego Convention Center May 2-6, 2008.

"Fractional Resurfacing -- A Critical Assessment," a panel of investigators and consultants to the laser industry, will be moderated by Barry DiBernardo, MD (Apira Science, Cutera, Cynosure, Lumensis), and will include Jason Pozner, MD (Bioform, Sciton), E. Victor Ross, MD (Alma, Candela, Cutera, Lumensis), and Jeffrey Kenkel, MD (Palomar).

Fractional resurfacing is a cosmetic treatment that employs a laser to remove wrinkles, reduce acne scarring, alleviate dark pigmentation, and improve other conditions of the skin. Unlike earlier laser technologies, with fractional resurfacing only a tiny proportion of the skin receives the laser light. The laser delivers a series of microscopic, closely spaced laser spots to the skin while simultaneously preserving the normal healthy skin between. This preservation of healthy skin results in rapid healing following the laser treatment. Fractional lasers strive to achieve the skin improvements obtained with ablative lasers without the associated side effects or downtime.

"When fractional resurfacing first appeared on the market patients had more than a week of downtime where they would basically be in hiding. Patients said they wanted a procedure that would offer no such downtime," said Dr. DiBernardo, a plastic surgeon in Montclair, NJ. "For the last few years the latest fractional resurfacing machines offered a no-downtime option but patients would need to have at least five sessions to see any improvement. More recently, machines have become available that offer visible results in one session with less than a week of social downtime."

"There are many different and new types of technology in fractional resurfacing," said Dr. Pozner, a plastic surgeon from Boca Raton, FL, who will be discussing fractional resurfacing and comparing to non-fractional resurfacing technologies. "With newer fractional technology we can achieve very remarkable results with minimal to moderate downtime."

The newest laser treatments are office-based procedures done on an out-patient basis, with a recovery time between three and five days. Costs can range from several hundred to several thousand dollars, and because they are usually considered cosmetic, these procedures are generally not covered by insurance.

One such device is the new CO2-based fractional laser -- Deep Fx by Lumenis. "This device penetrates deeper than other devices we have used and is showing nice enhancement in wrinkles and acne scar patients," said Dr. Kenkel, a plastic surgeon in Dallas, TX, who has been involved in the initial evaluation of the FDA-approved laser and will present his experience with the device as part of the panel discussion.

The popularity of these out-patient, office-based laser procedures has been rising as the technology has improved. According to recent data from ASAPS, laser skin resurfacing was among the top five cosmetic procedures performed in 2007.

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