Facial Resurfacing

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1. Am I a good candidate for facial resurfacing?
2. What does facial resurfacing involve?
3. How do I plan my facial resurfacing?
4. How do I prepare for facial resurfacing?
5. What results can I expect after facial resurfacing?
6. Where will my facial resurfacing be performed?
7. What type of anesthesia will be used for my facial resurfacing?
8. What should I expect after facial resurfacing?
9. When will I be able to return to work following facial resurfacing?
10. Are there any side effects associated with facial resurfacing?
11. Are there any risks associated with facial resurfacing?

Am I a good candidate for facial resurfacing?

Individuals with facial wrinkles, superficial scars, uneven pigmentation and other cosmetic skin problems may consider facial resurfacing to regain a more youthful appearance. Individuals with lighter skin tone, and those who have limited sun exposure after treatment, typically achieve the best results. Patients with a darker skin tone may be more susceptible to skin pigmentation changes after treatment. Individuals with a history of abnormal scarring, such as keloid or hypertrophic scars, have had bacterial or viral infection of the skin, or with special conditions that could impede the healing process may not be good candidates for facial resurfacing procedures. Patients considering facial resurfacing should be in good general health, both physically and emotionally before pursuing treatment.

What does facial resurfacing involve?

1. CO2 laser facial resurfacing entails the delivery of intense busts of high-powered laser energy to undesired skin tissue. The unwanted skin is vaporized one layer at a time to reveal the fresh, healthy skin underneath. This procedure has a low risk of scarring, causes mild to moderate discomfort, and requires about 2 weeks of recovery time.
2. Erbium laser facial resurfacing delivers a less intense laser energy (compared to the CO2 laser) to the unwanted skin tissue, which minimizes damage to the surrounding skin and reduces the recovery time to about 1 week. The wavelength of light that the erbium laser emits gently penetrates the skin, is readily absorbed by water, and reduces the extent of thermal damage created by laser treatment. This method is suitable for patients with mild to moderate facial wrinkles, scars and/or skin discolorations. More severe cases will achieve greater results with CO2 laser resurfacing.

How do I plan my facial resurfacing?

On your initial visit, your physician will review your health history and any daily medications you are taking. Individuals who have special conditions such as bleeding disorders, healing disorders, diabetes, or have had radiation therapy must disclose this information to their physician. If you are a smoker, you should quit for 1 month prior to treatment to minimize the risk of infection. In addition, it is prudent to quit smoking for 6 weeks following treatment to promote the healing process. Individuals considering facial resurfacing should not take Accutane, a strong acne medication, within 18 months of treatment and should make sure that their skin is free of active infections before treatment. You should be prepared to follow strict instructions that are provided by your surgeon to minimize potential risks and maximize the benefits of facial resurfacing. Finally, you will need to arrange for a friend or a spouse who can take you to and from the treatment facility and care for any small children who may need to be lifted since you should not do any bending, lifting or straining the first week following surgery.

How do I prepare for facial resurfacing?

If your facial resurfacing procedure requires general anesthesia, you must take several precautions prior to surgery. First, you will have to avoid eating and drinking after midnight on the day before surgery. This precaution ensures that your stomach is clear of digested foods that could potentially be aspirated into your lungs during induction of anesthesia. Since, you will have anesthetic medications administered throughout the case; you will remain groggy for several hours and will require a ride to and from the treatment center.

What results can I expect after facial resurfacing?

Most patients are extremely satisfied with the significant improvement in the quality of their skin and rejuvenated appearance. Patients benefit from smoother, more evenly colored, and brighter skin as a result of facial resurfacing treatment. Facial resurfacing results generally last for several years, varying upon each patient’s diligence to protect their skin from the sun and maintain a healthy lifestyle. Over time, natural facial movements and expressions will also cause wrinkles to reappear. Patients may require additional facial resurfacing procedures in the future to maintain their rejuvenated appearance.

Where will my facial resurfacing be performed?

Depending on the severity of the treatment and type of anesthesia required, facial resurfacing can be performed at a physician’s office-based facility, outpatient facility or at a hospital. If your case requires general anesthesia, it may be performed in an operating room that is part of a hospital institution or outpatient surgery center. Frequently, patients may be operated on in an in-house office based operating room, but it is of utmost importance for patients to make sure that a surgical accreditation body such as AAAASF accredits the office facility. Cases that do not require general anesthesia are usually performed at a physician’s office-based facility.

What type of anesthesia will be used for my facial resurfacing?

For small areas to be treated, patients are usually administered a local anesthetic that is sometimes combined with an oral sedative. For facial resurfacing of the entire face, patients are either administered intravenous sedation or general anesthesia.

What should I expect after facial resurfacing?

Recovering from anesthesia, patients will be wearing a soft head wrap around their head to minimize swelling after surgery. Patients usually experience mild swelling and skin redness for the first few days. Patients may also notice some bruising and feel that they have a “surprised look” due to the swelling, which temporarily elevates a patient’s eyebrows. Patients will use antibiotic ointments and/or wear occlusive dressings to retain moisture, prevent infection and promote the healing process. Most patients claim to feel mild to moderate discomfort after procedure due to sensations such as numbness, itching and/or tightness around the treated area. Appropriate amounts of antibiotics and pain medication are prescribed by your physician and you should only take pain medication as needed.

Patients are able to bathe immediately after surgery as long as they can keep their head dry. Patients should sleep with their head elevated and avoid bending, lifting or straining within the 1st week following treatment. Since there may be some crust over the treated areas in the first 10 days, patients will need to gently wash their skin several times a day to prevent infection. Patients can usually resume normal activities and return to work within 2 weeks after treatment. Your new skin may remain pink or red for 3 to 8 weeks following treatment and it may take several months to one full year for patients to fully recover achieve their desires results.

When will I be able to return to work following facial resurfacing?

Patients can usually return to work within 2 weeks after CO2 laser resurfacing. However, it is important for patients to continue wearing a strong sun block after treatment. Patients may also want to wait an additional week before returning to work if they are concerned with privacy because mild swelling may persist. Individuals undergoing erbium laser resurfacing usually have a shorter recovery time and may be able to return to work between 7 to 10 days after treatment.

Are there any side effects associated with facial resurfacing?

Side effects are events that may be experienced by patients as a result of your surgery and should not be considered adverse events. Our patients are counseled regarding these effects and if experienced they are tolerable and often temporary in duration.

1. Redness: Patients may experience redness for several weeks, or longer, depending on the size of the treated area and method of treatment. The redness will become pink and gradually lighten to your natural skin color over time.
2. Crusting: Immediately after treatment, the skin may appear red or pink and be covered with a fine layer of crust. The crusting usually subsides within 1 to 2 weeks and protective sun block should be worn at this time.
3. Mild swelling: Mild swelling may occur after treatment and usually subsides within a few days.

Are there any risks associated with facial resurfacing?

Risks are unwanted events that may occur during or following surgery. These events are recognized as “complications” but their occurrence is minimized by appropriate patient selection, proper surgical decision making, effective surgical technique, and thorough preoperative and postoperative patient management.

1. Infection: Infection may occur after treatment, but is generally avoided by rinsing the skin several times a day with cool tap water. Applying an ointment to the skin or using occlusive dressings to retain moisture in the skin also promotes healing and minimizes the risk of infection.
2. Irregular pigmentation: Some patients may experience hyper-pigmentation (darkening of the skin) or hypo-pigmentation (lightening of the skin) as a result of skin resurfacing. However, skin discoloration has treatments available. Skin discoloration after facial resurfacing may be permanent in some cases, especially when deep laser treatment is required.
3. Burns: Heat from the laser power may cause burns. To minimize the likelihood of burn injuries, patients should follow their physician’s special instructions, such as avoiding unsafe sun exposure before and after treatment.
4. Scarring: Although scarring may occur in some cases, the risk of scarring is very low for facial resurfacing procedures. Furthermore, the appearance of scars can be reduced with skin medication.