The skin of the face is very different from that of the body. Not only does the facial skin contain a greater number of pores, but the skin is thinner overall and tends to receive much more sun exposure than the rest of the body. Facial skin can also be very sensitive, making it prone to conditions like acne and rosacea.
Fortunately, cosmetic improvements in the facial skin are possible through various minimally-invasive procedures, including laser skin resurfacing treatments. Laser treatments are the gold standard in skin rejuvenation for their ability to transform aging or damaged skin. Dr. Allan Wulc of W Cosmetic Surgery is a board-certified eye and facial plastic surgeon specializing in skin care and treatments, as well as cosmetic surgery of the face. The doctor’s practice serves patients all over the greater Philadelphia, PA area who would like to improve the quality of their skin with a resurfacing procedure.
Our laser skin resurfacing gallery features patients whose treatment options included laser resurfacing using one or a combination of lasers.
*Each patient is unique and individual results may vary.
How Our Treatments Work
The term “laser” is actually an acronym for “light amplification by stimulated emission of radiation.” Lasers can improve the skin in a number of ways because they can be adjusted to emit different wavelengths of light. Laser treatments are used in a variety of medical applications, from tattoo removal to cutting tissues during surgery. In cosmetic treatments, lasers are most often used for permanent hair removal, lightening unwanted pigment in the skin (hyperpigmentation), and collagen remodeling, which has anti-aging effects.
When the heat from the laser penetrates through the surface of the skin, it encourages the skin to produce more collagen and elastin by activating the body’s natural healing responses. The heat creates micro-injuries below the skin, and in some cases, causes the deep layers of skin to contract and tighten. Ablative lasers, which offer more dramatic results, cause visible injuries to the upper layers of skin, which gradually heal over with fresh skin tissue. Once the skin has healed, it is refreshed and repaired, appearing more youthful and smooth. Resurfacing treatments can improve a range of skin concerns and produce skin rejuvenation results that often make patients look years younger.
Facial Skin Issues
Lasers are extremely versatile, allowing plastic surgeons to improve and rejuvenate the skin in many different ways. Facial skin issues such as sun damage, acne scars, fine lines, and other signs of aging can all be improved with resurfacing treatments. Here are some of the most common facial skin issues patients bring to Dr. Wulc for treatment with a resurfacing procedure.
Genetics cause some individuals to have increased oil production in their pores. This can lead to the look of oily skin and the formation of acne and enlarged pores. Acne forms when dead skin cells shed into the pore rather than away from the skin’s surface and off the face. The combination of oil and skin cells clogs the pores and leads to inflammation. Acne can be curbed with a specific type of laser and acne scars can be improved through similar treatments at different wavelengths.
Changes in hormones can lead to a range of issues that affect the look and feel of the skin. During puberty, surging hormones can cause frequent acne flare-ups. Women can experience breakouts and other issues during their menstrual cycle. Certain hormone levels are raised during pregnancy, which can cause irreversible hyperpigmentation (uneven patches of darker skin), known as melasma. Menopause in women and decreased hormone levels in men can also cause changes in the skin, like a decrease in collagen and elastin production.
Maturing skin can appear irregular in tone and texture, with discoloration and fine lines forming throughout the facial skin. Sun damage contributes to signs of aging in a number of ways. The UV rays penetrate to the deepest layer of skin, the dermis, where collagen and elastin are present. These two main support structures of the skin weaken as the result of repeated unprotected exposure. This breakdown of collagen and elastin can cause wrinkles to form prematurely or more extensively than they would during the natural aging process. Sun damage can also cause brown spots to appear on the skin that detracts from color uniformity.
Non-Ablative and Ablative Laser Technology
During a non-ablative laser skin resurfacing treatment, the practitioner operates a less invasive laser that results in less downtime because the skin is not ablated, or removed. Often known as a fractionated laser, thousands of microscopic areas are targeted during a single session. Other columns of skin are left unharmed, leading to a controlled injury pattern that is less visible than in ablative lasers. This non-aggressive laser treatment option will improve the look of uneven skin tone, mild sun damage, acne scars, and fine lines and wrinkles.
Ablative laser skin resurfacing creates more damage to the upper layers of skin, which are removed during the procedure. Although ablative lasers require more recovery time, ablative laser skin resurfacing will result in a more dramatic improvement. Ablative lasers are typically reserved for correcting major skin issues like deep wrinkles around the mouth, pitted scars, and very uneven pigment and texture.
In many cases, the laser operator will use a variety of wavelengths as well as a combination of non-ablative and ablative lasers to treat the face. Non-ablative lasers can be used to treat the skin after a simple topical numbing solution has been applied to the skin, whereas ablative resurfacing treatments are often performed after anesthetic injections and sedation, as needed. Non-ablative treatments are often performed in a private room at the W Cosmetic Surgery clinic in Philadelphia, while the ablative treatments take place in an operating suite in the facility. Either resurfacing procedure is performed in 15-60 minutes. During the session, the eyes will be covered by protective gear to ensure safety from the light. Patients should expect a longer recovery time after an ablative laser treatment due to the removal of the upper layer of the skin.
Following laser skin resurfacing, Dr. Wulc’s staff will place a cool compress on the treatment area and smooth an emollient product over the skin’s surface. This helps to protect the skin and begins the healing process. There may be redness and swelling present in the skin for several days or weeks.
Aftercare is important following any type of laser treatment, but the care required differs depending on the specific treatment performed. Ablative lasers remove the surface layers of skin, leaving the face with injuries that require proper care for optimal healing. While each patient will be provided with specific post-care instructions, the steps generally consist of compresses, gentle cleansing, and the application of recommended ointments or creams. The office may also recommend special types of skincare products or routines to use during a patient’s daily regimen.
Following an ablative procedure, patients will be scheduled for follow-up appointments to ensure proper healing. After the new base layer of skin cells has formed, a staff member will instruct patients to use a lighter cream on the skin. The formula is hypoallergenic and breathable, with pigments that restore the patient’s skin shade to their face. There will likely be some redness and irritation for a few to several days following non-ablative laser treatment, and up to a few weeks following an ablative resurfacing. Six weeks after a patient undergoes laser skin resurfacing, they can undergo a light-based treatment if necessary to curb residual redness.
Patients will be prescribed antibiotics and antiviral medications, depending on the type of resurfacing treatment. Prescription pain medication is not necessary and patients are recommended to take Tylenol® to control any discomfort. Patients will be encouraged to apply sunscreen to their treated skin daily and to avoid sun exposure to prevent hyperpigmentation.
Because this type of light therapy is so versatile, most people can benefit from undergoing a laser resurfacing procedure. The sessions are performed to improve skin quality, often resulting in patients appearing years younger. The skin color will appear more even with fewer imperfections, like scars, lesions, and heavily pigmented areas and brown spots. Those who would like to see a more youthful, vibrant version of themselves should consider laser treatments. Dr. Wulc will inform prospective patients of any limitations in specific cases. These limitations may prevent those with keloid-prone skin, sensitivity to anesthesia, or certain active skin conditions from undergoing the standard version of the procedure. He may make modifications to the treatment plan or recommend other types of skin rejuvenation intervention.
Yes, patients with dark skin can safely undergo modern laser skin resurfacing treatments, but they may be at greater risk for developing keloids or other types of scars. In scar-prone skin, Dr. Wulc may recommend a non-ablative laser, specific laser settings, or different treatment options.
There must be adequate healing between appointments, but patients are able to undergo multiple intensive laser sessions. Because single treatments are so transformative, it may be several months or years before a patient elects to receive additional laser treatments. No cosmetic surgery or treatment can stop aging altogether, so many patients choose to have more than one ablative laser treatment during their lifetime to look years younger.
Generally, lasers are used to treat the skin on the face, neck, chest, and hands for anti-aging and skin resurfacing purposes, as these areas tend to age more quickly than the rest of the body. Some practices may safely use the lasers off-label, but each circumstance will vary.
Will I see results right away?
No, resurfacing results will not be instantly visible because the skin will likely appear a reddish-pink color and slightly inflamed. Non-ablative results will be visible sooner than ablative resurfacing results, but they will not appear as dramatic. Because light therapy changes the skin at the cellular level, the technology will keep improving skin, but results may not be fully visible for several months.
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What are some different methods of skin rejuvenation?
Skin rejuvenation treatments are focused on improving the skin from the inside out. By creating medically-controlled damage to the skin, the body’s natural rejuvenation processes go into overdrive and form new, better-quality skin. In recent years, there have been a number of developments in non-surgical cosmetic treatments. Not every patient is a good candidate for laser skin resurfacing and may want to consider a different resurfacing procedure instead. These are some of the most popular alternatives.
Chemical peels are available in varying strengths to address different skin issues. Stronger acids will create a deeper peeling action, while mild peels can treat more superficial issues. After undergoing a chemical peel, patients will notice the upper layers of skin have been replaced by newly formed skin.
During microdermabrasion treatments, a handheld device is used to mechanically exfoliate the skin and reveal the healthier layers below. The buffing action removes imperfections of the skin for an improved complexion. The skin will appear healthier and smoother following the treatments. Microdermabrasion typically requires a series of treatments for best results.
During a microneedling treatment, tiny sterile needles penetrate the skin vertically, creating columns of controlled damage that the skin will work to repair, improving skin quality in the process. Because the microneedles enter the skin in a pre-defined pattern, there are areas that are left undamaged. This allows for minimal side effects while encouraging gradual changes to take place within the many layers of skin.
BBL or broadband light is pulsed against the skin to penetrate its layers and improve color and texture. The light is directed at problem areas and the practitioner presses a button to treat the particular area. BBL can be used on the face, neck, and chest.
What are the side effects of CO2 and erbium laser resurfacing?
Laser resurfacing can cause hyperpigmentation, scarring, and non-correction. Infections are fortunately very rare, but it is not uncommon to employ a healing emollient or ointment to the skin post laser that can cause a skin allergy that itches or burns and requires switching to a different emollient. A CO2 laser can cause hypopigmentation; this is much less common with erbium laser. It is our experience that co2 laser resurfacing is slightly more painful than erbium laser resurfacing.
CO2 lasers can also be used for cutting and we commonly might employ this laser for upper and lower eyelid blepharoplasty. Some studies show that the procedure is associated with less bruising. We recommend several types of makeup to conceal the redness and bruising that occurs after any surgery using laser resurfacing. These are discussed with you during your consultation.
Philadelphia’s Premier Facial Cosmetic Clinic – W Cosmetic Surgery
Dr. Allan Wulc, MD, FACS, is board certified by the ABMS board in Ophthalmology. Additionally, he is board certified in Facial Cosmetic Surgery by the American Board of Cosmetic Surgery, where he served as a trustee for six years. He is also board certified in plastic surgery by the American Board of Physician Specialists.
He is further trained in Oculoplastic Surgery, Orbital Surgery, and Cosmetic Surgery and a diplomate of the nationally recognized and highly exclusive American Society of Ophthalmic Plastic and Reconstructive Surgery and is a Fellow of the American Academy of Facial Plastic and Reconstructive Surgery, the American Academy of Cosmetic Surgery, and the American Academy of Surgeons.
Dr. Wulc specializes in minimally-invasive treatment options and surgeries and offers a variety of methods to help patients reach their aesthetic goals. The doctor has more than 25 years of experience and stays at the forefront of innovations in the field of facial plastics. Not only has the doctor developed his own surgical methods, but he has published numerous works to educate doctors and patients alike.
Contact W Cosmetic Surgery in Philadelphia, PA to schedule a laser skin resurfacing consultation with Dr. Wulc. Call (610) 828-8880, or complete our Contact Us form to communicate through email.