For Miglia, she couldn't be happier. "I had the procedure done two and a half weeks ago and I love it. The experience for me was not really painful at all. It was more like a really bad sun burn. My skin is smooth. The brown spots on my face are gone," she says. "It makes me feel much younger. It just feels good to look in the mirror."
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The procedure takes about 45 to 90 minutes. Patients will arrive about an hour in advance of their appointment. A topical anesthetic cream is applied to the area being treated and allowed to soak for in for about an hour.
Patients are then given tiny injections of lidocaine to additionally numb the most sensitive parts of the face.
To ensure wrinkles are eliminated as close to the eyes as possible, patients are given protective eye shields so the laser can be applied to the skin up to the eyelash line.
"Patients are generally treated in two passes. The first pass acts very deeply on the skin, working on deeper lines, atrophic scars and the like," Orringer says. "The second, more superficial pass, typically focuses more on blending skin tones and getting rid of sun spots and uneven pigmentation."
Recovery and results
While the immediate effects of laser treatment include redness, swelling and oozing of clear fluids called serum, initial healing essentially occurs within three to four days. The serum, which contains proteins that help the skin to heal, continues to seep out onto the surface of the skin periodically during the first couple of days as the microscopic holes begin to seal off. Orringer says by the third or fourth day there's essentially no wound care required other than applying a thick moisturizer. Redness gradually dissipates in about one or two weeks for most patients.
"Patients experience an immediate improvement during treatment associated with the laser heating their skin. The collagen contracts making the skin appear immediately tighter," Orringer says. "However, even better is the type of improvement related to collagen production which takes several weeks to a couple of months to fully appear. Patients will continue to see improvements in their skin for the first three to four months following treatment."
As with any surgical procedure or medical treatment, there are risks. For fractionated carbon dioxide laser treatment, Orringer says the risks are fairly small. "Concerns like infection and scarring or discoloration of the skin are certainly theoretical possibilities, and it is something that patients should always discuss with their treating physician," he says.