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Answer: you can proceed now at your leisure, best of luck. JG 7.23.10
Answer: it is true with the CO2 also but the deeper the laser, the longer the improvements will last.When I say remember, that relates to the pigmentation and not the wrinkles. As to the wrinkles reforming, there is nothing that can stop that because nothing will halt the aging process. New collagen can be formed but the aging process causes loss of collagen so the skin will age. Along with that, there will be small amounts of swelling for a while after any laser, and swelling will make wrinkles look better when in reality they are the same, just swollen and not able to be seen as easily. The laser does remove skin, but the amount of new collgaen that can be recreated will never be as much as what was there once, and the older you are the less robust the collgan creation can be, no matter what technique. All the best. JG 7.15.10
Answer: well, for starters, I guess you got some ablation if you have the waffle appearance at this time. I suggest using some hydroquinone 4% mixed with Retin-A 0.1% to help it fade, also total sunblock and seeing the place that performed it for you to get the prescriptions, I do not think it will go away on its own, but if treated, should not be permanent, funny about the IHOP though. JG 7.8.10
Answer: I feel Potrait is better as it treats all of the skin rather than leaving numerous skip spots untreated but the Portrait company went out of business and there are only a few of us that still have the tips to treat patients. It should be done after the cheeklift and neither one will replace a cheek lift, as to how many treatments wil be needed, it depends on how badly damaged the skin is. Best of luck. JG 7.1.10
Answer: after 4-6 weeks we use Retin-A and hydroquinone until healed to avoid hyperpigmentation and then we go the usual moisturizers and sunblock. JG 6.27.10
Answer: I suggest longer than 6 months, preferably 12 months or longer, all depends on how deep they go. Also, there is a law of diminshing returns, as you get older you will get less from the repeated treatments, no matter fractional or not, it is related to your skin`s ability to create new collagen. As to the limit on the number, the deeper they go, the fewer the number that can be done but there is no set number of treatments one can have as skin thickness varies from patient to patient. All the best. JG 6.24.10
Answer: personally I would go with the regular CO2 at this point, it was a light treatment, and yes, you had problems, but the skin should be healed enough I feel to proceed. Thinking that the Fractional laser is any safer in terms of time for the original treatment I think is not a real concern. I understand the desire to decrease risk, or at least think you are reducing risk with a fractional laser ( I don`t agree it reduces anything except the result), but I think ultimately you will require the regular CO2 when it is all said and done. All the best. JG 6.23.10
Answer: I would use a YAG for spot treatments rather than a Fraxel. JG 6.21.10
Answer: likely, if on the nose alone, about 7-10 days before make up can be applied to hide it, it will be red for a few weeks too. You can send the photos to drgarcia@lvcosmeticsurgery.com, if you would like. JG 6.8.10
Answer: it is hard for me to give very specific answers without seeing you, but a guess woudl be one or two CO2 laser treatments, more if they are a fractional or pixelated CO2 laser. As to the filler, it is an option for indented scars but is not permanent, there are longer lasting fillers but I suggest trying something like Restylane first as if it does nto work well it can be easily dissolved. In some cases the most expeditious option is to accept a scar and have the spot cut out and sutured closed, it is quicker and reliable in most cases, but does leave a permanent scar. JG 6.8.10
Answer: I think a CO2 laser would be best if you are going to try a laser. As to fillers, I suggest trying Restylane first. You might need both. All the best. JG 6.7.10
Answer: well, the honest truth I do not think very highly of any of them, lots of hype and little return for the investment. JG 6.3.10
Answer: yes, we do, after a CO2 laser I like the patients to stay for about 10 days so I can evaluate healing and making sure there are no infections or viral break outs. I always treat the patients with antiviral and antibiotics and Retin-A cream first, if you are going to have the procedure with us we should do as much before you come out here, otherwise an in person consultation and then the procedure at a differnt time would be best. JG 6.1.10
Answer: well, yes, if you never have a reset at a better level, you will look worse, better to get worse from a better point than build further aging on no improvement. The depressed scar in many if not all cases extends to the fat, that is why it is tethered. JG 6.1.10
Answer: more effective if done on spots, to be honest. Your own fat can be used, likely not too different than other fillers. The need for repeat treatments is because as the person ages, the skin gets looser and that makes the visibility of the scars re-appear. It is more for maintainence than progressive improvement as there will be a point at which no further improvement can be achieved. I would be happy to have you come here for a treatment but I think you can likely find someone that can do the treatment much closer and save you the costs of travel and hotel. Thnak you for the kind words too. JG 6.1.10
Answer: fillers are hard to get right, maybe a series of microdermabrasions is about the safest thing I can suggest at this point. JG 5.25.10
Answer: anything to make it look worse is rare, and should get better in time, I have not seen any cases of fat loss with a 1540 laser and that would be the only thing that could make it worse long term. Should be better in another 2-6 weeks. Not much you can do at this point except sit and wait I am afraid. Congratulations and best of luck with the wedding, hang in there for now. JG 5.25.10
Answer: I honestly cannot say because I would never use a CO2 laser that is fractionated as I think it skips too much area for it to be effective past the time interval of swelling. If I were to use a laser for acne scarring it would be a completely ablative CO2 laser, not pixelated or fractionated. sorry. JG 5.25.10
Answer: I think in Indian skin with those problems you will get little improvement with either the Fraxel ReStore or the IPL as they cannot be used too strongly. It is best to do the Accutane first to control the acne, wait 6-12 months for the skin to regain its ability to heal and then do the treatment. If you break out after the treatments then there will be new scars that will not have been improved with the treatment. JG 5.25.10
Answer: not common, should see the doctor to make sure it is not some type of bacterial or viral infection that needs treatment. If it is and is not treated it could affect the outcome, best of luck. JG 5.25.10
Answer: I suggest waiting until the skin regains its normal moisture and oilyness to allow it the best chance to heal with no scarring. The pricing for the treatments is set by the doctor so I cannot say why the difference. I would not use bi-polar or uni-polar rf for anything on the skin. It has been around for a long time and has been a resounding failure at living up to the claims. JG 5.25.10
Answer: yes, it might, but it could take time if the treatment was not too deep, with time and a litle sun exposure it might come back. JG 5.23.10
Answer: from what you are describing I think a more realistic time to fade wil be 3-4 weeks I am afriad. He might have gone deeper to get a better effect and that has made it go the way it has. All the best and hang in there. Also, thank you for the kind words of encouragement. JG 5.17.10
Answer: in most cases, what was going to repair itself after a laser will do so by 6 months I feel. I am afraid there is not much you can do to help nature along in this scenario. Once all the healing that is going to happen has occured, I feel Sculptra might be a good option for the refilling of the loss of the facial fat. Best of luck. JG 5.16.10
Answer: the laser has that temporary effect until the new skin comes to the surface, part of the procedure and expected. When one is trying to stimulate new collagen production you need to go through a destructive process first, for lack of a better word. As to my opposition, it is because the claims made are over inflated and they also market it as essentially risk free and I have seen and heard about too many disasters from non-ablative therapies to agree with that. They are feeding on the patients` fears and desires for a profit. Don`t get me wrong, we need to make a profit,but you should give the patient something significant in return.Some patients are quite happy with the results, but then one needs to ask, were their expectations so low that anything would have made them happy. JG 5.12.10
Answer: it is the slow damage that occurs with the suntan that is worse, the quick burst from a laser vaporizes the skin and causes no long term damage to the DNA of the skin cells, not a dumb question at all. JG 5.11.10
Answer: the Palomar 1540 is pixelated and is abalative in smal spots, not entirely surface abalative though, essentially the same as what you had. Calling the Polamar 1540 non-ablative is a lie, it is used for marketing only because it creates numerous microbeams or holes, read ablative here, that go into the skin with untreated areas around them. JG 5.5.10
Answer: it is essentially the same. As to what happened, if it was done too deeply or at too high a setting it could have burned the skin slightly causing the textural changes too. I would proceed with much apprehension. JG 5.5.10
Answer: not much help I am afraid, and Fraxel and IPL will likely not help and could make it worse, just think about what those machines are marketed for, treatemnt of hyperpigmentation and spots. JG 5.5.10
Answer: should be OK. JG 5.4.10
Answer: we use Retin-A and hydroquinoe before a CO2 laser to prepare the skin and lessen the risk of hyperpigmentation. Julio Garcia MD 4.19.10
Answer: although it can happen, it is not supposed to happen, it all depends on what energy levels were used. That striping in most cases falls off in a few days, but it is not needed for the good effects to be seen. I cannot say whether it bodes ill or good as I am not sure of the settings used, but as long as the skin did not burn and flake off it is likely going to be OK. Best of luck. JG 4.16.10
Answer: it is likely from the lasr and the controled burn, short of more laser to try to smooth it out I am afraid there is not much to offer, sorry. JG 4.16.10
Answer: if they went deeply, it ca take months as essentially, it is a burn, or frost bite if you will. I think hydroquinone will likely make it worse, as will Retin-A, best to let it heal, you can use some copper peptide cream or aloe if you desire. I think IPL will likely just aggravate it and make it not heal any faster. JG 4.11.10
Answer: probabaly, for a short period of time, and then he will need to sell you another series of treatments. JG 4.11.10
Answer: all normal, the petechia can occur for the first 6 months as the skin is thin and can tear from minimal shearing, even from your pillow case, that will also get better in time as the skin continues to heal. The healing period will take at least 6 months. Best of luck. JG 4.11.10
Answer: it can be repeated, yes. Tumescent liposuction will only remove fat, if you are lucky enough to have good skin quality, the skin should shrink back down well, but removing fat will not, in and of itself, tighten the skin. If the skin sags, the only solution is to have the skin cut out with the resultant scars. JG 4.9.10
Answer: a deep one under general anesthesia is $4000. JG 4.5.10
Answer: I think they are not as good as Portrait as there are millions of skip areas, it allows the skin to heal faster, but you are only treating a small percentage of the skin. The bigger drawback with the portrait is the healing time I feel. JG 4.4.10
Answer: stick with just the peptie and hang in there for a bit, all the best. JG 3.29.10
Answer: I think any procedure like that will just slow the healing, taking Vitamin C orally is OK, but topically, it is just an acid. It is OK for intact skin but not on recently injured skin like yours I am afraid. I understand your frustration, but just hang in there a little longer. JG 3.28.10
Answer: it is possible if a too aggressive treatment is done. In some small number of cases injections of kenalog or 5FU will help, there are also cases where in a short term fillers like Restylane will support the lid until it softens, but I think the filler is likely not an option in your case. If the injections of kenalog does not help, you will likely need a skin graft procedure. I am not sure why the other doctors did not mention the possibility, it is rare, but can happen. All the best. JG 3.28.10
Answer: I suggest letting time heal it and avoiding further irritation that would increase risks of hyperpigmentation, got to give it time is all. JG 3.22.10
Answer: the genuine dermaroller is not as effective as a laser. As to the lasers, the CO2 is strongest, the erbium is less so, and the YAG is used mostly for discolorations of the skin and not skin tightening. JG 3.15.10
Answer: I do nto think chemical peels will help long term. I think in most cases the scars need to be undermined with a process called subcision and then lasered, but it woudl need a traditional CO2 laser for the difference to be significant. I do not use nor perform pixleated laser treatments as I am not a fan. JG 3.15.10
Answer: I stil have a few heads left and am doing it on select patients, I am not a fan of the other lesser invasive pixleated lasers enough to recommend them, especailly for acne scarring, for that I almsot always do a CO2 laser resurfacing to make it worth the treatment. JG 3.14.10
Answer: yes, still normal, hang in there for a bit more. JG 3.10.10
Answer: I lived in Chicago for 27 years so I know a little about the cold, but not Canada cold.All the best. JG 3.7.10
Answer: yes, I am sorry, it can be normal. JG 3.7.10
Answer: 6 month should be OK to proceed. All the best. JG 3.5.10
Answer: well, just be sure they treat you with bleaching creams before and after to avoid post-inflammatory hyperpigmentation and understand that since they cannot go too deeply for safety reasosn, the results are not going to be super dramatic. JG 3.4.10
Answer: well, possibly more risky but lots stronger and more effective. JG 2.28.10
Answer: lasers become effective only when used in a narrow band, some machines offer multiple wavelengths, but when it comes to the use, it needs to be focused narrowly. JG JG 2.23.10o
Answer: I would not perform a CO2 laser on Asian skin. In view that you have already tried an erbium and had disappointing results, and because I think that is already more aggressive than anything I would suggest, I am afraid I really do not have anything effective and safe that I can recommend, I am sorry. JG 2.17.10
Answer: with CO2 that is very normal yes. Patience is about all I suggest now, anything else can aggravate the skin at this point, but I think the next two weeks will surprise you as to the degree of fading.All the best and congrats on the Canadian Gold Medal at the Winter Games!JG 2.16.10
Answer: no, it likely needs to be repaired surgically for it to be even, skin alone will likely not do help and more likely would make it worse. It can be due to normal aging or from the previous lower eyelid surgery. JG 2.14.10
Answer: well, in some small number of cases, it can be very long lasting. I think I would suggest some YAG laser treatmetns to fade it, that is how we handle those cases. All the best and thnak you for the flattering words. JG 2.14.10
Answer: should be OK by then, best of luck and keep the fires burning! JG 2.11.10
Answer: it is the reaction of the skin due to an injury where it gets darker in order to protect itself from further damage, it usually can get lighter some on its own but in most cases needs medical treatments with creams. JG 2.10.10
Answer: all depends on how deep they went, the IPL can likely be done in 4 weeks and the sunblock in 3. JG 2.10.10
Answer: Alexandrite or a YAG is an option, it is a risk with any laser resurfacing and it why we use sunblock both inside and out until totally healed. It more likely did not expose damage that was already there, more likely it is something called post-inflammatory hyperpigmentation. We alwyas pretreat with hydroquinone before any resurfacing to limit the potential of it happening. JG 2.7.10
Answer: well, it will not work as well as the CO2 did for you in the past, but I guess something is better than nothing. I think in general it is safe, yes.JG 2.6.10
Answer: not a fan of the new and improved oen either. Funny how they promoted all of the earlier versions as the best, yet they seem to always have a need to make it better, ever wonder why they need to do that if the one before was so great. JG 2.3.10
Answer: stay warm and get some rest! JG 2.2.10
Answer: they would be similar to any other time you get an infection, redness, a pimple or a bleb that has pus like material.The vinegar is used to dislodge the dead skin off the healthy healing skin below it, prolonged and extended use would cause skin dryness, yes, but you will only be using it for a few days JG 2.2.10
Answer: for 1-2 minutes and 3-4 times per day. Over the entire face. JG 2.2.10
Answer: it is warm and no, it is not too late. Best of lcuk and get some sleep. JG 2.2.10
Answer: no, it should not scar, you can take a little water and put a teaspoon of vinegar in about 16 oz and then use that to soak a wash cloth, lay it on the area, and that will help loosesn the crusts over the areas so they fall off easier on their own. You need to always wipe the ointment off totally before applying more over the area. I think the medications are appropriate, just hang in there, it wil heal in time. JG 2.1.10
Answer: yes, all still normal. JG 1.31.10
Answer: no, let it heal and it will get better on its own. I would suggest trying not to force it off. Just follow up with Dr Mon, all sounds normal, best of luck. JG 1.31.10
Answer: 1)yes. 2) impossible to say, maybe 2-5 years. 3) yes. 4) induction of scarring into the dermis. 5) good, maybe 2 years. 6)no. 7) you are incorrect as you are saying it was permanent but now it is less, it lasted because you were younger and as you age the length of time of correction will be less. 8) safe and it thickens the derms. 9)not at the present time. JG 1.28.10
Answer: most of the improvement will be there by 6 months, the last 20-25% will be a year. Massage will not help the depressed area, sorry. JG 1.25.10
Answer: might suggest a YAG laser to help them fade some. It will likely fade but any sun exposure will make it come back in time, and don`t forget the sunblock all the time, best of luck. JG 1.25.10
Answer: well, this will get into a matter of religion, because if I assume what he is saying is correct, then Feather Touch will give you 100%, but I believe since I think the Active Fx will likely give you at most 20-30% after 6 months I think the Feeather Touch will give you about 50% after 6 months. JG 1.25.10
Answer: red splothces can turn into hyperpigmentation, but it likely is just a deep burn, the brown should have occured by now if it were to happen. I suggest you see a doctor in order to prevent permanent scarring as things should be healed by now with that technology, and report the person to the local medical board or practicing medicine without a license. JG 1.24.10
Answer: correct, not a fan. JG 1.22.10
Answer: reasonable one to use, best of luck. JG 1.21.10
Answer: well, the face will be more red but more but more importantly, if you sweat, the sweat can plug the pores that are still healing. JG 1.21.10
Answer: well, safety is dependent on the energy setting that is used, but it is likely safe. Best of luck. JG 1.21.10
Answer: I would start with a Retin-A and hydroquinone regimen and then possible a light laser peel, but the lines will progress with aging. JG 1.18.10
Answer: with a CO2 laser it is not anything to worry about. Best of luck. JG 1.13.10
Answer: I woudl use a regular CO2 laser, not a dot CO2 with the understanding that, even with that, the effects on the eyes will go away in likely 18 montsh and around the lips in about 24-36 months, sorry. Thanks for the kind words too. JG 1.13.10
Answer: I think all of those will give relatively nice results for the sun damage, but less for the wrinkles, especialy on the upper lip. The upper lids will look better for a bit but will not last too long either, I do think that healing is quick and downtime is minimal, but there is always a trade off or those things. JG 1.13.10
Answer: sorry but I do not have that information. JG 1.13.10
Answer: it can but a mild session will likley not give anyting signficant, maybe just a more even skin color. JG 1.13.10
Answer: I would wait 2-3 weeks fot the Botox and 6 weeks for a filler.JG 1.12.10
Answer: they should be blending in by now, make sure you are avoiding sun and also any creams that have any acid compounds that can irritate the skin and aggravate the redness, also, of course, see your doctor to make sure there is nothing else going on that I cannot see. Retin-A can aggravate the redness so I would hold off until that has all faded. It sounds like it was more of a technical issue with a different scanner, compared ot the older procedure. Experience can help though. Best of luck. JG 1.11.10
Answer: if it was deep we ask them to wait three weeks. JG 1.11.10
Answer: I stil have some heads that I have been able to but from other doctors, a light CO2 is pretty close to the effect, maybe a little more down time though. JG 1.10.10
Answer: it could be cream and it could be swelling, but I think using corneal shields with that type of laser is important. JG 1.10.10
Answer: I am sorry, but it is hard to say, sounds like burns that are not healing, injecting steroids directly into the streak might help but run the risk of tissue atrophy below the skin. JG 1.9.10
Answer: it can be done, but I would never just treat the wrinkles alone, the surrounding areas also need to be treated to get the wrinkles to soften, lasers do not work like fillers. I suggest doing the entire face. Best of luck. JG 1.7.10
Answer: that can happen from the temporary swelling that can occur, it usually goes down in a few days. Keeping your head elevated, minimizing salt intake and ice all help. Best of luck. JG 12.31.09
Answer: should be OK to do. Happy New Year to you too. JG 12.29.09
Answer: well, hard to say without seeing you but it might be a CO2 totally ablative laser that you ae looking for, best of luck. JG 12.28.09
Answer: lasers, chemical peels and Retin-A can be used. Merry Christmas and a Prosperous New Year. JG 12.22.09
Answer: it is part of the normal healing and the ointments needed will make it worse for a little, but will get better.Crepey skin is just fine lines with less elasticity, like cigarette paper. As the skin heals all of that will get better. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.21.09
Answer: I like CO2 laser, just not a fan of the fractional ones as I feel the degree of improvement is not great. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.21.09
Answer: with the use of sunblock, Retin-A and Hydroquinone it might take 6-12 weeks, all depends on how high the energy was on the laser. I guess you are now seeing that the risks those docs did not like for the full CO2 are still there for the one they felt was safer. I would also never have done a laser resurfacing on your neck or chest due to what you are seeing and the high potential of scarring. I have never seen any correlation between PIH and effectivenss I am afraid. Just do the above thinsg and in the vast majority of the time it will get better, gotta hang in there for a bit though. Thank you for the kind words too. Merry Christmas, Happy Channukah and Happy New Year. JG 12.17.09
Answer: it is safe and most likely will not affect the filler in any way. Merry Christmas, Happy Channukah and Happy New Year. JG 12.17.09
Answer: I would not try anything for at least another 3 months. Retin-A would never cause that to occur. Give it time and do not do anything for a while. JG 12.12.09
Answer: no benefit from massaging with lasers, best of luck. JG 12.10.09
Answer: I think it is possible to reepat the CO2 laser there, all the best. JG 12.9.09
Answer: I will be honest, I have never seen that happen after a CO2 laser and do not see how the skin resurfacing would cause that. It can certainly happen when the air is dry though. JG 12.7.09
Answer: I am sory bvut it is nearly impossible to tell as it all depends on the individual`s skin. I would guesstimate that it would be about 10 days or so. JG 12.3.09
Answer: I normally suggest every 4-6 weeks in the summer and a little less in the winter. All the best. JG 12.3.09
Answer: oops, sorry, Vinegar. As to typing fast, luckily, yes, I do. JG 12.2.09
Answer: it is from the ointments causing the pores to plug, not uncommon and does not continue after the skin is healed. I suggest a teaspoon in 2 cups of water and soaking a cloth on your face with that solution and they will open up. In most cases, as the skin heals, all the pimples go away, even with nothing being done. Best of luck. JG 12.2.09
Answer: the Bio-restorative cream for what ails you. JG 12.1.09
Answer: redness will likely not get better with oral or topical steroids, the skin has essentially been burned and it needs to heal, it will take time, cold compresses and avoiding spicy foods should help, but it is mostly a time issue. I have never seen that type pf redness become permanent but in totally ablative cases I have seen the redness last for 6 weeks or more and then the pinkness might last for 4-6 months. 6 weeks is when I see patients turn the corner with regular CO2 laser resurfacing. I would hold off one the hydroquinone until a little more healed as it will irritate the skin and cause delay in the resolution fo the redness, just stick with the sunblock. Might want to try Neocutis products, they have helped me on many occasions with such issues. Hang in there, thank you for the kind words and I wish you the best. JG 12.1.09
Answer: it almost always heals unevenly. The red stirpes are not always hyperpigmentation, that is usually brown. I would use sunblock and see your doctor to make sure nothing like hydroquinone is needed in addition. Hang in there. JG 11.29.09
Answer: I cannot say that a series of fractional lasers will ever equal a totally ablative CO2. I think the totlaly ablative is far superior. JG 11.29.09
Answer: Oil of Olay, Cetaphil are good OTC. JG 11.29.09
Answer: well, fillers will last a few months and in olive complected skin, lasers can be risky in terms of pigmentation problems, may want to see someone for possible fillers and in addition Dysport or Botox. JG 11.24.09
Answer: it can take 10-14 days, your doctor could try giving you some oral steroids to help too, we use them prophylactically on our deep lasers. JG 11.23.09
Answer: I would recommend it but expect about 18-24 months if done as a totally ablative CO2 and less if fractional. Recovery will be about 10-14 days before make up will hide it. JG 11.23.09
Answer: I find fillers very disappointing for acne scarring in general and the laser I typically use is a totally ablataive CO2 resurfacing laser. JG 11.19.09
Answer: better skin tightening by comparison but will not help shrink the pores and it will be harder now due to the previous dermabrasion as the skin has some additional scarring from that. Sorry. JG 11.19.09
Answer: what I said is that it will not improve dilated blood vessels, it will never make them better.In some cases it can make the dilated blood vessles worse in terms of makeing more of them visisble. If you are trying to correct dialted blood vessels then the CO2 laser is not for you, if you are trying to improve agng skin it is the best choice but it can make the dilated blood vessels worse. There is no one procedure that will correct all of the symptoms of aged skin, they can be treated in sequence though, CO2 first for the aging and then a VBeam for the dilated blood vessels. JG 11.13.09
Answer: the skin has to be healed so I cannot say without seeing you, sorry. JG 11.12.09
Answer: that is normal and does not mean you have developed scars, too early for that. The itching and redness are very normal at this point also. The same occurred long ago with the previous laser, but with the bandages on, you did not see it all happen. I would not start the Retin-A until your doctor tells you to, likely not for at least 4-6 weeks. Best of luck. JG 11.12.09
Answer: I do not feel they will do much of anything. JG 11.11.09
Answer: well, if you do you can break out with herpes over the laser areas so I suggest staying on it until the skin is healed, I think it is something else besides the acyclovir though. JG 11.10.09
Answer: yes. JG 11.9.09
Answer: it is normal, just plugged pores that will open up in time, make sure you see your doctor for follow up, JG 11.8.09
Answer: yes, that is where the percentage comes from. I think the peels and fillers are a good idea and as to the lip lines, you need to purse your lips as little as possible, so no smokng, no drinking out of straws or sports bottles, nothing like that. Best of luck. JG 11.7.09
Answer: I use a CO2 laser, but not in a fractional way. It is about 3 days downtime, and then beautiful skin does emerge and then in a few weeks it is all gone.Sorry. For the non-believers in the audience, ask the doctor to show you a picture 6 months after a series of fractional CO2 lasers and compare it to the before, I think you will find it very educational. JG 11.6.09
Answer: it is mostly for dyschromias, the skin texture effect is mild and short lived. As to the CO2, it will aggravate the redness, even if it is a fractional CO2. All the best. JG 11.6.09
Answer: Well,although I feel a totally abalative is superior to a fractional or pixelated laser, and I feel a CO2 laser is beter than an Erbium laser, I do not feel a totlaly ablative Erbium will ever give anything close, at least in the long term, to a CO2. The reason is the Erbium generates no heat while the CO2 does. That is the diference that makes the CO2 better as the heat causes shrinking of the collagen causing a significantly greater degree of tightening. JG 11.4.09
Answer: likely enough, yes. JG 11.1.09
Answer: there should be no problems with the fillers and the laser. Best of luck. JG 11.1.09
Answer: I would still see him and the vinegar is not used as much in the CO2 as it heals differently, the effects of the erbium will likely never be close to the CO2. JG 10.30.09
Answer: I still recommend him and Aquaphor can be used and is a good alternative, the Erbium and CO2 will heal very differently and I think the CO2 will always give better longer lasting resutls. JG 11.1.09
Answer: hold off and wait. I would be happy to look at pictures for you, you can send them to drgarcia@lvcosmeticsurgery.com, please send straight on, three quarter views and profiles, both smiling and not. I apprecaite your kinds words and I am humbled. JG 10.30.09
Answer: I think it can be effective but since it will not cure it, I find it to be a bit too aggressive of an approach. Not much will treat the hypopigmentation, but an IPL or a YAG laser will remove the sun damage from the surrounding area so the difference is less visible. Best of luck. JG 10.26.09
Answer: I have not seen the hair loss be permanent, it does take time though, could try some Rogaine to help it along a bit though. Thanks for visiting. JG 10.26.09
Answer: we typiclaly put corneal shields over the eye when doing that so it should not be a problem, all the best and thanks for the kind words. JG 10.25.09
Answer: not a believer, sorry. If what you need is a very small improvement, then it might be OK. JG 10.25.09
Answer: typically lasers, will not make that change apparent because the degree of tightness is not as much as what surgery can accomplish. There will be less tightening with fractionated technology, yes. The fat lss stories are really from radiofrequency treatments that are at times combined with minimal ablative lasers to try to make two minimally effective treatments appear better, but I remain unconvinced. I have not seen legitimate fat loss from an IPL unless there was a deep burn of the skin. Lasers will improve mostly just the fine tiny lines and not shrink skin enough to simulate a facelift, they compliment one another, not replace. JG 10.23.09
Answer: yes, I stil have a few heads in my possesion. JG 10.22.09
Answer: well, to be honest, if the scar was raised, it was raised because it already had too much collagen so there is a strong possibility that in a few months it will look absolutely the same, the use of a fractionated laser to correct that was more wishful thinking than science. JG 10.16.09
Answer: I am unimpressed. JG 10.9.09
Answer: buy it here, we do not sell it on our site, sorry. JG 10.3.09 http://skincarerx.com/neova.html?gclid=CPzDyoryo50CFSMNDQodnGqW1w
Answer: I would start with Retin-A and hydroquinone and then maybe progress to a light chemical peel or a YAG laser. And always use Sunblock when outside or under florescent lights. JG 9.29.09
Answer: I would not use it. JG 9.28.09
Answer: we personally go rigth to the day of resurfacing with the Retin-A. We also do not use bandages, just our ointments and leave it open so you can monitor for the very rare infection. Best of luck. JG 9.21.09
Answer: no way to really say as there are so many different fractional lasers out there in terms of number of pixels, the energy source, the amount of energy, there is no clear conversion. I think a fractional laser, no matter what the source, CO2 or Erbium goes counter to an improvement on a burn scar, at least long term. Understand that a laser, especially Erbium or CO2 is a controlled depth burn, how can a new burn help an old burn? It might look better while healing and still swollen, but not long term. A chemical peel would do the same in terms of not improving it. I would not do either one to a burn. JG 9.21.09
Answer: no, you get a fraction of the improvement. No way to tell how many fractional treatemtns would equal one totally ablative one.JG 9.17.09
Answer: I think a YAG will not help the depressed acne scars, and it will work for the disoclorations, but only after a series of sessions. JG 9.15.09
Answer: well, considering that no matter what laser you use they will all come back in time, I suggest having one that does not cost you too much. JG 9.11.09
Answer: telangiectasisas are small superficial broken blood vessels in the skin, they can appear from lasers, from sun exposure, from many skin treatments like microdermabrasions, from normal aging, genetics, acne, rosacea, lots of reasons. The pigment changes can be significantly reduced by using lesser energy so the CO2 does not go too deeply to damage the melanin cells. I do not think the dot will cause fat loss in the face though. The fat loss has been reported only with radio-frequency machines like Thermage. I know of no real lasers that have caused facial fat loss. The Erbium, especailly if done in a pixelated fashion takes a very weak skin tightening laser and makes it even less effective by the fractionation. You are right about the post laser swelling showing the degree of improvement. I think showing laser results at anything less than one year is disingenious. If I thought the dot laser worked I would have bought one long ago, it is easy to use, heals quickly, benefits from patients wanting short healing tiem, but fails to deliver a worthwhile return on investment. JG 9.1.09
Answer: the Totla FX is stil a fractionated laser or pixelated laser, it just went from using the erbium to the CO2 laser to try to improve its effectiveness.It limits the effects of the CO2 by using fractionated technology. I have seen severe complications including visible scarring and have also read about them in the laser literature when fractionated CO2 lasers have been used. There is no laser that is 100% safe. I remain not a fan of the Total FX or any fractionated laser. JG 8.31.09
Answer: there have been anecdotal reports but no one can say whether it was the Accutane or the birth control method that was used while on the Accutane that caused problems. JG 8.30.09
Answer: I think it would be worth using, start a couple of days before and continue until swelling and bruising has gone. Sinech is a good brand. JG 8.30.09
Answer: yes, I think the results will be much more dramatic and worth it. JG 8.30.09
Answer: any resurfacing treatment can cause scarring as you allude to,from chemical peels to fractionated lasers and the Portrait. Done in an appropriate manner, the risks of that are quire small though. I think one needs to always be careful with blogs though as people with positive experiences rarely post anything but those with bad experiences usually do, so the impression you get is soemwhat biased. Done too weakly the results can be disappointing as they are very mild too. In general, the patients I have treated have been quite happy, but I make realistic claims and do not hype things past what is possible on a routine basis. JG 8.17.09
Answer: it depends on what you are trying to improve, if you are looking for the redness, I like a YAG laser. I do not think a Fraxel will do much. JG 8.16.09
Answer: Retin-A and hydroquinone is all I would suggest. JG 8.13.09
Answer: I think most likely the effect you saw after the first treatment was due to swelling pushing the veins lower, collapsing the veins with lasers is not a very reliable thing and I do not recommend it. Usually I use fillers like Restylane to plump the skin and hide the darkness and the veins. JG 8.13.09
Answer: the nose skin does tend to fade faster in terms of the redness compared to the cheeks so it might be your best option. JG 8.13.09
Answer: if it is just the perioral, then I think that is OK, a good block with local anesthesia should work well in that area, but not on the entire face. JG 8.5.09
Answer: might try an IPL or a YAg laserfor the redness, as to a recourse against the clininc, short of filing a medical malpractice suit, there are really not many options I am afraid, sorry to hear about all the issues.I wish you the best. JG 8.5.09
Answer: well, I understand wanting to do it under local, but CO2 is not erbium. I NEVEr do a CO2 laser unless it is under general if I am treating the whole face. It is not a matter of the side effects, it is if the local is not enough, then they will not be able to do the procedure as it should be done, and if you move due to the pain and the laser hits something it should not, then it is not good either. I know Dr Gregory and you are in excellent hands. JG 8.4.09
Answer: unpredictable depth as the variables are too great, you can end up having skip area, areas that were treated too deepluy, and scarring.I feel CO2 laser is much better, yes. JG 8.2.09
Answer: the softening lasts a few months, correct, that is why they choose the word soften, since they can always fall back on that, what defines a softer wrinkle, who knows. All the best. JG 7.31.09
Answer: just tell then you do not want a fractionated or pixelated treatment and that you want total surface ablation. The laser will help the fine lines around the mouth but likely not much for the marionette lines as they are there due to sagging cheek tissue that no laser will significantly improve for very long, you need surgery for that. JG 7.30.09
Answer: could be long standing, suggest adding Retin-A to the hydroquinone for better penetration, best of luck. JG 7.29.09
Answer: that is essentially the old fashioned CO2 laser, as long as the pattern is set correctly without skip ar eas. I had a Sharplan and a Lumenis CO2 laser, no difference. JG 7.29.09
Answer: no way to tell without knowing which Sciton laser was used the energy settings and the numbers of passes, but likley will be healed in 2-4 weeks. JG 7.29.09
Answer: I would not suggest you do it unless you have money to burn. I think the dot laser effects will be short lived too. If you have volume loss, you will continue to need fillers, yes. Wish I had better news for you. JG 7.29.09
Answer: well, the doctor can make the high energy anything between 3-4 joules so there is no way I can answer that question, but 2 passes at 4 joules would be pretty close to 150 microns I would guess. As to your second question, that is something the doctor needs to know, not you. JG 7.26.09
Answer: if the erbium is totlaly ablative, I would chose that, if not, either one. JG 7.24.09
Answer: I think lasers might help with skin discolorations and for a short time for fine lines, but that improvement is short lived as lasers cannot be done deeply on the neck for fear of scarring. It will not tighten loose skin. JG 7.19.09
Answer: no, it helps only fine lines and not bands. JG 7.19.09
Answer: all traditional CO2 laser, yes. JG 7.12.09
Answer: all hype, it will create more collagen and skin tightening but no effect on the cupid`s bow. JG 7.12.09
Answer: it is true, I still have some tips and am still doing the procedure in my office, the hope is someone buys the company and starts making the tips again. JG 7.7.09
Answer: I would save your money. Sorry. JG 7.7.09
Answer: I personally do not think the lasers will do anything long term, while swollen it will look better as the swelling makes the veins harder to see is all. There is nothing permanent to remove those veins I am afraid, sorry. JG 7.2.09
Answer: well, if it worked on you I think it might be a good option, although I will say that lasers for large blue veins on the lower eyelids does not work in the majority of patients, but no need to argue with success on an individual basis. I would keep it up when you can do it. JG 7.2.09
Answer: VBeam or YAG Lasers. JG 6.24.09
Answer: mild to no effect I feel. In your case I do not think it will help at all as the issue is laser related.Sorry. JG 6.24.09
Answer: the company closed, I stil have a few tips and am stil treating patients, we are awaiting a company to produce more tips in the future. I think the next best thing is a light CO2 laser. JG 6.23.09
Answer: I think the peel will do nothing for the fine lines and might aggravate the capillaries that were improved with the IPL. I would likely do the IPL alone. JG 6.9.09
Answer: 3-6 months, maybe. JG 6.8.09
Answer: it is very mild so it might be enough for your case. JG 6.8.09
Answer: the peri-oral region can be done alone, in some people with lots of sun damage on the entire face we like to do the whole face so there is more even healing, but since the dot laser is so weak, doing the area around the mouth alone is certainly commonly done. Gald you took my advice about the Botox too. Best of luck. JG 6.5.09
Answer: I am sorry to hear about your trials and tribulations, I think you are in a difficult spot. I think the TriLuma cream would help with dark discoloration but not with redenees and due to its irritating factor, will make the redness worse. I think a VBeam laser or a YAG would help fade the redness with low risk of developing post-inflammatory hyperpigmentation. As the redness abates the darkenss should also get better too. I wish you the best. JG 6.3.09
Answer: no, it will grow in time. JG 6.1.09
Answer: I think it might improve the texture to a mild degree and also the sun damage if it is light and recent but will do ntohing for the pores past a few weeks. Neither will the CO2 laser. JG 5.30.9
Answer: sounds good. JG 5.26.09
Answer: much weaker than the traditional totally ablative CO2, I am not a fan, except maybe for recent sun spots. JG 5.26.09
Answer: Retin-A is your best and least expensive option. JG 5.25.09
Answer: it is a very light Rhytec Portrait session. Hard to say what would be best without seeing you, medium CO2 migth be best though. JG 5.23.09
Answer: CO2 laser. JG 5.23.09
Answer: I prefer to do a single deep one, it is more effective. JG 5.18.09
Answer: by Sciton, an Erbium laser used to peel skin, I am not a fan. JG 5.17.09
Answer: I am not a believer in Thermage but it leaves the skin intact and tries to rely on deep heat being delivered beneath the skin to cause tightening. The CO2 is the gold standard but does remove the skin in order to create new collagen. JG 5.17.09
Answer: The plasma laser or Rhytec I think is a good option for milder skin ablation, less down time than the CO2. The Derma-K combines CO2 with Erbium and I think adding the Erbium adds little positive in terms of results or healing times. I also want you to understand since none of the techniques mentioned stop the aging process, in time, the appearance will return to its previous state. JG 5.17.09
Answer: damage to the melaoncytes of the skin which give the skin its color can take time to show. Some sun exposure might help, but you would need to keep the other areas covered with sunblock and expose only the upper lip to the sun to see if it could get better. JG 5.17.09
Answer: I would wait 3 months but do not expect much from the Ellipse as fractioanl lasers in general show little improvement and only for a short period of time. JG 5.14.09
Answer: yes. JG 5.14.09
Answer: the CO2 is only for fine lines so it will not help, you likely need surgery to remove the fat pocket. JG 5.13.09
Answer: I am not a fan, sorry. JG 5.13.09
Answer: no, becasue the body`s ability to create new collagen and elastin starts to peter out and the skin degenerates even if you avoid the sun, doing those things will slow the progression down but not stop it. You would always be better than if you never had it done, but the wrinkles would not stay away forever. JG 5.5.09
Answer: in most cases, 18-36 months, depends on the quality of the skin and how deep the laser is performed to. JG 4.30.09
Answer: it will help, yes. I think the improvement under the eyes might be 3-5 years, depends on your skin and the amount of damage, but phenol peels have risks, like loss of pigmentation. JG 4.30.09
Answer: I think you will likely be disappointed with both after a few months once the swelling goes down. JG 4.29.09
Answer: removing the epidermis will only give you an improvement for a few days and there are less expensive and safer ways to remove the epidermis alone, microdermabrasion, glycolic acids peels for example. For there to be anything lasting you need to stimulate the dermis and the basal layers to create new collagen. I think going into the papillary dermis is needed to smooth fine lines but lasers really do not effectively tighten skin like a facelift would, it is a fine line treatment. JG 4.29.09
Answer: it is permanent only in rare cases of scarring, it goes away as soon as the skin has healed enough that it does not need to overproduce oil to help the healing process. JG 4.29.09
Answer: textural changes that do not resolve with time, stiff and hardened visible scars are the most common. JG 4.27.09
Answer: properly done it should not scar and it will not close or shrink pores. At times, during the healing process the sweating is actually the oil from your pores being released in an attmept to aid the skin healing. I would likely imagine the offices that told you that do not offer CO2 laser so I would expect them to down play it. Has it been around for a long time, yes, does that make it bad, no, are there newer things out there,yes, are all new things beter, no. JG 4.27.09
Answer: A CO2 laser should not thin your skin. Thin skin does not look lighter and if you tan the skin should get darker. JG 4.27.09
Answer: about all you can do is try to get it exposed to the sun and see if it darkens. JG 4.27.09
Answer: sounds like skip areas where the laser overlapped and caused a deeper injury. JG 4.26.09
Answer: hard for me to say without seeing you in person. I think though that texure alone might be able to be improved with more lasers or retiniols to some extent. The problem though is the breaking of the skin and the pain, with that happening I would be apprehensive about further lasers until that has totally resolved. If the skin has been demaged by the CO2 laser, that can happen in rare cases, then further lasers would only make it worse. I do think using things like Capsacin cream, which is the hot pepper cream can help in some cases. You can also try Emu oil and I have had some people get better with topical DMSO, sold at most large health food stores. Wish I had more to offer you. JG 4.26.09
Answer: no, it will not help the red capillaries. It will help the fine lines, might improve the scars by smoothing them out and will remove sun damage in most cases. As to tightening the skin, also yes, but not to the degree a facelift would. The Triple Mix does help reduce hyperpigmentation risks. JG 4.25.09
Answer: wll, the honest truth is all you are seeing at this point in time is swelling and much if not all of that will go away for the next 4 weeks, at that point the new collagen will have been laid and then it will take 4-6 months for its maximal tightening to occur, so you will be on a little bit of a looking better roller coaster for now. I would not consider doing anything else for at leasst 6 months and preferably 12 months in order to let the skin heal and avoid scarring from to much burning. JG 4.24.09
Answer: not sure which of the Sciton lasers you are speaking of, if it is a fractional laser, I am nto impressed. JG 4.24.09
Answer: they are the folds that are from the corners of your mouth down to your jaw, they are formed from the tissues if the cheeks sagging and falling downward. Hard for me to say whether a laser will help your scenario without seeing you in person. JG 4.21.09
Answer: dermatology or plastic surgeons often carry it, otherwise the internet, we use CU3. JG 4.20.09
Answer: sorry, not a fan. JG 4.20.09
Answer: usually after 2-3 weeks make up should be able ot cover it almost entirely, btu in some peopel it will take a little longer. We use copper peptide creams on the skin until healed. I would not use Oil of Olay products after a CO2 laser for at least 6 weeks or more. JG 4.20.09
Answer: yes, should be back to normal by one year. JG 4.20.09
Answer: because the intent of a laser is to incite damage in the deeper laers of the skin and then the skin heals by the creation of new collagen, the new collagen is laid down in 4-6 weeks but it is disorganized and will take 4-6 months for the collagen bonds to form from one strand to another to get the maximum amount of skin tightening. Sounds like whoever sold you on the laser and performed it on you did not give you much of an explanation before you had it done. JG 4.18.09
Answer: it will take 2-6 months to get the maximum resolution of those lines, if you were not told that, they should have. JG 4.17.09
Answer: I would always start with Retin-A, it will help the texture and stimulate collagen to some degree. I think there are lots of lighter fractionated lasers that claim great results with no downtime, as I am sure you can figure out, if it sounds too good to be true, it ususlaly is. When the time comes it will likely need something with some downtime JG 4.17.09
Answer: I am sorry but I am noe a believer in the effectiveness of the fractionated lasers so in good conscience, I cannot recommend anyone. JG 4.17.09
Answer: well, the CO2 would have gotten a better result for the fine lines over the erbium as the heat the CO2 geneates helps that but erbium has no heat, even if done to the same depth. As to the oral commisure and the slight nasolabial folds, no laser will correct that, that is surgery or filler. Lasers will never be able to long term tighten the skin enough to correct that. JG 4.16.09
Answer: I only use it in order to remove the cream we apply only if it does not come off when washing the face, otherwise we do not use it routinely, it is only as needed. JG 4.15.09
Answer: the skin typically regenerates so it does not thin and 100 microns is not that deep. A revision rhinoplasty is OK to do after the laser, yes. JG 4.13.09
Answer: I think the burning is likely due to some element of scarring and the hypopigmentation might get better with a little sun. I think either a plastic surgeon or dermatologist could see you as long as they have laser experience. JG 4.13.09
Answer: if it is done too deeply it can injure the melanocytes that create the pigment. The burning sensation is not a normal thing. JG 4.13.09
Answer: that is too much vinegar, decrease it to the prescribed amount and it should get better. JG 4.12.09
Answer: that is normal for that depth laser at this point, got to hang in there. JG 4.12.09
Answer: light chemical peels remove the epidermis, if you desire wrinkle reduction you need to go into the dermis. My preference is CO2 as it is ablative and also heats the colagen to shrink it which the Erbium cannot,therefore the erbium heals fasetr and the improvements are not as dramatic. The tripel mix cream will help avoid the potential hyperpigmentation that can occur with both CO2 and erbium. I always do a TCA peel on the neck to help the color of the face blend in better with the neck when I do a facial laser. I tried the erbium technology long ago and abandoned it as I was disappointed with the results. Best of luck. JG 4.9.09
Answer: I would skip it. JG 4.7.09
Answer: I do not feel the new lasers are more refined, they have been dialed down in terms of energy, and therfore likewise in their effectiveness. It is all a matter of depth and experience on the surgoen`s part. JG 4.6.09
Answer: we use fillers all the time on vertical lines, are they 100% gone, no, but they are usually substantially improved. The injection results do depend on the skill of the injector though. JG 4.6.09
Answer: I think erbium is not as effective as CO2 becasue CO2 causes heating of the collagen to about 37 degrees celcius and that causes the collagen to shrink and tighten more than the cold Erbium. JG 4.6.09
Answer: to some degree yes, but the advantage the CO2 has is that it heats the collagen which causes it to shrink and tighten and erbium is a cold laser so it would never be the same, even if the same depth is used. JG 4.6.09
Answer: I feel the erbium is not as good because the CO2 heats the collagen so it shrinks and the erbium does not, but it does not sound like you have much choice. JG 4.6.09
Answer: properly done, it should not look shiny once healed. There is no specific evalaution done before though. JG 4.6.09
Answer: in males I find that the Rhytec might not be enough, acne scars are less willing to show improvements than wrinkles due to the subdermal scarring.Sorry, might not be worth your money. JG 4.5.09
Answer: I am still doing it as I stil have some tips left, I feel the results are better when done deeply, it would allow you to be in public but pink after 10-14 days but in male skin the resutls are mild, whether it is worht it depends on the severity of your wrinkles and I cannot tell that without seeing you in person, sorry. JG 4.5.09
Answer: OK to use the cream for that long, and I think you need to be on it twice per day for 4 weeks before the CO2 laser. What they have told you is about the same as what we do, best of luck. JG 4.5.09
Answer: no, it will not, the marionette lines are from the cheek tissues becoming loose and falling forward and no CO2 laser will effectively lift the skin to that degree. I think the best option is a facelift or at least a cheek lift. JG 4.5.09
Answer: if it is deep, by that I mean a non-fractioanl CO2 with a depth of 150 microns, there will likely be no makeup for 10-12 days. JG 4.4.09
Answer: I am not a fan of PDT, I feel it is an attempt to get a deeper exfoliation with a method that has less safety and predicatbiity than other tried and true methods. JG 4.4.09
Answer: I have a couple more tips that another US doctor sold me, I have not been able to get anymore though. JG 4.4.09
Answer: well, in my humble opinion, then they are not much of an expert, it is well documented, and I am sure it is in their consent, that hyperpigemntation is a known risk, and the way to reduce that risk is pretreatment with Hydroquinone and the addition of Retin-A helps the absorption, so I just flat disagree with your expert. By the way, who says she is an expert,some national organization or their own marketing materials? JG 4.3.09
Answer: well, that is his choice, I would never do a CO2 laser without pretreatment. JG 4.3.09
Answer: I think Vitamin E is OK before and smoking is also OK, although that ages your skin. I would press him to have him show you some pictures though, or speak with a live patient. I am not a believer in fractional or pixelated treatments though. JG 4.6.09
Answer: no, likely not. JG 4.2.09
Answer: it is a waste of time. JG 4.2.09
Answer: well, CO2 laser is ablative so if you go to the pappilary dermis, there is no epidermis left, that rebuilds in time from the basal layer, certainly one can go deeper or shallower, all depends on your skin thickness and the area being treated, not all areas on the face are the same thickness. The tightening of the skin of the upper lids will be there but mild. The three ingredient cream helps to get the skin into the healing process and also helps to decrease pigment formation both before and after the resurfacing. In most cases I will go to a depth of about 150-200 microns, less on the lids, in some patients I will go as deep as 300 microns, but not commonly, how deep that is varies from patient to patient. JG 3.31.09
Answer: my opinion is I would not perform or offer them to patients. I think the effects are unreliable, mild at best, and not long lasting, sorry. JG 3.31.09
Answer: the deeper you go the more effective but the higher the risk, especially in syringomas, because they will always come back unless they are cut out. JG 4.1.09
Answer: I would only do the whole cosmetic subunit which is the entire upper and lower lip in order to make it easier for make up to hide the full segment. JG 3.31.09
Answer: sorry, but not always, it is depth dependent, but with deeper treatment, the greater the scarring risk. JG 3.31.09
Answer: yes, but milder than the Rhytec I feel. A light CO2 in that area would have you wearing makeup in about 7-8 days. JG 3.30.09
Answer: the CO2 will likely make the Rosacea worse for a period of time but not permanently. If done properly and if no complications arise, the moisture and pigment should all return to normal in time. The CO2 will not repigment white scars though. JG 3.30.09
Answer: I do not think Portrait helps Rosacea and can worsen it temporarily it. I do think 4 Joules for two passes is higher than I would ever use. If you are not healing now, it is due to scar tissue. JG 3.16.09
Answer: probably, as long as they are not on any medications that will cause healing problems . JG 3.16.09
Answer: at times a VBeam can hide the redness, but nothing will remove the scarring, kenalog injectiosn in dilute amount or 5FU can also be tried. I would not resurface darker skinned individuala or Asians. JG 3.16.09
Answer: it can be done on the neck and chest, yes. I would say it could be done monthly in most cases. IPL can be done after but the energy might have to be reduced. JG 3.16.09
Answer: the skin would remain red and stiff long term. JG 316.09
Answer: you can adjust the depth to just about anything you desire with most lasers by adjusting the energy and dwell time. JG 316.09
Answer: might be due to some degree os scarring or maybe irritation from a skin care cream being used. JG 3.15.09
Answer: I think the CO2 is a good choice and should give you some degree if improvement for the entire face. I try to do resurfacing in the fall as it is easier to avoid the sun, but as long as you are good about avoiding sun and using sunblock, it is OK to proceed. I think to get any degree of worthwhile improvement, I suggest at least 150 micorns. Best of luck. JG 3.15.09
Answer: hard for me to say without identifying the cause, sorry. If it is due to dermal scarring there might not be much, maybe topical DMSO or an ibuprofen cream. JG 3.13.09
Answer: well, if there is scarring some nerves can be affected in the skin and cause that. JG 3.13.09
Answer: you would need to wait until the skin is loose eneough again to cut the scars out, there is no laser or cream that will pigment a white scar. Any hair loss at the edge from a CO2 laser will be temproray as the follicles are not injured. JG 3.13.09
Answer: no, that is impossible to occur. If you have scarring that can lead to difficulty with make up but it is not because the pores are closed and scarring is normally a rare occurnace. C02 laser will not always remove the ability to produce melanin, that depends on how deep you go and can happen with chemical peels too if you go too deep. Regaining color is dependent on sun exposure and the normal oilyness of the skin and should return in time. JG 3.13.09
Answer: complications are that of superficial burns, hyper or hypopigmentation, and poor improvement of the wrinkles. I think you are in good experienced hands with Dr Guyron. Best of luck. JG 3.12.09
Answer: better than a regular Fraxel but I think, personally, that the results will be mild and shortlived. JG 3.11.09
Answer: that is certainly a possibility, no bad side effects from that except it can be uneven and permanent. JG 3.11.09
Answer: personally I feel the only laser that will stimulate collagen to any visible degree is a CO2 laser, IPL will have little to no visible effect on skin tightening. JG 3.10.09
Answer: should be either a plastic surgeon or dermatologist board certfied in that specific field and might ask to check that because there are many pseudo-boards that doctors can pay to get a fancy certificate, ask them how long they have been doing CO2 laser resurfacing and about how many pateitns they have treated and then ask to speak to a patient or two. Best of luck. JG 3.10.09
Answer: still being used, and still disappointing in its results, other companies have made their versions under different names. JG 3.10.09
Answer: well the IPL is really not a laser, it is a lighter treatment but works on a similar basis as the lasers do. The VBeam is a true laser and I will say that if a VBeam did not do anything, the IPL will certainly not help. Best of luck. JG 3.7.09
Answer: I do not think it will be permanent if it resolved previoulsy but it might take 4-6 weeks to get better. A temporary suture laterally in the eyelid or a week 10 days to keep it closed will help some but not entirely. Best of luck and thnaks for the kind words. JG 3.9.09
Answer: I think it is the most effective for crepey skin, yes. JG 3.8.09
Answer: it tightens in all directions so with your history I can say that likely for at least a short period of time, the lid will be pulled down again. JG 3.8.09
Answer: no need to wait for the surgery of the IPL is done first, if the surgery comes first I would wait 4-6 weeks for the IPL to be done. JG 3.8.09
Answer: no, second degree. JG 3.6.09
Answer: I think the cream is fine and as to the medium depth, I would use a CO2 laser for that. All the best. JG 3.5.09
Answer: no, the CO2 will make it look better. Best of luck. JG 3.5.09
Answer: we precondition the skin before with Retin-A and hydroquinone and as to the makers of the CO2 laser, as long as the energy delivered, the surface area treated and what is called the dwell time is the same, they are the same. Preconditioning with Retin-A actually speeds the healing as it kicks the healing elements into gear. JG 3.5.09
Answer: it usually will aggravate it it, yes. I would avoid usng it in people with Rosaea. JG 3.4.09
Answer: scarring already has collagen, it is abnormal collagen, but there is no lack of collagen so I do not think what you are suggesting will help. As to scarring after a CO2, it is not due to incorrect products unless you have an allergic reaction or an infection. JG 3.3.09
Answer: from what I have been told, there are companies out there that are in discussions to purchase the technology. There are companies out there selling refurbished tips but I would not use them for fear they are not properly constructed. I think there will be some time before someone steps in due to the general economic issues and the decrease in cosmetic procedure spending, but many companies with newer technology go through these issues and continue to survive. As to when, I am not sure about Rhytec`s emergence, but I am hopeful. There are some physicians that had tips and are still doing the procedure and some physicians have sold their tips to others, so it is still out there. JG 3.2.09
Answer: no one is selling new tips yet, and Rhytec`s technology is stil out there, but with the economic issues as they stand and the decrease in cosmetic procedures, no one knows for sure when things will turn around. JG 3.2.09
Answer: we use Total Block by Fallene. We do not give make up recommendations though as all people like different things. As long as you have sunblock on, then it is OK to go outside after a CO2 laser session. JG 3.2.09
Answer: you might be referring to a scar from a laser that can occur in very rare cases, because normally the skin heals smoothly if there are no problems. JG 3.2.09
Answer: although there are different variations of CO2 lasers, and they do coagulate the proteins on the surface of the skin, those proteins are quickly replenished and the moisture of the skin is mostly from the oil and sweat glands and not due to the proteins. The shiny appearance will take longer to fade the deeper they perform the laser to. There should not be any increased sensitivity to the sun, but if you are going to the risk and expense of a CO2 laser, I think you should never go out in the sun without a total sunblock. JG 3.2.09
Answer: I do not have enough information to help you I a afraid, CO2 laser can be a totally ablative procedure and it can be fractionated. If it is fractionated it is safer than a totally ablative, but the effects are much less. I cannot say whether the light procedure will be enough in your case without seeing you in person. JG 3.2.09
Answer: the risks are prolonged redness, the deveoplment of hyper or hypopigmentation, shiny red skin for a few weeks to a couple of months in rare cases, and the possibility of the wrinkles and scars not improving to any visible degree if not done deeply enough, but the deeper you go the greater the risks. JG 2.27.09
Answer: I am sorry but I am not familiar with the lasers he is referring to. JG 2.27.09
Answer: no, that happens if you go too deep and develop some slight scarrring, but in general that does not happen long term, while healing it does, just like any other peel with laser or a chemical. JG 2.26.09
Answer: very little to none. I think a deep Rhytec or a light CO2 will do much more. JG 2.26.09
Answer: the extended burning and sensitivity is usually from the laser going too deep, if that has occurred and there is some element of scarring, then make up might not absorb and hold as well. JG 2.25.09
Answer: the vast majority if it is within 3 months, in some cases 6 if the procedure was done deeply. Once healed, your skin should return to its previous moisture and oil content. JG 2.25.09
Answer: no, he will not burn you and it shoudl work well and I agree with him that the totally abaltive is beter than the fractional treatments. JG 2.20.09
Answer: about all I can say is Retin-A, sorry. JG 2.20.09
Answer: not sure why he would nto use the Ultra-Pulse, that is what is considered the totally ablative, no-fractional ablation using CO2 with a computer generated scanner to minimize dwell time and control penetration. JG 2.19.09
Answer: A light one does help, and since it is light, there should not be any problems with long term color differences but while healing it will be different due to the pinkness. Light CO2 should have you back in 7-14 days. Best of luck. JG 2.19.09
Answer: most likely becasue the treatment went too deep, might suggest squalene oil or skin care products from NeoCuits. JG 2.19.09
Answer: should not last more than a couple of weeks, and if kept protected with creams, should not burn much at all during that time. JG 2.19.09
Answer: well, yes, but I prefer sunblock, rather than sunscreen, it should be a complete sunblock. All should go back to normal in time after the procedure, yes. As to oil production and normal skin moisture, that depends on how deep they went and how old the patient is, the deeper and the older, the longer it takes. JG 2.18.09
Answer: in most cases yes, unless you had a large amount of sun damage and then that sun damage is removed so your skin will look lighter as the damage is gone. I think if you are wanting to sun tan in the future you should not have a CO2 laser. The reason I say that is that sun tanning will age your skin and I see no reason to spend money on a CO2 laser and take certain rsiks and then go out and voluntarily do things to redamage the skin you just made better. JG 2.18.09
Answer: it is essentally a controlled burn of the skin, like a chemical peel. In most cases it is healed enough to wear make up in 2-3 weeks, and the skin remains pink for 2-4 months, depending on the depth it is perforemd to. Skin texture normally returns to normal, it works well for fine lines and sun damage. Freckles will eventually come back, pores will return to their previous state. Shinyness usually is gone in 6-8 weeks or so if no make up is worn, otherwise the make up can cover it sooner. No difference in terms of skin sensitivity afterwards in most cases and the skin will tighten for 6-12 months afterwards. We have a line of skin care products that we use but any good quality moisturizer after it is healed is enough. JG 2.18.09
Answer: if healing takes too long, to the point where make up is unable to be worn after 6-8 weeks and there is cracking of the skin, then it is not typcial. JG 2.17.09
Answer: typically, that is correct and no increase in skin cancer rate that have been reported. JG 2.17.09
Answer: sunblock, you need to choose between faster skin aging and your described normal life. JG 2.16.9
Answer: might be there a few weeks, the sun will just prolong the time of redness. JG 2.16.9
Answer: actually, forever, or at least wear sunblock for the rest of time when outside. JG 2.16.9
Answer: shiny, stiff, unable to hold make up, easily cracks, there are many different degrees of scarring though. All I can suggest is moituirizers and avoiding any acids on the face and sun exposure. The skin should come back to its normal sensitivity and texture by 6 months or so. JG 2.16.09
Answer: I would always choose the original CO2 over a fractional one. I think the only thing the fractional is better in is less downtime but the rsults cannot compare to the original in terms of improvements. Going too deep with any laser, fractional or original can lead to problems so an experienced doctor and care must be taken. Frustration happens at times I am afraid when the patient`s desires are not able to be met in a safe fashion, if you push the envelope you can have problems. Not all that is desired is acheivable. JG 2.15.09
Answer: might suggest squalene oil, occasional DMSO topically will help along with the skin care products from Neo Cutis. Best of luck. JG 2.13.09
Answer: delayed healing and can also in some cases be scarring from the procedure. JG 2.13.09
Answer: in most cases it should. JG 2.13.09
Answer: only time and maybe different moisturizers or squalene oil for the face. JG 2.13.09
Answer: it should go back and should not be any different in terms of its sensitivity to things. I think for most people, when they heal well, it is very worth it, yes. JG 2.12.09
Answer: well the allergic reaction would not last 6 months, but if one of the ointments caused an allergic reaction early on, it can cause the depth of the laser to go deeper and prodcue scarring. JG 2.12.09
Answer: not always negligence. It can happen from adverse events after the CO2 laser too, like infections or allergic reactions. JG 2.12.09
Answer: this far out, yes. Not much you can do except let it heal on its own and see. Going outside will do nothing to get it to heal any faster.JG 2.12.09
Answer: seems like a long time after the procedure for that to be happening, that should normally all be gone after 6 weeks in most cases, might have some scarring that is slowing teh process down some. JG 2.12.09
Answer: ablative lasers lieke CO2 and erbium can make them worse. JG 2.12.09
Answer: well, patients can at times be dissatisfied with the degree of improvements due to unrealistic expectations, as to problems, any laser or surgery can have those and remember, what you read on blogs is usually just the negatives as people that do well do not post happy things on blogs. As to the degree of improvement from a single light Rhytec, I think it is very small. The company promoted the treatments, if doen lightly, to be done in a series of three, three weeks apart. I think you can ask the doctor what he will do if you follow his advice and do the ligth Rhytec single treatment and it does nothing to visually improve the wrinkles and fine lines. Some people do have a genetic predisposition to hyperpigment their skin after an injury and lasers of all kinds are certainly considered an injury and can cause the hyperpigmentation. Best of luck. JG 2.12.09
Answer: from what I have seen and heard from patients that have come to see me after both of those treatments, they are both disappointing in their improvements and the plastic and shiny look comes from it being done too deeply too many times. JG 2.12.09
Answer: the IPL might work and the risks of that hyperpigentation are much higher in Asian skin, so you need to go low with any light or laser therapy. I think bleaching cream and Retin-A are a good addition. I would do them and the IPL both. They should go away, but impossible to tell, in some rare cases they can last forever. JG 2.11.09
Answer: might suggest some Retin-A and hydroquinone and no sun, should get better in time. JG 2.11.09
Answer: I avoid olive, black and oriental skin. As to knwoing if it went too deep, often you cannot tell until after, at least from the patient`s point of view, prolonged healing is the first sign. The doctor should be able to have some signs during the procedure but it is not always able to be seen. Always better to err on the side of caution. JG 2.9.09
Answer: a laser, no matter what type, if done too deeply is like a flame burn, if it is burned too deeply, the scar will develop and like scars all over the body, in most cases, there is little that can be done. At times in the attempt to improve things, it can be made worse. With the degree of scarring she has, which by comparison is slight but enough to cause her the problems she is experiencing, not much can be done except what I have suggested. I a sorry you were amazed that I told her that nothing can be done, but that is the truth. Unfortunately, there are times when some side effects are permanent, and keeping that information from the patient and having them hold out hope and trying things that will hurt them more is worse than the truth. I know many people wish there were solutions to every problem, frequently saying that with all of the advances out there, that there must be something that can be done, but I am afraid that is not always the case. She has a difficult problem, that luckily affects only a small number of patients but it happens I am afraid. JG 2.9.08
Answer: Retin-A mixed wth hydroquinone, light chemical peels, spot treatments with a YAG laser, and sunbock and no sun exposure. Best of luck. JG 2.9.08
Answer: those lasers will likely make it worse, could try a YAG laser to fade the brown spots. JG 2.9.08
Answer: might suggest the NeoCutis skin care products and squalene oil too. As to the sunblock, I like Total Block by Fallene. Self tanner can be used but I am not sure how well it will work. I have no personal preference on the self tanners. Wish I hade more to offer, but if it is due to scarring, it might never get better. JG 2.8.09
Answer: not worth it as the skin of the face is different from one area to another so a spot test does not predict how the skin will react in a different location. JG 2.8.09
Answer: no, that is not normal, sounds like it might have been done too deeply or her skin was just not the right type for that procedure. I think at 10 months you should be able to use the skin care you used previously, it is just that I have my own skin care products that I formulated that I like my patients to use is all. Before the procedure we pre-treat with Retin-A and hydroquinone for 4 weeks, afterwards we use a topical antibiotic for a few days then switch to a copper peptide cream, once healed we start the sunblock, add the Retin-A in again with the hydroquinone if there is any hyperpigmentation, and then slolwy get them back on their normal skin care regimen. Best of luck. JG 2.7.09
Answer: should improve it, cannot say it will remove it 100% though. JG 2.7.09
Answer: short term it can be from the reactive dryness or pigmentation issues, long term it can be from going too deeply with the laser.If there is some scarring, it can look worse than the original skin at times. The skin cracking can happen the first couple of months as the skin is tight but that usually is gone after a couple of months once the skin regains its normal moisture and oil content. In time it should get better. JG 2.7.09
Answer: might suggest some squalene oil from the health food store or soem skin care from NeoCutis, your doctor should be able to get it for you. JG 2.6.09
Answer: if all heals well there should not be any difference in sensitivity to heat and sun, but I think if you are doing it for wrinkles, you should not be going out when it is like that. Exercise if fine too. I have our own skin care products that we use afterwards. JG 2.6.09
Answer: I think it will, but only mildly, one deep yields more than three lighter ones. The lighter ones downtime is usually 4-5 days unless done really light and then it is likely not going to do much at all for the wrinkles. No breakouts typically but usually at 1.5-2 joules, the usual setting, it takes 4-5 days before make up will come close to covering it. JG 2.6.09
Answer: if doen properly the skin texture should be normal once healed. It does not go deep enough normally to affect the moisture of the skin long term. The waxy feel is when the laser has gone too deep and I suggest using sunblock if you decide to go outside in the sun again to avoid the aging effects. If done deeply enough, there can be irregualr pigmentation of the skin, yes. The oilyness is your skin going through the healing process and is usually not permanent and the length of time it takes to have the redness go away depends on how deep they go, the deeper the laser is done to the longer it takes to go away. Best of luk. JG 2.6.09
Answer: it might cause bruising and purpura, yes. There are no negative long term effects. I think the IPL will not be as effective though for the improvement of the scarring. Having said that, the only improvement would be for redness, it will not remove the scars. JG 2.5.09
Answer: I do not think anything will help that, it is essentially a light layer of scarring and further treatments have little chance to improve and a greater chance to worsen it. JG 2.5.09
Answer: as long as the skin is well healed with no scarring, it can be repeated. As to how many times, that varies dependent on the thickness of one`s skin and how deeply was the laser done to. I must say though, 4 CO2 lasers in one year, not knowing how or where they were done, is unsual. I think if done lightly they can be done yearly. JG 2.5.09
Answer: I do not think the Erbium will affect the fillers, best of luck. JG 2.5.09
Answer: I do not think that a full strength Rhytec is as strong as a CO2 laser. JG 2.3.09
Answer: I think the microderm will do little and the VBeam will only fade the red. Nothing will eliminate the scar totally though. JG 2.2.09
Answer: sorry, it can never be removed completely, no matter what you do for it.Improved, maybe, but never removed. JG 2.2.09
Answer: I personally feel it is a waste of time and money. I would push for your money back and not more of something that did not already work. JG 1.29.09
Answer: CO2 laser wil not remove the broken blood vessels, sorry. Might suggest a diode laser, but I think the best option is to go to the University departmenr of dermatology. Best of luck. JG 1.29.09
Answer: I would not use it for olive skin, fractional or totally ablative. JG 1.27.09
Answer: well, yes, but it leaves more skin intact than what it treats, that is whay it is called fractional, so it heals faster but treats less skin so the improvements are less than a completely ablative laser. JG 1.27.09
Answer: it is true, it is potentially risky in olive skin. I am afraid that the only thing out there safe would be Retin-A, at least for now. JG 1.27.09
Answer: the pimples are there because the top layers of the skin were removed and the pores of your skin are getting clogged while healing, it is normal. I do not think the small pimples will scar though. Best of luck. JG 1.24.09
Answer: I cannot recommend it for your issues, sorry.JG 1.24.09
Answer: I think if you can aavoid the lighter spots it would be best, but not a problem if it gets some too. Might suggest Dr Tina ALster, a well known dermatologist. Best of luck. JG 1.24.09
Answer: all depends on how deep they went, no way for me to tell. Usually after 3-4 weeks one can apply the self tanner. JG 1.24.09
Answer: I am not impressed with the results, sorry. JG 1.24.09
Answer: I think in most cases the skin will repigment in the futue, especially in darker skinned individuals, the challenge now will be to make sure the areas of hypopigmentation do not heal with hyperpigmetnation. I think avoid sun and the Triluma is OK to use and should continue it. As to anthing further, I suggest seeing a dermatologist or palstic surgeon for these issues in the future and leave the Internal Medicine person to do Internal Medicine.JG 1.23.09
Answer: tightess the skin, reduces fine lines, improves pigment problems. All the best. JG 1.21.09
Answer: could repeat the CO2, it will not be permanent though and it will also not be as dramatic of an improvement as it was in the past as your body`s ability to make new collagen is not as good, sorry. JG 1.21.09
Answer: I think lasers will yield the longest lasting result, but nothing is permanent, I would never inject Artefil around the lips for fear of permanent lumps and I would never inject Botox either for fear of weakening the lip muscles and having you look like you had a stroke. JG 1.21.09
Answer: well fillers will never do it, the Erbium might help as the skip areas might not need as deep of a treatment as the CO2. I would likely do another CO2, very lightly everywhere except on the skip areas. What has occured is all technique related due to the operator, and not the machine. I have to respectfullly disagree with him though, skip areas can occur and are due to inadequate spacing by the placement of the laser by the operator. I think it can be fixed but will require more surgery, in careful hands. Best of luck. JG 1.20.09
Answer: Not sure laser will do much as it is indented, might suggest a filler to raise the surface to match the surrounding skin. JG 1.20.09
Answer: well, if the fractional laser gave you some improvement, you can continue, but in time it will likely not be enough. I like the CO2 laser done lightly which mitigates the downtime or a Rhytec Portriat but the company is closed and we are all awaiting for a new company to sell the tips. I find chemical peels ot work well for discolorations but not skin tightening as once the swelling is gone, so are the improvements. All the best. JG 1.19.09
Answer: I do not think the Gentle Wave will help, and I am also afraid what you expected to get in terms of improvement from the Active Fx will also not happen, just apply some warm moist soaks and let the pimples open, they are just plugged pores, do not pick at them. I do not think it will be red for months, but likely about another 4-6 days from what you are describing.Best of luck. JG 1.19.09
Answer: yes, the fractional laser will not help and will actually worsen the broken capillaries, they will need to be treated later with a YAG, a VBeam or IPL laser. Best of luck. JG 1.15.09
Answer: ask for a non-pixelated, or non-fractionated CO2 laser, complete ablation. JG 1.14.09
Answer: I would not waste the money on the machine and I would not offer it to a patient. JG 1.14.09
Answer: I have all of my remaining tips spoken for treatments already, I am waiting to hear from Europe about obtaining some more before I can book any new patients though. I still have my machine though. JG 1.13.09
Answer: I honestly have not been impressed with the results that I have seen, I am sure a few patients have nice results, but the vast majority of the ones I have seen show little to no improvement. JG 1.13.09
Answer: the upper lip can be doen alone, yes. Usually with the Rhytec the color difference is not seen. JG 1.12.09
Answer: might suggest trying some Retin-A with Hydroquinone and then a series of medium to light chemical peels to even out the pigmentation. Also need to always use sun block. Best of luck. JG 1.12.09
Answer: I am using a low energy CO2 lasaer until the tips are avialable again, I am pretty confident another company will but the technology. JG 1.11.09
Answer: hard to say and at this point I suggest no further treatments for 6 months after the laser. As to why it did not weep, it might be because of the depth of the laser. As to the ripples, that can happen from swelling, yes, but since so much time has passed it is more likely that some areas ended up having a deeper treatment than others and resulted in a depression. This can happen from inadvertent overlap during the procedure. Although the laser is attemtping to create new collagen, the amount and quality of your own collagen would not cause these things. If the redness has faded you could try some ligth Retin-A now for the pores, not much more I can say I am afraid without seeing you in person. Best of luck. JG 1.7.09
Answer: I think at best 30% improvement. It will not help the acne heal, it will just smooth out the skin and will never prevent it from continuing to occur. The ice pick scars can at times be cut out and stitched to leave a smaller flatter scar. I find the regular ablative old fashioned CO2 laser the best for acne scarring. JG 1.4.09
Answer: well, I will at times do some lighter TCA peels on the body, but the body having peels is not as safe as the face, hard problem to improve I am afraid. JG 1.4.09
Answer: 30-50% I would say it might last 18 months to three years in many cases. All the best. JG 1.4.09
Answer: I think it will do little for the stitch mark and at best will leave the redness the same, likely not improve it though. If the VBeam did not work for the redness, the CO2 will not either I am afraid. Best of luck. JG 1.3.09
Answer: I doubt the change will be much, there is not much that can be done for them. JG 1.2.09
Answer: the comments in th audience at national meetings where plastic surgeons see presentations is that most of us cannot tell which is the before and the after photos, I just do not think you get much result for what you spend. It is due to the technology being used. JG 12.31.08
Answer: I use the regular Arnica Montana sold at the health food stores, the small little tabelts that dissolve under your tongue, we suggest 4 tablets under the tongue 4 times per day and take the whole bottle, about 14 dyas worth. We usually start it 2-3 days before the procedure. Best of luck. JG 12.31.08
Answer: I do use Arnica and I do think it helps bruising and swelling, but it is relatively short lived swelling on the Portrait and really no bruising to speak of, so I am not sure it is worth using it for that case. I have bene using Arnica Monta for over 12 years. JG 12.30.08
Answer: not a fan. Merry Christmas and Happy New Year. JG 12.27.08
Answer: yes, there are a variett of different setting and typically for acne scars a deep setting needs to be used. I think if the float procedure was done long ago it will work about the same as no procedure being done. If the float is done 4-6 weeks before I feel it gives a better result though. Best of luck. Merry Christmas and Happy New Year. JG 12.27.08
Answer: I have heard it, there have been many attempts with different methods of heating and I think overall the results are unpredictable, especially when one considers the cost. I would not suggest it. sorry. JG 12.22.08
Answer: Rhytec Portrait Plasma. JG 12.22.08
Answer: I am afraid the only thing would be to have the skin cut out with a tummy tuck or a mini tummy tuck, sorry. JG 12.21.08
Answer: many companies have gone through bankruptcy lately, even ones like Fraxel, and emerge under different management. I am still using the Plasma in my office and their European branch appears poised to keep us supplied with nozzles. I am stil using the CO2 laser when indicated though, and when patients are willing to deal with the downtime. JG 12.19.08
Answer: that would be one word for it, yes. JG 12.18.08
Answer: well, I guess that at least some of them have been duped, I certainly have been, I bought a Theramage machine because surgeons I trusted told me it was a great machine and I had to sell it because almost all of my patients, and myself, were unhappy with the degree of improveemnt for the pain and cost. I am sure there are some patients that have good resutls, and that handful is on all the brochures, in fact, most of the time when you see results pictures in doctor`s offices they are supplied by the company and are not the doctor`s pictures. In most cases when the patient comes back disappointed the doctor then tells them they had unrealistic expectations. I just find it hard to recommend something that costs alot of money when the results are unpredictable. JG 12.18.08
Answer: personally, I think it is, I see too many patients that were promised dramatic results and that after even a series of treatments see little difference. I feel the plasma, as it is a totally abaltive technology, yields a better result than any fractional treatment, but slightly more downtime. At present the non-fractional CO2 is the best, followed by the Plasma a few steps behind. JG 12.17.08
Answer: The scar revision, by cutting it out, might run about $500 and we do not have an aesthetician in the office to do extractions, sorry. JG 12.12.08
Answer: any thing you do for the pores is very temporary and as to the Genesis, I am not a fan. JG 12.11.08
Answer: it is not fractional. JG 12.11.08
Answer: the lighter the setting the less the improvement but the faster the healing time. No bandages, but ointment until healed. I think it should work fine though. JG 12.11.08
Answer: all of what you did not like about Obagi will be magnified with the dot therapy. JG 12.11.08
Answer: well, for the texture I would use a totally ablative CO2 laser, not a fractionated one, as to the pores, nothing you do will last more than a couple of months as your skin will replug the pores with oil. The worst thing if the dot did not work is you would have wasted your money. If he is so sure, will he continue to treat you or do something else if what he promised you does not work? JG 12.11.08
Answer: I am sorry but I think you will likely be disappointed with the dot theray, it cannot be done on the neck as it can potentially scar that area in some patients. If you cannot tolerate the Obagi, the dot therpay will be worse. JG 12.11.08
Answer: I am sure there is a dermatologist or plastic surgeon in your area that has experience with a CO2 laser that can help you, call the local county medical society for a referral. Best of luck. JG 12.10.08
Answer: people are always looking to get the same benefits with less risk and downtime, it is human nature, but in this realm it does not work. If I thought fractionated lasers worked, I would own one, but I do not. JG 12.10.08
Answer: I usually treat the whole face to avoid different colors while healing, I cannot give you a percentage though. JG 12.10.08
Answer: I think the CO2 is far superior, there are limitations with it but most times, if done properly all heals well, albeit with some downtime. JG 12.10.08
Answer: to the best of my knowledge, yes, it does apply there too. I am sorry but I do not have any referrals in London for that. JG 12.10.08
Answer: well, filles will never have the same effect as a laser becasue they do different things, so that is the first thing. As to the doctor not having a license to use the laser, that is blatantly false, there is no such thing as a license to use a laser. I think the doctor is being manipulative nad deceitful and is using a used car salesman technique of bait and switch. I suggest never ever seeing that doctor, not even for a hang nail and tell all your friends too. JG 12.9.08
Answer: my personal opinion is tha it is a waste of time. JG 12.8.08
Answer: the Fraxel CO2 takes away all of the advantages of the CO2 so I remain not a fan of any fractinated technology, it is merely a marekting attempt to get people to sign up for something that they found did not work with the inital Erbium based technology and now want to sail on the coat-tails of the CO2 without acknowledging that they are weakening the CO2 to such a degree that it renders it ineffective. I think the unfortunate thing is that one has to compromise when you impose downtime, if you limit the downtime you will limit the improvement, at least with any technology now in use or in the pipeline at present. I think the Ultrapulse is the way to go if you want substantial improvement worth your investment. JG 12.8.08
Answer: I think that it would not be worht it. I think the scarring potential is small but I think it will not generate enough of an improvement, I think a subcision and filler is a good option. JG 12.7.08
Answer: waste of time three times. JG 12.7.08
Answer: well, the risk is less but never 100%. JG 12.7.08
Answer: well, tnhe CO2 UltraPulse can be done lightly, but it might leave you red for a long time is all. JG 12.7.08
Answer: the company has recently declared bankrutcy and there are attempts to have someone take the company and the assests over. The same thing happened to Fraxel last year and they were bought up by Thermage. In theses financial times, things like this are unfortuanately common. I think a light CO2 laser is still an option in one sitting. JG 12.7.08
Answer: a high intensity light, not a true laser, good for brown and red spots, needs multiple sessions, does not do mcuh for fine lines, collagen production or wrinkles. JG 12.4.08
Answer: that is correct, but it is a pixelated or fractionated treatment which means there are millions of little holes made with the CO2 and then trillions of areas not treated, so you only get a fraction of the skin treated and that is what limits the degree of improvement. I think for the greatest degree of improvement you need a full ablative CO2 laser, not one of the new ones that are just less area of treatment for an attempt to get faster healing, but as with everything in life, when you give something up you get less in return. JG 12.1.08
Answer: I am sorry but I believe most likely you will be disappointed with that treatment for what you are concerned about. I think you would likely need a CO2 laser and possibly some fillers too. Aggressive therapy will not be the answer with that technology. JG 12.1.08
Answer: well nothing is 100%, it is a matter of depth performed and skin type, I prefer CO2 lasers or a Rhytec Portrait procedure, I do not feel the SmartXide Fractional will do much. All the best to you. JG 11.26.08
Answer: I do not feel it is, no. All the best. JG 11.26.08
Answer: usually not unless you have a lot of sun damage, then it will be a little lighter at times. The CO2 will not do anything for the puffyness I am afraid. JG 11.26.08
Answer: I cannot in good conscience endorse either one. JG 11.25.08
Answer: a non-ablative laser removes no skin, like an IPL or YAG microlaser there is truely no such thing as a non-ablative fractional laser, it is a name that is improperpy used, fractional treatments work by making millions of little holes in the skin and leaving trillions of areas not treated, so it is ablative, just a minmal ablation. CO2 laser is a complete removal of the skin surface and is the 100% ablative option, as is Portrait Plasma. A fractional CO2 lasers is nowhere near the same as a complete CO2 as the fractional part means again that there are millions of holes treated and then trillions of areas not treated. They went to the fractional CO2 laser when they saw that the fractional erbium laser failed to show consistent reproducable results in most patients. JG 11.25.08
Answer: Plasma would be relatively mild, I likely would suggest subcision and CO2 laser for the most dramatic improvement, the shallow scars respond well to that. JG 11.25.08
Answer: I would suggest waiting at least 3 months if not longer. I think if something does not work the first time, the second time will not prove worthwhile. All the best. JG 11.24.08
Answer: I think the Medlite laser is sgnificantly safer, I personally would not perform the Fraxel, no matter what the pretreatment. Best of luck. JG 11.22.08
Answer: well, when done lightly the skip areas can happen and they end up blending in well, when done deeply it is more important to get a smooth cover, I would never use anything with AHA in it for at least 4 weeks as you want to allow the skin to heal before irritating it anymore. JG 11.22.08
Answer: I would not do it if your lower bleph involves skin removal, only if it were being done via a transconjunctival approach. JG 11.22.08
Answer: well lasers help skin quality and surgical excision improves skin quantity, so it depends on what the problem is with your lids. Hard to say without seeing you in person I am afraid. JG 11.20.08
Answer: well, I cannot speak for your surgeon, I think believing a TCA will tighten skin for longer than the period of swelling is wishful thinking and I am not a fan of fractional lasers and do not perform them. Some surgeons believe they work but I have never seen photos that show reproducable effects in the majority of patients. As to what he should do, I think that is up to the individual surgeon, some are more helpful than others. JG 11.20.08
Answer: it is a hot plasma generator that ablates or removes the top layers of skin and induces new collagen formation and therefore skin tightening and improvements of skin discolorations. It is a good option for fine lines on the lower eyes, but it, like all other treatments, is not permanent. JG 11.20.08
Answer: I think the second treatment will give you some degree of further improvement but I personally have not been impressed with the fractional treatments. JG 11.20.08
Answer: I personally would not do it that way, one flinch and you get burned somewhere where you do not want it. JG 11.20.08
Answer: I do it under general anesthesia, is done by both plastic surgeons and dermatologists and social downtime is realistically 3 weeks if done deeply. I do mine in an out-patient surgery center. JG 11.19.08
Answer: personally, I do not think it is good for much and the laser you speak of is an Erbium I believe. JG 11.19.08
Answer: well, they can both be a factor, but the patient`s skin, since we have no way of adequately evaluating it beforehand, is the more risky as it is unknown. Certain ethnic issues are also important, for example darker skinned individuals and orientals have possibly higher risk of scarring too. JG 11.19.08
Answer: well anything you do will relax as the aging occurs, for the first month or so they look about the same but the CO2 will give you the improvement for much longer than the Erbium. In the long run, nothing is great, not even surgery, you need to understand that these are all incremental attempts to slow the process of aging down, nothing will stop it and that is why it is not an option for all people. I think the added risks, in experienced hands that can decrease the risk certainly are worth it, not all patients lose pigmentation, but it depends greatly on the amount of sun damage they have. JG 11.19.08
Answer: no problem with the questions, I just do not feel it is the best of any world due to its low effectiveness. JG 11.18.08
Answer: well, I think what you have just found out is that none are right and none are wrong, there is dissention among the options because there is no clear winner. I think your last doctor has oversimplified the issue though. The degree of firming comes from heat, which the CO2 does give and the Erbium does not but a discontinous surface allows less tightening. Think of a drum skin versus a pair of lady`s nylons pulled over a drum head, the solid piece when tightened will lead to greater tautness whereas the nylon will stretch and not tighten as much because there are holes in it. For the greateset degree of tightening you need a continuous and not pixelated or fractionated surface treatment. As to safety, maybe, but then the degree of effectiveness goes down too. JG 11.18.08
Answer: that would be my first choice, yes. JG 11.18.08
Answer: as to the Erbium, yes, I sold my Erbium laser long ago. JG 11.18.08
Answer: well, after having used it, my patients and I have been consistently diasappointed with the reliability of its degree of improvement. JG 11.18.08
Answer: I am sorry but for darker skin and acne, I have nothing safe, maybe subcision and fillers is about all, or when one is older a minifacelift will give improvements for awhile. JG 11.18.08
Answer: I would shy away form an abaltive laser, both CO2 or Erbium in darker skinned patients, so I would not suggest it for your condition of acne scars. JG 11.18.08
Answer: I still would choose the Plasma over any fractional laser, I would expect the company to say it is effective for many areas on their website. JG 11.16.08
Answer: just ask about your specific concerns, if they pretreat the skin to avoid hyperpigmentation, and how long the post teatment redness would last in your case. Best of luck. JG 11.15.08
Answer: still not a fan, although it is better than a single one. Imagine this, you want to tighten the skin on a drum using the torque screws around the rim, you tighten one or two, close your eyes, spin the drum, and then tighten two more, you have no way to know the new two tightened are the best ones, one always gets the best degree of tightening when the entire surface is done at the same time so there are no skip areas and the tightening is uniform and smooth. JG 11.14.08
Answer: yes, very good choice. JG 11.14.08
Answer: no laser will help the dark circles unde the eyes, I like a CO2 laser the best and a Rhytec Portrait second for the wrinkles, I do not like the fractionated lasers because they only treat a percent or a fraction of the skin, therefore it leaves a lot of skin untreated and thereby does not give as significant of a result, that is why they are called fractionated lasers. JG 11.13.08
Answer: I think they can both do a good job. JG 11.13.08
Answer: I personally would not attempt any chemical peel for acne, I think the results are not worth it. JG 11.13.08
Answer: it creates new collagen for somewhere between 2-6 months, the deeper they went the longer it makes new collagen. I am not a believer in factional lasers though. JG 11.12.08
Answer: orally I suggest Omega 3 fish oils and a B complex and Vitmain C, I do not think oral glucosamine will make much difference, topically we use things like aquaphor or copper peptide ceams to help with the healing. Best of luck. JG 11.11.08
Answer: I think NLite would be a waste of time for acne scars. I think combining it with microdermabrasiosn adds very little, the laser is certainly not selective to one bacteria over any others and the degree of collagen stimulation in most cses is not seen by the average observer. JG 11.10.08
Answer: I think there are always negative reports on blogs on the internet, but also understnad that happy patients do not go on the internet to praise things, so if you are in experienced hands, it should be good, all the best. JG 11.10.08
Answer: the blood thinners will not affect the ability to perform either ablative skin treatments. I will say that the FRaxel repair will likely bleed much more than the Rhytec. If you are intent on doing the combo, I suggest the Fraxel CO2 first and then finish with the more complete Rhytec. As to the time between, I suggest at least 6 weeks. For the Rhytec for acne scars I would use between 3-4 joules on the cheeks, or a double pass at a slightly lower setting, as to the Fraxel, I am not a believer in it so I cannot say. Best of luck. JG 11.9.08
Answer: the larger pores can be temporary and also the creams might be clogging the pores, migth want to ask him about changing the creams. The oilyness comes from your skin trying to heal itself, might consider trying some squalene oil topically, that should help moisturize the skin without you creating more oil. JG 11.7.08
Answer: it is a good laser, yes. The laser I have was made by the company Lumenis bought. JG 11.4.08
Answer: yes, there are millions of small pinpricks but they do not bleed for very long. In my personal opinion I think the results of a series of them will never reach the degree of improvement from a complete continguous ablataive laser, becasue some pin holes will be treated multiple times and some areas of skin will be missed. JG 11.1.08
Answer: I do not think they are close at all, I feel the Rhtyec, if chosen to be used that way, is much stronger. JG 10.31.08
Answer: well, it has the power yes, but it will treat a very small surface area, that is what makes it fractional, so you have a large percentage of the skin that remains untreated and therefore, although it heals quickly, that is because so much of the skin is not improved or treated. I think because of the fractionated surface it will be less of an improvement than the Portrait treatment. My major objection is that of large percentage of patients with disappointing results. It is not me that objects, but the patients that spent money and do not feel they got enough for what they spent and went through. JG 10.28.08
Answer: 12-18 days before makeup. JG 10.25.08
Answer: we allow patients to wash after 24 hours, but you shoudl ask your doctor as they may do things differently. JG 10.23.08
Answer: CO2 laser for something dramatic, Rhytec Portrait for something less but with less downtime, on the order of totally back to normal skin in one month.JG 10.22.08
Answer: personally, if you have had to use Accutane for that period of time to control your acne, it is likely you have deep scarring and I seriously doubt light treatments with PST or other technologies will help, even with the really deep CO2 lasers, improvements are limited as the problem is below the surface of the skin and lasers work best for wrinkles. The treatments will likely be safe, but will not control your acne, will yield minimal scar tissue improvements and may not be worth your investment. JG 10.22.08
Answer: there is really no scar, just fat loss and no laser will replace the fat. All pock marks look better if the skin is tightened but since it is not release the pock scar tissue as time goes on its appearnace returns, lasers work well for wrinkles but less well for pocked skin due to the scar that was caused by the infection and inflammation, not related to the Thermage. JG 10.21.08
Answer: well, here is the thing, firstly, the scars are looking worse because your skin is begining to loosen, no matter what you do, it will worsen with time, the CO2 laser will give you the most change with the longest improvement but with risks, all of the others are essentially interchangeable as the results will be mild at best and short lived. There is at present nothing really good I am afraid for your skin type. JG 10.21.08
Answer: only for as long as there is swelling. JG 10.21.08
Answer: they are supposed to work by removing pieces of the superficial skin and then getting the body to create new collagen to tigthen the skin. JG 10.19.08
Answer: well, I feel they are all ineffective but the lasers have a lesser chance of introducing infection into the skin as the tissue is vaporized and no needled where surface bacteria can be introduced. Also the number of punctures per square inch is much much more with the lasers than with the dermaroller. JG 10.19.08
Answer: only if there is a burn and then scarring from the burn. JG 10.17.08
Answer: the risk are that of segmental loss of pigmentation at least partially, leaving a line of demarcation between that and the untreated skin. The lesser the energy the lesser the degree of improvement. I think Portrait is safer only becasue it does not go as deep and therefore is like the low energy CO2. As to how long it takes to come back, anywhere from 1-3 years, the older one is the faster they come back, the lighter the treatment, the faster they come back. JG 10.16.08
Answer: the older one is the less time it lasts, cheeks and foreheads can last 5 years but the area around the mouth and eyes,maybe 2-3 years or so. As to driving, we ask patients to wait two weeks so they can turn their heads easily after the surgery to look for traffic. JG 10.14.08
Answer: well, the thinner the skin the greater the chance of those problems at higher energy, that is why in inexperienced hands I always tell patients to be conservative. High enery is not to be used on thin skin like eyelids but some people have thinner cheek or forehead skin than others. Once you select the energy, it is all dependent on the skin. I do go to high energies, at times as high as 4, but only on thicker skinned patients like men as their skin is at least 10-15% thicker than females. Best of luck. JG 10.13.08
Answer: I do not think it will affect it in any way.JG 11.12.08
Answer: I do nto think there is any problem doing the laser with the fillers in place. I do not think the laser will reliably affect even the superficial fillers causing the Tyndall effect. Best of luck. JG 10.12.08
Answer: CO2 is more effective than a Plasma Portrait and unfortuantely neither one will help the seborrheic dermatitis, but safe to use, you will be a little more red than the normal skin though in those areas. The risk of the CO2 if you go deep is pinkness for months and potential relative loss of skin color when compared to the non-treated skin. The squalene is usually found in health food vitamin stores, it is also called shark liver oil, or buy it online. Best of luck. JG 10.12.08
Answer: I think somewhere between 3-4 is where I would treat you also, the skin should do fine with that settting, just not on the eyelids. Hyperpigmentation can happen but much less chance in fair skinned people. If concerned you can pretreat with hydroquinone. I think as long as there is not alot of overlap of the sections it will be fine. Best of luck. JG 10.11.08
Answer: in some cases that will happen while the skin is healing and trying to regain its normal moisture, it should subside in time, can use a moisturizer to help your skin moisturize and that way it will not need to make as much on its own. JG 10.11.08
Answer: not necessarily a contraindication, no. JG 10.11.08
Answer: in some people that is what I do too, not on the eyelids but on the remainder of the facial skin, yes. I have done it at 4 and the downtime is about 12-14 days. I still prefer the Rhytec over the CO2 Fraxel on he neck though. I think for the lip lines I would do the deep Portrait. Best of luck. JG 10.10.08
Answer: I think dramatic results can occur in high energy patients but in general I tell my patients that even after a high energy Portrait treatment they should expect between a 35-50% improvement, not more than that. People will usually show the best photos as a selling technique. In my experience, multiple low treatments do equal one deep one for pigment problems but not for wrinkles. Initially it was said that three light ones equalled one deep one and now he is saying 5, so I would say in genera, no, they are not equal. It will not affect the dermatitis long term but can flare it up in the short term, it will certainly not help it nor control it. As to seeing a different surgeon, that is all up to your confidence level. I do not agree with what you have been told, and although I have not seen you in person, I disagree with what has been said and that is why I think seeing a different surgeon in persn would help you decide, if they both say the same thing then you can go ahead with a clear conscience, if they disagree, there must be a reason for the disagreement and you need to ponder the decision. I think OTC skin creams will help soften the skin temporarily only. Oatmeal is included in the products as a mild exfoliant, it does not moisturize anything. Best of luck. JG 10.10.08
Answer: I pretreat everyone, in this case maybe two weeks. JG 10.10.08
Answer: do not think it is worth it. JG 10.10.08
Answer: sorry, not a fan, better results compared to what other ineffective over-priced over-hyped machine on the market? JG 10.9.08
Answer: it can go as low as 30 microns but I would not use it on olive skin. JG 10.8.08
Answer: each one has about 4-5 days before you can wear make up and then the next one is done two to three weeks after the treatment. JG 10.6.08
Answer: when I do it lightly we use a topical anesthesia and when done deeply I put the patients to sleep. I think a plastic surgeon or dermatologist are good choices for the procedure. JG 10.6.08
Answer: well, I inherently disagree with your first sentence, if the CO2 laser is set to the strength you desire, it can go just as deep as the fractional laser claims, it is a matter of settings, not the machine itself. I strongly recommned not going any deeper than the skin so in many cases 2mm is way too deep. I persoanlly would not recommend the fractional laser, I think subtle resutls will likely be an understatement. If you do not need something like a Rhytec maybe you should stick with topical agents like Retin-A. JG 10.6.08
Answer: I would suggest you wait about one month. Having a Fraxel should not prevent having another procedure in the future. JG 10.5.8
Answer: Erbium offers no coagulation and will not give the degree of improvement that a CO2 laser would, I do not agree with what you have been told. JG 10.4.08
Answer: well, the greater the degree of improvement needed or desired, the deeper one needs to go, I do agree with the statement that CO2 is more risky, but it is also more effective by a large degree. A single deep Rhytec will do much more than a single light Rhytec, that is true. I would agree with you that he has not been honest with you in terms of expectations. I understand that he is respected, but if he is making claims that are biased, I would wonder why.Doing a minimally effective thing twice will, most of the time, not make a dramatic improvement, but it does minimize the risk. I would seek another consultation and see what the other surgeon says. Best of luck. JG 10.2.08
Answer: Less is less, so in my opinion, especially for acne scars, if you want a visible degree of improvement, you need to have downtime. I cannot say to what degree your scars wil improve without seeing you in person but with a deep Rhytec, expect 10-12 days of downtime. Best of luck. JG 10.2.08
Answer: I personally think the Rhytec will because it treats a larger area of skin. JG 10.1.08
Answer: the cortisone she prescribed to you appears to be a combination with some hydrocortisone in it,also possibly clindamycin and the moistrel, I am not sure. I would agree that she is likely tyrying to treat the inflammation with it. As to giving you a bleaching cream and then telling you that you do not have pigment problem, I think you figured it out correctly. The redness should settle though. I would not do another treatment until all has healed without any problems. Best of luck. JG 10.1.08
Answer: well the CO2 will yield more dramatic longer lasting results but with more downtime and more risk, the Rhytec done deeply is a good option but will yield a lesser result.The recovery for the Rhytec is wearing makeup in 2 weeks and pinkness gone in one month, the CO2 is wearing make up in 2-3 weeks and pink for 2-3 months in many cases. JG 10.1.08
Answer: well, firstly, you cannot believe everything you read on message boards. I personally have never seen a well-documented case of fat loss from a Rhytec Porriat treatment, and if it were to occur you would have had to burn the skin over the area and have left a large burn. Have there been burns and scars from the Rhytec, yes, in inexperienced hands. As to getting all of the fine lines to be gone after a single light treatment, which is what they have described to you, I would doubt that. Improvement yes, abolishment of the lines, no, but it does get better for a few months. The Portrait can be done with Eczema, might be a little slower healing though. All the best. JG 10.1.08
Answer: I think you should see a doctor like a plastic surgeon or a dermatologist to have the procedure done in oreder to get teh most drmatic worthwhile investment of time and money. JG 10.1.08
Answer: I am not sure to be honest, I can only surmise that is happened after the laser treatment and they are temporally related but not causally related. Maybe they were treated by a machine that they were told was a laser when it actually was a radiofrequency machine and they were not told correctly what they were having done. As to the hyperpigmentation, sooner is better, and prevention is even better. JG 9.29.08
Answer: I have actually never heard or read that, it is commonly done to prevent and treat hyperpigmentation and it does cause irritation but I have not read anything in a scientific journal that says it lessen collagen formation. JG 9.25.08
Answer: if it is uniformly bronzed and still stiff, I doubt it is hyperpigmented, just that the dead skin is still attached, got to give it a little more time. Bleaching cream works well for hyperpigmentation only and will not affect future treatments but for now, just use sunblock until the skin peels off. Best of luck. JG 9.25.08
Answer: I think it is safe to do it now as long as only the non-treated areas are covered with the Portrait, the surrounding area heat should not cause a problem this far out, and the longer you wait, the harder it is to see the areas that were not treated. Best of luck. JG 9.21.08
Answer: yes, it could even be done sooner. JG 9.20.08
Answer: sorry, not a fan of it. JG 9.20.08
Answer: nothing good I am afraid. JG 9.20.08
Answer: well, it is easier to match skin tone of the whole face is done and the tightening will never be permanent, maybe a couple of years, no matter what technique is used. JG 9.18.08
Answer: no, I think the Fraxel Repair will do less than the Rhytec. For the neck I use a lighter Rhytec or a chemical peel and educate the patient that their expectation of neck skin improvement needs to be tempered and is usually not dramatic. At times what you want is not possible. For the perioral wrinkles we use fillers, Rhytec ad CO2 laser. JG 9.18.08
Answer: I do not think too much positive of it I am afraid. JG 9.17.08
Answer: it helps by scarring the skin, if you are not willing to use lasers I am not sure why you would elect to have a procedure done that is more risky in all aspects than a laser would be. JG 9.16.08
Answer: Rhytec is better than Fraxel I feel. For upper lip lines I usually use fillers, then a Rhytec Portrait and then a CO2 laser. JG 9.20.08
Answer: I feel there is little to no difference. I personally think they are a waste of money. JG 9.5.08
Answer: high intensity treatments can be done on the face but not on the neck, sorry, but you can do a series, also, there will need to be about 3-4 months to see the new collagen form, so it is too early at 4 weeks to make a final decision. In most cases in weathered skin, it will take more than one treatment for the neck though. JG 9.3.08
Answer: I think the plastic surgeon will likely use more sutures at different levels and it might result in a better quality scar long term. There is no laser that removes scars, but they can fade rednesss if the right one is used. JG 9.1.08
Answer: just another modification of the previous one that has proven not as effective as they claimed so they keep coming up with the new and improved. I think the likely side effect is being disappointed with the degree of improvements. JG 9.1.08
Answer: A TCA peel, 30-35% or a Rhytec Portrait Plama treatment. JG 9.1.08
Answer: yes, to a milder effect, but yes. JG 9.1.08
Answer: the only treatments I would do on the face for that is either a Rhytec Potrait Plasma or a TCA peel, no CO2 laser and I think the fractional lasers are not effective enough to warrant their use. JG 9.1.08
Answer: some technicians in spas are experienced, you need to check it out, in some states, like California is can only be done by certified nurses or docotrs, if doen in a spa,makes sure the supervising doctor does the procedure as part of his normal practice and not just as a far away non-practicing cosmetic surgeon. JG 8.31.08
Answer: it helps brown and red spots, melasma, and maybe tiny little lines in younger patients is about all, no skin tightening to any appreciably visisble end. Are only pink for a few hours and the neck can be treated. Best to you. JG 8.29.08
Answer: I would not suggest either, I do not think the amount of collagen they produce is orth the money spent. If it did improve collagen, since collagen is constantly degrading in the body, you would need to continue the treatments and the older you are the less the degree of collagen production would be for each treatment. JG 8.29.08
Answer: there is no number I can give you, the deeper they go the greater the risk but there is no set depht I can give you as safe. I think men do develop less loss of pigmentation but at times there is a relative color difference as many men have severe neck sun damage and that cannot be removed as effectively so the color difference between face and neck can show.I think CO@ Ulrapulse will be the most effective choice to see a visible difference so if your concerned about the changes that have happened over the past few years I would go ahead. Best of luck with it. JG 8.27.08
Answer: skin discolorations mostly. JG 8.28.08
Answer: thank you for the kind words and all the best to you and yours. JG 8.27.08
Answer: it might, but all treatments are temporary and the Fraxel, as it is ablative, albeit fractionally, has a risk of causing hyperpigmentation. JG 8.27.08
Answer: no matter what the intervention is there are always risks, if the procedure is done with the requisite safety precautions and in experienced hands the risks are reduced and complications are quite rare overall. JG 8.25.08
Answer: depends on how deep they go, 7-14 days before make up. JG 8.22.08
Answer: I think the area that did not peel will likely reduce a small fraction of the fine lines that remain at this point but will not remove any more sun damage spots. In my experience the skin needs to peel for a dramatic effect. I think another Portrait after 6 months is fine, but if one did not do it, the second might disappoint also. Might want to consider something stronger like a CO2 laser, but that cannot be done on the neck though. As to the neck the best you can hope for is spot removal, the neck might be well treated with a TCA peel otherwise for the spots. Best of luck. JG 8.20.08
Answer: I usually suggest waiting 6 months before the next one. If she had a series of three light ones I would wait 6 months, and likewise for a single deep one. But if she had a deep one already I see no reason to repeat something that did not work the first time. The neck cannot be done as strongly so the changes will not be as dramatic. You have to go light on the neck, so it is more for spots than wrinkles there. All the best. JG 8.18.08
Answer: well, a series of light ones will not equal one deep one, I think the deeper she is willing to have the better. I understand that she has concerns about pain and downtime, etc, but she needs to understand that therefore there will be compromises in the results too. There is no free lunch. JG 8.18.08
Answer: sounds like you will need another treatment done, it is usually best to wait 6 months but can be done sooner as long as you do not go too strongly. All the best. JG 8.15.08
Answer: not an unusual setting use. Higher settings with lesser passes do not mean a better result, but it does increase risks. The areas you describe are likely skip ares, and should not happen too often when doing a session with multiple passes, those areas in some small fraction of cases might need a little touch up in the future. The untreated areas will likely blend in fairly well in the first month and I would not repeat the treatment for 6 months or so. The burning is normal,just do not try to peel or rub the skin off, let it fall off on its own and it will hurt much less. JG 8.15.08
Answer: my recommendations depend on patient`s skin, desires and risk tolerance. I have done deep sessions on older individuals, it is safe, but the results might not be as dramatic as in a younger person. I do not think any collagen would be damaged to the point of causing more sagging than the normal aging process. JG 8.14.08
Answer: that should be enough to remove the spots. Skip areas are not uncommon, especially if a single pass was done and in most cases it all blends in over time. It will likely not need a touch up. JG 8.14.08
Answer: yes, OK to do there, but that skin is thin so they cannot go too deep whch means it will last a couple of years and then have to be redone. Best of luck. JG 8.14.08
Answer: swelling is there for 2-3 weeks, as to the redness, it is depth dependent, the deeper one goes the longer you are red or pink for. In many cases like yours it can last 3-6 months, but can be covered by make up. JG 8.13.08
Answer: I do not think it would cause any scarring. It will either do little, a reasonable improvement, or in a rare case could burn and scar someone. I commonly use it for older skin with the education being that the degree of improvement is not as much as a CO2 laser. JG 8.13.08
Answer: a burn scar that is permanent. JG 8.13.08
Answer: not always, it does in some thinner skinned individuals, but not in all. JG 8.13.08
Answer: would need to see you in person, sorry. We charge the same for the entire eye region. JG 8.13.08
Answer: those are about what I would have used, higher settings might give more dramatic changes but also has higher risk of scarring and pigment loss. At times I will back off on the energy setting depending on how the patient feels the pain, that is part of the parameter of how we set things, so backing off and then doing a second pass or a third is safer than going too deep, it is a matter of cumulative heat delivered. I do not routinely use the last pass at 1 joule but I have done it on occasion. Best of luck. JG 8.13.08
Answer: it needs to be redone if you need it from further aging changes.The older you are the less collagen the skin makes after an injury such as a laser. JG 8.13.08
Answer: it can be done under local, yes, but it can be a little uncomfortable. The laser should not normally burn off the lashes but it can at times. If they are burnt they will grow back. JG 8.13.08
Answer: I think since what caused it was the CO2, that will be what wil be needed to correct it and blend the areas in by doing it a lighter settings. The Titan will do nothing and the Erbium is what you used and that left the areas unchanged, you need to use the one that changed the area. Best of luck. JG 8.13.08
Answer: Rhytec Portrait or a light CO2 laser. JG 8.12.08
Answer: to be honest I think fractional lasers of all kinds are not worth it.I cannot in good conscience recommend either one. Sorry. JG 8.11.08
Answer: no, it is a hot plasma, no radiation. Rhytec is not a laser where there is radiation but the radiation occurs inside the laser and not on or in the ksin so there are no radiation issues on the skin itself. JG 8.10.08
Answer: fat loss of the face has not been reported with Rhytec. The heat does not go through the skin so the effects are to the skin only and the heat disapates in minutes. We at times do nerve blocks for the lighter sessions but for the deep ones we put the patient under general anesthesia. The local anesthesia shots have no long term effects and wear off in a few hours. JG 8.10.08
Answer: Copper peptides have been shown to help speed the heaing process of the skin after a surface injury like a sunburn or a laser. We use them until the skin has totally healed, so for about 10-14 days, it can be used for one month if desired though with milder benefits after the two weeks. I think NeoCutis is a good brand but is sold only by physicians` offices. Nothing agianst your dermatologist, I am sure he is a fine physician, but I think it might be better to see a dermatologist who does these all the time. It is not that he cannot perform it well, it is more of knowing what is normal healing and what to do if something happens, you are better off with someone with experience on the cosmetic end. JG 8.8.08
Answer: could you please refernce the question you asked previously as I want to make sure I refer to the proper Rhytec question. Or repeet the entire question wihth the additional points of new questions. JG 8.8.08
Answer: it can if you go very deep, yes. The skin does turn brown with the lower levels but it comes off faster and there is less underlying pinkness. Minimal post-op pain after the initial 4 hours and the complications come only when the settings used are too high and a burn occurs, then you get all of the bad effects of the burn, such as thick skin and texture changes. JG 8.7.08
Answer: it is for milliseconds so the heat is doubtful to cause any cancer, there are many more common issues that are more worrisome. There is only heat and no radiation that I am aware of. It is more like hot water, very hot water. JG 8.7.08
Answer: kenalog and or 5FU injections, the redness will fade a little with the shots, or a YAG laser could help with the redness too. JG 8.7.08
Answer: I am afraid the only thing would be to excise the scar and skin graft it, injections might soften it but thats about it. JG 8.7.08
Answer: I think for the redness I would suggest an Nd:AYG laser or a VBeam laser, I think the microdermabrasions with IPL will do little good and the same for the Stralux in most cases. The scars wil be permanent, the best you can hope for is the redness to fade some. JG 8.7.08
Answer: well, one could attempt to remove the color from the darker areas, might not be to effective in terms of getting it smooth out though, hard to get it to do something undesirable when you want at times. I think if anything going slow with it is best but unfortunately the lighter treatments will not be as effective in achieving your goal. I think using IPL again on the dark areas only and totally avoiding the hypopigmented areas would be best. JG 8.6.08
Answer: I used to think so but now as time has gone on I feel the single deep will give you more than a series of lighter ones, at least for wrinkles and scars. I do high energy passes to the lids and that should not be a problem. JG 8.6.08
Answer: we use a copper peptide cream from NeoCutis right afterwards. As to moisturizers, we suggest using one that has no glycolic acids or retinols in it. Best of luck. JG 8.6.08
Answer: it is Cetaphil cleanser, a copper peptide cream (NeoCutis) and and a bottle of atomized water spray(like Evian), he can get all of that for you, no need to buy it from us. JG 8.6.08
Answer: $4500 plus the post-op kit. JG 8.5.08
Answer: typically no. JG 8.5.08
Answer: I perform it there as well. JG 8.5.08
Answer: I do not use them but use a protective barrier over the lashes and to avoid any gas blowing into the eye. The corneal shields are certainly OK to use, too. The nevi will likely be a little flatter and darker for a little bit but eventually return to the way they were and the skin over them will heal well. JG 8.4.08
Answer: Plasma, but the improvement for the laxity will be mild, no laser will do much there except a real CO2 done deeply, the Fraxel will not do it even if it has CO2, if it is going to work, it has to be totally ablative for the tightening. JG 7.31.08
Answer: can try some progesterone cream and even Accutane for the acne, as for the repeat Rhytec, it is possible, otherwise a CO2 laser would be good. As to the healthy glowing skin complexion, I am afraid that will not be possible with anything you due to the damage already done. Sorry. JG 7.31.08
Answer: the burn is a remote possibility, in most cases that will all go away in a few more days, stay out of the sun in the meantime. JG 7.31.08
Answer: I do not think it will do anything, sorry. JG 7.29.08
Answer: I have not seen laser help with swelling and the ketoprofen will not always work, it is more for pain than anything. In your case especially since it is so long from the injury. JG 7.29.08
Answer: no real difference, prety much the same, neither very effective. The Fx CO2 is stronger but since there are so many skip areas it will not do much either. It is not the type of laser used that makes fractional lasers ineffective, it is the amount of non-treated skin. JG 7.27.08
Answer: depends greatly on you skin and age, I think you will likely be disappointed with a fractional laser as that is exactly what the Fraxel is, a fractional laser. JG 7.26.08
Answer: sorry, but no, there is not. The melanin cells have been damaged and there is not much that can re-establish that for you. JG 7.22.08
Answer: I think any laser, no matter what they tell you, if it is going to help the wrinkles, will make the Rosacea worse for awhile, if it does not, it will not do anything for the wrinkles, sorry. JG 7.21.08
Answer: it will work well to control the redness from the Rosacea but will not do much for wrinkles I am afraid. It will not do much for the scars either, but some of the pores will likley get better if they are plugged with oil. All the best. JG 7.21.08
Answer: well, if the melanin cells in the skin were damaged, exposure to the sun might make the unaffected skin darker and not allow the damaged skin to get darker and it could make the scenario even worse, sorry. JG 7.21.08
Answer: I think the improvement from a deep Rhytec for acne will be maybe 50% at most and the redness will be gone in one month. Prices will vary from office to office but usually about $4500 or so. JG 7.19.08
Answer: well, if done too agressively , that can be normal, as to how long it will last, it will probably take weeks but I cannot say as there are variations from patient to patient and it also greatly depends on the depth of the treatment. One has to wonder why the doctor would do a very aggressive Fraxel treatment when the technology is marketed as a minimal downtime procedue. Seems to me that he had one hammer and you became the nail. A more appropriate technology along with better preoperative preparation for post operative healing should have been entertained.JG 7.19.08
Answer: I am unimpressed. Retin-A does help control the acne and does improve scars a mild amount. JG 7.18.08
Answer: once the swelling goes down, I have never seen Erbium yield a worthwhile improvement for acne scars. The redness will vary on the depth it is performed to, I would guess one month or so with a moderate depth application. JG 7.18.08
Answer: I would wait and do the laser first and then a few days later for the others. JG 7.16.08
Answer: maybe 10-15 %, might last 18 months after one deep treatment. JG 7.16.08
Answer: I am afraid that you will be disappointed. No short or long term negative effects though. Might be better with punch excisions and then a CO2 laser. JG 7.14.08
Answer: I do not perform regular dermanbrasions anymore due to too many variable, I only do excisions and CO2 laser as you have had done I am afraid. JG 7.12.08
Answer: well, my honest opinion is that option has never made any biological sense to me. CO2 lasers work by essentially heating the tissues to shorten collagen fibers and try to create new collagen to tigthen the area. In a scar, there is injured tissue and the ability to develop new collagen or tigthen what little collagen exists is severely depressed. It might appear to help in a small subset of cases where the CO2 laser causes swelling and makes it look smoother, but once it heals, the best you can expect is likely the same result you would have gotten without the laser. In some cases, it will actually burn the scar and create an even worse scenario. I would not do it myself. JG 7.10.08
Answer: well, I think a test site is totally wasted as not all of the skin on the face is the same thickness so you cannot genralize one spot to the entire case. I also think that the effects you might get will be very minimal, in fair skinned individuals where they can go more aggressively, the results are minimal once the swelling has resolved. In your case, since the nergy has to be decreased,the results will be even less. JG 7.9.08
Answer: nothing safe and reproducable that I am aware of. JG 7.7.08
Answer: I am not impressed with the degree of improvement to be honest, the results are dramatic, but not predictable I feel, in many patients the degre of improvement is disappointing. I think the fillers and Botox will still be needed in addition, yes. One more thing about Botox. It has come out that the education that injectors were given since the beginning of Botox release was incorrect. The bottle is to be used for a single patient. That means that a bottle should not be shared between multiple patients. The company that makes Botox has known about this but has never issued an alert to doctors or patients. The risk is that of the bottle becoming contaminated and passing a communicable disease like HIV or hepatitis from one patient to another. There are no known reports of disease transmission in the use of Botox, but it has not bee looked at yet in order to determine that issue. For that reason I strongly urge you to demand that a new bottle be used when you are treated and then observe the injector destroy the remainder of the bottle. If that is not done I urge you to contact the local board of health for the violation. Ask to look at the box it comes in and you will see the single patient, single use wording. JG 7.5.08
Answer: might want to try a series of YAG lases to improve all of that. JG 6.30.08
Answer: If you have lost fat then the surgical lifting will not help the fullness aspect, just the skin. Might be best to have the Rhytec and then Sculptra to fill the cheeks back up. JG 6.28.08
Answer: well if it is still hard I think proceeding with more injections is OK, just have the use a dilute concentration is all. JG 6.28.08
Answer: not, to settle the small lumps, it will not affect the redness. The risk of the laser is not due to the person performing it, it is the laser itself as that skin does not heal well from lasers. It might for the redness if doen very lightly, but not anything for the small red bumps. JG 6.24.08
Answer: I think it is the most effective, safe to do with Rosacea too. The healing proces and pain is all dependent on the depth, the deeper you go the greater the pain and recovery but the greater the improvement too. JG 6.25.08
Answer: yes, but you will need to go through that to eventually get it to lighten, there is a trade off, I would use the YAG, yes. As to the bleaching cream, I suggest hydroquinone, but it is a prescription. JG 6.24.08
Answer: I have never seen nor heard of CO2 allowing unseen scars to surface, and although most patietns do see improvements of their scars, it all depends on how deep the laser was performed to. If not deep enough, the results will not be visible. If CO2 lasers scar they are typiclaly seen in 6-8 weeks and are raised and red, like a burn scar. JG 6.24.08
Answer: I do not think a YAG laser will harm it in the long run, and it will likley need a longer series of treatements and likley stronger than the YAG, not lighter. You might have some temporary post-inflammatory hyperpigmentation, not uncommon with lasers. Should get better in time and avoiding sun.JG 6.24.08
Answer: it is a chronic thing, can be contolled, but never cured. Typically glycolic acid products do well with the control, both cleansers and topicial creams, all OTC, no one brand better than others. JG 6.23.08
Answer: I would suggest the Portrait as more effective, especially if doen deeply. The redness with the Portrait, as with all lasers, depends on how deep one goes, in most cases when done deeply, the patient can wear make up in 10-12 days and the redness is gone in one month. JG 6.23.08
Answer: well, safe is relative, I would not do it myself. I think it is safer than the older CO2 but the degree of improvement is also much much less. JG 6.23.08
Answer: as to whether a single deep or a series of three lighter ones is indicated depends on the patient`s needs and limitations, I prefer one deep one but it has more down time, it helps with fine lines and brown spots, It should not affect the previous fillers though. JG 6.10.08
Answer: I think the steroid cream will not help, and could make it worse. I think a series of IPL treatments is safer than the VBeam and would try that first, the VBeam might be needed if not, but I would suggest going with the least risky option first. It certainly could be a reaction to the Fraxel and millions of little holes made in the skin. Also avoid any skin irritants like Retin-A and retinols too. Best of luck. JG 6.9.08
Answer: I would step it up to a CO2 laser. JG 6.5.08
Answer: sorry, but that is correct. It is not what dermabrasion is supposed to do, the risks of that are much higher with dermabrasion than it is with laser resurfacing. JG 6.5.08
Answer: if you stop, the hair you have regrown, wll fall out, yes. You will need continued use. JG 6.4.08
Answer: they are probably related to the Rosacea and they will be difficult if not impossible to treat with topical treatments if they are below the skin. As to the acne scarring, yes spot treatments of CO2 laser can be done but the color there will be red for months and will be difficult at times to hide with make up. JG 6.4.08
Answer: the steroid will not help and I think the VBeam, done lightly is certainly an option. Best of luck. JG 6.3.08
Answer: sorry, but a series of weaker ones does not equal one deep one as the heat is needed for collagen formation and shrinkage. I think the CO2 laser yields about twice the improvement as the deep PSR. JG 6.2.08
Answer: excision of the ice pick scars followed 6 weeks later by a CO2 laser. I would not have expected any of the options you have had done to yield much improvement. Save your money as to the Cool Laser, the PSR will help some, less than the CO2 though. JG 6.1.08
Answer: because there is a focused light that is set to hit a certain color and if it hits your eye the retina can be damaged. If you understand radiation, you would know that lead will block the radiation and no eye protection worn is made of lead. Teh reason nurses do most of the lasers is that in most cases it is for financial reasons, not anything to do with radiation. JG 6.1.08
Answer: that all occurs inside of the machine which is shielded and never is applied to the patient so it has no effect on the patient. JG 5.31.08
Answer: there is no radiation from a laser. JG 5.30.08
Answer: it will depend entirely on what I am trying to achieve and the patients needs and skin quality along with their age. JG 5.30.08
Answer: likely 150 microns. JG 5.30.08
Answer: I would stop all irritants and use a copper peptide cream before continuing to irritate it with plasma or lasers, let it heal as much as it can on its own first. JG 5.30.08
Answer: I think you need to stop the treatments and let the skin heal totally before considering anything else. It is due to the trauma from the laser used. JG 5.28.08
Answer: nope, might make them worse. JG 5.28.08
Answer: brown spot and fine wrinkle reduction is good, at times though, if the skin is very damaged, the degree of improvement is not as much as desired. Shorter healing time versus a CO2 laser. JG 5.27.08
Answer: well, since CO2 is stronger and can go deepr, the chances of scarring and loss of pigmentation are greater. For that reason the CO2 laser is usually done to a depth where the improvement will occur but lessen the risk of the problems. The Rhytec is safer as it is weaker, the CO2 can be done at a weaker setting to simulate the Rhytec but then the results are closer to the Rhytec. In short, if you want dramatic resutls, you need to accept the risk. JG 5.25.08
Answer: the depth required is based upon the expereince the docotr has with the laser and your skin`s needs. I do not ask trick questions but if you have specific areas of concern, you need to tell the doctor of that before they do the procedure to make sure what you desire is atainable. JG 5.25.08
Answer: I think the IPL is a good idea and should not result in loss of pigmentation. I can look at it for you, or you can send me some photos to drgarcia@lvcosmeticsurgery.com JG 5.25.08
Answer: Portrait is less effective than a CO2 laser but is safer in most cases. What can be done will depend greatly on where the skin was burned and where the wrinkles are now. JG 5.25.08
Answer: it is very difficult to tell without seeing you in person what I would suggest to improve your problem. I think that regimen of Accutane is unusual to say the least. I also think whoever suggested filling in the pores with collagen is confused, that will not work and can make the scenario worse. Also, collagen does not need to settle, it is there at the end. Accutane can in some people help reduce new dilated poes from starting but it does not really help the pores that are aleady plugged. The Accutane is certainly causing the dryness and irritation but likely not the pore issue. I think if you were contemplating surgey or a laser, since the amount of Accutane you have taken is low, a few months is all that would be needed to wait. JG 5.24.08
Answer: might just need to have more treatments is all. The longer you have the Rosacea, the harder it is to control. JG 5.23.08
Answer: whichever lists more copper. JG 5.22.08
Answer: the greater the copper content, the better it is. JG 5.22.08
Answer: the more copper the better. JG 5.22.08
Answer: I only do CO2 laser under general anesthesia. Dentures can stay in place. The results at your age could last 3-5 years in most cases. I do not think at present any OTC cream can do what Botox can do. JG 5.21.08
Answer: yes, but not as storng so it will likely take more treatments, it might remove the top layer of skin but it does not need to do so for it to help with the redness. It will attempt to clot the small blood vessels that have overgrown and caused the rednesss and doing that will reduce the redness. JG 5.21.08
Answer: I feel the only laser that is effective for loose skin is the CO2 laser, the Rhytec will help with fine lines but not loose skin. JG 5.20.08
Answer: I have seen Fraxel causing loss of pigmentation, yes. It can show up after a single treatment, yes. In most cases it will get better but the more treatments are done the greater the chance that it will be permanent. If it is permanent there is not much that can be done. JG 5.20.08
Answer: I think all lasers that are fractional in results and will limit the results. JG 5.18.08
Answer: yes.JG 5.16.08
Answer: at your age it will help with the crows feet and lip lines if done deeply, the neck will likey not improve though, nor the marionette lines. JG 5.16.08
Answer: it will only reduce the size I feel, Erbium is a relatively superficial improvement and as it generates no heat, the degree of collagen fiber contraction is small to none. It will stay red for weeks, how many weeks depends on how many passes and also the number of passes to some degree affects the results, the more passes the more the improvement but the greater the downtime. JG 5.15.08
Answer: I think Fraxel offers little improvement for the risks incurred, I am not a fan, I think a YAG laser would be better, but no matter what you use to fade them in time, they will all come back. JG 5.14.08
Answer: well, honestly, the degree of improvement in older skin is not as much and not as long lasting, while you are swollen all looks good but the older one is the less collagen is made from these procedures, so I cannot tell you that it is a good long term option. JG 5.8.08
Answer: I think Portrait is more predictable and works better. JG 5.8.08
Answer: I think most physicians would start with the IPL head as it is less risky, and then move on from there, I will tell you, even if the YAG head is used, it will take a series of treatments. A VBeam laser might get rid of it in one setting or it could be hyfercated to remove it, old fashioned and low tech but effective. JG 5.6.08
Answer: it will remain raised from the selling and might not go flat until the vein is totally ablated or clotted. I would never expect a difference after one session with the Lumenis One. The indentation is normal and usually fills in with time. JG 5.6.08
Answer: the entire vein is treated but the treatment head is larger than the vein so there will be a small square which is treated, not just the vein. The slight raising is just swelling and is all normal and will go away. JG 5.6.08
Answer: that is what I would suggest to start, it will take a series of treatments, one will never be enough, might need more than three too. JG 5.4.08
Answer: I think you have post inflammatory hyperpigmentation, the laser is long ago healed and that is not the cause. You might need some bleaching creams and sunblock all the time when outside. JG 5.4.08
Answer: I think it will help with the discolorations and not much else once the swelling is gone. JG 5.4.08
Answer: depends on the depth, but if they go to the usual depth, 2-3 weeks out of work. JG 5.1.08
Answer: I think with proper protection after the treatment it should not happen and the risk is not different than as if it were the first one. JG 4.29.08
Answer: I am familiar with it and I think it is not as good as the Portrait treatment. There is no free lunch, if you need improvements, there will be downtime, and the older one gets the lesser the improvements from the lesser procedures. JG 4.29.08
Answer: it can, but if it is was deep, it might need bleaching creams at least. Could try a series of IPL treatments to help fade it too. JG 4.28.08
Answer: the fee is about the standard but I am not impressed with what that laser can do for scars. I like the Rhyec Portrait for scars, or a CO2 laser. JG 4.28.08
Answer: go with the Photogenesis. JG 4.26.08
Answer: I agree, counterproductive as the pressure will diminish the target color red. JG 4.25.08
Answer: I think it is much milder and will give you some improvement but understand that for less downtime you get less improvement, so your expectations have to be lower in terms of the final result. JG 4.25.08
Answer: I am sorry but I have not had a chance to see anyone who was treated with Isolaz, typically lasers that are effective for acne scars will not be good choices for rosacea though. JG 4.23.08
Answer: copper peptide creams for the healing phase is about all. JG 4.23.08
Answer: I am sorry but I do not have anything that will likely help, anything that could be tried, like lasers, might be risky with taht history and even without that history, the degree of improvement on hands and feet is quite mild and likely will not be enough from what you describe.Sorry. JG 4.23.08
Answer: well, hydroquinone is for brown spots and not redness do it would never have helped, the topical steroid Desonide is quite strong so you should not use it for more than 5 days in a row before taking a break, prolonged use will thin the skin and cause broken blood vessels. If the steroid worked that fast you were having either an allergic reaction, or a topical irritation/dermatitis, more likely and that will help along with stopping the irritating agent, it could be the lanolin, although that is uncommon. Glad all is better though. JG 4.22.08
Answer: I think it will not lift it enough in most csases. I think the only thing will be a facelift I am afraid as all non-invasive treatments at your age will not create enough tightening. JG 4/22/08
Answer: that would be the soonest I would repeat it, but it really depends on how deep they went, the less deep they went the sooner it can be repeated. JG 4.22.08
Answer: hydroquinone will never help redness and might actually make it worse, so I am not sure what they were trying to do. I do not think you have permanently damaged your skin, but I would stop the hydroquinone. I have not heard of allergic reactions to Aquaphor causing prolonged redness though. JG 4.21.08
Answer: I agree but also know that the improvement will not be permanent, how long it will last will depend on how much your skin will rebuild the sebaceous glands after healing. I think if downtime is an issue I would suggest the erbium. JG 4.19.08
Answer: the light treatment should leave you out of commission for 4 days or so. JG 4.18.08
Answer: depends on which technology, and how deep they go so it is almost impossible to tell, if they go as hard as they can, likely no more than three years. JG 4.17.08
Answer: might need to do a light CO2 laser on the entire surface to remove the top layers and get everything to the same depth or surface. Sorry to hear about your problems. JG 4.17.08
Answer: not normal, you have post inflammatory hyperpigmentation due to the procedure and the lack of adequate skin protection afterwards, it needs to be treated with Retin-A nad hydroquinone along with no sun exposure and complete sun block. JG 4.17.08
Answer: not in my opinion. JG 4.14.08
Answer: it is possible, especially if the exposure is soon after a facial treatment, you neeed sunblock all of the time. JG 4.14.08
Answer: the skin area will likely still look pink to red, might be hard to cover that up with make up in 5 weeks if done aggressively. JG 4.13.08
Answer: not permanent but would likely work for a number of weeks. JG 4.2.08
Answer: at least 150 microns. And it might take mroe than that in some areas of the face like the lip. JG 4.1.08
Answer: I think the risk of hypo-pigmetnation is never spoken about as it is very very rare. JG 3.31.08
Answer: I would wait at least 6 weeks but I think while a regular dermabrasion would help, the microdermabrasion will probably not do much. JG 3.31.08
Answer: light would be 75 or less, medium 75-150, deep is more than 150. Scarring results from deeper depth, that is correct. Scarring is not a for sure if heat is generated deep, it depends on how long the heart lasts. JG 3.27.08
Answer: the risk is higher if you have had procedures done before, yes. I think all three things have potentially caused some superficial scarring that can make the loss of pigment a higehr risk, yes. JG 3.24.08
Answer: I think for a skin prep for faster healing I would use Retin-A and hydroquinone for one month twice daily before, there is nothing that will prevent loss of pigmentation, that depends entirely on the depth of the peel. I think the most realible would be the UltraPulse CO2 laser and the repeat dermabrasions, if done to the same depth as the CO2 laser to acheive equal results will have the same loss of pigment risk. Best of luck. JG 3.24.08
Answer: not much I am afraid. JG 3.24.08
Answer: for the face it will require at least three of the PSR2 and the neck with light treatments will have very mild improvements. JG 3.23.08
Answer: not impressed by either I am afraid. JG 3.22.08
Answer: no damage, just dry skin that needs more moisturizer. Could consider a DMAE cream or Vitamin C cream for the eye area. JG 3.21.08
Answer: It can be dramatic but it does not last more than a couple of years because the skin is thin and it folds so many times per day. Multiple light passes try to get the same as one deep pass, so you need to understand that not all passes are the same, the energy setting is also important. JG 3.20.08
Answer: I have not seen pigment loss with the Portrait because it does not go as deep so it has less risk of damaging the melanin cells. JG 3.20.08
Answer: for dramatic chnages it is the CO2. JG 3.20.08
Answer: laser is better. JG 3.10.08
Answer: I think you can repeat the CO2, as to how many times you can do it, it depends on how deep they have gone. I think the pro-fraxel over the filler is OK also. JG 3.8.08
Answer: that is correct on the bleaching cream. I believe he has a duty but judging by their response of it never happens it apperas that doctor is willing to say anything to get a patient to spend money. As to the derm board, I think it best first to speak with the state medical board. Best of luck. JG 3.8.08
Answer: I understand, I just think there are alot of shady scenarios out there and I was just trying to inform the public, I was not implying you should sue the doctor, but when you hear the word never just beware. JG 3.6.08
Answer: well, to make a long story short, IPL is not a true laser, it is an intense pulsed light, it was supposed to be purchased by a physician and then performed by technicians under the supervision of a doctor. Many med Spas have a doctor who buys the machine and is not trained in dermtology or plastic surgery, but the company cannot refuse to sell it to them. I am a big proponent of having a supervising doctor who actually does the procedures on a regular basis, but there have been threatened lawsuits for not allowing people to perform it. I agree, in the wrong hands they can cause serious damage. I think calling your local medical society is also important and for them to say the IPL never causes IPL tells me they do not know what they are doing or talking about because that is common knowledge of the potential side effect of PIH. Best of luck. JG 3.6.08
Answer: that should be enough time. Best of luck. JG 3.6.08
Answer: The Pearl is not as strong as the Rhytec Portrait, if you can only choose between the Fraxel and the Pearl, I think the Pearl will heal as fast as the Fraxel, and I think the results will be pretty similar. Neither one will give results as strong as the Rhytec though. JG 3.6.08
Answer: I think the degree of visible improvement in skin tightening is very small. I think for fine lines I would prefer the Rhytec portrait treatment. JG 3.5.08
Answer: as time goes on after a CO2 resurfacing, the skin will age like it normally would. As all skin ages, it gets thinner and new or old fine wrinkles will recurr. The sensitivity to the sun will not change after the CO2. I think whether it can be repeated depends greatly on how deep you go with each treatment, understand that the degree of tightening you get on the second or third go round is less as when you age the capacity of the skin to tighte and form new collagen is decreased due to the aging process, so even if they do it exactly the same way, you will not get the same degree of improvement as before. JG 3.3.08
Answer: not very effectve for the nasolabial folds, as to how long it lasts, there are too many variables to answer that question for you as it depends on the laser used, the energy applied the number of passes, the condition of your skin,casues of the skin problems and your age. JG 2.29.08
Answer: if treated with bleaching creams, sunblock and at times repeat laser it will help it go away but there is always a tendency for it to try to come back. It does not have to get red for it to be reactive like that. JG 2.27.08
Answer: there is always the risk form a pulsed light therapy or a laser to develop post inflammatory hyperpigmentation which is what you have. I think what you are doing is a good way to go. More light therapy can cause either improvement and also potentially more darkening. JG 2.27.08
Answer: I am sorry but I have not personally used either Fraxel as I do not think the have valid technology that will give the patients a good and reproducable result.JG 2.27.08
Answer: well, if they are very small it might work, if they are slightly larger and on the green side, they might not improve at all. JG 2.27.08
Answer: I think lasers might help some for fine lines, depending on which one is done, but will likely not do much for the sagging. JG 2.25.08
Answer: I think Rhytec Potrait is superior to the others. JG 2.25.08
Answer: I think the cicapalst can help healing wounds fade their redness but trying to use an ablative laser like an erbium to remove red spots shows lack of knowledge of the technology of that laser and its effects. Go somewhere else. JG 2.25.08
Answer: regular non-fractional CO2 laser. JG 2.23.08
Answer: it is not as effective as only microspots of skin are removed with the CO2 laser, and for the best effect you need to remove it all, otherwise the degree of tightening is only a fraction of the result, there in comes the name fractional treatment, because there are millions of skip areas. It does heal faster but you get what you get, which is a fraction of the result. JG 2.23.08
Answer: well, it replaces the lost fat, and will lift skin to some degree, but never like a facelift, it will do things a facelift cannot though in terms of acheiving fullnees in thin faces. I think the degree of tightening of the jowl and neck with a Rhytec is mild at best, it is more for fine lines and texture. I think the better option there is surgery. JG 2.19.08
Answer: it might help some but likely will not remove them all, and if it does work it is likely not permanent. I think 3 weeks of a daily steroid can cause some damage yes, if you are young the skin should be OK long term though. JG 2.19.08
Answer: short term while helaing it will be shiny and if it was shiny to start with, although it is safe to perform it, it will not control the oilyness. JG 2.16.08
Answer: I think those lasers are much less invasive than CO2 laser so the horror stories should be much less of a risk. Physician skill is still involved though, it is never totally removed as they set the energy levels on the machine. JG 2.15.08
Answer: no problems there. JG 2.17.08
Answer: the time back to work all depends on how deep you go, for acne scarring you need to go much deeper than for wrinkles so in my experience, if you are going to give the patient the maximum benefit, it will be closer to 3 weeks, you might be able to wear make up in 2 weeks but there is no way the make up will hide the redness underneath the makeup. Dermabrasion is no comaparison to the laser, the laser is safer and more effective. As to how long the laser lasts, the older you are the less time it lasts, in younger patients it can last 5-7 years, in older patients less, but no way to tell how long. The Rhytec will heal faster but the improvement will be less, that is the trade off. JG 2.14.08
Answer: I think a YAG laser or a series of IPL for the brown is a good idea, otherwise a Rhyec Portrait or a CO2 laser to remove the pigmentation and tighten the skin too might be in order. JG 2.11.08
Answer: usually 1-3 years or so, but if needed it could be repeated after 6 months. JG 2.10.08
Answer: I do not think so, it will remove skin discolorations though. JG 2.10.08
Answer: improve skin discolorations and fine lines, provide a healthier glow and some mild skin tightening. JG 2.9.08
Answer: I would give it another couple of weeks and then start the creams every other night to see if you tolerate it, the redness will fade but the deeper they went the longer it takes. Best of luck JG 2.9.08
Answer: my answer is that I do not think you should waste your money on either one, but if you insist on doing it then go with the Starlux, best of luck. JG 2.9.08
Answer: I think the single deep one is much better. JG 2.9.08
Answer: 25% or so. JG 2.9.08
Answer: I recommend either a CO2 laser or a Rhytec Portrait laser, neither one of the ones you are aksing about though. JG 2.8.08
Answer: thanks for the info, I certainly feel there are difference between erbium and a CO2 laser but when done in a fractional method, I think the differences are small due to the simple fact of the pixelation and large areas of skin left intact. I wil take you advice and look into it though. JG 2.6.08
Answer: It might help the blood break up, yes. It also migth cause more swelling, yes. JG 2.6.08
Answer: might smooth them out some. JG 2.4.08
Answer: I have not heard of any fat loss with either IPL or KTP. I think the IPL should do fine for those issues. Best of luck. JG 2.4.08
Answer: Rhytec Portrait and then for something stronger a CO2 laser. JG 1.31.08
Answer: well it will be mild for the acne scarring around the mouth, maybe 20-25% improvement. The underlying scars from the acne is what makes it less effective than what it is for wrinkles. JG 1.31.08
Answer: would not recommend it for that on your skin. JG 1.29.08
Answer: well, the amount of them that are pleased I would say is over 95% but I think much of that is because I am very clear with them and educate them on expectations. If someone has high expectations then the Rhytec is not for them, it is a mild improvement for wrinkles, better for skin discolorations but the safety margin is high. Three treatments are likely a little less effective than one deep one in most cases. So I think with reasonable expectations, satisfaction is high. JG 1.29.08