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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
Answer: I am unimpressed with its effectiveness and I think there are still risks with a fractional laser in oriental skin. I would likely not suggest you use it. JG 1.29.08
Answer: low risk for micropeel as it is quite light, the risks increase with the Rhytec and the higher energy used the riskier it gets. JG 1.28.08
Answer: it can be done after Juviderm injections but I would give it 2-4 days in between to limit the amount of swelling from them being combined too close together. I think you will need a little deeper than a light passs for the oens around the mouth due to the skin thickness there. Best of luck. JG 1.28.08
Answer: it is an OK laser, not as effective as a CO2 and works similar to an old fashioned dermabrasion, but should help some, best of luck. JG 1.28.08
Answer: the only ones I think are effective for skin tightenig are a Rhytec Portrait and a CO2 laser. JG 1.28.08
Answer: I do not think either one works. JG 1.28.08
Answer: I feel the Q-switched YAG laser that we use is the best for that. There is no way to predict how many treatments it will take, schedueled every 4 weeks to remove it, and we charge by time, $100 for 15 minutes which should be more than enough for that size tatoo. There are no known side efects from the laser. JG 1.28.08
Answer: there is no laser that will control acne, the BLU light lasers do have some bacterial control but will not prevent future breakouts totally. I think the Laser Genesis is a waste of time for controlling acne. JG 1.27.08
Answer: I suggest you continue until the peeling stops, yes. The washing makes it also feel tight due to it being a little dry, that gets better in time. Hang in there. JG 1.25.08
Answer: well I usually tell patients to wait 3-4 weeks in between for fear of burning, so I would likely skip the spots for now. JG 1.23.08
Answer: it is not the technician as much as it is the filter and amount of energy used. IPL machines are all pretty standard for the most part, not an appreciable difference. JG 1.23.08
Answer: well, I do not think thin skin will do that, it sounds more like the amount of skin excess you had was not large enough to warrant skin removal and if you did have it done, then the excess skin removal would indeed pull your lids down. If the skin is in excess, then surgery is indicated. If it is a quality of skin issue, then the laser or Rhytec is indicated, I think the risks of that occuring with the Rhytec are low as it is not as strong as a CO2 laser, which could cause lower lid retraction in people that do not have enough skin. JG 1.21.08
Answer: actually due to both of the reasosns you cite. I think even with multiple treatments with the Sciton Profractional machine you will likey never get the CO2 type of improvements. The Sciton could be done under local but you will still feel it.Best of luck. JG 1.21.08
Answer: there are no reports of fat dissolving with the Rhytec. I routinely do the under eye area. I think partial treatments are fine to do. JG 1.20.08
Answer: I feel it works and the down time depends entirely on how deep you go, so it is variable. There is no radiation with the Rhytec Portrait as it uses nitrogen plasma to heat the tisues, not a laser. The plasma is superheated gas. JG 1.20.08
Answer: I think the CO2 is more efective. I think the improvements will last longer but I do think there is a slightly higher risk, as you go deeper with the CO2 all increase, benefits and risks. A light CO2 might last 1-2 years. JG 1.17.08
Answer: yes, I think that is appropriate. Best of luck. JG 1.16.08
Answer: I think it is a good option for the broken blood vessels. It is a safe option. JG 1.15.08
Answer: CO2 laser for the collagen. I think for the discoloration I would start with IPL and then move on to a YAG if needed, I would not recommend a Fraxel for that. The CO2 will take it off too but no matter what you have done, the discoloration will come back with sun exposure. JG 1.15.08
Answer: I think you have them in about the correct order of effectiveness, I think the Active FX is not even close, I am friad to the CO2.Thanks for visiting. JG 1.14.08
Answer: I think the light CO2 would give you more than a deep Rhytec actually. Glad you like my creams too, I appreciate the follow up. JG 1.13.08
Answer: if I have to, the Sciton Profile. JG 1.13.08
Answer: pretty mild. JG 1.13.08
Answer: very mild improvements. JG 1.13.08
Answer: minimizing the pores is only temporary so for that likely microdermabrasions. For tightening the skin I think maybe light Rhytec Portrait treatments but it cannot be done deeply so you cannot expect too much. JG 1.13.08
Answer: yes, hydroquioone and if you have soem Retin-A I would mix them together. Also need to use sunblock all the time, see you soon. JG 1.13.08
Answer: it can if done too deeply. JG 1.12.08
Answer: I thik the best thing is to ask to see pictures of patients they have done, possibly tak to a patient or 2 and ask how may they have done and if they do other lasers, doctors that have lots of laser experience in general do well, if the Rhytec is their first foray into lasers, I would seek out someone else. Best of luck. JG 1.11.08
Answer: YAG laser will fade the redness, is about all that anything will do, all else is not worth it. JG 1.10.08
Answer: I am afraid that the series is not as effective as one deep one as the heat generated is less. I think there is no compromise here, sorry. JG 1.10.08
Answer: I have been unimpressed to be honest. I would use a CO2 laser and if not then a deep Rhytec Portrait. JG 1.8.07
Answer: I think with your skin type the excision is likely the best long term option with continued treatment of the discoloration too. JG 1.5.08
Answer: I think this guy has made this whole thing up I am afriad, I speak with representatives from the company at least once per month and they have never mentioned anything like this. JG 1.5.08
Answer: I think at most it will limit the effect, probably nothing bad though. When it is wet the water stops the hot plasma from affecting the skin. JG 1.5.08
Answer: never heard of such a thing, it might help cool the skin and that is nice, as long as the water does not drip on the skin they are trying to treat at the same time. I use the water sprays after to help cool the skin but never do it during the procedure itself. JG 1.5.08
Answer: the lotion might have aggravated it and I think the steroid cream is OK but not for any longer than 5 days without taking 5 days off, best of luck. JG 1.4.08
Answer: it is more effective for depressed scar, raised scars are from too much collagen and can be lessened with lasers like a YAG by decreasing the redness mostly. JG 1.4.08
Answer: I see no reason to do it on the eyelids themselves as there are no discolorations there typically and the amoutn of skin tightening you will get there is not visible. JG 1.4.08
Answer: not normal, I think you need to see the surgeon to make sure there is not too deep of a burn that needs to be treeated with topical steroids or something else. JG 1.4.08
Answer: not a fan or a believer in their claims. JG 1.3.08
Answer: I would wait at least 6 weeks if possible to let it heal as well as it can before the Accutane. Best of luck. JG 1.2.08
Answer: well, could do subcision and then immediate fillers, or subcision and then a Rhyetc Portrait or a CO2 laser. No matter what is done, in time the scars will regain their appearance I am afriad. The Rhytec has less chance of losing pigment than the CO2 but it is not as effective as it is milder. JG 1.2.08
Answer: I have not seen any problems from doing a Rhytec over a recent filler injection of the HA types. JG 1.2.08
Answer: yes, OK tt do some best of luck and Happy New Year! JG 1.1.08
Answer: another 5 months or so. JG 12.28.07
Answer: newer machines that make promises I feel they cannot keep. JG 12.28.07
Answer: I woudl wait at least 6 months. JG 12.27.07
Answer: I think it can be repeated in 3 weeks. JG 12.27.07
Answer: maximum improvements are seen after about 4 months. I think you would see 80% at about 2 months. JG 12.26.07
Answer: I am humbled by the kind words ansd I wish you and yours a Merry Christmas and a Happy and Prosperous New Year. I raise my champagne glass to you too! JG 12.23.07
Answer: I think what the pateint gets from the Refirme for what they pay is not a good trade off and as to fractional CO2, it is better than some of the non-invasive treatments but it is only a fractional improvement since most of the surface is not removed, it is better than a fractional Erbium though. Overall, I think again, what the patient sees for what they pay for is not a worthwhile trade off. I think if the patient`s expectations are low they will be happy, but that is the rare exception to the rule, most people want visible changes. JG 12.22.07
Answer: I think in younger people it might work better, but I think even in younger people the effects are minimal to none I feel. Sorry. JG 12.17.07
Answer: sorry but I cannot in good conscience recommend either one. JG 12.16.07
Answer: it is precaution but I have done it on people and have seen no problems, in theory it might make the fillers dissolve faster is about the worst you could see, but I have not seen that happen, at least if they are the legal fillers sold in the US at present. JG 12.14.07
Answer: I think it can be done, just need to maybe go not too deep and consider opting for two lighter ones 6 months apart to make sure it heals well is all, best of luck. JG 12.14.07
Answer: none reported. JG 12.14.07
Answer: a Portrait PSR3. JG 12.14.07
Answer: I think the CO2 is safe to os over an area where the BioAlcamid has been injected, but I cannot imagine that the BioAlcamid would have ever softened anything, I am not sure what the doctor in Europe was thinking on that one. JG 12.12.07
Answer: waste of time and money. JG 12.12.07
Answer: if there is an allergy it is OK for just a few days, no longer. JG 12.12.07
Answer: well, it must have been part of an FDA study because there is no cooling handpiece from Rhytec, as to equaling a CO2 laser effect, if it ever were to get to that point, then all of the things peoeple want to avoid with the CO2, prolonged redness and increased risk of loss of pigmentation, would be there also. JG 12.10.07
Answer: 4-5 months. It does provide skin tightening and the results will need that much time to be seen in terms of the final reuslt, the initial results after a couple of weeks is just due to swelling. JG 12.10.07
Answer: might want to try a Nd:YAG laser. JG 12.10.07
Answer: I feel that they do help with skin disoclorations and that is about it. I feel Fraxel is a waste of money and it is an ablative laser, just that it is only partially ablative, but the holes it creates are all ablative holes. JG 12.10.07
Answer: of those two I prefer the Candela. JG 12.9.07
Answer: not much effect from either unless they are very recent and still red. The skin will look irirtated for a couple of days each time you have it done. JG 12.9.07
Answer: I do not think icing will cause broken blood vessels if just done for that short period of time. JG 12.9.07
Answer: I think the true laser, KTP 532 at the dermatologist will be more effective. Thanks for visiting too. JG 12.6.07
Answer: to allow some fading of the pigmentation and to allow some of the effects of the heat generated wear off so there is not a constant irritation that can cause problems. JG 12.2.07
Answer: I believe it is, yes. I think pixelated lasers can at times be helpful, and at times also cause hyperpigementation. JG 12.2.07
Answer: I think a Q-Switched Nd:YAG laser. JG 12.2.07
Answer: yes, it can be reduced, but in so doing, it wil also reduce the effectiveness. JG 12.1.07
Answer: all of that is normal, the peeling off of the bronze is never even and there are always areas where the skin beneath is a little more red than in other spots. I think all you need to do is continue the wound care that you have bene using and all of that will balance out in time. Splotches are common for all patients in the healing period and will get better in some areas faster than in others. JG 11.29.07
Answer: I believe the two passes might yield a 4-5. I think there would be a combined effect with a series of 2-3 but there is no way to be exactly the same because the CO2 once is so much stronger. JG 11.28.07
Answer: it depends on how active the acne is, no way to predict that. There is no problem doing a CO2 laser a few weeks after a Blu-Light treatment. We have our CO2 laser patients use Retin-A and hydroquinone before for 4 weeks and then restart that at about one month after, we use a copper peptide cream for the healing right after the laser too. We try to stay away from vaseline if possible to avoid developing milia. We also use oral antibiotics and anti-virals too. JG 11.28.07
Answer: I have never heard of that type of reaction but if in fact that is what has happened I think you should avoid any other laser treatments, I would wait at least 6-12 months before trying anything else. I think if in fact they are scars you might want to contact the FDA and report an adverse event to the FDA and also contact the manufacturer of the laser to get their input. JG 11.27.07
Answer: please clear something up, are you talking about for the scarring or an attempt to control the outbreaks. For the outbreaks the Blu-light works but is very temporary no pateint experience with the others you mention for controlling the outbreaks. JG 11.27.07
Answer: yes, they can be mixed. JG 11.26.07
Answer: hydroquinone and Retin-A mixed together and sunblock. JG 11.26.07
Answer: Co2 laser or a deep Rhytec Portrait. JG 11.23.07
Answer: the cream needs to be removed before the treatment, so no, if the skin is dry it can burn, but if it is well moisturized there is only so much moisturization it can have. JG 11.21.07
Answer: not uncommon, and it should get better over the next few days too. JG 11.20.07
Answer: the tightening of the skin can take 6 months for the final results and I do not think the chin implant placed years ago added any prolonged healing to your scenario. I do not think there is much to speed the helaing at this point though besides time,sorry. JG 11.19.07
Answer: waste of time. JG 11.19.07
Answer: I think the VBeam is OK this far out. It is caused mostly from the heat and in most case goes away on its own in time without anything being done. The makeup will stick better in another week, when skin is still healing the top layer of skin does not allow the makeup to attach as well, so it will not cover as well either. JG 11.18.07
Answer: there is no reason to beleive it would hurt any less because it goes to essentially the same depth into the skin and that is what casues the pain, and it is a pixelated laser just like the Fraxel so it is ablative where the laser hits and not where it does nto, it leaves millions of small little holes interspersed with normal skin. Therefore it is ablative, juts not entirely abalative. JG 11.17.07
Answer: well they become more visible as the tissues get more lax and less tight. They eventually will look very close to the original scar, although some slight permanent improvement remains if done deeply. JG 11.16.07
Answer: the redness will likely go away in time and might want to try a YAG laser or VBeam laser for the redness too. JG 11.15.07
Answer: mine is a Sharplan, which is a company that Lumenis bought out years ago, they also bought out Ultrapulse too. Lumenis still sells the Ultrapulse under that name. JG 11.14.07
Answer: mine is one of the old ones that is not made anymore but it essentially has not changed, just newer shinnier boxes with the same technology inside. JG 11.14.07
Answer: yes, it wil have less of everyting, including the positive effects. JG 11.14.07
Answer: yes. JG 11.14.07
Answer: I use a Lumenis model CO2. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 11.14.07 http://www.surgery.org/public/findasurgeon.php.
Answer: for the Rhytec, 10-12 days before make up, most to all of the redness gone in 4 weeks. Down time for social after a Light CO2 is about three weeks before makeup and pink for 2-4 months. Cost is about the same. JG 11.14.07
Answer: it will do everything to a lesser degree, less risk of aggravating the redness and less degree of improvement too. I suggest a Rhytec Portrait and then followed with IPL later if needed. IPL is too mild to do what lasers can. JG 11.13.07
Answer: well a CO2 laser done deeply can change the texture. It may take 2-6 months for the effects of the laser to finalize or go away in some cases. Hard to say which laser would be best in your case without seeing you in person I am afraid. I certainly would stop the Retin-A and use some good moisturizers. JG 11.13.07
Answer: Deep Rhytec or a light CO2 laser, folowed 6 weeks later with IPL treatments, and sunblock. JG 11.13.07
Answer: well I think Fraxel will have limited effects on the acne scars and I do not think it will do anything for the redness. I think the redness is not rosacea but some element of residual dermabrasion redness from the skin being thinned and I do think vascular lasers would be a good option to fade the rendess, things like a YAG or a VBeam laser. The availablity of lasers at a univeristy will be larger than that in a pricate practice too. JG 11.12.07
Answer: well I suggest Rhytec or a CO2 laser, the Rhytec is milder while the CO2 has more downtime. I do not think any laser, no matter how aggressive, will give you more than a couple of years, adding Botox every 3-6 months will extend it some. The aging process will continue regardless of the treatment, and the older you are the less time the improvement will last. JG 11.11.07
Answer: I do not as there is mininmal bruising and that is what I use them for, it might help with the swelling a bit but that does not last too long. JG 11.10.07
Answer: not always, no. CO2 will not re-pigemnt skin that has lost its color. JG 11.8.07
Answer: I think it will wear off sooner than that and the effects will be mild I feel. JG 11.7.07
Answer: should be no fat loss. It is true that a series will be needed to see any significant improvement,yes. JG 11.7.07
Answer: I think there are always risks but relatively small in experienced hands. Best of luck. JG 11.6.07
Answer: I think lesser settings have less downtime and the degree of improvement is less but they are meant to be done as a series of treatments so it really cannot be compared as the deeper treatments are supposed to be done as a single treatment. The setting I use will vary from patient to patient depending on their skin, I have no set joules. JG 11.5.07
Answer: it can stay pink for 3-6 months. You will need good make up after three weeks I am afraid. It has to heal on its own and there is nothing that can be done safely to reduce it during the first three weeks I am afriad. JG 11.4.07
Answer: well I think doing lasers on someone your age for eyelid skin is already aggressive and the steroids for a continuous three weeks is too much, I think in time it will get better but some of that skin has been likely thinned I am afraid. JG 11.4.07
Answer: Obagi will not help pinkness, just brown, and I do not think the sun exposure can cause pinkishness, that is from an area being treated too deeply and is still healing. Maybe try some IPL treatments. JG 11.3.07
Answer: I have been involved with IPL treatments for over 8 years and have never seen fat loss occur. Not sure what you mean by skin clarity but if it is removing brown spots either one will probably work. JG 11.2.07
Answer: less healing time means less improvement in the long run, so it is a matter of expectations, if you want mild I think the fractional ones are OK, if you want significant change, you will be disappointed I am afraid JG 11.1.07
Answer: why mess with success, go for the CO2. Best of luck. JG 10.30.07
Answer: I would guess 6-7 days, maybe more if you have thin skin. JG 10.30.07
Answer: no, I think there is a risk of skin burning so I do not ablate the skin with any laser when I am also lifting it. JG 10.30.07
Answer: likely you are mostly done with the healing from a single Fraxel. I have to tell you I think trying to fix wrinkles on the eyelids on a 22 year old with Fraxel I think was not a great idea. JG 10.30.07
Answer: it just helps remove the old vaporized material on your face, it is safe to use in most cases. JG 10.25.07
Answer: it will likely help some but it is not permanent, low risk of problems with that one. JG 10.25.07
Answer: I think you are going to incite the same damage that you had removed with the treatments. I would not tan your face and you might benefit from some IPL treatments to fade the redness some. JG 10.23.07
Answer: hard for me to say, I have not sen that happen nor am I sure what can cause that after the Rhytec, sorry. JG 10.25.07
Answer: might be from an aggressive treatment, could consider some IPL treatments to fade the redness and smooth the skin a bit. JG 10.22.07
Answer: correct. JG 10.22.07
Answer: a general number would be less than 2%, it is a little higher in sundamaged and dark skinned individuals if done very aggressively.I have not had any of my patietns lose pigmetnation, and any hyperpigmentation was resolved within one month with topical creams and did not recurr. JG 10.20.07
Answer: you can send them to drgarcia@lvcosmeticsurgery.com
Answer: there will be some tightening even in the areas that did not get as red, there is always some uneveness,mostly thin stipes, that is normal, but if there are large skip areas then they might need to be re-touched, you should see your doctor in the next few days. JG 10.18.07
Answer: the splotches might take 4-10 days to fade depending on how deep they went. Swelling is normal for the first 2-6 days too. JG 10.18.07
Answer: just keep the head elevated, avoid salt and cold compresses once OK by your doctor. JG 10.17.07
Answer: all normal, it will balance out in time. JG 10.17.7
Answer: I think for what you describe the CO2 will be the most effective but have the longest healing time. You do not want to do something lesser and not get substantial results. Usually in 2-3 weeks you are back to weigthts. Fine hairs go away for the short term but all come back as they regrow again. I do all my CO2 as out patient for greater safety and comfort. All the best. JG 10.17.07
Answer: can also try light TCA peels. JG 10.16.07
Answer: not really, I think a YAG or IPL would be better. JG 10.16.07
Answer: I have and to tell you the truth I think it will not be permanent in its effect. JG 10.16.07
Answer: any laser that ablates the skin, even if just in pixels and not the entire skin surface, can have milia as it heals. It does not happen with IPL/KTP and it can happen in dry skin too. JG 10.16.07
Answer: it would help but the light ones take 4-5 days to heal and then needs to be repeated n 3 weeks I am afraid. JG 10.15.07
Answer: I would start with the IPL. JG 10.15.07
Answer: I do not think Thermage, Titan,Fraxel nor Rhytec Portrait will get you what you desire, you will need something much more aggressive like a CO2 laser I am afraid. JG 10.15.07
Answer: first thing to realize is that the less down time you have the less the improvement, also the effect on pores will be short lived no matter which you choose. If you are limited in down time I think the YAG/KTP and IPL might be what you are looking for. JG 10.15.07
Answer: not a common problem, could be due to the treatment or the creams applied after the treatment. Did you have the pixel and IPl done on the same day? JG 10.15.07
Answer: I think the risks are small and I think a double pass is warranted if you have significant wrinkles. JG 10.15.07
Answer: well, there is some truth on the pathology slides but in the vast majority of cases, unless the tissue are heated to a significant degree, there is not much change that is visible, and that degree of heat will have weeks at least of downtime from the burn. I think the PSR3 for rolling scars might give 25-35% improvement in most cases. JG 10.13.07
Answer: I think the CO2 laser is stronger, yes, it does also carry longer healing time, but will be a more dramatic change. JG 10.13.07
Answer: I think a lighter CO2 laser will more effective than the others mentioned but no laser will permanently remove the wrinkles, there needs to be conservative use to avoid a burn or scar. JG 10.13.07
Answer: well the Portrait will take another 2 months to get to where it is going to be but I will say that redness at this point is not normal, I think you need to see your doctor to make sure there is nothing else going on. As to pores, there are only temporary remedies like microdermabrasion, glycolic peels or Retin-A. JG 10.10.07
Answer: should all fade in time, can consider some IPL treatments to help fade the redness. JG 10.10.07
Answer: I have not heard of people losing fat from a Fraxel treatment. As to the degree of tightening, I think if you look like you had a facelift you are one of the few that got that dramatic of a result. JG 10.10.07
Answer: I think surgiwire alone is not very effective but surgiwire and a laser at the same time might be a good idea. There is nothing permanent in terms of the scar improvement I am afraid. JG 10.10.07
Answer: start with moisturizers, sunblock and DMAE. JG 10.10.07
Answer: anything fractional will give you a fraction of the improvement, the difference between the CO2 Fraxel and any other ablative laser for the pixels will be small because the number of pixels will be small compared to the areas not treated. As to RCIT, as big of a waste of time as the fractional lasers but cheaper. I do not think the amount of collagen produced with Sculptra is large nor long lasting but I find it to be a good filler for the cheeks and temples. JG 10.8.07
Answer: I have not seen it occur as it is lighter than a CO2. JG 10.8.07
Answer: I think Rhytec can be used thee, but only very lightly, no laser can be done to strongly there due to scarring potential. I would wait between 6-12 months after the Rocutane before any resurfacing. JG 10.8.07
Answer: the feathering is not as crucial with the Rhytec Portrait as it is with a CO2 laser, so although safer, most likely not needed to be feathered since it is ligther than the CO2. JG 10.8.07
Answer: well the surgery will not correct the issues above your lip so you might need them both. I always suggest the surgery first and the resurfacing second. I have never seen the Botox add anything to the Portrait treatment. PP will not plump the eye and it can be done on the skin there but the results are mild and if you have already had too much skin removed it is not a good idea as it might pull your lid down too much. I can give some people inforamtion but it is always best to see and feel the tissue to give the best estimate, but it is still an estimate. JG 10.8.07
Answer: I think it wil reverse some effects and slow the progression some but dynamic wrinkles are the hardest to improve, especially in that area. I do not think you will look like you are in your 20`s again I am afraid. JG 10.7.07
Answer: well, I think they like to know thses things to see if they can correct something, not sure how much can be done in your case though. JG 10.7.07
Answer: imporves skin texture, skin discolorations and fine ines. JG 10.5.07
Answer: The Pearl is less than the Fx and much less than the CO2, I think the downtime will be small and the improvements will be small also. JG 10.4.07
Answer: IPL is less painful and less expensive and less effective. JG 10.4.07
Answer: both will at best fade the redness and that is about all they will do. JG 10.4.07
Answer: can happen, I suggest some Copper peptide creams or some NeoCutis skin care products. JG 10.3.07
Answer: start with Retin-A and progress to Rhytec and then to CO2 laser. JG 10.3.07
Answer: I typically increase the strength of the joules as tolerated, I do the treatments ideally every three weeks. The last one is at about 2 joules if tolerated. JG 10.2.07
Answer: I think one deep one will work better I feel. I think Sculptra is straightforward to do so need need to travel, although I am flattered your would consider it. JG 10.2.07
Answer: well a single treatment of PSR1 will not do much, I usually do a series of three of those, as to the Sculptra, I would wait until you are not doing any more Rhtyec Portraat treatments. JG 10.2.07
Answer: no benefits I feel. JG 10.2.07
Answer: it is most likely due to the Advantan, but the Fraxekl can cause it also. At your age it should correct itself though to a great extent. JG 10.2.07
Answer: I think there certainly be some improvements with the proposed options, yes, but probably not a complete correction. JG 9.30.07
Answer: I would start with a low dose and I think it should be OK since the Fraxel only takes part of the skin off. I do not think the Roccutane will cause any worse scarring either. JG 9.29.07
Answer: let it fill in for 6 months, at that time re-evaluate and consider a filler or excision at that time. I do not think another laser will be the answer. JG 9.28.07
Answer: I do not think so. I think if the treatment parameters are the same, nothing has changed, I will say that at the begining some doctors were being much more aggresive than at present and that yielded some good and some bad results. JG 9.28.07
Answer: I like to avoid the alcohol as if it has not totally dried when the plasma goes on it can cause a flame. I use a dry gauze to get the topical cream off, then use a wet one and then dry it after that.JG 9.28.07
Answer: well it could be one of two things, either they used it too strongly and too close to the skin or she developed a herpes outbreak after the procedure and that can cause blisters and skin loss, Sorry to hear about it. JG 9.27.07
Answer: well if it is not used proeprly and burns the skin it can make a hole but it would really need to be done way out of the norm, if it did happen it likely would be permanent though. JG 9.27.07
Answer: it will tighten it some but there is a number of weeks of downtime and pinkness, one cannot go too deep there as the skin is quite thin. JG 9.27.07
Answer: I think in deep treatments it is a good bet it will look worse before it looks better, yes. I think once the skin is healed you can re-start the Obagi to control hyperpigmentation risks. All the best. JG 9.26.07
Answer: not common at all, thery are essentially at least second degree burns and should not happen with that treatment. As to what can be done now, hard to say without seeing you but maybe some YAG or VBeam lasers to settle the redness and the scars down somewhat. JG 9.26.07
Answer: YAG or VBeam will get it off in a few treatments. JG 9.24.07
Answer: not a fan. JG 9.24.07
Answer: it is a second degree burn and likely will fill in over time. JG 9.24.07
Answer: hard to say about its effectiveness in your case without seeing your skin but if they are talking about 4-5 days downtime they are speaking about a light treatment that is usually done in a series of three, the deep single treatment might give you more effect but more like 7-10 days downtime. JG 9.24.07
Answer: Thanks for visiting and the kind words. JG 9.23.07
Answer: I think you can write the board and see if they will do it, might be the best way to get it all behind you. Keep us posted. JG 9.20.07
Answer: I can appreciate your frustration, I think the micro lasers are a reasonable option, I am sorry to hear about all of the hassles but I think now that it has started, just let it runs its course. All the best. JG 9.20.07
Answer: it comes back in time. JG 9.20.07
Answer: YAG or VBeam laser. JG 9.19.07
Answer: not common this far out, I think I would forget the Fraxel, I think the risk benefit ratio is not good in your type skin. The hyperpigmentation is brown spots usually. JG 9.19.07
Answer: a YAG would help it usually. I think it is more likely that it is just redness form the blood vessels being easy to see through the thin scar tisue. I do not think the lasers you have had done would have given you any improvements for what you have. I think the YAG will help fade it but there will always be a scar. JG 9.17.07
Answer: well, if it was done at the standard distance of 10mm, there should be at least a little redness, may want to ask them how they did it, but in people with thicker damaged skin the 1 joule is pretty light. JG 9.17.07
Answer: I think all of the fractional treatments yield lesser results, yes down time is less and risks are less, but so is the improvment so there is a big trade off. JG 9.17.07
Answer: defintely. I think there is a risk after repeated treatments of some color loss, yes. There is no perfect frequency for orange I am afraid. JG 9.17.07
Answer: they should not remove hair follicles. JG 9.17.07
Answer: probably just one or 2. JG 9.16.07
Answer: I think that is what it is best for, mild problems. JG 9.16.07
Answer: downtime, really red and flaky will last about 10-14 days. Social downtime is 2 weeks. JG 9.16.07
Answer: well if you have the ports still in for the implants that can be done in the office, otherwise it is surgery and most likely what you have been led to beleive is not possible as changing size, as to the scars they can be treated with YAG laser at $150 per session, multiple sessiosn required. JG 9.16.07
Answer: probably the whole face. JG 9.16.07
Answer: well maybe the lighter ones would be OK. I do not use it as a preventive technique though. JG 9.16.07
Answer: yes, but needs to be done lightly. JG 9.16.07
Answer: 14-24 days, we use Copper peptide cream until healed and then just a good facial moisturizer until the red is gone. JG 9.16.07
Answer: it can be, not unusual. The skin will at times not react as aggressively but as it heals, it blends and fades and still gives a nice imporvement. JG 9.7.07
Answer: there are areas where the energy delivery is not uniform and in all cases I have seen and treated they fade, blend well and the intervening skin tightens the same. JG 9.6.07
Answer: no problem with the Rhytec over the filler. I personally feel the single deep one is a little more effective if you can afford the downtime. JG 9.5.07
Answer: yes, it is common and can last a week or more. The swelliing is really a matter of time, not much besides keeping your face elevated above the level of your heart. I am unsure about the sticking pain, might want to see your doctor to make sure you do not have a scratched cornea. JG 9.5.07
Answer: the visibility of the acne scars will come back as the skin loosens with time. I think the deep Rhytec is good for acne but not as effective as the CO2, but it is safer. JG 9.2.07
Answer: we use a Q-Swithced Nd:YAg laser for that and would be happy to see you in consultation if you would like, I agree it does sound like some type of blood vessel issue or slow growing birthmark. JG 8.31.07
Answer: not to any appreciable degree. JG 8.30.07
Answer: well, firstly thank you for the kinds words. As to the Derma-K, no, I do not own one. I do own a CO2 laser and a Rhytec Portrait. Having said that, I can say that the depth of injury of any laser can be tempered by adjusting the settings to make almost any laser give you a fingerprint thick skin surface removal. I will also say that being thinner might be good in terms of speed of healing, but also will have very limited improvements. Think of a sunburn, when it peels while the skin is swollen it looks smoother but that effects goes away once the swelling goes down. There is no free ride in life, if you want minimal results then light procedures will get you there. If you want dramatic resutls that last a long time, then you need to give something up. In the future, other options might come but at present we have no good way to get reliable dermal stimulation of any significant degree to cause skin tightening without taking the top layers of skin in some fashion, sorry. JG 8.29.07
Answer: I do not think lighter series of treatments with the CO2 will give the same result as one deep one. JG 8.29.07