Friday, August 29, 2008

Cosmetic Laser Surgery Procedures 101


If you have wrinkles on your face, especially around the mouth or eyes that can be seen by others across the dinner table, you most likely will benefit from facial resurfacing, also called laserbrasion, laser abrasion, or a laser peel.

On the other hand, if your wrinkles, or the beginning of them, can only be seen when you study your face in a triple-magnification mirror, you're probably a candidate for alphahydroxy acids, Renova, and other beauty-before-the-beam measures, and not a laser peel - just yet.

Facial resurfacing is not a face lift! A face lift is a surgical procedure that has more to do with lifting the cheeks and recontouring the neck to counteract the effects of gravity. It is a "nip and tuck" that removes sagging, unwanted skin and extra fat deposits. No laser peel can correct these problems but it can improve the appearance of lines and wrinkles on the face. After a laser peel, in fact, it is not uncommon for people to appear ten to twenty years younger than their actual age!

In truth, lasers cannot make you look "light years" younger, but ten or twenty is another story. There is also no guarantee that your new face will "launch a thousand ships," but who wants to launch ships anyway!

If wrinkling is only in a limited area of the face, a person may opt for a perioral laser peel, which removes the fine lines in the "mustache" area of the upper lip as well as lipstick "bleed lines," and/or a periorbital laser peel, which removes the fine lines around the eyes (in the area covered by ordinary eyeglasses). In addition, there is the laser peel of the nose, which eliminates many effects of sun damage, or a laser peel of the earlobes, which improves the wrinkles on and dramatically shrinks their size.


Also called upper blepharoplasty, this laser procedure removes a crescent of skin and some underlying fat from the upper eyelids to correct their drooping or sagging. Anyone with droopy, overhanging upper lids that diminish the appearance, seem to impair vision, or obscure the area where eye shadow is applied, is a good candidate for this procedure.

A laser-assisted transconjunctival lower-lid blepharoplasty is a procedure that removes excess fat from the lower eyelid. Anyone with "bags" or puffy lower lids is most likely a candidate for this procedure.


Candidates for this procedure have depressed acne or chickenpox scars that indent the skin. After resurfacing, when the skin heals, a new band of horizontal collagen forms in the upper layers of the skin, greatly improving the skin's contour and tightening its overall appearance. While this procedure can erase years of heartache, it involves a warning: anyone who has taken Accutane for cystic acne must not have laser treatment for one to two years after discontinuing the medication.


Remember the bulbous red nose of W.C. Fields? He suffered from rhinophyma, a condition that is characterized by a gradually enlarging, reddened, and misshapen nose with enlarged pores. This is a condition that makes people very self-conscious but with laser resurfacing it vanishes within minutes.

Resurfacing lasers also treat a variety of other skin conditions:

* Seborrheic keratoses, the common wart-like brown growths that appear to be "stuck on" to the surface of the skin.

* Warts ~These common and often distressing flesh-colored bumps are caused by the human papilloma virus and have the potential to spread and persist for years.

* Scars and keloids.


In this condition tiny blood vessels under the skin "break," dilate and, increase in number, causing flushing in the central portion of the face around the cheeks and nose. Quite common in women, it is often (but mistakenly) called "adult acne." It affects thirteen-million Americans. The problem is eliminated with laser treatment, but it may return, requiring follow-up treatments.


It is always distressing when a baby is born with a port-wine stain, particularly one that covers a beneath portion of the face. This dense network of blood vessels the surface of the skin enlarges as the child gets bigger and never goes away on its own.

Laser surgery, performed in several sessions, is tremendously effective in eliminating port-winestains. But before such surgery is undertaken, a child must be fully evaluated to rule out other, rare conditions that might account for the stain.

The laser(s) that is used for red problems also treats a variety of other skin conditions:

* Hemangiomas ~ These "strawberry marks" usually disappear on their own. However, if they interfere with a vital function, laser treatment can help them disappear safely and more quickly.

* Scars, keloids, warts, spider veins, psoriasis, Kaposi's sarcoma, and miscellaneous vascular lumps and bumps can also be treated with the laser that treats red problems.


Typically, stretch marks occur as a result of pregnancy, adolescent growth spurts, weight lifting, or rapid weight gain in areas that have undergone extensive stretching such as the hips, tummy, and breasts. The hormone estrogen seems to play a role in their development.

Cocoa butter and other "potions" that promise to firm the slackened skin and prevent or heal stretch marks do little to improve their appearance. However, they may diminish slightly with the daily application of Retin-A or alphahydroxy acids. Laser treatment is highly effective.


Also known as sun spots, liver spots, or large freckles, these blemishes are largely the result of life-long sun damage. Sometimes, topical medications, bleaching creams, or alphahydroxy acids can lighten the spots, but the appropriate laser eliminates them in one easy treatment.

The laser(s) that is used to treat these brown problems also treats a variety of other skin conditions:

* Cafe-au-lait spots are flat, light brown, or tannish lesions - which are the color of coffee with milk and always benign. They are, however, a cosmetic nuisance and often respond to the laser.

* Dark circles ~ Many people hate the raccoon-like appearance that the dark circles under their eyes create. Again, laser can improve them.

* Beauty marks are really moles that, for the most part, are not beautiful. These, along with other large and small nevi, can often be improved with laser surgery. But sometimes laser surgery is not the best way to remove these spots. Beauty and the Beam explains why.

* Melasma (or chloasma) ~ Commonly called "the mask of pregnancy," this discoloration of the skin often disappears after childbirth but can also be treated safely with the appropriate laser, as can a variety of other conditions which are covered in Beauty and the Beam.


An estimated ten million people in the United States have at least one tattoo. Female college students account for the application of fifty-thousand to one-hundred thousand tattoos a year, while ten percent of adult males sport at least one. Yet, more than half of all people with tattoos eventually regret having them and many want them removed.

If a tattoo is comprised of different colors, several lasers are commonly used to remove it, each one targeting different-colored tattoo inks. While the procedure only takes a few minutes, several treatment sessions may be required. The good news is that the result will last forever, although in some cases trace pigments of the tattoo may be visible.


There are a variety of reasons why women seek out physicians or paraprofessionals trained in micropigmentation - the art of depositing small amounts of colored pigments into the skin. Whether they choose permanent make-up to add color to their eyebrows or to create eye liners, lip liners, or even rouge for their cheeks, the goal is the same: cosmetic enhancement. But sometimes women change their minds and want the "permanent" make-up removed. The same laser methods used to remove body tattoos are used to remove permanent make-up. For both, however, risks exist, which are spelled out in Beauty and the Beam.


Varicose and spider veins have a great deal to do with family inheritance. Simply, genes play a big role in who does and does not get them. But inheritance is not the only risk factor. Women who are overweight, have frequent pregnancies, or take birth control pills or estrogen and progesterone replacement are also vulnerable to varicosities and to the little spider veins that have such a rude and unexpected way of making themselves apparent. The situation is aggravated as well by wearing clothing that is tight around the waist, standing in one place for long periods, prolonged sitting, the habitual crossing of one leg over the other, and straining from constipation.

Many women try compression stockings to improve circulation and reduce discomfort, although they don't eliminate the veins. Others opt for sclerotherapy, which involves injecting a chemical solution into a vein, which causes the vein to collapse and disappear. Lasers or light sources are the newest, non-invasive way to zap these unsightly veins.


Photorefractive keratectomy, or PRK, is the surgery performed with the excimer laser that, since FDA approval in 1996, has been allowing nearsighted Americans to throw away their eyeglasses!

Nearsightedness occurs when light enters the eye and focuses at a point in front of the retina, causing close-up vision to be clear and distant objects blurry. In just a few minutes, the excimer laser changes the shape of the eyeball and often restores vision to 20/20! (Read a detailed description of this exciting laser procedure in Beauty and the Beam.)


Dentists who practice cosmetic dentistry can now recontour overgrown gums and give their patients the smiles they always dreamed of. Although not every one with gingival (gum) overgrowth is eligible, many are. (Read a detailed description of this laser procedure in Beauty and the Beam.)


In the same way, tooth whitening has been revolutionized by laser technology. Some people even find that their childhood tetracycline stains and adult nicotine stains are removed. (Read a detailed description of this laser procedure in Beauty and the Beam.)


In a recent study, nineteen percent of subjects described themselves as habitual snorers, while twenty-four percent of males and fifteen percent of females said they sometimes had a problem with snoring. Snorers don't enjoy peaceful sleeps; they usually find it hard to wake up and go through the day feeling uncharacteristically fatigued. And anyone who sleeps with a snorer suffers from both sleep deprivation and aggravation. Occasionally, snoring may be a sign of a more serious condition known as sleep apnea, a momentary cessation of breathing. Laser surgery, specifically the LAUP procedure (or, more complicatedly, laser-assisted uvulopalatoplasty) can eliminate snoring! (Read a detailed description of this laser procedure in Beauty and the Beam.)


Most women are enslaved to their tweezers, bleaching creams, razors, and depilatories, or to the aestheticians who perform electrolysis or waxing on the hair of their upper lips, eyebrows, arms, legs, and bikini areas. Every week they must attend this ritual, week in and week out, year in and year out, over a lifetime.

In contrast, laser hair removal is so efficient and rapid that small areas can be treated in seconds and large areas can be treated in minutes without the risk of contamination or scarring; electrolysis of the same areas would take months of weekly visits. However, the jury is still out about how "long-lasting" or "enduring" the resuls will be. (Read a detailed description of this laser procedure in Beauty and the Beam.)


Women may have an interest in removing body hair, but men, by and large, are the ones who are interested in adding it - particularly to the head. Most men, when they find themselves losing hair, "try everything" to bring it back, from toupees and wigs to special shampoos and conditioners to hair thickeners and even vibrating hair brushes that promised to "stimulate" hair growth. Others try Rogaine (minoxidil), a topical, over-the-counter drug that promises to retain or restore the hair that seems destined for the shower floor.

Laser-assisted hair transplants seem better than all these methods but, again, the jury is still out about whether the laser offers any advantage over a traditional hair transplant. With this procedure, the experience of the laser surgeon is paramount; he or she must have a good cosmetic eye for achieving a natural hairline. (Read a detailed description of this laser procedure in Beauty and the Beam.)