).Laser resurfacing technologies represent an exciting development in the cosmetic surgeon's repertoire to improve the tone, texture, and pigmentation of the skin. Although laser resurfacing is not a substitute for a facelift or blepharoplasty, the appropriate laser not only tightens the skin somewhat but also improves the appearance of lentigines, rhytides, skin texture, and a wide variety of scars.There are ablative and nonablative lasers as well as fractionated and nonfractionated lasers. Nonfractionated lasers act on the entire projected surface area of the treated skin, whereas fractionated lasers target an equally distributed portion of the projected area. An easy way to understand the difference is in looking at the pixels that compose a TV image. Nonfractionated devices treat every single pixel whereas fractionated devices treat only a percentage of the pixels in the treatment area.Ablative lasers vaporize tissue and therefore are more aggressive compared with the gentler nonablative lasers that leave the skin intact. Although ablative lasers result in far more down time and a more difficult recovery process, they remain the lasers that produce the most dramatic outcomes. For more severe facial wrinkles, dyspigmentation, and textural skin challenges, the ablative laser is often the treatment of choice.For patients seeking more moderate improvement-without the possible side effects of ablative lasers-nonablative lasers are often ideal. These lasers leave the epidermis intact while producing rejuvenating skin effects. Depending on the technology, nonablative laser treatments may minimize the appearances of finer wrinkles, ameliorate the texture and tone of the skin, and treat dyspigmentation. By comparison, the treatments are gentler and require little to no downtime, but produce a more moderate response.Ultimately, a patient's needs dictate the selection of the ideal laser. In this review, we seek to demystify the differences between the many available lasers and thereby facilitate the identification of the most appropriate laser for the patient.
Ablative Nonfractionated LasersAblative skin resurfacing removes the epidermal layer, producing the most dramatic laser-treated results for skin resurfacing. The lasers quickly superheat water molecules in the skin tissue. When the water turns into gas, the skin cells are vaporized in a precise skin-peeling effect. This effect promotes collagen formation and retraction of the dermis and
AbstractNumerous laser platforms exist that rejuvenate the skin by resurfacing its upper layers. In varying degrees, these lasers improve the appearance of lentigines and rhytides, eliminate photoaging, soften scarring due to acne and other causes, and treat dyspigmentation. Five major classes of dermatologic lasers are currently in common use: ablative and nonablative lasers in both fractionated and unfractionated forms as well as radiofrequency technologies. The gentler nonablative lasers allow for quicker healing, whereas harsher ablative lasers tend to be more effective. Fract...