Minimally Invasive Laser Treatments Here in Beverly Hills

Here in Beverly Hills, Hollywood and in the greater Los Angeles area where skin damage is profound due to the strong southern California sun, we will see many more patients with wrinkled, sun-damaged skin. Red spots, brown spots, age spots, excess capillaries and, for want of a better term - "worn out skin".

We are constantly on the prowl for better, safer and more practical treatments as we joust with Nature.

Since the introduction of the first medical laser for skin rejuvenation in 1995, there has been a proliferation of laser and laser-like technologies to make the skin look younger and more attractive.

The original laser system was a carbon dioxide, or CO2, laser which was very powerful and had the ability to deftly remove wrinkles, age spots, grooves and crevices as well as the all-time champ, the deep phenol skin peel. However, there was one big negative with this powerful technology, and that was that the practitioner had to be extremely accomplished and to get the desired result without complications.

Due to very aggressive marketing and publicity by the laser manufacturers, at that time, a large number of practitioners started to use the devices. Because there were not enough cases concentrated in the hands of just a few plastic surgery, cosmetic surgery or dermatology surgery superspecialists, the results were variable and in some cases there were complications which were very problematic.

We learned that while the science may be good, in the end, the results depend on the art form, skin and judgment of the practitioners. Plus, it takes a long time to master these techniques. As a result of the high rate of complications and dissatisfied patients, the carbon dioxide laser somewhat fell by the wayside. There were other laser and laser-like devices that came into play. There was the YAG-neodynium laser. Not quite as powerful as the original CO2 laser, it was "non-ablative", i.e., it did not penetrate as far into the skin's thickness to destroy the deeper layers of the skin. There were a large number of machines that were sold to physicians including Cool Touch, Visage, N-Lite, Smooth Beam and Aramis.

Recently, there was developed what I call the "second generation" of fractional carbon dioxide lasers. By fractional, we mean that not the entire skin surface is treated but rather there is a pattern of alternating treatment spots with untreated spots. The computer within the laser machine lays down rows of tiny dots that represent the destruction of the sun-damaged, wrinkled, aged skin. This pattern of treatment is a hedge against overtreatment.

We now have significant experience with one particular system called the SmartXide DOT advanced fractional CO2 laser system manufactured by NuMed Aesthetics.

Fractional skin resurfacing is safer than the standard CO2 laser. For the doctor, the learning curve is shorter. With the computerized grid pattern placed on the skin, there is more precision with respect to how deep the penetration is and how much of the skin is destroyed in order to produce new, young, smooth, fresh skin. What I like about the system is it can be used on the face but also on the neck and upper chest and even the hands. This is very important because while we get excellent results with the deep phenol chemical skin peel on the face, that technique is not appropriate for anywhere but the face. It is always ideal to have very little color and texture difference between adjacent anatomical areas. If the face has been treated with a phenol agent and the neck has not, there can be a color and textural difference between the adjacent areas and that is not satisfactory.

We believe that fractional CO2 lasers are an answer to this dilemma and will continue to watch its progress. I would not recommend any product, service or technology unless I had seen the results and had studied the science of it. So far, I like what I see and so do our patients.

We look to technology help us further improve our techniques and results. Remember, as I said in my book, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON, "science never sleeps."

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