What is it?

A procedure that helps counteract the affects of aging by removing the top layers of the skin of the face and thereby eliminating wrinkles, blemishes, and large facial pores. As we age wrinkles occur in the corners of the eyes (laugh lines), the lip, or forehead. Such fine lines cannot be removed by the classic techniques of face-lifting or other methods of skin tightening. Resurfacing procedures such as Chemical peel, dermabrasion, and laser resurfacing are methods that specifically address such problems. Each technique uses a different method of creating a superficial burn in the face. The new skin is formed, by the deeper layers will be tighter and have fewer wrinkles.

What does it accomplish?

The purpose of the laser resurfacing procedure is to remove the signs of aging in the face by removing the top layers of the skin. The lower layers of the skin then create new skin that has less wrinkles, pores and blemishes.   The beneficial effects of a laser resurfacing can vary depending on the patient's anatomy and lifestyle.   In addition, the depth of the wrinkles, pores and color differences in the skin will be important in the result achieved.

What happens during the first consultation?

In the first consultation you will get a chance to discuss your concerns with our patient care coordinators and Dr, Marefat. We will tell you what you need to know about your procedure and will help you determine what is best for you.   You will receive information booklets, review before and after photographs, and receive pricing on the procedures.

How is it done?  

We usually perform this operation in an out patient surgical facility under general anesthesia.   The skin of the face is treated with the laser. The light creates a superficial facial burn that causes the top layers of the skin to peel off. The skin cells that are in the lower layers of the skin will then regenerate a new skin layer that has less wrinkles, pores and pigmented spots. You can think of it as a laser induced 'sun burn' that peels your skin.   The new skin of the face will be tighter giving the affect of a face-lift without the scars.

Procedure: Laser Resurfacing continued

What can I expect after surgery?

There will be a moderate amount of swelling and with a Laser Resurfacing. You cannot do this procedure and plan to go back to work the following week. Most patients elect to take two weeks off from work.   This would give them adequate time to recover sufficiently from surgery and to be seen without drawing attention.   Although most of the evidence of surgery has disappeared by the end of the third week the ultimate result of the Laser resurfacing will not be evident until at least five or six months have passed.   You should expect a moderate degree of redness in the skin of face during this period that will slowly resolve. This is because Lasers create new vessel growth to the skin and give a blush to the face. As this blush goes away you will have a lighter color in the area that was lasered as compared to your natural skin color. This depigmentation results from all resurfacing procedures to one extent or another. There is a greater degree of depigmentation with deep lasering. You will also remain very sensitive to sunlight and therefore using sun block and protecting of the skin from direct sunlight is advocated.

When are the sutures removed?

With laser resurfacing there are no sutures.

How many visits do I have after surgery?

We like to see our patients frequently after surgery. You are seen by the doctor or nurse within 2-3 days of surgery. Then the normal routine is 1 week, 1month, 3 months.6months, and 12 months after surgery. Of course if there is a need, you are seen as many times as necessary. We encourage our patients to come for routine follow-up visits every 3-5 years.

When can I cover my bruises with make-up?

You should be able to put makeup on your bruises after one week. However, we do not recommend your putting makeup on your incisions until the skin is completely healed because this may result in tattooing of the skin by the pigments of the makeup.

Am I a good candidate?

The ideal candidate for a Laser Resurfacing is person good facial skeletal structure but loose and sagging skin. There is no definite age category when the surgery should be done.

In general, the ideal candidate for plastic surgery is a self-motivated patient who has realistic expectations about the results.   Generally the younger you are the better a candidate you are for surgery. But the physiologic age of person is more important than the chronological age. That is to say you may be 60 years old, but your skin and general health could be better than most who are 50 years old.

What does the surgery cost?

The cost of surgery varies but here are some guidelines that will help you determine roughly what you could expect. Remember that these are only rough estimates . These estimations include the cost of the operating room and the anesthesia. The fee may be subject to change without notice. The best way for you get an accurate cost analysis is to see a doctor.

Laser Resurfacing:     $3,900 - $5,800

How do I pay for surgery?

You can pay for surgery by certified check. Credit card, or cash. Payments for cosmetic surgery are expected prior to the procedure. If you are scheduling several weeks in advance of surgery you can pay by personal check.

Are there scars?

With laser resurfacing there should not be any scars. Scarring may occur if the skin has been deeply lasered and the regenerating cells have been destroyed. This is why very deep pox marks or deep wrinkles cannot be completely effaced.

Does it hurt?

Yes. However, the pain involved in Laser Resurfacing procedures is very tolerable. We have heard our patients describe it as 'discomfort' or 'soreness'. For some reason, injuries to the face (including ones surgically induced) do not hurt as bad as they look. Many patients do not finish the pain medications prescribed to them for pain relief. But having said that remember that pain is very subjective, and it is not easy to predict what degree of pain you will have.

Will I be awake during surgery?

If you are having a regular Laser Resurfacing operation you will be asleep. It is to your advantage to be comfortable and have an anesthesiologist monitor your heart and lung. This would also help the surgeon because he can concentrate on his work and accomplish what he wishes to do with expediency.

Where is the surgery performed? (i.e. office suite or hospital)

The operation is performed in an out patient surgical facility under general anesthesia. Only in rare situations in which the patient may have medical risk factors does Dr.Marefat suggest the hospital environment for surgery. In certain cases where the area being treated is very small and amenable to local anesthesia, you may have the procedure done in the office.

Are medical photographs taken?  

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory because this is the only way for us to compare you before and after results. Photographs in plastic surgery serve much the same role that x-rays serve for orthopedic surgery.

Date Revised: 1/23/07

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