Your Ablative Laser Procedure

	Laser resurfacing, along with eyelid surgery and facelift.

Before laser resurfacing, be sure to discuss your medical history fully with your doctor. It's particularly important to let your doctor know if you have a history of cold sores, herpes, or other viral skin infections, as you will need to take antiviral medications both before your procedure and during the healing period to prevent a new outbreak.

Ablative laser skin resurfacing is not an invasive surgery in the same way a facelift is; however, it is an aggressive form of skin rejuvenation. Therefore, the procedure must be performed in an operating room or surgical suite.You will be hooked up to a heart monitor, and a blood pressure cuff. Because the anesthetics used can stimulate the heart, routine monitoring is required.You’ll also wear a small device, a pulse oximeter, on your index finger to monitor your blood oxygen level.

To guard against infection, your skin will be cleansed with disinfectant, and you’ll be covered with sterile drapes.You’ll also be wearing special goggles or eye shields to protect your eyes from the laser light.

Depending on the procedure, your doctor may apply a topical anesthetic. More often, ablative resurfacing requires either an injected nerve block or twilight sedation, which is given through an IV. When extensive work is needed, general anesthesia is sometimes recommended.

As the treatment starts, the doctor will use an instrument about the size of a pencil to pass the laser beam over your skin, removing the epidermis and part of the upper dermis. Because the laser is fully computerized, your doctor can precisely control the amount of energy in the beam, the density of the light, and the length of time it stays on your skin. Depending on your skin’s condition and the areas to be treated, the procedure will take from 30 minutes to over an hour. Some parts of the face may require a second pass; your doctor will carefully avoid letting the laser’s light penetrate too deeply. In many cases, as doctors treat the skin surface, they also see the skin firming up as the laser is passed across the face.

When the ablative resurfacing is complete, your face will be wrapped either in an antibiotic-soaked gauze bandage or in a mask-like dressing that resembles plastic wrap. Many surgeons use autologous platelet gel on the lasered skin to help accelerate healing.

You’ll rest in a recovery area for a few hours until any lingering light-headedness from the sedation or anesthesia has worn off. Then you’ll need a friend or relative to drive you home.

After Your Ablative Laser Procedure

	Four months after skin resurfacing with ablative laser.

In the first few days your face will be quite red and will be swollen. You’ll be wearing the dressings on your face for several days. It is important that you wear these because they help your skin retain moisture and prevent exposure to the air, which might encourage scabs to form and cause scarring. You may be asked to return to the doctor’s office several times for dressing changes; however, some of the newest coverings can remain up to one week, avoiding the need to change the dressing.

Full recovery from ablative resurfacing is lengthy and can take two to six weeks. Still, most women can apply makeup in about two weeks; most can return to work around this time. Men usually grow their beards for two to three weeks, which helps camouflage their pink skin. For both sexes the pinkness gradually fades over the next two to three months. How quickly it does so is dependent on the regimen the physician
recommends to the patient (skin care products both pre- and post-treatment) and how closely the patient follows it. Recovery times vary widely.

After the dressings and ointments are gone, you’ll see much softer, pinker, and smoother skin. Most lines and wrinkles will be radically reduced if not eliminated entirely, along with roughness and pigmentation spots. During the next several months, the changes generated by new collagen formation will slowly appear. Your skin will appear firmer and tighter, in many cases dramatically so.

You’ll be visiting your doctor again a few days to a week after your procedure to have the dressings removed, and you’ll be given specific instructions for your follow-up care. Pain is generally minimal, and most patients use narcotics for only one day, if at all.To further the healing process, you will want to take the following steps:

• Sleep on two pillows for a week or two to reduce swelling.
  
• Follow the detailed instructions from your doctor on how to apply the ointments and replace the protective dressings. Do not remove the dressings unless you have been instructed to do so.
  
• Wash your face several times a day with a gentle warm-water spray and the soap your doctor provides (unless you have an extended dressing in place).
  
• Take any other medications, antibiotics or antiviral medications your doctor has prescribed for you.
  
• Become a sunscreen zealot - safeguard your new skin with generous daily applications of a high-quality, high-SPF sunscreen.

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