Can I have laser treatment for wrinkles but without the downtime?

Since the mid-1990s laser treatment has become well established as one of the most

effective ways to treat wrinkles of course the term laser evokes

science-fiction imagery which implies immediate results with no downtime in

reality there are different ways that lasers can be used to help improve the

appearance of wrinkles based on principles which determine how the skin

heals after light energy is absorbed by different parts of the skin and how

different forms of energy interact with these parts of the skin one approach for

example is using a laser like the co2 laser which is absorbed by water to

remove the top layer of skin so afterwards a new smoother and more

youthful layer of skin can come in this is known as ablation in addition to

removing wrinkled and discolored skin the heat generated by the co2 laser can

cause the skin to contract and stimulate cells called fibroblasts to produce

collagen another laser technology which can improve the appearance of wrinkles

without any downtime is a non ablative laser when you learn about the existence

of these two very different options how do you decide what to do at a time when

a lot of lasers are aggressively marketed to be the best laser for

wrinkles every other day it’s helpful to understand some principles of laser

treatment so you can see past the noise and the hype if your goal is to improve

the appearance of wrinkles I’ll discuss how I apply customized strategies which

include lasers to help my patients improve their wrinkles without downtime

every day in my practice I’m Dr. Amiya Prasad I’m a Board-certified cosmetic

surgeon and Fellowship-trained oculofacial plastic and

reconstructive surgeon have been in practice in Manhattan and Long Island

for over 20 years I’ve been performing laser treatment since the mid 1990s with

the first fully ablative co2 lasers as technologies changed I continue to

integrate newer technologies such as fractional co2 and erbium laser as well

as more recent technological advances such as long pulse erbium and nd-yag

laser in addition to non ablative technology such as q-switch laser I also

perform radiofrequency treatments like peleve particularly for darker skin

types who are not laser candidates I was also among the first proponents of using

platelet-rich plasma or PRP for improving skin quality when the first

fully ablative co2 lasers were used in the 1990s the outer layer of facial skin

would be removed leaving the skin raw the aftercare was essentially burn

management downtime was for several weeks with intense redness lasting for

months once the new layers of skin came in and the wrinkles improved the

patients were mostly happy with their results this prolonged downtime as well

as conspicuous appearance in the first week to two weeks kept a lot of

potential patients away from this treatment fractional laser technology

allowed for shorter healing times for partially ablating the top layer of skin

and allow the skin to heal faster fractional laser treatments such as co2

and erbium are very effective in improving skin quality and texture as

well as stimulating collagen but they still require some downtime although

much less than fully ablative laser treatment so how can we apply the

benefits of laser technology without any downtime by first understanding the

underlying problem the skin we’re trying to address I look at it this way the

skin which is about two millimeters in thickness is made up of two

the dermis and the epidermis the dermis is the backbone or foundation of the

skin this foundation is supported by cables made of collagen aging health and

environmental factors caused breakdown and loss of collagen loss of collagen in

the skin has an effect on the skin like the brakes and the foundation of a

structure that would be like a building lines or wrinkles which are present at

rest refer to as static lines can be the result of loss of support caused by loss

of collagen a universal goal in the claim of superiority for every new

technology in the stimulation of the skin to produce collagen if you look at

the claims made by technologies such as laser or radiofrequency and micro

needling they all list the stimulation of collagen production as being a

significant benefit much of this stimulation of collagen is based on the

physiologic response of the skin to a medically induced controlled injury the

skin recovers from injury by producing collagen there is however a limit on how

much collagen can be generated by your skin regardless of the technology this

concept is something that I have observed as being generally ignored by

practitioners it is common in our practice to see a patient

after they had several different laser treatments by several different

practitioners over the course of a few years I often find the skin to be

scarred or thinner than I would expect this is the result of over treating I

compare this injury to the skin to be comparable to the type of injury which

occurs if you force someone with weak muscles to lift weights that are too

heavy this means that a strategy for wrinkle treatment needs to be well

thought out before being implemented to improve the appearance of wrinkles laser

treatment can be used to stimulate collagen in the dermis to restore

support and new the top layer of skin to restore

even texture and color during my assessment I look at what my patient

wants to improve and determine the level of severity of the fine lines they’re

interested in treating I explained to my patients that as a general rule the

deeper the lines the more aggressive the laser treatment needs to be practically

speaking I find that unless I’m doing a surgical procedure such as eyelid

surgery or facelift surgery when people are already taking a week or so off so

they have a period of time they will not be seen my patients generally prefer to

avoid procedures where the skin is ablated and they have to be out of

commission even for a few days for minimal to moderate depth wrinkles laser

treatment can be performed without ablation and without the downtime one

laser I use is a non ablative 1064 YAG laser the outer layer of skin is

preserved but the heat of the laser can penetrate into the dermis to induce a

collagen response and remodel the skin since wrinkles are often associated with

Sun induced skin discolorations I also treat these discolorations refer to as

solar disk crummiest and solar lenta goes I use the q-switch laser to treat

pigment at this level without ablation of the top layer skin in our office we

use the same q-switch laser for tattoo removal I then deliver platelet-rich

plasma or PRP to induce maximal collagen production within the body without using

heat PRP is a concentration of wound healing and growth factors present in

your blood PRP is prepared by drawing a patient’s blood and then spinning the

blood in a centrifuge to separate the platelets the skin can benefit from PRP

with collagen stimulation improvement in blood supply increase in skin thickness

which ultimately results in a nice glow and luster to the skin which is fairly

unique to PRP while PRP is often injected into the skin or applied

topically after micro needling I find that a treatment we call skin boosting

by using a specially designed device effectively delivers PRP directly into

the skin without causing swelling bleeding or bruising PRP can also be

mixed with hyaluronic acid to provide a scaffold for the fibroblasts to place

collagen more effectively as well as adding hydration to the dermis to

improve the skin surface or epidermis without downtime we help our patients

with a procedure called HydraFacial HydraFacial uses water for the same

effect as microdermabrasion to remove dead skin cells from the outer skin

layer while avoiding irritation often associated with traditional

microdermabrasion glycolic acid and hyaluronic acid is often used during the

HydraFacial session which provides maximum benefit to the epidermis Hydra

facial also involves no downtime and the skin can look really good right after

the procedure more aggressive lasers have an important role in wrinkle

treatment as skin improvement fractional and partially a blade of lasers like co2

erbium and Andy AGG are still highly effective for combined treatment or

improvement of the dermis and epidermis although downtime is required anytime

the outer skin layer is partially ablated it can be for a limited time in

my practice I strive to help my patients with minimal to moderate wrinkles with

combined combinations of technologies such as non ablative laser PRP and Hydra

facial to get maximum results with no downtime I provide my patients with

perspectives and a strategy for maintenance consumers our bra

with aggressive messaging from companies who pay celebrities to claim that the

secret to their youthful appearance is the technology that the celebrity was

paid to endorsed you can potentially avoid getting your skin cooked and

damaged by finding an ethical and highly experienced doctor to be with you for

the long-term so you can achieve your goals and look your best

I hope you found this information helpful thank you for your question