Thank you for your question.
You submitted a question without a photo and you’re asking what the best laser for, in
2016 to improve, to do resurfacing, to improve skin texture and pores and tighten pores and
tighten skin.
You’ve also stated that you are interested particularly in the eyes and nose area and
lastly you are concerned about the possibility of lasers causing blood vessels to form or
the onset of rosacea.
So certainly, I can give you my opinion about this question and how I approach that question
when people ask that exact same thing in my practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years.
I began my career with the first CO2 Lasers for ablation back in the early to mid 90’s
and have many lasers in my office and I can tell you a little bit about how I make these
decisions and give you some guidance on how you should also consider and what you should
consider when you are thinking about laser treatments.
So to begin with, the very question you are asking results in almost a knee jerk reflexive
reaction by physicians who are all thinking, with the best interest of patient in mind
but usually is also because they own a particular laser or they are leasing a particular laser.
And although there are many choices on what can be used for resurfacing or improving skin
quality and improving pores but the first question is really about proper diagnosis.
You see, there has been this natural evolution of improvement in the types of lasers and
the modalities in which we are able to apply these lasers.
There also has been radiofrequency technology brought in but when you get down to all of
this, you have to still understand what your desired outcome is.
You have to think will laser be the right solution instead of saying which the best
laser is.
For example, we’ve also learned a lot about the potential of what we want to do with the
laser being accomplished with alternatives.
For example, when you talk about tightening skin, improving texture, improving texture,
improving the appearance of the skin, you are talking about increasing collagen, improving
the quality of the skin and the blood supply and the skin looking smoother.
Well, I found that what I used to do with more aggressive ablative laser like a fully
ablative CO2 laser, I do differently now but not with laser alone.
I’ll do a combination.
I’ll use something like platelet-rich plasma (PRP)and place it under the skin.
And platelet-rich plasma (PRP), in case you are not familiar, is a concentration of your
blood of wound healing factors that stimulate repair when you get a cut.
And so your body knows how to restore collagen, restore blood supply as a response to injury.
So with platelet-rich plasma (PRP), what we are doing is concentrating those same growth
factors from your own blood.
So instead of using heat to try to stimulate a healing response, we are actually using
your body’s own growth factors to stimulate comparable response.
Now where does lasers fit in there?
Well, when you do something like platelet-rich plasma (PRP), you can actually be more conservative
with the type of let’s say resurfacing laser.
So instead of fully ablative, we’ll do fractional depending on skin type.
We use fractional Erbium or fractional CO2.
I try to not to always talk about the brand name of the laser but rather the category
of that laser.
We have several lasers in our practice and all these lasers are actually very adjustable.
We also have non-ablative lasers which is called Nd:YAG technology.
That type of laser, you actually improve the texture of skin quality by going through the
skin and into the deeper layers of skin to stimulate new collagen formation.
So I think that it is very important that you get an understandings of what your options
are by proper evaluation.
Literally every week, I get to see people who will tell me that they got the “best
laser” last year but they didn’t get the result that they wanted and often people are
going from one laser in one doctor’s office to a laser in a medispa and versus going to
another place and basically bouncing from one laser to another because they keep watching
television and seeing the promotions of different brands of lasers.
But what is really critical is the physician who communicates with you about your skin
condition.
A lot of times, it is better to prepare the skin before doing a laser and so I think my
point is don’t hang your hat on a single laser as the best laser of this particular
year.
It is really about the doctor who makes the diagnosis, makes the recommendation and then
performs the laser and then treats you after the laser.
This is really a tool.
It is a very exciting and very capable tool but it is part of a spectrum of many different
technologies that are now available.
So I would say that you can certainly get ideas of what’s out there but really there
is going to be an art to helping people improve their skin and it takes a lot more variables
taken and factored in before you decide what is the best laser.
That’s why with a busy practice like ours, we have multiple lasers and all those lasers
have different applications in different scenarios.
So meet with doctors, figure out what your particular skin issues are, understand what
the treatment and plan would be and what you can expect.
And I think that you just have to understand and not about one particular best laser because
frankly if there was just one best laser, everyone would own the same exact laser but
rather it really is about what is the best approach that’s right for you.
So I hope that was helpful, I wish you the best of luck and thank you for your question.