Fractionated CO2 technology has revolutionized our ability to treat moderate to severe skin aging and scarring with minimal downtime. In the past, the best laser treatment as far as effectiveness was standard (unfractionated) C02. Unfortunately, while producing dramatic skin tightening and smoothening of wrinkles, the standard deep CO2 laser peel often causes permanent skin lightening.
Fractionated CO2 harnesses the power of CO2 but decrease the chances of skin lightening by fractionating the laser beam (treating a fraction of the skin surface at a time).
By treating only a fraction of the skin surface, the healthy untreated skin aids in the healing process and decreases chances of hypopigmentation (permanent skin lightening), scarring, or prolonged redness. By controlling the density of the treatment (what percentage of the skin surface is actually hit by the laser) as well as the depth or power of the laser, a skilled surgeon can tailor a fractionated CO2 skin resurfacing treatment to achieve dramatic results in most skin types.
In our practice, the Ultrapulse CO2 laser from Lumenis is used for this treatment. This was the first device to introduce fractionated CO2 resurfacing and has made a lot of progress as far as treatment options and parameters. The Active FX is the name given by the company to their fractionated treatment done with a standard spot size of 1.25mm. At this spot size the treatment depth is relatively superficial but by increasing the density and or frequency of the pulses one can achieve fairly dramatic skin tightening and texture improvement. Deep FX is the name given to the treatment when performed with a decreased spot size of 0.12 mm. The smaller spot size means greater power which means the laser goes deeper into the tissue. However, it is still fractionated, making it a relatively safe treatment. Total FX means a combination of Active FX and Deep Fx spot sizes. Generally, the Deep FX is used on deeper lines or scars (around the lips or corners of the eyes in most patients). Active FX is then feathered over these areas and the rest of the face. This combination is currently believed to provide the best total rejuvenation with the quickest recovery and minimal risks, according to the company.
In our practice our patients have been very satisfied with Active FX, and when the deeper lines around the lips are softened further with the Deep FX this has been icing on the cake for them.
The cost of fractionated CO2 laser skin resurfacing varies. Some clinics have nurses performing Active FX and occasionally deep FX. The problem with this is that outcome is highly dependent on the level of comfort and experience of the practitioner. Density of the treatment can vary from 1 to 5, at which point only a doctor should be handling the laser. Another factor is the brand of laser being used. The Ultrapulse from Lumenis has been around longest and therefore has the best track record with established parameters. This is also the most expensive laser at around $150,000 to purchase. It should generally be expected that a combo treatment or "total FX" combining different spot sizes will be more expensive. This requires more time and planning on the part of the surgeon, and also more expensive equipment.
A final consideration that can affect cost of treatment is "after care." The treating facility should have an experienced esthetician who has been trained to deal with post-laser skin. The esthetician should provide quality skin care products and guidance, without making patients feel they are paying a "second procedure fee" or exorbitant cost for products.
Roy David Amir, MD, FACS
La Jolla Center for Facial Plastic Surgery
(858) 658-0595
sandiegoface.com sandiegoface.com
No comments:
Post a Comment