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Skin Resurfacing

Are you confused by all the different options you hear about making your skin look younger? Non-surgical skin rejuvenation, laser skin resurfacing, wrinkle treatment, fillers, face lift, and skin tightening are common approaches for improving the look of your skin. Among these options, laser skin resurfacing is the most effective, non or semi-invasive surgical approach to achieve drastic results. A multitude of technologies for skin resurfacing is currently available. They include carbon dioxide lasers, erbium lasers, plasma and radiofrequency devices delivering their results in a fractional, ablative or non-ablative manner. This review will help you understand the different skin resurfacing options and determine which one fits you best. You will learn about the different treatments, looking side by side at each attribute of skin resurfacing - expected results, social downtime, number of treatments needed, time results last, and cost.

Treatment Options

CO2 Laser ActiveFX(TM) Fractional
Lasers
TCA Peel Glycolic
Peel
Micro-
dermabrasion
Results ++++ +++ ++ ++ + +
Social downtime 5-14 days 3-5 days 1-6 days 5-7 days None None
# Treatments 1 1-2 4-8 1 6-8 6-8
Lasting results 10 years 10 years Unknown 1-2 years 1 Year 1 Year
Avg. total cost $3000 $3000-$4500 $4000-$7000 $500 $700 $1000
  • Skin Resurfacing - Introduction
    • Maintaining beauty and a youthful appearance date back several thousand years to the ancient Egyptian. However, the advances in technology have never before awarded such a choice of modalities. Non-surgical skin rejuvenation, laser skin resurfacing, wrinkle treatment, fillers, face lift, and skin tightening are common approaches for improving the look of your skin. Particularly, the introduction of a multitude of skin resurfacing devices has caused a lot of confusion amongst consumers. Among these options, laser skin resurfacing is the most effective non or semi-invasive surgical approach to achieve drastic results.

      First of all you must know that every new resurfacing laser or device is measured against the industry's most powerful machine for the past 40 years, the carbon dioxide (CO2) laser. It was invented in 1964 and has been the most widely used laser in medicine. In the area of dermatology, its use has been predominantly for facial resurfacing. It often achieves desired results in a single treatment, works on fine and intermediate lines and acne scars, maximally tightens the skin and delivers results that last a number of years. Its drawback is a long, 10-14 day social downtime, making it less desirable for any working person. To overcome this handicap and minimize healing time, many devices that do not injure the uppermost layers of the skin (non-ablative) have recently been developed by the aesthetic industry. The single most important advance was the creation of fractional technology. Leaving small islands of normal skin behind, the skin regenerates much faster than with the traditional full ablation of skin.

      You will learn about the current industry recognized ablative and non-ablative strategies that rejuvenate your skin and about the benefits and downsides of each of these techniques.

  • Fractionated Ablative Lasers -- Carbon Dioxide Laser - CO2 Laser
    • As an ablative laser, it vaporizes the tissue and is able to eradicate fine and intermediate lines, smoothes overall skin texture and acne scars, eradicates uneven pigmentation as well as tightens the skin. It lets you appear about 10 years younger and often replaces the need for a face lift unless skin sagging is severe. Preparation and postoperative care most closely resembles a full fletched surgical procedure, however, CO2 laser resurfacing can be performed under local anesthesia. The price you pay for the results is one to two weeks of social downtime while the skin reepithelializes. In addition, the resurfaced skin may appear pinkish for several months thereafter.

  • Fractional CO2 Laser - ActiveFX(TM), DeepFX(TM), Fraxel re:pair(TM), Mosaic eCO2
    • Since the beginning of 2007, refined systems with partial degrees of ablation that leave small islands of normal skin from which the skin can regenerate much faster, have revolutionized the resurfacing market. Amongst these, the combination of DeepFx and ActiveFx, manufactured by the leader in CO2 technology (Lumenis) give results that most closely compare to the traditional laser resurfacing. This new technology offers faster healing times with still excellent results. In the meantime, a number of laser companies have now developed their own permutations of a fractionated CO2 laser and names include Fraxel re:Pair, Slim MIxto/SX, Exelo 2, Mosaic.

  • Erbium YAG Lasers
    • The traditional erbium laser has produced results that were absolutely comparable to the CO2 laser yet it fell out of favor because of significant post operative bleeding. As with the fractional method developed for the CO2 laser, today's erbium laser treatments are almost exclusively fractionated and may also be called pixelated. Names that you may read about are Pearl, Pixel, ProFractional and Starlux 2940. However, with the exception of the Pearl, these do not deliver results that mirror the original. While downtime is typically limited to 1-4 days, the downfall of most of the fractionated erbium technology is the very superficial nature of the resurfacing results, being excellent at improving sun damage, and skin texture, but will target only the finest lines. They are considered more like an aggressive peel. Several treatments are often necessary to achieve such results. These fractionated lasers do not significantly contribute to skin tightening, removal of wrinkles, let alone acne scars.

  • Non Ablative Fractional Lasers
    • Protecting the epidermis, the upper most layer of our skin, and thereby minimizing social downtime, non-ablative lasers deliver energy in the lower layers of skin, ideally only causing swelling which is socially much more tolerable than oozing. Amongst the non-ablative lasers, FRAXEL is the most marketed. Other brands include Affirm, StarLux-Lux, Mosaic.

      Using a wave length lower than that of a CO2 laser, these lasers drive energy into the skin, stimulating collagen production and thereby tightening skin. Results after a single treatment are minimal and it can easily take 4-8 treatments to observe an effect. While its effects on wrinkles and lines after 4-8 treatments is fairly close to the results of a single CO2 laser treatment, it does not seem to deliver on scars as well. In addition, the Fraxel has been FDA approved for the treatment of melasma, also known as the mask of pregnancy, which shows as symmetric pigmentation on the face as a result of sun exposure with increased estrogen levels.

  • Non-laser Fractionated Resurfacing Devices
    • Plasma and radiofrequency devices belong to this category. Because of the more convincing results, plasma technology will be discussed here. The plasma device is not based on laser principle. Plasma is pushed into the skin to induce partial ablation of the epidermis and renewal of collagen beneath the surface of the skin. Treatments can be delivered in 1-2 aggressive sessions, results mimicking nearly those of fractionated CO2 laser resurfacing. When energy levels are minimized to allow for as a little as a few-hour lasting redness, several treatments will be needed for an effect. With the latter technique however, results tend to be much less dramatic. Having gained FDA approval in the second half of 2007, the technology is fairly new and long term results are not known yet.

  • Skin Resurfacing - Summary
    • In sum, many exciting technologies are available nowadays. The general rule of little downtime little results still applies. Non-ablative technology seldom achieves noticeable results in a single treatment and the overall outcome even after several treatments is often below expectations. Ablative devices appear to deliver best, require only a small number of treatments results and social downtime can effectively be lowered by the uses of fractional technology. Ultimately, your goals, your ability to tolerate social downtime and your wallet will steer you and your treating physician to a resurfacing plan that is tailored to you.

How can we help you?

SKIN

# of surveys: 3749
Last updated: 05/18/2017 4:45 PM,

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%

Compare our service to other similar practices

excellent
87.9%
very good
10.1%
good
1.8%
poor
0.06%
very poor
0%

Overall doctor performance

excellent
94.2%
very good
4.89%
good
0.80%
poor
0.03%
very poor
0%

The doctor listened to you attentively

excellent
93.9%
very good
4.97%
good
1.05%
poor
0.05%
very poor
0%

The doctor took time to answer your questions

excellent
94.0%
very good
4.66%
good
1.27%
poor
0.02%
very poor
0%

The doctor explained treatment options

excellent
94.3%
very good
4.16%
good
1.25%
poor
0.14%
very poor
0.02%

The doctor explained treatment options

excellent
92.0%
very good
5.69%
good
2.18%
poor
0.11%
very poor
0.0%

Front desk performance

excellent
85.6%
very good
10.2%
good
3.66%
poor
0.31%
very poor
0.08%

Aesthetician performance

excellent
88.6%
very good
7.61%
good
3.39%
poor
0.24%
very poor
0.08%

Office comfort

excellent
90.9%
very good
6.93%
good
2.08%
poor
0.05%
very poor
0.05%

Parking

excellent
66.4%
very good
14.4%
good
15.7%
poor
2.49%
very poor
0.9%

Friendliness of the staff during appointment

excellent
90.9%
very good
7.23%
good
1.85%
poor
0.05%
very poor
0%

What WE DID WELL

(Answers:674)

The time spent with the doctor....I always feel she cares and will take the time with you.

#12017-05-02

The doctor was excellent - really explained the issues and approaches very clearly. I would recommend this pratice to others!

#22017-04-02

It is clearly evident taht Dr. Ringpfeil is genuinely motivated by listening to your full symptoms, issues and then selecting the approach that is best for you. I scheduled my appt with the hopes of undergoing pricey treatments. Rather than signing me up and taking my check, she insisted that we first address the cause of my problems. Obviously, her goal is to heal the patient, not simply select the treatments that would be most lucrative for her. Impressive.

#32016-12-01

Everything! I appreciate the fact that Dr. Ringpfeil has a great understanding of my medical condition and how it has affacted my skin. I look forward to seeing her for all my future dermatalogical needs. I really needed a wonderful dermatologist and am grateful to Dr. Sandorfi for referring me to Dr. Ringpfeil.

#42011-01-12 12:15:01

That was the most thorough appointment I have had in a very long time. I was given numerous options that were tailored for my skin needs.

#52011-12-06 10:16:06

I liked the office, very nice and clean. The doctor and doctor assistant were very nice and very concerened with my problems and answered my questions very well. Thank You agian

#62017-08-07

visit was great

#72016-12-05

nope. i've been to a lot of dermas and i never felt so positive, hopeful. thank you!!!

#82017-02-19

Time spent with doctor was longer than expected. Doctor said she liked Retin-A Micro.

#92011-03-30 10:03:23

I liked all rthe art work that was hanging up in the hallways. I also liked how friendly everyone was. It seemed as though they all wanted to be here. Some times at otjher places the people at the counter can be disrespectful. Not here. The or was very caring and explained the treatment in terms that we could understand.

#102017-08-04

What can we do better?

(answers:373)

Keep doing what you are doing!

#12016-12-02

Nothing missing.

#22017-09-24

Complimentary BMW with first visit

#32017-02-26

Better parking?

#42017-09-22

It would be helpful to have some later evening hours, but the early morning hours work for me too!

#52017-05-06

I checked off compimentary consultation with aesthetician on the intake forms, but it wasn't mentioned and I forgot to ask during the examination.

#62016-09-29

Everything was perfect today

#72010-10-05 10:42:21

Later evening hours and/or weekend hours.

#82011-05-27 15:59:15

The experience was very pleasant, and relaxed. I would not recommend changing anything!

#92017-02-19

keep on on trying to do your best

#102016-11-24
Customer Rating : 4.3

Based on 33 ratings