Fractionated Laser Resurfacing

For years, Dr. Rapaport and other dermatological surgeons have been looking for an ideal method for eliminating wrinkles, correcting acne scars, and improving ageing and sun damaged skin. Laser resurfacing is the latest breakthrough in rejuvenation of the skin.


Using a wand like laser hand piece wrinkles are vaporized and replaced by fresh skin cells. There is more control in the depth of penetration and this allows more precision and safety in the treatment.


What is a laser?


  • Laser stands for “light amplification by stimulated emission of radiation”. What this means is that lasers function by creating an intense beam of bright light that travels in one direction. The laser has the ability to produce one specific color of light, and the newest lasers can be tuned to precise and selective wavelengths allowing specific treatments and safety levels not previously available.


What is skin resurfacing?


  • Laser resurfacing is a highly effective method for eliminating wrinkles, flattening protruding acne scars, and improving aging and sun damaged skin. The laser beam can selectively vaporize wrinkles and scars. There is more control in the depth of penetration, and the laser leaves normal skin between pulses, this allows more precision and safety in the treatment.


How does the Carbon Dioxide laser work?


  • Unlike the older continuous carbon dioxide lasers, the new generation of CO2 laser delivers short bursts of extremely high laser energy. This revolutionary technology can remove skin one pulse at a time, revealing fresh skin underneath. Often referred to as a fractional CO2 laser, the new CO2 laser functions with a lower risk of scarring and complications.


How does the fractional Erbium Yag laser work? (Fraxel)


  • The high-powered Erbium Yag laser produces a wavelength that gently penetrates the skin and is highly absorbed by water. These properties allow Dr. Rapaport to heat columns of skin with exquisite precision.



How does Dr. Rapaport decide to choose a laser?


  • The Fraxel laser is selected for patients who have superficial to moderate facial wrinkles, mild surface scars or discolorations. The gentleness of the Fraxel laser is selected in areas where the skin may be more delicate. These areas include those around the eyes, mouth, neck and hands. Furthermore, the Fraxel laser is selected for patients with darker skin types and for those who cannot tolerate prolonged redness after the procedure.



The Fractionated CO2 laser, on the other hand, is more effective for deeper facial wrinkles or severe sun damage. Although there is more tissue tightening with this laser, this comes with longer healing time and more prolonged redness.


Who is qualified to perform laser skin resurfacing?


  • Traditionally, the experts in skin care and skin disease have been dermatologists. Dr. Rapaport has extensive experience with laser surgery and treatment of conditions during the postoperative phases. Since results are technique-sensitive, it is important to select a doctor with demonstrated laser experience. Dr. Rapaport is often consulted by other aesthetic surgeons and asked to treat patients who have had complications from other surgeries.


What conditions can laser resurfacing treat?


  • Improve fine lines and wrinkles of the face, especially on the upper lip, cheeks and forehead.
  • Smooth and tighten eyelid skin.
  • Improve crow’s feet around the eyes.
  • Soften pucker marks and frown lines.
  • Remove brown spots and splotchy, uneven skin color.
  • Improve and flatten scars.
  • Repair smoker’s lines.


What are the benefits of laser surgery for facial resurfacing?


  • Improved treatment results.
  • Relatively “bloodless” surgery.
  • Precisely controlled surgery.
  • An addition or alternative to other skin rejuvenating procedures.
  • Safe, reliable and effective out-patient, same day surgery.


What can be expected during and after surgery?


  • Depending on the specific condition being treated, patients may receive a topical anesthetic cream with mild sedation, or local anesthesia. Discomfort is usually minor both during the procedure and throughout the recovery phase. The time required to complete the procedure is generally one hour, although this may vary depending on the sites treated.


  • Following Fractionated Co2 skin resurfacing, the treated areas usually are kept moist with ointment or occlusive dressings for the first few days. The skin is typically red or pink and may be covered with a fine crust. The treated sites must be protected from sunlight after the procedure. Once healing in completed, sun block lotion should be applied. Depending on the type of laser used and the individual’s ability to heal, a pink surface color may remain for several days to several months. Makeup can be worn after about 7 days.


What are the possible complications of the procedure?


  • All surgical procedures carry some degree of risk. With the new Fraxel Fractionated and CO2 laser surgery, the risk of scarring is low. Common side effects may include crusting, mild swelling, redness or brown discoloration at the treatment sites. Some patients may require bleaching creams to help regulate skin color following laser resurfacing. Significant pain, bleeding swelling and infection seldom occur and can be minimized by surgical techniques and vigorous postoperative care. These surgical techniques and pre-and post-operative regimes have been pioneered by dermatologic surgeons and continue to be enhanced and improved for patient safety and comfort.


What are the limitations of fractionated laser resurfacing?


  • Laser resurfacing is not a substitute for a facelift, nor can the procedure eliminate excessive skin or jowls. However, beneficial tightening of loose skin can occur from fractionated laser resurfacing, resulting in an improvement of certain folds and creases. In many cases, laser resurfacing offers an alternative to traditional methods for skin rejuvenation, such as dermabrasion and deep chemical peels. It can also work well in conjunction with or as an additional treatment to other aesthetic procedures, such as chemical peels, blepharoplasty (eyelid surgery).