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Lasers:
Uncovering Younger Looking Skin
Lasers
are used to help uncover the fresher, younger looking skin that
we never knew we had. They allow us to remove the sun
damaged, wrinkled and dull upper layers so that when you are
fully healed all that remains is a younger, smoother and
rejuvenated appearance.
What
Is a LASER and How Does It Work?
LASER is an acronym for
Light Amplification
by Stimulated Emission
of Radiation.
Or according to Merriam-Webster's Medical Dictionary: [: a device that utilizes the natural oscillations of atoms or molecules between energy levels for generating coherent electromagnetic radiation in the ultraviolet, visible, or infrared regions of the
spectrum].
Light energy is changed into a tight, intense beam of monochromatic radiation
capable of delivering large amounts of power or heat. All lasers
possess a lasing cavity consisting of two mirrors placed parallel to each
other. One of these mirrors is partially reflective and between these
mirrors is a lasing medium or conduit which can be either a gas
(CO2 or Halide, etc.), solid (Alexandrite or Ruby) or liquid state.
An external power source is
directed into this medium, granting energy to the lasing cavity which causes the
light amplification process by exciting this medium. From this level of excitation,
it may return to its resting state or if it is struck by a photon,
releases two photons of the same energy and wavelength in time with one another.
Some photons strike other excited atoms and the photons not parallel to
the long axis of the cavity are then lost as heat. The small
percentage that are given off parallel to the long axis form an energy
wave which strike the mirrors and reflects back and forth, back and forth and so
on Unlike ordinary light, laser light is collimated, monochromatic
(uniform wavelength), coherent (in tune with each other) and uni-directional.
Therefore, light striking the epidermis may be reflected, transmitted to deeper
tissues, scattered or absorbed. The laser effect occurs when absorbed
light is converted to heat, resulting in coagulation of the targeted tissue and
depending upon the medium used the particular desired effect is gained. For
example, alexandrite for darker tattoos of black or blue ink, black spots,
darker hyper-pigment, CO2 for tightening or the epidermis, etc. Here is some
info from the Yale Medical University Core Curriculum regarding CO2 laser
resurfacing and rhytids.
"In a study of 259 patients, Alster et al
assessed the efficacy of high-energy pulsed CO2 [: a heavy colorless gas that does not support combustion, dissolves in water to form carbonic acid and is formed esp. in animal respiration and in the decay or combustion of animal and vegetable matter]
lasers in treating
facial wrinkles. Responses to treatment were assessed at 1, 4, 8, 12, and
24 weeks postoperatively. On average, the investigators found a 90%
improvement with periorbital [around the eyes] wrinkles most responsive to the therapy (93%).
Wrinkles which were more severe and caused by excessive muscle movement such as
forehead wrinkles had the least improvement (86%). Persistent erythema
[: abnormal redness of the skin due to capillary congestion (as in
inflammation)]
and
hyperpigmentation are the most common complications but these usually resolve
after several months. Other potential complications include acne, milia
[: a small pearly firm noninflammatory elevation of the skin (as of the face) due to retention of keratin in an oil gland duct blocked by a thin layer of epithelium --called also whitehead;]
,
dermatitis, infection, and hypertrophic scarring. Most complications are
related to postoperative care. Weinstein et al recommend the use of
Flexzan, a semiocclusive biosynthetic dressing made from polyurethane foam in
the immediate postop period. This is applied after the face is dried and
usually changed at 24 hours to remove wound exudate [: exuded matter; esp : the material composed of serum, fibrin, and white blood cells that escapes from blood vessels into a superficial lesion or area of inflammation]
. The face should be
gently, but thoroughly cleansed with preservative-free tap water and
perfume-free cold cream. The face is carefully dried with a cool hair
drier or low-energy laser to enable the dressing to stick better. This
dressing is left for 7 to 10 days. The patient then showers, washes the
hair, and returns to the office with wet dressings which are removed with baby
or bath oil. Usually the skin is completely healed. A few small
areas may be incompletely healed and will need reapplication of small sections
of Flexzan. Antiviral medication is started 24 hours before the procedure while
antibiotics are started the morning of the surgery. These are usually
continued until reepithelialization [: restoration of
epithelium (: a membranous cellular tissue that covers a free surface or lines a tube or cavity of an animal body and serves esp. to enclose and protect the other parts of the body, to produce secretions and excretions, and to function in assimilation)
over a denuded area (as a burn site) by natural growth or plastic surgery]
is complete. After reepithelialization,
the skin should be treated with oil-free, perfume-free cleansers and
moisturizers. A tinted titanium dioxide UVA blocking sunscreen should also
be used to minimize hyperpigmentation." Yale Medical University
Core Curriculum - Lasers
YTF! Tip:
A good Sunblock that I use after peels is Neova Ti-Silc® 45 tinted sunblock
with Copper Peptides -- by Procyte Corporation. I began using this product
while on an intensive 9 month Retin A and Hydroquinone regimen. I never burned
or hyperpigmented once. I still use it for my daily sunblock.
Now that
all that garbage is over let's get to what you really want to know. If you had
wanted a course on the utilization of LASERS you'd have signed up last semester,
right?
What Is Laser Resurfacing?
Laser resurfacing (or laser peel, laser rejuvenation, laser
surgery), is the act of using a carbon dioxide (CO2), erbium, pulse dye or other
laser to remove
wrinkles, discolorations, age spots, and sun damaged skin or stimulate your
body's fibroblasts to form collagen to treat the wrinkle from
within. The laser is passed over the
treatment area to eradicate wrinkles around the eyes and mouth or anywhere you
have unsightly lines, hyperpigmentation or blemishes. Lasers are an effective
way to remove those superficial lines that make you appear aged. Plus, laser resurfacing
is a considered a safer, less invasive procedure say than deep TCA peels or Dermabrasion.
However, laser resurfacing is not for everyone.
Resurfacing with a laser is considered ablative and non-ablative
lasers are basically thermescent fibroblast stimulators that treat a wrinkle
from the inside out rather than literally removing it. Ablate literally means to
remove, especially by cutting (laser excision/evaporation included).
Non-ablative being
that there is no "resurfacing", per se, but rather the heat-induced
fibroblast stimulation to thicken the underlying collagen structure. With
ablative lasers, the skin surface will appear red and weep afterwards as the top
layer(s) has been removed. With the non-ablative there is little downtime,
perhaps just a little swelling or pinkness.
Available
Types Of Lasers
There are many types of lasers
which address the variety of complaints one may have. Please read
below for a sampling of the various machine types on the market. We will, of course, not have every machine listed.
Carbon Dioxide
Laser (CO2 (including UltraPulse Laser Systems): (technically:
carbon dioxide gas lasing device) This is the most common. We
will use the CO2 to demonstrate the explanation of the surgery itself.
Unfortunately CO2 lasers aren't for everyone. They can be used to
eradicate excessive or irregular scarring from a prior procedure
although care must be taken when determining a candidate.
Hyperpigmentation and hypertrophic scarring may occur in persons who are
prone to such or in persons of
ethnicity (Italian, Asian, African, African-American, Greek, etc.)
Spot test: usually required and strongly suggested.
Longevity: If it is for photo-damage or photo-damage
induced wrinkles, you will only continue to get photo damage if you
frequently subject yourself to UV light exposure or spend a lot of time
in the sun without a proper sunblock or hat, etc. Discuss with your
surgeon his longevity percentages.
Approximate Cost: $1,500 - $6,000.US
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Cool
Touch 1320 Laser:
(technically: thermescent Nd: YAG 1320 LASER) This is also a
selective dermal heating type of procedure such as NLite. This laser
supposedly can be used on any skin color, any skin type, and on any part
of the body without the risks of hypo- or hyperpigmentation or the
healing times associated with conventional lasers. It is considered a non-ablative lasing device.
Outer skin and sensitive nerve endings with a unique cooling spray, then
use precise laser pulses to stimulate cells called fibroblasts which
produce the natural collagen that is the foundation of your skin. As the
collagen layer thickens, skin tone and elasticity improve.
According
to a lecture by Dr. Robert A. Weiss, the assistant
professor of dermatology at the University of John Hopkins School of
Medicine in Baltimore, Maryland by on non-ablative treatments:
Thermescent
CoolTouch 1320 treatments are usually performed 3-4 times at one month
a part although you will not see results until the 2nd or 3rd
treatment. Also the improvement may appear immediate although this is
due to edema (swelling), etc. The patients sometimes use moist
gauze or goggles. It was reported that 50% of the patients opt for an
EMLA cream (topical anesthetic).
As with
NLite, this type of laser delivers the amount of infrared energy to
trigger a thermal wound response but without the harmful effects to
the epidermis. In other words, the laser heats up where your
dermis/epidermis meet, thereby stimulating your collagen production
and correcting the rhytids (wrinkles) from within. The difference with
CoolTouch 1320 is that the cryogen spray cools the epidermis allowing
the penetration of the Nd: YAG to depths of 200-400 microns in the
dermis layer with a surface temperature of no more than 44º to 48º Celsius
(111.2º to 118.4º Fahrenheit). Improvements were seen on rhytids
(wrinkles), acne scars, pore size reduction and "crepiness".
Also it was mentioned that the subcision (undermining of scar
bands under an acne pock) was beneficial to the patient when treated
with the CoolTouch 1320 as well.
Spot
test: usually
required.
Longevity: If it is for photo-damage or photo-damage induced
wrinkles, you will only continue to get photo damage if you frequently
subject yourself to UV light exposure or spend a lot of time in the
sun without a proper sunblock or hat, etc. Discuss with your surgeon
his longevity percentages in average cases.
Approximate Cost: dependant upon area and practice.
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Er:YAG Laser (Erbium):
(technically: Erbium: yttrium aluminum garnet)
This LASER is at a wavelength of 2940 nm and is absorbed by superficial
layers of the epidermis. When Q-switched, the laser is
emitted in pulses which evaporates or "blasts" the damaged or
unwanted tissue away. The pulsing actually lessens the heat on the skin
emitted by the LASER so there is less damage.
Spot test: usually required and strongly suggested.
Longevity: If it is for photo-damage or photo-damage
induced wrinkles, you will only continue to get photo damage if you
frequently subject yourself to UV light exposure or spend a lot of time
in the sun without a proper sunblock or hat, etc. Discuss with your
surgeon his longevity percentages in average cases.
Approximate Cost: Approximately $3,000.US for a full face
treatment.
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NLite:
(technically: class IV medical, non-ablative HeNe flashlamp pumped,
pulsed-dye LASER) ICN Pharmaceuticals' NLite is a class IV medical
LASER, specifically designed for non-ablative removal of rhytids
(or wrinkles) and collagen rejuvenation. Ablative lasers are more
damaging and invasive -- they remove quite a chunk of your skin in order
to resurface it - actually removing the wrinkle along with
it's surrounding skin. Whereas, the yellow light of NLite passes right through
the epidermis without damaging it, thereby stimulating
your own dermis to produce its own natural collagen. We have a
separate section on this laser so please Click Here for more
information on NLite.
Spot test: usually required, $75.US
Longevity: It is natural collagen and will age like natural
collagen -- since this is a newer laser its long term effects are not yet
known. However it is believed that you will not have as deep of lines as
you would have without ever having the treatment. If it is for
photo-damage induced wrinkles, you will only continue to get photo
damage if you frequently subject yourself to UV light exposure or spend
a lot of time in the sun without a proper sunblock or hat, etc. Discuss
with your surgeon his longevity percentages in average cases.
Approximate Cost: Approximately anywhere from $800. to $1,800.US for
full face and neck. For specific areas, it costs approximately
$10.US per pulse with a minimum of $100.US at some offices
Approved: The SLS NLite Non-ablative Wrinkle Reduction device was
approved by the FDA for use on peri-ocular wrinkles (wrinkles around the eye).
Although NLite is used effectively elsewhere.
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EpiStar Diode Laser
System: (technically: infrared diode laser)
"The EpiStar Diode Laser System, which can be used to remove hair
and to treat vascular and pigmented skin lesions such as birthmarks. The
EpiStar system, manufactured by Nidek of Fremont, California, uses an
infrared diode laser to treat a 2-millimeter to 5-millimeter area of the
skin in a random scanning pattern. The device's thermoelectric cooling
system cools the skin to 5 degrees Celsius, protecting the area from
heat exposure and minimizing patient discomfort."
"Most laser
systems use a gas such as carbon dioxide to cool the skin during the
procedure, but the EpiStar system does it electronically by blowing
cool air onto the skin site... The EpiStar laser includes a touch
screen display and interchangeable hand pieces for different treatment
sizes." (Reuters - Aug. 2000)
Spot test:
usually required and strongly suggested.
Longevity: permanent, unless you develop another lesion, which has
nothing to do with the prior lesion. If it is for photo-damage, you will
only continue to get photo damage if you frequently subject yourself to
UV light exposure or spend a lot of time in the sun without a proper
sunblock or hat, etc. Discuss with your surgeon his longevity
percentages.
Approximate Cost: dependant upon area and practice.
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Smooth Beam Laser:
This is more like CoolTouch
Laser than NLite with its miniburst of cryospray to cool the epidermis
and the subcutaneous levels before the laser pulse to hinder damage.
NLite does not need cryospray and passes harmlessly through the
epidermis and subcutaneous levels without pain. It seems that the
SmoothBeam must have the cryospray burst or the proteins coagulate and
the tissues are damaged - not to mention it is more painful if there is
no cryospray. Although technically dissimilar, the Sooth Beam Laser may
produce the same type result as the NLite system because of the thermal
wound response they create.
Spot test: usually required.
Longevity: If it is for photo-damage induced wrinkles, you will
only continue to get photo damage if you frequently subject yourself to
UV light exposure or spend a lot of time in the sun without a proper
sunblock or hat, etc. Discuss with your surgeon his longevity
percentages.
Approximate Cost: dependant upon area and practice
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Dye laser VStar® : (technically: Pulse
Dye Laser) Brought to you by Cynosure, this laser isn't exactly a
resurfacing laser, it is a laser designed for spider veins, redness,
broken capillaries and other types of vascular lesions. This machine is
capable of 4 pulse lengths for varying cases.
Spot test: usually
required.
Longevity: unknown, as this is a newer laser -- reportedly
permanent
Approximate
Cost: dependant upon area and practice
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Genica V® (technically: photo-flash lamp-pumped pulsed dye
photo laser) Also brought to you by Cynosure, this laser is yet
another vascular lesion removal system. A treatment area usually takes
under a half an hour. Purpura is apparent after treatment. These bruises
will subside within 7-10 days. Patients report
"stinging" sensations and seldom need sedation. However,
for patients without a high pain threshold tropical anesthetics can be
sued. It is reported that the treatment affects depths up to 1,5mm.
Spot test: usually required.
Longevity: unknown, as this is a newer laser - reportedly
permanent
Approximate Cost:
dependant upon area and practice
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Depilase YAG
Laser/"Depilase YAGLASE":
(technically: High Power Long Pulse Nd:Yag laser system)
Brought to you by Depilase North America, this system was designed to
remove both vascular lesions and even hair. The unique factor regarding
this laser is that it can be used on dark skin types. Whereas, most
other lasers, are contraindicated in some ethnic skin types.
Spot test: usually required.
Longevity: unknown, as this is a newer laser - reportedly
permanent
Approximate Cost: dependant upon area and practice
Contact Info: DEPILASE North America, LLC Phoenix,
AZ Tel. 602.257.4113
Website: http://www.depilase.com
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Q-switched Nd:YAG laser:
(wavelength 1064 and 532nm) This laser is manufactured by ConBio. This
system can remove general pigmentations and for darker pigments, such as
professional tattoos which may be blue or black, may take between 8 and
12 sessions,
Longevity: unknown, as this is a newer laser -- reportedly
permanent
Approximate Cost: dependant
upon area and practice. Packages can be bought for more difficult cases
- decreasing overall costs to the patient.
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Long-pulsed Nd:YAG laser
(VersaPulse®): Manufactured by Coherent, this laser system is also
for vascular lesions and has proved very effective in removing such
complaints as facial
flushing, redness, broken capillaries, telangiectasia (Teel-ann-ject-AZE-yah)
which are purple or blue veins on the face, hemangiomas (sacks of
red, purple or blue blood vessels resembling a blister, also known as
strawberry hemangiomas) and more.
Spot test: usually required
Longevity: unknown
Approximate Cost: dependant upon area and practice
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Eximer laser (including
XTRAC™): Brought to you from PhotoMedex. This system is the first
FDA approved lasing system beneficial to suffers of Vitiligo and
Psoriasis. Sessions may be from 3 to 30 depending upon your
case. Visit their website for more information.
Spot test: usually required
Longevity: unknown
Approximate Cost: dependant upon area and practice
Contact: Tel: 1-877-44-XTRAC Email: mgensel@PhotoMedex.com
Website: http://www.photomedex.com
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Long-pulsed alexandrite
laser Apogee 9300®: This laser is brought to you by Cynosure and is
specifically for hair removal of the face, neck and other areas. You
may need up to 15, averaging at 10 treatments before permanent results
are seen. However, permanency has not been reached for leg and the
back areas.
Spot test: usually required
Longevity: unknown
Approximate Cost: dependant upon area and practice
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Are You a Candidate For Laser
Resurfacing?
Not everyone is a candidate for laser resurfacing. If you are prone to keloids, hyper or
hypo pigmentation or do not react well to burns or excessive scarring due to minor cuts
and abrasion, laser resurfacing is not such a good idea. The laser is a type of burn as it
literally evaporates the top layers of skin to reveal younger, tighter skin beneath. If
you scar badly when you are burned, the results of laser resurfacing could be disastrous.
Also, if you have ethnicity (like Greek, Italian or African American, etc.) in your
biological family, you may be prone to hyper or hypo pigmentation resulting from the
procedure. An ideal patient would be of white European descent with elastic, non-oily skin.
For some ethnic patients, The Erbium, pulse dye
and NLite laser is a safer choice although every case is individual and only a qualified
surgeon who is very skilled with a LASER can make this diagnosis. NOT
just some surgeon who performs Laser resurfacing on a part time basis whenever
he can get into the local hospital. Your skin will thank you for it.
What to Expect At Your Consultation
First and foremost, only choose a surgeon specifically
trained in laser resurfacing and who is well-educated on the subject. Not all cosmetic
surgeons know how to perform laser surgery. There are techniques to be followed and levels
of experience differ with each surgeon.
Even if you and the surgeon were to decide to have the procedure performed in-office and
an accredited surgery center, find out if he has hospital privileges to perform laser
surgery at that accredited hospital. Usually a doctor with hospital privileges to
perform such a procedure is well trained and has been thoroughly tested and trained in
laser resurfacing.
After deciding on a few surgeons you will make an appointments for a consultation.
At this
consultation you should discuss your expectations and desires and and complaints that you
may have. Make sure you give your surgeon full disclosure. This is
very important, if you do not alert your surgeon to your specific background.
Even if your
great great grandmother was Italian you should tell him this. Even though my mother is
French and my dad is part German and part Italian, I need to have a spot test behind my
ear for laser resurfacing. Even if a person looks pure white European, if they have a
trace of ethnicity in their blood, they could develop hyper or hypo pigmentation
post-operatively or scar severely from contact with the laser.
You will disclose your full medical history and will discuss your realistic expectations.
The surgeon should discuss in detail the procedure and its risks and complications and what
to expect during the procedure. You will also
discuss the available anesthesia that will be used for your procedure. Most
Laser Resurfacing procedures are performed under Light Sleep Sedation although
some docs may use Local only or even General Anesthesia. Either way, discuss
this beforehand. If
you do go under General, you make sure that the anesthesiologist
is certified! Please
read the All About Anesthesia Page.
You will discuss what areas should be treated as sometimes only around the eyes,
lips and perhaps the forehead will be resurfaced. You will discuss protocol and discuss
what to expect post-operatively and how to care for your treatment area. You will also
discuss fees and medications. You may take before photos of the area to be treated, but
usually this is reserved for a pre-operative visit a few days before the procedure.
You may also come to the conclusion that perhaps Dermabrasion
or a light chemical peel may be ideal for you instead of laser resurfacing.
If you are honest and speak your mind and desires at your consultation, you surgeon will
be able to visualize what it is that me or she may do to achieve that. The
surgeon may even recommend that you have 2 or 3 sessions instead of a very deep
peel all at once. Discuss with your doctor your target depth and downtime
you will experience at the different depths as well. Even though you may wish to
have a lighter peel for lighter recovery - it may not give you the results that
you desire.
Preparing
For Your Surgery
You will be given a pre-operative information packet that explains everything
you should do and know before your surgery date. The packet should include
all the medications you should not take for up to 2 weeks before your surgery.
These medications will include, but are not limited to, aspirin containing
products. Would you like to view a typical Medication
& Supplements List? Also, your surgeon may or may not advise you of the
benefits of Arnica montana for swelling and bruising. Would you like to learn of
the benefits of Arnica
montana?
It is quite possible that you will have
preliminary blood work
performed. This is normally an extra out-of-pocket expense that the patient must
participate in to check your white and red blood cell count (complete blood
count, CBC) which ultimately alerts your surgeon to disease or disorders beforehand.
So many things to do... so little time.
Surgery will be here before you know
it so visit the Preparing
For Surgery page and relax. This section contains, printer-friendly pre-op
lists, tips and advice as well as things you must do to prepare for your big
day.
How Laser Resurfacing Is Performed
Laser resurfacing is normally performed under Light Sleep
sedation or Local with a mild intravenous sedation (Valium, Versed, etc.)
although, some surgeons use General.
The surgeon then passes the laser over the are to
be treated. This could take anywhere from a few minutes to an hour and a half
for very deep facial or body resurfacing. Unfortunately, some doctors are still making 1 or 2 very deep passes instead of
several light passes. This saves them time and money, and personally I think they
should be smacked for cutting corners at the expense of a patient. My surgeon
informed me of this at my laser resurfacing consultation in July of 2000. He
told me that making 1 or 2 deep passes can penetrate very deep leaving a
noticeable line where the laser did not pass, i.e. the jaw line and
just before the ears and hairline. Very skilled surgeons know to make several
light passes resulting in a blended area where the laser did not pass. This way
there is no tell-tale obvious line. The laser literally evaporates the targeted
areas of skin. It is almost magical as the targeted, damaged skin disappears
leaving only a faint trace of smoke and revealing undamaged, pink
skin as a result!
If you have specific complaints such as lines and
wrinkles of the forehead or crow's feet and lip lines. The surgeon will
concentrate on these areas a little more for deeper penetration. My surgeon in
particular and many others, as well limit the laser's penetration to the
epidermis (the uppermost areas of your skin) for the very lightest and medium of
peels. Although when the damage is anchored deeper the laser is set to penetrate
the upper layers of the reticules dermis. The reticules dermis is the
deeper part of the upper most layers -- if that makes any sense..
After the skin resurfacing is complete, your
surgeon will cover your face with either a thin film of Bacitracin or antibiotic
burn cream like, Silvadine. Some surgeons use a second synthetic breathable skin
to protect the newly surfaced tissue during its
healing process.
EXTRA!
A relatively new and exciting burn bandage is made from cotton and purified chitin,
called chitosan, (a polysaccharide), which is extracted from the
exoskeletons of crustaceans (crab, shrimp and lobster shells). Incidentally,
Chitosan is also an ingredient in controversial "fat magnet" pills and
supplements. Below is from Youngdeok Chitosan:
"Chitosan is a natural product derived
from Chitin, a polysaccharide found in exoskeleton of crustacean like crabs
and shrimps, in the crusts of the insects like beetles, gold bugs, and
grasshoppers, and in the cell wall of bacteria and fungi like molds and
mushrooms.
Crab's shell consists
of Chitin substance, Protein, Calcium carbonate which are all boned together
very strongly to become a hard and stable crust.
Therefore, pure
Chitin (acetylamino-polysaccharide) is extracted by removing protein and
calcium carbonate from crab's shell. Through the process of deacetylization
called purification, Chitosan (amino-polysaccharide) is obtained from Chitin
by getting rid of acetyl radicals.
Chitosan-Oligosaccharide
is obtained by an enzymatic hydrolysis of chitosan using chitosanase. Compared
with Chitin and Chitosan that has poor solubility and absorbability into our
body, Chitosan Oligosaccharide is absorbed perfectly. "
Some bandages
consists of several layers, the main layers consisting of the purified crab shells
(chitosan) as well as a synthetic barrier that whisks
away moisture and fluids from a weeping, healing wound. An outer layer of cotton
gauze absorbs the fluids. The gauze pads can be changed but the synthetic skin
and chitosan covering stays to protect the wound. The chitosan are actually
absorbed harmlessly into the body and excreted. Miraculously, the crab shells
have a superior antibacterial property unheard of in any relative substance.
Reportedly, no known fungus or germ can adhere to it's surface. When the bandage
is removed, flawless skin appears.
The
Long Road to Recovery
There will be redness and swelling and slight discomfort
post-operatively. Your surgeon will have instructed you on the proper care of
your treatment area as well as prescribed you the necessary antibiotics and pain
medications to help alleviate your discomfort. Take
your temperature regularly. An elevated Temperature could mean an infection.
Take those antibiotics ON TIME. And don't forget
if you are taking birth control that some antibiotics can interfere so in the
event that you do have relations, use another form of protection as well. The swelling can be alleviated
with ice packs. You really should ice your treatment area (without getting it
wet!) for the first 48 hours but not directly on the ski. According to Yale
Medical University regarding a facial burn from either Laser or any heat
source...
"Cooling decreases WBC
[:white blood cell]
adhesion, increases perfusion [: an act or instance of perfusing; specif : the pumping of a fluid through an organ or
tissue],
decreases protein denaturation
[b : to modify the molecular structure of (as a protein or DNA) esp. by heat, acid, alkali, or ultraviolet radiation so as to destroy or diminish some of the original properties and esp. the specific biological
activity],
and prevents excess production of thromboxane
[: any of several substances that are formed from
endoperoxides (: any of various biosynthetic intermediates in the formation of
prostaglandins or (: any of various oxygenated unsaturated cyclic fatty acids of animals that have a variety of
hormone-like actions (as in controlling blood pressure or smooth muscle contraction)), cause constriction of vascular and bronchial smooth muscle, and promote blood
coagulation].
Cooling must occur in the first 30 minutes after the burn.". Yale Medical University Core Curriculum
Your healing time totally depends upon the depth
of your treatment. You can expect to be down for at least 2 weeks. Your
skin will feel like a major sunburn. It may weep and need dressing changes and
additional ointments which will be supplied by your doctor directly or by
prescription. You will wear these bandages for about 5 to 7 days. You will more
than likely have them removed by your doctor on day 5 but this could be longer
if the penetration was pretty deep. After your bandages are removed your doctor
will go over with you the proper care for your treatment area such as cleansing
and applying ointment. You will notice crusty formations and as gross as this
sounds DO NOT PICK AT THEM OR PULL THEM OFF! You
will scar as a result -- probably more than before your treatment. but, don't
worry, they usually subside by day 10.
You may be given a bovine
mucopolysaccharide ointment or cream, this is a cow-derived cartilage extract
that has the anti-inflammatory properties of 1 to 2% hydrocortisone. It accelerates
epidermal healing and stimulates the production of prostaglandins and
interleukins. The ointment and cream act like a steroid application
without the risk of steroid induced atrophy or telangiectasia formation.
The product is CX-10 Ointment and CX-5 Correction Cream, manufactured by Donell
Inc. in NYC.
You will have to use sun block religiously! I am serious, don't
mess around! Your skin is very susceptible to damage by UVA/UVB radiation (the
sun). That means artificial sunlight like tanning beds as well as just driving
to the store or around town all day in your car. Believe it or not you do get
sun exposure when you drive around. No using AHA's and Vitamin A and stuff like
that either. Your skin is very fragile in its healing stage -- which could last
for months!
Your skin will heal and become very smooth and
young looking. The pinkness will subside as will the tenderness. You may be pink
for up to 5 months or more, depending on your skin's ability to bounce
back. You must take
care of your skin in order to keep it looking vibrant and fresh. Although, no
procedure can keep your skin from aging -- it can give you a young, relaxed
appearance and buy you some time.
At about 2 weeks or as soon as there is no
weeping and no crusting (but ask your doctor first!) you can safely wear
cosmetic to cover the redness. There are special cosmetic one can buy to offset
the redness or you can experiment on your own with what you have. Physician's
Formula is an inexpensive and effective camouflaging cosmetic line that can be
bought in your local pharmacy or drug store. Or you may want to try
products specially formulated for tell tale signs of recovery.
Risks
& Complications Associated with Laser Resurfacing
Make sure that your surgeon discusses all of the risks and complications
with you at your consultation. There could be allergic reactions to the
anesthetic. Just make sure that you disclose your medical history and this is
very important -- your nationality. I don't care if you are an eighth of a quarter of a tenth of Italian descent --
let your surgeon know this! I am only about a 1/4 Italian (on my father's
side) and I scar horribly from burns. You can slice me to ribbons and I heal
normally, I mean I don't get hypertrophic or Keloid scarring but I do have major
hyperpigmentation from burns. ANY kind of burn. If you are susceptible to Keloid
scarring or have active skin infections or say herpes outbreaks, you are not a
good candidate for Laser Resurfacing. If your skin is olive, black or
brown and even yellow skin -- take care in your choice of resurfacing measures.
Even Dermabrasion and chemical peels can wreak havoc on ethnic skins. You should
ask for a "spot test" if you or your doctor are uncertain. You can
never be too careful!
There is also the risk of bullae
(blisters), infection, thicker scar
tissue of the treatment area and hypopigmentation as well as hyperpigmentation,
as said before. You must also be very careful if you have taken Accutane within
the past year and a half (12 to 18 months).
The
Least You Need To Know
-
What: LASER is an acronym for
Light Amplification
by Stimulated Emission
of Radiation.
Or according to Merriam-Webster's Medical Dictionary: [: a device that utilizes the natural oscillations of atoms or molecules between energy levels for generating coherent electromagnetic radiation in the ultraviolet, visible, or infrared regions of the
spectrum].
There are many types of LASERS, read
above for a better understanding.
-
Why: Laser resurfacing (or laser peel, laser rejuvenation, laser
surgery), is the act of using a carbon dioxide (CO2), erbium, pulse dye or other
laser to remove
wrinkles, discolorations, age spots, and sun damaged skin or stimulate your
body's fibroblasts to form collagen to treat the wrinkle from
within.
-
When: whenever
the above complaints exist.
-
Who: Research
your doctor very well! Only a qualified surgeon who is very skilled
with a LASER can make this diagnosis. NOT just
some surgeon who performs Laser resurfacing on a part time basis whenever he
can get into the local hospital. Your skin will thank you for it.
-
Where: Accredited
Surgical suite or hospital
-
Risks: READ
THEM!
-
incisions/scars: no
incisions, but scars and irregularities are possible.
-
Anesthesia: local
with oral sedation, IV Sedation (Light Sleep) or General. Read
All About Anesthesia
-
Duration:
few minutes to an hour and a half
for very deep facial or body resurfacing.
-
Pain Factor:
mild to moderate, pain meds should alleviate any discomfort. If not, call
your surgeon immediately!
-
Swelling: Mild
to moderate -- depending upon individual; I suggest arnica montana and
bromelain.
-
Bruising: Mild,
more redness than anything -- depending upon the individual; I suggest
arnica montana and bromelain.
-
Post-operative
instructions: Have someone there to help care for you during your
recovery, keep elevated -- even when sleeping. A recliner works best.
Please
read above for more information, aftercare for laser surgery is very
important!
-
1st Post-op visit: possibly
the next day, depends upon depth, extent of work, aftercare protocol and
surgeon.
-
2nd Post-op visit:
depends
-
Return to work:
at least two weeks for standard or major resurfacing. For lighter
procedures a week, and for some like NLite, the next day.
-
Activity: No
exercise until at least 3 weeks post-operative for standard and even minor
work. Be careful not to raise your blood pressure for several weeks, you
don't want to inhibit proper healing or get an infection. Check with your
surgeon!
-
Sun exposure:
You will have to use sun block
religiously. I am serious, don't
mess around. Your skin is very susceptible to damage by UVA/UVB radiation (the
sun). That means artificial sunlight like tanning beds as well as just driving
to the store or around town all day in your car. Believe it or not you do get
sun exposure when you drive around. No using AHA's and Vitamin A and stuff like
that either. Your skin is very fragile in its healing stage -- which could last
for months.
-
End result: 3
months to a year. Sounds like a long time huh? Well.
-
Loss of Sensitivity:
It is possible to lose sensation. Long term or permanent
loss of sensitivity is possible.
-
Anything else?
Possible eyebrow and eyelash loss from medications. Possible permanent hyper
or hypopigmentation, redness or shininess.
-
Longevity:
depending upon your habits and sun exposure. Stay out of the sun if
you want to keep the results longer.
-
But Wait! There's
More! Visit other sites, this is your life!
Research as much as
you can on the subject. Disclose all your medical background. If you
are a smoker, if you are taking medications, or if you have any other
medical concerns. Be realistic in your expectations. NO plastic surgeon can
perform miracles, he can only try and improve upon what you have beforehand.
-
The average prices for
a laser resurfacing: $1,500 -
$6,000.
Related
Links (all
links leading outside of the site launch a new window)
NLite Non-ablative
Laser
Information
YTF!
Facial Plastic Surgery Message Board
Intense Pulsed Light (IPL) Information | PhotoDerm
References
Burns & Their treatment -
Yale
Medical University Core Curriculum
Merriam-Webster Medical Dictionary
Epistar
laser as treatment for rhytids - Reuters; Aug. 2000
Weiss, Robert A., asst prof. derm. U of John Hopkins School of Medicine - Baltimore, Maryland by on
non-ablative treatments - Applications of
Thermescent Laser Treatment (Lecture)
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