The Reason Why Not all Fractional Laser Resurfacing is the Same

Fractional laser resurfacing is sort of the “it” procedure right now. Everything from scars to dark spots to lines and wrinkles can just be resurfaced away with a laser. Well—this isn’t exactly true. In fact, it’s not really true at all! While laser resurfacing is certainly a popular procedure right now, not all laser resurfacing treatments are the same. And not all practices providing laser resurfacing treatments can get the same results—even if they are using the same laser!

We regularly get phone calls from unhappy patients who feel that they didn’t get the results they were looking for from a Fraxel or other fractional laser resurfacing procedure.  While it is understandable that they are upset, we want to help you avoid the same situation.  Few consumers realize that it’s not the laser used that determines the outcome.  Many of the fractional lasers available are very similar, and it’s how the laser is used and how the patient is prepared that determines the outcome.

Here is the reason why not all fractional laser resurfacing procedures are the same.  It comes down to the depth of treatment, whether or not coagulation is used (deep heating of the skin), and % of the skin resurfaced. Each of these parameters is 100% customizable by the practitioner. This means that if your practitioner doesn’t understand how to manipulate them in a way that is most beneficial for your condition (scars, wrinkles, etc.), then you won’t see the results that you’d hoped for.

Out the unhappy patients who contact us, about 90% of them simply didn’t get a treatment that was deep enough. Here’s how we know:

1. We ask if they were informed of (or asked about) how deep their resurfacing was? Most of the time, the answer is “No.” This is vital information that you will need to know before your procedure so that you can set the right expectation for your results after. In general, regardless of the skin condition that’s being treated, the deeper the resurfacing, the more improvement you’ll see in your scars, wrinkles, photodamage, etc.

2. We ask what type of anesthesia or numbing was used. The typical response is “numbing cream.” This also tells us a lot about the depth of the resurfacing. Deeper resurfacing procedures are more painful, which requires more (and different) anesthesia than just numbing cream alone. A resurfacing procedure that you can tolerate with just topical numbing cream is a very superficial resurfacing that likely only effects the top few layers of your skin. In other words, you may not see much change in your condition over the long run.

3. Lastly, we ask about how much bleeding was present after the procedure. If you look at the diagram below, you will understand how this question helps us determine the depth of the laser resurfacing procedure. Superficial treatments don’t penetrate down into the deeper dermal skin which is full of blood vessels.

At Celibre Medical, we will perform ablative fractional resurfacing down to 1000 microns (or 1 millimeter). Most other practices limit this number to 200-300 microns. While we are more aggressive and our patients have more bleeding, we find that when they’re educated and prepared for it, they handle it very well. And we also ensure that they understand our rationale for choosing a deeper treatment approach. We want them to see their skin problems improve greatly after just a single treatment!

We have also included some photos of what a typical 7-day recovery process looks like at our practice. You can see that immediately after the procedure there is some bleeding. While it may not look good, we know that this sign means that we’ve provided a deep resurfacing treatment that will look good once it’s healed!

We don’t believe in providing just a standard laser resurfacing. We know this means we must spend more time talking with you, carefully examining your skin, educating you and preparing you for all aspects of your treatment and recovery! Yes, this takes time and is more complicated, but it ensures that we will provide the best outcome for you that we possibly can. And happy patients are the reason we do what we do.

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