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Fractional CO2 Laser - Questions and Answers - Plastic Surgeon in Los Angeles - Raffy Karamanoukian, MD

What is fractional CO2 laser resurfacing?

The fractional CO2 laser skin resurfacing system employ by Dr. Raffy Karamanoukian at Kare Plastic Surgery and Skin Health Clinic is the SmartXide DOT system.  This laser treatment is an ablative E laser that has been described as one of the best antiaging breakthroughs in the last decade.  The laser is different than other skin tightening systems such as Thermage because it uses ablative high energy laser to resurface and tighten the skin.  The fractional system is encouraging for those patients who require less downtime with maximal effect.  The SmartXide DOT laser skin resurfacing treatment is FDA approved for skin surface resurfacing.  Dr. Karamanoukian uses the fractional CO2 system for cosmetic skin tightening and for acne scarring.  Several studies from Asia have shown tremendous benefit for the fractional CO2 system in patients who have scars, atrophic acne scars, and loss of collagen leading to mild and moderate skin wrinkles.


How do I know if I am a good candidate for fractional CO2 laser skin resurfacing?

During your consultation for cosmetic skin rejuvenation for acne scar treatment, Dr. Karamanoukian will evaluate your skin texture, skin resiliency, and skin elasticity to determine whether the fractional CO2 laser will be effective in your particular skin type.  The patients are often asked to indicate their cosmetic facial surgery goals and define whether they prefer surgical facial rejuvenation or nonsurgical facial tightening.  The fractional CO2 laser can help with freckling, skin discoloration, mild-to-moderate skin wrinkles, uneven texture, large pores, and aging skin.  The patients who have a strong history of skin discoloration or melasma may benefit from a pretreatment skin protocol including Melaquin AM Daily UV Protect and Melaquin PM night moisturizer.


How uncomfortable is the fractional CO2 laser skin resurfacing treatment?

The SmartXide CO2 laser can be performed under IV sedation, general anesthesia, or under local anesthesia.  The majority of patients will note mild discomfort during a local anesthesia based fractional CO2 laser skin resurfacing treatment.  The stinging and burning usually subsides within hours after treatment and the patients will note a generalized discomfort related to the resurfacing of the skin.  The patients also will note mild swelling after the procedure.  Dr. Karamanoukian will provide you with full details regarding your recovery and whether ibuprofen and Tylenol can be used in the post treatment period.


Will I be red after the fractional CO2 laser?

Depending on the degree of superficial broken blood vessels and rosacea, most patients will be red immediately after their procedure, lasting for approximately three to seven days.  As the redness subsides, the patients will note a gradual pinkness to the skin which represents a healing phase with superficial blushing.  Once this period subsides, the patients will be able to cover up the pinkness and redness of the skin using makeup.  Both men and women can undergo the fractional CO2 laser skin resurfacing treatment and may employ coverup makeup to the procedure.


How many treatments are required for laser skin resurfacing?

Depending on the specific treatment protocol, one to three treatments are necessary to provide maximal benefit with the fractional CO2 laser. The patients with deep acne scars may benefit from one to three treatments, whereas the patients with mild-to-moderate skin wrinkling and uneven texture may benefit from a single procedure.  Dr. Karamanoukian will discus your options during your consultation and provides you with specific treatment protocols for your surgery.  Your skin type and history of previous treatments may also affect your recovery and healing time.


What are the major side effects to treatment?

The fractional CO2 laser skin resurfacing treatment has a high safety profile with maximal benefit in healthy patients who utilizes a skin care protocol before and after treatment to maximize skin resiliency and texture.  Dr. Karamanoukian will take necessary steps to minimize complications after your SmartXide DOT laser treatment.  The most common, but rare, complication with laser skin resurfacing include mild skin discoloration, transient pigmentation, redness, for hypervascularity to the skin, sun-sensitivity, and transient swelling.  During your consultation for treatment, Dr. Karamanoukian will evaluate the specific risk in your case and determine ways to reduce your risk of complications.

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