Laser Skin Resurfacing

Laser skin resurfacing is a relatively new laser procedure to improve the appearance of the skin. The laser burns the superficial layers of the skin to treat wrinkles, scarring, or facial pigment abnormalities. When the skin heals, the new skin layers are tighter and the wrinkles are less apparent.

The laser can be used to treat the entire face, or can be limited to the fine wrinkles around the eyes and mouth. Aging, cigarette smoking and a lifetime of sun exposure are some of the factors associated with wrinkles. Laser skin resurfacing is not a substitute for a face lift procedure, which tightens and repositions loose skin on the face and neck, but can be combined with it to diminish some of the fine wrinkles. Younger patients who are not yet candidates for a face lift may be candidates for the laser procedure.

Laser resurfacing can be done as an outpatient procedure using local anesthesia. If the entire face is treated or if this procedure is combined with other cosmetic procedures, intravenous sedation or a general anesthetic may be used. The procedure can last from a few minutes to two hours depending on the treatment area.

After surgery, the treated skin must heal much like any wound that removes skin. There is significant swelling of the treated skin, especially around the eyes and lips. If treatment included upper eyelids, the eyes may be swollen shut. New skin layers take five to ten days to grow, depending on the depth of treatment with the laser.

Laser skin resurfacing has advantages over traditional resurfacing methods such as chemical peels and dermabrasion. Healing is generally quicker and there is less postoperative discomfort after a laser treatment. While there is similar redness and swelling after surgery, there is less chance of scarring or skin pigment changes.

A consultation with your physician is necessary to determine if you are a candidate for laser skin resurfacing in combination with other types of cosmetic surgery or as an alternative to other procedures. It is important to tell your physician if you have had previous cold sore infections, are using the drug Accutane, or have any other conditions that might interfere with normal healing.


Ptosis is drooping of the upper eyelid. The lid may droop only slightly or it may cover the pupil entirely. In some cases ptosis can restrict and even block normal vision.

Congenital ptosis, or ptosis that is present at birth, requires treatment for normal visual development. Uncorrected congenital ptosis can cause amblyopia, or lazy eye. If left untreated, amblyopia can lead to permanently poor vision.

Except in mild cases, the treatment for childhood ptosis is usually surgery to tighten the levator muscle that lifts the eyelid. In severe ptosis, when the levator muscle is extremely weak, the lid can be attached or suspended from under the eyebrow so the forehead muscles do the lifting. Children with ptosis, whether they have had surgery or not, should be examined annually by an ophthalmologist for amblyopia, refractive disorders, and associated conditions.

Ptosis in adults is commonly caused by separation of the levator muscle from the eyelid as a result of aging, cataract or other eye surgery, an injury, or an eye tumor. Adult ptosis may also occur as a complication of other diseases involving the levator muscle or its nerve supply, such as diabetes.

If treatment is necessary, it is usually surgical. Sometimes a small tuck in the levator muscle and eyelid can raise the lid sufficiently. More severe ptosis requires reattachment and strengthening of the levator muscle.

The risks of ptosis surgery include infection, bleeding, and reduced vision, but these complications occur very infrequently. Although improvement of the lid height is usually achieved, the eyelids may not appear perfectly symmetrical. In rare cases, full eyelid movement does not return.

Tattoo Removal

Tattooing is the ancient art of permanent body painting, accomplished by inserting various pigments into the skin with a needle. These pigments, or inks, sometimes last much longer than we wish they did. Attempts at removing tattoos have generally not been as successful as the initial tattooing efforts.

Dermabrasion and the use of either argon or carbon dioxide lasers have been used to remove tattoos but these methods often cause scarring. Tattoo removal is most effective using a type of laser called a Q-switched laser, which removes most tattoos with less associated scarring. There are three types of Q-switched lasers: Ruby, Alexandrite, and Nd: Yag.

The laser emits very short flashes of light called pulses. Each pulse may produce discomfort similar to the snap of a rubber band against the skin. The laser uses light to disperse the pigment within the skin, permitting the body to reabsorb some of the pigment. Lasers are designed to produce light at very specific wavelengths. The tattoo pigment better absorbs the wavelength of light produced by the laser than the surrounding skin. The light absorption fades the tattoo pigment without injuring the surrounding skin.

Multiple treatments are typically required to remove a tattoo. Professional tattoos may require 6 to 10 treatments, while amateur tattoos may only require 4 to 6 treatments. The number of treatment sessions depends on the amount and type of ink used, and the depth of the ink in the skin. Dark blue, black and red inks respond best to treatment. Orange and purple inks respond well. Green and yellow inks are the most difficult to remove, although additional treatments can produce significant fading. Complete tattoo removal is rare.