aesthetic plastic surgery procedures

Top 10 Tip #4…Combination Laser Peel plus ProFractional

Posted on June 24th, 2014
Posted by Julene

Our Sciton laser was designed to be able to deliver two of our favorite laser treatments to face and neck in a simultaneous treatment session…the laser peel for smoothing, and the ProFractional for tightening. This is a very popular combination treatment for our patients, and the results from combining skin smoothing with tightening are even better than when each of these treatments is performed alone. There is a little down time with both the peel and the ProFractional, but the down time is not that much longer for the combination (usually 3 to 5 days).

The laser peel is called a “Microlaser Peel” if the depth chosen is less than 40 microns, and the recovery for this depth peel is anywhere from 1 to 3 days. The deeper the peel depth in microns, the longer the recovery, but the more smoothing that can be achieved. For peels over 40 microns (up to 120 microns can be performed awake in our office), one can add 1 to 3 days of downtime. In other words, if a patient tells us they have a certain number of days of down time that can be allowed, we can design a peel that fits that desired recovery period. Since the Sciton laser uses erbium energy, it works more by an evaporative effect than by a heat driven “burning” effect, so there is much less redness in the recovery period, and the recovery period is far shorter, than with traditional CO2 (carbon dioxide) laser devices, which work via a process of coagulation (more heat).  Patients look like they a sunburn and do not peel or scab over as with dermabrasion or CO2 lasering procedures.  Fine lines, large pores, and deep wrinkles can be resurfaced with the peel modality.  Patients are given some relaxing medications, the skin is pre-chilled, treatments take approximately 30 minutes and are performed in sequential passes over the face and neck.  Acne scars can also be resurfaced.

ProFractional is a skin tightening tool designed to deliver vertical micro-columns of energy to a fraction of the skin’s surface.  Since erbium works via ablation rather than coagulation necrosis (as do other technologies, which leave scar tissue in their path), this ensures that the tissue within the micro-column is ablated (gone or evaporated), such that the undisturbed surrounding normal skin can then “fall together” to fill the column resulting in a tighter skin appearance on the surface.  Since only 1 to 2% of the skin’s surface is actually heated, the recovery time is marked more by a little swelling and bruising than by a really red or “burned” appearance.  Again, patients are very comfortably treated awake with a little relaxing medication, and are usually healed within 3 to 5 days or less depending upon the depth of the treatment chosen.

When performed together, peel and ProFractional results really “pop’ in my opinion! Skin smoothing and tightening together may even decrease overall the number of individual treatments it takes for most patients to be happy, and they aren’t much more uncomfortable than each performed alone.  Down time for the combination patient is increased by a couple of days only, and total treatment time is still within an hour. Patients use a little over-the-counter aqhaphor or Catrix (a prescription healing cream) or other post-procedure topical provided by my office for a week, and are usually able to apply make-up within 5 to 7 days…again depending totally on the depth of treatment chosen.

This combination laser treatment is my absolute favorite skin maintenance treatment to be performed on an annual basis after other skin problems are corrected.  We usually do a little bit of prepping of the skin before a combination laser peel and PF and then resume these same  products after healing, both to add to the laser results as well as to maintain them long term.  The best way to prepare the skin for a combination laser treatment is with a cleanser, a toner, a retinol or Retin-A and hydroquinone (or other bleaching agent) to decrease the “blotchies” seen in a typical healing period.  The best laser result can be evaluated approximately 3 months after the treatment and the overall skin care program will be adjusted accordingly.

So you can see that with this approach to the health and rejuvenation of the skin, each patient gets an individualized treatment plan, depth recommendation, and follow-up care tailored to their specific needs by myself and my skin care and laser personnel.  All of the treatments are performed by either me or my nursing staff depending upon the overall depth of the treatment and how invasive it is designed to be.

Tune in soon for Tip #5VASER Shape!

Best regards,



Leave a Reply