Laser treatments have played an increasing role in plastic surgery as techniques have become less invasive and more precise.  The ability of lasers to vaporize, incise and remove tissue with minimal bleeding, reduced edema and tissue damage are of considerable importance in both aesthetic and reconstructive surgery.  Each type of laser produces a different tissue effect.  This means that each laser is useful for only certain applications.  Lasers do not improve all surgical procedures.  In some cases, there is no particular advantage to a laser technique over a conventional approach. 

            Another type of surgery which is sometimes confused with laser surgery is called minimally invasive surgery.  While this may use lasers, the cornerstone of this type of surgery is the use of small hidden incisions rather than long traditional incisions.  Using an endoscope, a long thin lighted tube, the surgeon can obtain a video picture of the structures to be operated on through the tiny incisions.

            Both laser and minimally invasive techniques provide reduced recovery time, post-operative discomfort and scarring, in general. 

Facial Wrinkles - Laser Skin Resurfacing

     "Wrinkles" about the face can be divided into three categories.  Loose folds of skin are generally best treated with facelift, eyelidplasty and browlift procedures, whether performed open or endoscopically.  Fine wrinkling or skin texture changes can be treated with microdermabrasion or Fraxel laser treatment.  This can be performed in the office with minimal, if any recovery time.  Follow-up home skin care treatments help maintain these results.  Deep wrinkles (frown lines, laugh lines) about the eyes, mouth or forehead have traditionally been treated with deep chemical peeling (phenol) or dermabrasion. 

            Laser skin resurfacing is a newer treatment for these deeper lines.  An updated version of the carbon dioxide laser or Erbium:YAG laser is used which delivers extremely short pulses of laser light.  This allows precise control of the tissue effect.  The laser is used to plane away a thin layer of skin about the wrinkle lines to create a more even surface after healing.  After treatment, the skin will be raw for 5-7 days and then red for approximately 4 weeks or sometimes longer.  The response to the treatment varies with your skin type and the depth of lines treated.  Advantages compared with traditional chemical peels and dermabrasion include a more predictable depth of tissue effect and enhanced stimulation of skin remodeling.  These lines are sometimes treated with Restylane or fat injection which provides a temporary improvement.  Forehead lines can also be treated with endoscopic brow lift or Botox injection for effective frown line removal.

The newer resurfacing lasers allow greatly reduced recovery time compared with older lasers and chemical peels while providing excellent improvement in wrinkle lines. 

Fraxel 

Fraxel Laser Treatment is a revolutionary new approach to skin rejuvenation.  This one laser therapy allows improvement of the full constellation of aging changes in the skin .  Typically, a series of four treatments is used to create a reduction in skin wrinkling along with improvement in pigment irregularities and vascular changes.  A minimal degree of skin tightening is also often obtained.  All this is accomplished without a raw skin surface or time away from work or social activities. Visit our Fraxel page for additional information. 

Additional Laser Treatments

In addition to the development of wrinkles, aging skin tends to accumulate an increasing amount of pigment irregularity and focal pigmented lesions such as age spots (solar lentigos).  These are particularly seen on the face, neck, chest and hands.  The non-facial areas often give away the true age of the individual who has a youthful appearing face due to facelift or laser wrinkle treatments.  Correction of the pigment changes in these areas can be done with 2-3 laser or intense pulsed light treatments which leave the skin red for 2-3 days but avoid a raw surface on the skin.  Vascular changes such as rosacea and telangiectasia (spider veins) on the face can also be treated at the same time.  

General Information

            Laser resurfacing is generally performed in the office under local anesthesia or local with sedation. You will feel well enough to return home after the treatment. The treated area is covered with ointment or a protective dressing. Starting the day after treatment, the area is washed several times daily. Usual activities are permitted so long as the treated area can be kept clean although most people avoid being seen until makeup can be applied. Approximately one week after treatment, makeup can be used to camouflage the treated area until redness subsides. Fraxel laser and intense pulsed light treatments generally do not require recovery. Although, the skin may look red or slightly swollen after the treatment, the skin surface is intact, not raw.

    The material on this page provides general information about laser treatments. The specific risks, benefits, and alternatives for any individual patient require a careful history and physical examination. Should you have any specific questions about these procedures, please call the office to arranger a consultation. 

Selected Research by Dr. Bass Relating to Laser Surgery

Presentations:

“Radiofrequency energy, lasers, -Erbium laser and a CO2 retrospective Fraxel laser treatment, new lasers –What’s real”.  Anti-Aging, Skin Care and Non-Invasive Cosmetic Procedures Symposium.  Plastic Surgery Educational Foundation.  Boston, Massachusetts.  July 2006.

“Fractional photothermolysis: Laser resurfacing in the 21^st century”.  Emerging Technologies & Techniques in Plastic Surgery.  NYU Medical Center.  New York, New York.  May 2006.

Course Director, Cosmetic Laser Surgery Update.  American Society of Plastic Surgeons.  Chicago, Illinois.  September 2005.

Course Director, Cosmetic Laser Surgery Update.  American Society of Plastic Surgeons.  Philadelphia, Pennsylvania.  October 2004

Course Director, Introduction to lasers for dermatologists and plastic surgeons.  American Society for Laser Medicine & Surgery.  Dallas, Texas.  April 2004.

Course Director, Lasers and photorejuvenation in cosmetic surgery.  American Society of Plastic Surgeons.  San Diego, California.  October 2003

Course Director, Emerging Technologies and Techniques in Plastic Surgery: Innovations in Facial Surgery, Breast Surgery, Body Contouring and Laser and Skin Care.  NYU Medical Center.  New York, New York.  May 2003.

 “Skin rejuvenation panel: Er:YAG laser, dermabrasion and nonablative lasers.”  Northeastern Society of Plastic Surgeons.  Bermuda.  October 2002.

 “Latest options for laser treatment of rhytids: Ablative and nonablative”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  May 2002.

“Microdermabrasion and  ultrasound driven pharmacotherapy”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001.  

“Latest trends in laser  resurfacing”.  Emerging Technologies in Plastic Surgery.  NYU Medical Center.  New York, New York.  June 2001.  

“Clinical outcome of high energy density Er:YAG resurfacing at two years.”
American Society for Aesthetic Plastic Surgery.  New York, New York.  May 2001.  

“Long-term follow-up of Er:YAG resurfacing”. Emerging Technologies in Plastic Surgery: The Next Millennium.  NYU Medical Center.  New York, New York.  April 2000.  

“Rejuvenation of facial rhytids: Modern options”.  8^th Annual Philadelphia Plastic Surgery Symposium.  Temple University.  Philadelphia, Pennsylvania.  June 2000.  

"Microdermabrasion”. Emerging Technologies in Plastic Surgery: The Next Millennium.  NYU Medical Center.  New York, New York.  April 2000.  

Course Director, Emerging Technologies in Plastic Surgery: The Next Millennium.  NYU Medical Center.  New York, New York.  April 2000.  

“New injectables and implantables for the nasolabial fold”.  Giants in Aesthetic Plastic Surgery.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November, 1999.  

“Microdermabrasion for rhytids, skin pigmentation, etc.”  Giants in Aesthetic Plastic Surgery.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November, 1999.  

“Erbium:YAG lasers for resurfacing”. Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1999.  

“Laser physics/Laser tissue interaction”. Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1999.  

Course Director, Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1999.

“Clinical and histological comparison of skin resurfacing lasers.” Advances in Aesthetic Plastic Surgery: The Cutting Edge II.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November 1998.  

“Technique to correct deep rhytides with Erbium laser.” Advances in Aesthetic Plastic Surgery: The Cutting Edge II.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November 1998.  

Live Surgery Demonstration, Erbium Laser Resurfacing.  Advances in Aesthetic Plastic Surgery: The Cutting Edge II.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  November 1998.  

“Optical profilometry assessment of Erbium:YAG and CO2 laser skin resurfacing.”  American Society of Plastic and Reconstructive Surgeons.  San Francisco, California.  October 1998.  

"Optical profilometry assessment of results with CO2 and Erbium:YAG resurfacing lasers."  American Society of Plastic & Reconstructive Surgeons.  Boston, Massachusetts.  October 1998.  

“Current State of the Art for Erbium:YAG Resurfacing.” Aesthetic Laser Surgery: The Revolution Continues. Plastic Surgery Educational Foundation.  Boston, Massachusetts.  October 1998.   

“Laser Tissue Interaction Related to Skin Resurfacing.” Aesthetic Laser Surgery: The Revolution Continues. Plastic Surgery Educational Foundation.  Boston, Massachusetts.  October 1998. 

Course Director, Aesthetic Laser Surgery: The Revolution Continues.  Plastic Surgery Educational Foundation.  Boston, Massachusetts. October 1998.  

“Erbium:YAG lasers for resurfacing”.  Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1998.  

“Laser physics, laser tissue interaction”.  Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1998.  

Course Director, Emerging Technologies in Plastic Surgery: Innovations in Endoscopy, Lasers, Liposuction and Tissue Replacements.  NYU Medical Center.  New York, New York.  April 1998.  

“Lasers in plastic surgery: Where we’re going, where we’ve been”.  Keynote Speaker, Laser Symposium, California Society of Plastic Surgeons.  Santa Barbara, CA.  March 1998.

Erbium:YAG: Practice and theory of advanced laser skin resurfacing.  Aesthetic Facial Symposium -A Multidisciplinary approach.  Mount Sinai Medical Center.  New York, New York.  March 1998.  

“Advances in laser skin resurfacing.”  Biomedical Optics Society.  San Jose, California.  January 1998.

“Preliminary evaluation of Erbium:YAG laser skin resurfacing.”  Northeastern Society of Plastic Surgeons.  Bermuda.  October 1997.  

“CO₂ and Er:YAG laser resurfacing: Birefringence and shrinkage measurement of thermal injury in vitro.” American Society for Aesthetic Plastic Surgery. New York, New York. May 1997.  

“Use of Er:YAG lasers for skin resurfacing”.  CLEO, Optical Society of America.  Baltimore, Maryland.  May 1997.  

“Short pulsed lasers for resurfacing”.  Emerging Technologies in Plastic Surgery: Laser and Endoscopy Innovations.  NYU Medical Center.  New York, New York.  May 1997.  

“Laser physics, laser safety, laser-tissue interaction”.  Emerging Technologies in Plastic Surgery: Laser and Endoscopy Innovations.  NYU Medical Center.  New York, New York.  May 1997. 

Course Director, Emerging Technologies in Plastic Surgery: Laser and Endoscopy Innovations.  NYU Medical Center.  New York, New York.  May 1997.  

“Shrinkage and thermal injury in human skin in vitro after resurfacing with carbon dioxide and erbium: YAG lasers.” American Society for Laser Medicine and Surgery. Tuscon, Arizona. April 1997.  

“Thermal injury and tissue shrinkage in human skin in vitro after Tru-Pulse, Silktouch and Ultrapulse exposure: Preliminary results.” Biomedical Optics Society. San Jose, California. January 1997.  

“Laser skin resurfacing with new mega-short pulse lasers.” Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.  

“Laser Resurfacing: How the laser does the job.” Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.  

Moderator, Full Face Laser Resurfacing. Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.  

Faculty, Advances in Aesthetic Plastic Surgery: The Cutting Edge.  Manhattan Eye, Ear & Throat Hospital. New York, New York.  October 1996.  

Faculty, Laser Skin Resurfacing Symposium. Manhattan Eye, Ear & Throat Hospital.  New York, New York.  February 1996.  

“Emerging technologies in laser skin resurfacing.” Laser Skin Resurfacing Symposium.  Manhattan Eye, Ear & Throat Hospital.  New York, New York.  February 1996.

Publications:

Jacobson D, Bass LS, VanderKam V, Achauer BM: Carbon dioxide and Er:YAG laser resurfacing results.  Clin Plast Surg 27(2): 241-250, 2000.

Bass LS and the Plastic Surgery Educational Foundation DATA Committee: Skin resurfacing with Erbium:YAG lasers.  Plast Reconstr Surg, 105(1): 462-463, 2000.

Bass LS: Recovery time and clinical results of Tru-pulse and Er:YAG laser skin resurfacing.  Lasers Surg Med 20(suppl 10): 55, 1998.  

Bass LS: Erbium:YAG laser skin resurfacing: Preliminary clinical evaluation.  Ann Plast Surg 40: 328-334, 1998.

Bass LS, Demallie E, Pohl D, Aston SJ: Thermal injury and tissue shrinkage in human skin in vitro after Tru-Pulse, Silktouch and Ultrapulse exposure: Preliminary results.  Proc SPIE 2970: 294-298, 1997.

Bass LS, Aston SJ: Shrinkage and thermal injury in human skin in vitro after resurfacing with carbon dioxide and erbium:YAG lasers.  Lasers Surg Med 19(suppl 9): 30, 1997.

Bass LS: Understanding of laser tissue interactions helps predict the clinical effects of new wavelengths and parameters.  Plast Reconstr Surg 95: 607, 1995 (letter).  

Treat MR, Oz MC, Bass LS: New technologies and future applications of lasers: Getting the right tool for the right job.  In: Surgical Clinics of North America, W.B. Saunders Co., Philadelphia, PA, 72(3): 705-742, 1992.

Manhattan: 568 Park Avenue at 63rd Street - 212.593.2600       

Great Neck: 833 Northern Boulevard, Suite 110 - 516.773.3705