Laser is an acronym for “Light Amplification by the Stimulated Emission of Radiation.” A laser is a source of a narrow beam of monochromatic (same wavelength or color), coherent (waves all in phase) light that is collimated (does not converge or diverge). With these properties, laser can be a very useful tool to deliver energy to tissue in a well-focused, powerful beam that has uniform and predictable light tissue interactions for the purpose of surgery. For clarification, Intense Pulsed Light (IPL) is not a laser since it has light of many different wavelengths. However, with the intensity of the light energy, photofacial can be done with IPL to correct mild color issues of the skin, such as sun damage, uneven tone or brown spots.
Different laser mediums can generate laser light of different wave lengths and with different light tissue interactions. For example, using carbon dioxide (CO2) as the laser medium, the wavelength of the laser generated is 10.6 µm, and the tissue effect is mostly vaporization, that is heating up the water content inside the cells to explode the cells.
The Nd-YAG laser has a wavelength of 1.06 µm and the tissue effect is photocoagulation that is turning the protein in the cells into a more solid form. The different wave lengths of laser light also determine how deep the laser can penetrate. For example, the CO2 laser has a very superficial effect, affecting only the first few cell layers, while the Nd-YAG laser penetrates deeper into the tissue layer.
Using the appropriate laser energy, the desired tissue effect can be achieved. Using the same example again, the CO2 laser can vaporize off superficial layers of tissue such as in facial skin resurfacing in cosmetic application, while the Nd-YAG laser can do deeper tissue coagulation to treat deeper skin tissue, such as tissue tightening. Also, advanced laser technology helps to design the laser ablation pattern. The Fraxel laser that we use frequently in our clinic leverages the fractional pattern of the laser treatment area to minimize obvious post-laser effect and therefore downtime, and yet still achieve the effect in reducing wrinkles, sun-spots, and melasma, Actinic Keratosis (AK). Fraxel does minimally invasive skin resurfacing to give maximal skin rejuvenation effect, also taking care of acne and surgical scars. Using a laser similar to Fraxel but of lower power-density, Clear+Brilliant can help clear the skin clear of color irregularities and give you the radiant look with absolutely no downtime.
Laser energy can be applied to improve the look of the skin and the contour of the underlying tissue by remodeling the collagen fibers. Also, the new technology of radio frequency (RF) treatment can tighten even the deeper tissue, while the ablative laser, such as CO2 and Er:YAG systems can produce good skin resurfacing results. Working together, the RF device such as Thermage and the laser such as Fraxel can achieve fantastic rejuvenation for the face, neck and other areas, resulting in tighter and radiant skin.
The solution of the appropriate laser or radio frequency energy depends on the desired aesthetic effect and an understanding of the different photon-tissue interaction and the optimal delivery mode. Using also Botox and dermal fillers, we can achieve great aesthetic effect without resorting to surgery.