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Dr. Beverly Friedlander

Fractional CO2 Lasers


Lasers can restore a more youthful look to your skin by treating the conditions that are typically associated with premature signs of aging, such as wrinkles, facial veins, redness, and sun damage. They are noninvasive and result in revitalizing and rejuvenating aging, sun damaged skin. Treatments are noninvasive and result in healthier more youthful looking skin.

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Which Fractional Laser does Dr. Bev use?


Here in the office of Dr. Friedlander and at the True Beauty Med Spa we offer treatments that address wrinkles and discolorations caused by the aging process. We use the Lumnis Ultrapulse Encore CO2 Laser – for all our resurfacing procedures. This laser will improve skin tone, smoothing out fine lines and discolorations while simultaneously tightening the skin, leading to a more youthful and healthier appearance.

It is a fractionated CO2 laser meaning that we treat a fraction of the skin. The fractional CO2 laser is like a pixel( a single point in an image) in that it delivers multiple points of CO2 energy leaving spaces in between. The points or dots of energy stimulate collagen production and sloughing of the skin (peeling) and the normal skin left intact in between speeds up the healing process. Fractional CO2 lasers have revolutionized resurfacing. In the early days of CO2 lasers, we performed fully ablative treatments which were limited by healing and downtime. Now we can precisely resurface the skin with fractional technology resulting in smoother skin with more even color with less risk and down time.

What is a CO2 Laser?


A CO2 laser is the grandfather of laser resurfacing. It has gone through many iterations since its early use in the 1990’s. The original CO2 laser was ablative. That meant that it treated the entire surface. It used CO2 as its energy source-the same inert gas that we exhale with every breath. Its target or chromophore was water in the skin. The CO2 would be absorbed by the water, creating a thermal injury. This thermal injury would destroy the skin on the surface and stimulate contracture of some of the deeper tissue resulting in an improvement in the appearance of fine lines and pigmentation and skin tightening. Longer healing times were seen with deeper treatments, but it was the deeper treatments that resulted in better outcomes. The prolonged healing and incumbent risks led to innovations and the development of the fractional lasers.

What is Laser resurfacing?


Resurfacing is any procedure that removes the superficial living layers of skin- the dermis. The original resurfacing procedure was Dermabrasion which is rarely performed today. Dermabrasion was the mother of microdermabrasion a very superficial treatment that removes the dead layers of skin with no downtime.

What is fractional Laser resurfacing?


Resurfacing can best be understood using the concept of pixels. If pixels are very close, there is barely any skin left between them. As pixels get further apart, there is more skin separating them. Ablative resurfacing removes all the pixels leaving no skin. Partially-ablative or fractional resurfacing removes pixels that are further apart leaving more untreated skin behind. The skin heals from the inside out, so the more skin we leave behind, the faster it heals. We can do a 10% fractional resurfacing or a 90% resurfacing or anything in between.

skin resurfacing

The more we resurface, the longer it takes to heal. The concept of pixels is the reason you may see small dots as the skin heals. The dots are the areas where the resurfaced skin is regenerating. Healing with fractional resurfacing takes about 5-7 days, but varies depending on how much skin is actually resurfaced. We can dial down the machine and reduce downtime to 1-2 days, but the flip side is that 4-6 treatments would be needed. In today’s busy world, many people can spare 1 week to heal so the popularity of fractional resurfacing has increased.

What is the difference between ablative and non-ablative Lasers?


These terms are sometimes used incorrectly. Ablative lasers remove the outer layers of the skin resulting in partial or total resurfacing. Non Ablative lasers are lasers which stimulate tightening without removing skin. They are focused deeper in the dermis where they stimulate a thermal reaction leading to skin tightening and collagen production without any damage to the surface. They tighten the skin, but do little to improve the surface imperfections. They are best used in conjunction with fractional (partially ablative) resurfacing. They result in visible redness for a few days and may be associated with a burning sensation for a few days after as well.

Which Lasers can do resurfacing?


There are many lasers that can resurface. Most of them use either CO2 and Erbium-Yag as their source of energy.

What can I expect from my Lumnis Ultrapulse Encore CO2 Laser
– Active FX and Deep FX treatment?


The Active FX treatment is excellent for brown spots and sun damage. It helps improve superficial texture and fine lines. Typically 1 or 2 treatments are required. A topical anesthetic is applied before the treatment. One can expect to see redness and pinpoint scabs afterward. Peeling occurs between days 3 and 5. The skin needs to be kept covered with an emollient ointment until healed . Once healed, gentle cleansers , moisturizers and sunscreen are permitted.

The Deep FX is designed for treatment of wrinkles, scars and skin tightening which are deeper in origin. The treatment results in some bleeding crusting and swelling for a few days. Downtime is about 7 days. Redness may persist for longer. Two or 3 treatments may be required for maximal improvement.

By adjusting the settings, we can resurface the décolleté and reduce the signs of photo aging.

The Total FX – We find that the best results are achieved when the Active FX and Deep FX are performed at the same time. This comprehensive treatment renews the skin, stimulating new collagen, increasing volume to minimize the appearance of wrinkles while repairing photo-damage and other imperfections on the skin’s surface. One -Two treatments are required for maximal improvement.

Schedule a CO2 Laser consultation


For more details and to find out if you are a candidate for skin rejuvenation with a CO2 laser, please contact us to schedule a consultation or call our office at 973-524-7124.

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Beverly Friedlander MD
636 Morris Turnpike, Suite 1A
Short Hills, New Jersey 07078

Phone: (973) 524-7124

Fax: (973) 912-8070

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