Public awareness and interest in Cosmetic Laser Surgery really took off with the introduction of laser resurfacing. This technique was made possible by new technology applied to carbon dioxide lasers. Although this technique has been used only since about 1992, it appears to have significant advantages over alternative methods such as dermabrasion or chemical peel. The laser method has a higher margin of safety as well as greater precision, which can result in increased efficacy (better results). Because there are many variables to treatment such as laser power levels used and the number of "passes" over the skin, there is a wide range of treatment intensity. Since the surgeon has control over all these variables, the result of treatment is very dependent on the surgeon's experience and skills. Thus, laser resurfacing is very "technique dependent," and prospective patients should ask the surgeon how many cases they have done and should request to see before and after photographs of previously treated patients.

Dr. Langdon uses two lasers for resurfacing: the UltraPulse carbon dioxide laser and the erbium:YAG laser. He uses the UltraPulse primarily for full-face resurfacing. The outstanding results of these treatments are due partly to the significant contraction of the facial skin that occurs during the healing process. Many of Dr. Langdon's full-face laser resurfacing patients achieve results that rival a face lift, but with a more natural look. A face lift can result in a "windswept" or plastic look due to the unnatural pulling forces that are applied to the muscle layers. In contrast, with laser resurfacing, the skin contraction occurs in all directions and thus appears more natural. Also, with the laser, a fresh new layer of skin replaces the old, sun-damaged skin, so that uneven pigmentation is removed. Wrinkles around the mouth and chin are removed with laser resurfacing, but are not affected at all by a face lift.

Dr. Langdon uses the erbium:YAG laser for nearly all regional facial resurfacing (involving areas less than the entire face). The great majority of these cases are done using only topical anesthesia (a cream only ---no needles!). Dr. Langdon reported on his results using this topical anesthetic for erbium laser resurfacing at the Spring 1999 annual meeting of the American Society for Laser Medicine and Surgery.

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