10 Years Younger Lecture Series - Lasers for Skin Rejuvenation (Dr Charles Cope)

1. 10 Years Younger Lecture Series -
Lasers for skin rejuvenatation
Dr Charles Cope
MBBS(Hons), BSc(Med), FRACS
Cosmetic & Reconstructive Plastic Surgeon

2. 10 Years Younger Plans
• 10 years Younger in 10 days
• 10 years Younger in 6 months

3. 10 Years Younger Plans
• 10 years Younger in 10 days
– Botox
– Dermal Fillers
– Intense Pulse Light
– (Blepharoplasty)

4. 10 Years Younger Plans
• 10 years Younger in 6 months
– Medical skin care regime
– Botox & Fillers
– 3D rejuvenation with lasers – Fraxel, Titan &
Laser Genesis
– Surgery

5. Combined treatments
(Botox/fillers/lasers)
• Creates more balanced natural look
• Avoids over-treated look
– frozen look of too much Botox or trout mouth
look from too much filler
• Must have an experienced operator

6. Combined treatments
(Botox/fillers/lasers)
• Combined treatments give the best results
– Botox in the upper part of the face reduces lines
& decreases the need for fillers
– Fraxel and Titan skin tightening laser reduce
the amount of fillers needed anywhere on the
face
– Botox in the upper part of the face after Fraxel
for lines reduces the speed at which lines come
back

7. Lasers for skin rejuvenation

8. Lasers
• Concentrated source of energy
• Usually one wavelength
• Wavelength can be visible or invisible

9. Absorption by the skin
• Depth of effect depends on:
– Wavelength light
– Characteristics of skin eg skin
type, pigmentation, blood
vessels
• Lasers aim at specific targets
in the skin

10. Lasers to rejuvenate the skin
• Intense Pulse Light (IPL)
– Pigmentation spots & fine blood vessels
• Laser Genesis (vascular)
– Deeper blood vessels, diffuse redness (Rosacea), pore size,
scars
• Fraxel
– Best textural improvement – wrinkles, acne & surgical
scars
• Titan
– Skin tightening laser (collagen contraction)

11. 10 Years Younger Plans
• 10 years Younger in 10 days
– Botox
– Dermal Fillers
– Intense Pulse Light
– (Blepharoplasty)
– Hair styling

12. Intense Pulse Light (IPL)
• Broad spectrum of light (560-1200nm)
• Treats range of surface problems including
pigmentation, fine capillaries (telangiectasias)
and surface texture
• 1-2 treatments give a significant improvement

14. Intense Pulse Light (IPL) for rejuvenation
IPL has been replaced by the Fraxel laser

15. Intense Pulse Light

16. Intense Pulse Light

17. Intense Pulse Light

18. Intense Pulse Light

19. 10 Years Younger Plans
• 10 years Younger in 6 months
– Medical skin care regime
– Botox & Fillers
– 3D rejuvenation with lasers – Fraxel & Titan,
Laser Genesis
– Surgery

20. Laser Genesis (1064nm)
• Treats
– Deeper blood vessels
– Diffuse redness (Rosacea)
– Pore size
– Scars (acne & surgical)
• Simple treatments with no downtime
• Often need multiple treatments (6+) for effective
scar treatment

22. Facial Telangiectasia
IPL for fine telangiectasia, Long Pulse 1064 nm Nd:YAG laser for discreet vessels

23. Leg veins
After 1 treatment

24. Laser genesis – acne scars

25. Laser genesis – acne scars

26. Scar revision & Laser Genesis

27. Fraxel laser resurfacing
Best textural improvement of any laser
• Wrinkles
• Age and Sun Spots
• Melasma (pigmentation of pregnancy)
• Acne scars
• Stretch marks/white-hypopigmented scars
• Can be used on any skin type

28. Fraxel laser resurfacing
• Replaced CO2 laser resurfacing
• Under topical anaesthetic (cream) applied to skin
• Minimal downtime
– 50% return to work immediately
– 50% 2-3 days redness/swelling
• Multiple treatments (3-5 treatments at monthly intervals)

29. Fraxel laser resurfacing
• Laser resurfacing without the downtime or complications
• Microscopic columns of thermal damage - ‘Microscopic thermal
zones’ or MTZs up to 1.4mm deep
• Normal tissue between columns
• Healing within 24 hours
• Long term collagen remodelling

30. Immediately post Fraxel treatment

31. Fraxel – pigmentation/texture/wrinkles

32. Laser resurfacing - wrinkles

33. Fraxel – sundamage

34. Fraxel – pigmentation/texture/wrinkles

35. Fraxel – acne scarring
Photos Courtesy Of Dr. Z. Rahman

36. Fraxel – surgical scar

37. Fraxel – hyper/hypopigmentation from
improperly performed IPL

38. Treatment of skin laxity with Titan laser
• Simple office treatments (30mins for full face & neck)
• Does not affect the epidermis (top layer of the skin)
• No downtime – redness at most for 2 hours
• Full effect not seen for at least 1-3 months
• 3 treatments required
• 90% patients respond well
• Useful for patients with early skin laxity or who don’t want
surgery

39. Skin laxity - Titan laser (1100-1800nm)
• Sustained heating of the
dermis using absorption
of light by water
• Treatment
– Immediate collagen
contraction
– Long-term collagen
stimulation

40. Heating of the Dermis with Titan
• Titan cools the surface of
the skin before and after
treatment
• Titan heats below the
surface of the skin
producing realignment of
collagen and stimulating
new collagen formation

41. Facial Laxity - Titan
1 month after 1st treatment

42. Facial Laxity – Titan

43. Facial Laxity - Titan

44. Facial Laxity - Titan

45. Skin laxity – Titan

46. Skin Laxity - Titan

47. Abdominal Titan

48. Abdominal Titan

49. Abdominal Titan

50. Lasers to rejuvenate the skin
10 Years Younger in 10 days
• Intense Pulse Light (IPL)
– Pigmentation spots & fine blood vessels
10 years Younger in 6 months
• Laser Genesis
– Deeper blood vessels, diffuse redness (Rosacea), pore size, scars
• Fraxel
– Best textural improvement – wrinkles, acne & surgical scars
• Titan
– Skin tightening laser (collagen contraction)