Your doctor will begin with a complete medical history and will examine your face, both the skin and underlying bone. He/she may also take photos, give you specific instructions to follow, that may include instructions for pre-treating your skin before the operation.

Your doctor will determine if laser resurfacing ? or another form of skin resurfacing ? is right for you. This decision may depend largely on your skin type and color, since laser resurfacing can cause uneven skin tone formation on people with darker skin tones.

Be sure to tell your doctor about any allergies you have (to foods, drugs, environmental elements), if you have been exposed to significant amounts of radiation, if you have a history of unusual scarring, or if you have had cold sores around the mouth (like herpes or shingles). Also tell your doctor if you have had previous plastic surgery, if you smoke, or if you take any drugs or medications, including aspirin.

Take this opportunity to ask all the questions you have about the procedure, and ask to see photos of the doctor?s recent patients, before and after the procedure. Also ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to ask your doctor below.

The surgery will follow these steps. First, the doctor, or an assistant, will cleanse your face to remove oils from the skin. Antibiotic is then applied to kill bacteria. A beam of light from a microphone-shaped instrument is passed over the skin to vaporize the outer layers of damaged skin. The laser can be can be programmed for varied levels of penetration. The doctor may choose to penetrate more deeply in some areas, in order to remove deep scars, stubborn spots, and wrinkles. As the laser works, you may hear it zapping, and smell smoke. Finally, your doctor, or a medical assistant, may apply a protective ointment or bandage to the treated area.

If a bandage was applied after the surgery, it may be changed in a few days, but it will be completely removed after approximately one week, at which time an ointment is applied. Some surgeons use a tape that retains moisture to bandage the treated area. Because this bandage must remain dry, you will not be able to shower normally until the bandages are removed.

If the treated area is not bandaged, you will need to wash your face several times daily. You will need to use caution in caring for the treated area. After each washing, you will need to apply an ointment, such as petroleum jelly, to the treated area. Scabs may form, and last for about 10 days. You must not pick at the scabs. If you experience pain, an over-the-counter pain medication can be taken.

Make-up can be applied approximately two weeks after the procedure to cover-up the redness.

After laser resurfacing, daily sunscreen is highly recommended to protect the sensitive new skin from sun exposure. Ask your doctor to recommend a sun block with both UVA and UVB protection, and apply it daily. If resurfacing was done around your eyes, you should use sunglasses.

• Physically healthy
• Psychologically stable
• Non-smoker
• Wanting to look younger and more refreshed
• Unhappy with the appearance of wrinkles or brown spots,
• specially around mouth or eyes
• Free of active skin infections, including acne
• Possessing the appropriate skin tone for the type of laser used
• Not taking Accutane, nor having taken it in the previous 18 months
• Without any unusual scar formations, such as keloids
• Well informed in regard to the procedure?s outcome
• Realistic in their expectations
• Willing to accept the limitations involved in the healing process

The above is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he / she considers you an ideal candidate for laser resurfacing.

Other resurfacing options include chemical peels and dermabrasion. In general, laser resurfacing allows the doctor to more precisely control the depth of penetration than these other two methods. In addition, the controlled vaporization of the laser produces less bleeding, bruising, and post-operative discomfort. The speed of the emissions of the laser also lessens the risk of burns. However, peels and dermabrasion have advantages in certain situations.

Your doctor will consider your expectations, the size of the area to be treated, and other factors in deciding which method, or combination of methods, is best for you.

Semi-permanent or permanent skin lightening may occur in the treated areas. This is unpredictable and hard to treat without permanent tattooing of the skin. The skin may also become hyperpigmented (darker) immediately following the surgery. Often this darkening treats itself, lightening on its own or responding to various skin care regimens that include hydroquinone (a bleaching cr�e) and alpha hydroxy (fruit) acids.

Laser skin resurfacing may not sufficiently tighten the skin, and surgical excision may be necessary to achieve the results desired. It is most often worthwhile the try to perform laser procedure first to avoid the possibility of scarring, so do not be dismayed if a secondary procedure is necessary.

Heat from the laser may cause burns or injuries. To reduce the risks involved in this procedure, carefully follow all of your surgeon?s instructions, both before and after surgery.

1. Are the desired results I described realistic?
2. How should I prepare my skin for the treatment?
3. Where is the surgery performed? How long will the procedure take?
4. Are there other procedures that I should consider to enhance the affects of laser resurfacing?
5. What kind of anesthesia is used?
6. How much does the procedure cost?
7. What is your experience in performing this procedure? (How long has he/she performed this procedure, and how many he/she has performed in the past year?)
8. What percentage of patients have had significant complications? (The physician should disclose this information to you.)
9. Will you repeat or correct procedures if it does not meet agreed upon goals? And if the procedure must be repeated / corrected, will I be charged again? (The physician should provide you with his/her policy on this issue.)
10. May I see "before and after" photos of recent patients? The physician should provide many photos of recent patients.
11. May I have the names and contact information for several recent laser resurfacing patients? (Follow up to get first-hand information on the procedure and the surgeon.)
12. Could I observe the exact procedure I am considering before I decide to have the surgery? (Either on videotape or ask to view one in real life.)
13. What should I expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity? Ask if your doctor has a list of activities that you should avoid.
14. Who will be assisting during the surgery? What are their qualifications? (Does the plastic surgeon perform the entire surgery?)
15. Have you ever had your malpractice insurance coverage denied, revoked, suspended?
16. Do you have privileges to perform laser resurfacing with a CO2 laser at an accredited hospital?
17. Do you offer patient financing?

• Tell your doctor about any allergies you have (to foods, drugs, environmental elements).
• Tell your doctor about all medications, herbal supplements or natural supplements that you are taking (both prescription and non-prescription), including such natural remedies as Echinacea and St. John?s Wort.
• Be sure to tell your doctor if you smoke. Smoking can lead to complications and poor healing.
• Tell your doctor if you have been exposed to significant amounts of radiation, have a history of unusual or poor scarring, or cold sores? like herpes or shingles.
• Let your doctor know if you have taken Acutane any time during the year and half before the surgery. This medication can affect your skin?s ability to heal after laser resurfacing.
• Tell your doctor if you have any serious medical conditions.
• Carefully follow any instructions your doctor gives you regarding eating and drinking, smoking, and vitamins.
• Avoid aspirin and all medicines that contain aspirin for two weeks prior to the procedure.
• Tell your doctor if you have had previous plastic surgery.
• Arrange for someone to drive you home after the procedure.

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