Cosmetic Laser Surgery–How Aesthetic Lasers Are Used To Improve Your Appearance
Cosmetic is defined as “serving to beautify” or “used or done superficially to make something look better, more attractive, or more impressive.” Cosmetic plastic surgery is used to change the form appearance of the normal face and body to make these structures look good or more beautiful. Cosmetic plastic surgery is different from reconstructive plastic surgery which is used to change the form and improve function of damaged or deformed facial and body structures.
Cosmetic laser surgery involves the use of medical lasers to beautify and improve the form and appearance of normal face and body structures. Although the term cosmetic laser surgery is applied to a wide variety of laser procedures, many of the laser procedures are not truly invasive surgery. While some cosmetic laser procedures involve an incision with the laser, most do not break the skin, and achieve their cosmetic result with minimal skin injury.
Cosmetic laser surgery has revolutionized cosmetic and aesthetic plastic surgery during the past 10 years. The perception that cosmetic laser surgery can be done with the press of a button has led many people to believe that lasers are miracle machines that anyone, trained surgeon or otherwise can use and get good results. This is far from the truth, lasers are very complex, potentially harmful medical devices that require medical and surgical education in laser safety, laser tissue interactions, and safe medical and surgical techniques.
In this article I will try to explain for you, the potential patient, what cosmetic laser surgery can do for you, how the cosmetic or aesthetic lasers work, what the risks of cosmetic laser surgery are, and how you can find the appropriate doctor to have a safe and effective cosmetic laser treatment.
How is cosmetic laser surgery used to improve or beautify your appearance?
• Cosmetic laser eyelid surgery-
• Laser Liposuction-
• Cosmetic laser skin wrinkle removal-laser skin resurfacing-
• Laser skin tightening
• Laser removal of brown spots and sun damage on skin-
• Laser stimulation of new skin collagen or skin plumping laser treatments-
• Laser acne scar removal
• Laser skin scar removal
• Laser removal of excess skin blood vessels spider veins, and Rosacea
• Laser hair removal-
• Laser tattoo removal
How do cosmetic lasers work?
Cosmetic lasers and medical lasers work by heating tissue. Heat can be used to remove unwanted skin tissue like a skin wrinkle. Heat can also be used to stimulate the new growth of tissue for example new collagen in the skin. What is so special about lasers is that the heat produced by the laser can be very specifically and accurately directed to heat only very specific tissue that is to be removed or effected, and not heat the normal surrounding tissues that are to be left in place. Lasers have the ability to remove tissue, similar to what surgery does, without scarring the normal tissue surrounding the removed tissue.
This specificity or accuracy of laser tissue heating is based on the fact that laser light is monochromatic, that is of one color, depending on the particular laser used. Laser light is also coherent, which means it is focused, and this coherence or focusing of laser light makes the laser beam very powerful.
A laser beam can be directed to heat and destroy a very specifically colored skin target such as a red blood vessel. A red laser beam, a laser with a wavelength of 532nm (nm is the abbreviation for nanometer which is one billionth of a meter and is a term used to describe the wavelength of light in the visible light spectrum) which is in the red portion of the visible light spectrum, will be absorbed by anything that is red.
When the 532nm laser beam is applied to a blood vessel which contains red blood, the blood is heated by the laser, the blood “boils” and injures the blood vessel wall, and the blood vessel closes. This is how the laser is used to remove spider veins on the leg, small blood vessels on the face, and the small blood vessels that cause Rosacea.
This process is called target specific photothermolysis. What this means is that the laser can heat and destroy or change a very specific target based on its color. Photothermolysis means light (photo) heat (thermo) disintegrate or dissolve (lysis).
For you techies, the word laser stands for Light wave Amplification by Stimulated Emission of Radiation. A laser beam is a light wave that is stimulated by an electrical charge which amplifies the light to make it stronger, and the stronger light wave is emiited from the laser tube as radiation. Cosmetic or aesthetic lasers emit very specific colors which are highly and specifically absorbed by different tissues of the human body.
Laser Wavelengths used in cosmetic or aesthetic laser surgery.
Laser wavelengths are chosen based on the color of the tissue in the body that needs to be removed or altered. Some lasers target water inside the cells of the skin and simply vaporize or remove tissue. Below I will list some of the common laser wavelengths used in cosmetic laser surgery.
• 532nm-Absorbed by red-purple-used to vaporize blood vessels and spider veins
• 755nm-Absorbed by brown-black and used for hair removal and tattoo removal
• 924nm- The 924nm is absorbed by the color yellow and is used to dissolve fat during liposuction
• 1064nm-Absorbed by purple-black and used for hair removal and closure of large veins
• 1308nm-Absorbed by fat and used in liposuction
• 1440nm and 1540nm-Erbium absorbed by water and used to coagulate deep collagen in the skin to stimulate new collagen and plump skin wrinkles and acne scars
• 2940nm-Erbium absorbed by water, vaporizes cells, used to resurface the skin and remove wrinkles
• 10,000nm-CO2 absorbed by water inside the skin cells, ruptures the skin cell, used for incisions and to vaporize skin growths
Cosmetic laser surgery was introduced to plastic surgeons in 1995 yet many have been very slow to adapt to the new technology. The new technology is very expensive and requires a significant investment in lasers.
More importantly, I believe is that these new techniques require a totally different approach to surgery. In traditional plastic surgery the surgical scalpel, and thus the surgeons hand is always in contact with the patient’s skin. With cosmetic laser surgery, all cutting is done with the laser beam and thus direct physical contact with the patient’s skin by the surgeon does not occur.
In my personal view, a different part of the surgeon’s brain is used with this new technique. Older scalpel procedures are manual and the left side of the brain is used. The laser procedure is more of a spatial, visual task that uses the right side of the brain. This requires that the plastic surgeon re-learn basic surgical techniques. After many years of training in a left brain task, re-learning and adapting to a right brain technique is a difficult and challenging task.
You will have to ask your plastic surgeon if he/she performs laser eyelid surgery. The following are good places to start your search:
• Check the American Board of Plastic Surgery to find a board certified plastic surgeon in your area
• Check the American Society of Plastic Surgeons to find a plastic surgeon in good standing in your community
• Check the American Society of Aesthetic Plastic Surgeons to see if your plastic surgeon is experienced in and specializes in aesthetic or cosmetic plastic surgery.
• Check American Society of Lasers in Medicine and Surgery to see if your plastic surgeon has experience and interest in laser surgery
• Do a web search under “laser blepharoplasty”.
Be careful to choose a plastic surgeon certified by the American Board of Plastic Surgery. There are many non-surgeons who offer laser blepharoplasty. Don’t be fooled, you want a trained board certified plastic surgeon if you are considering laser eyelid surgery.
If you are interested in reading my published scientific article on laser blepharoplasty in The Plastic and Reconstructive Surgery journal you can read a summary online.
If you want to learn more about cosmetic or aesthetic laser surgery you can read the first medical book published on aesthetic laser surgery, which I wrote in 1995.
Laser eyelid surgery is a very significant advance in eyelid rejuvenation. Do your homework and find an expert. Let the laser help you look as good as you feel.
For more information on cosmetic laser surgery call 978-369-4499 or email me. Read my free newsletter to keep up with new developments in cosmetic laser surgery and non-surgical face and body rejuvenation. Read Save Your Face to learn how to prevent facial and eyelid aging.
Dr Seckel
Concord, Massachusetts
Boston, Massachusetts