Dear Dr. Seckel, I have wrinkles on my facial skin around my eyes and cheeks, smile lines I guess you would call them. I take good care of my skin, use sun block and Retin A, have fair skin and am 50. I work out, take care of myself but I want to be proactive about the wrinkles and smile lines I see forming on my skin. I don’t want plastic surgery. My doctor recommended the Palomar Lux1540. He said it was like the Fraxel, a laser. I have a friend who had laser resurfacing and I don’t want to go through that, she was red for weeks. Can you tell me how the Palomar Lux 1540 works and if it is a good laser for removing wrinkles and smile lines? How bad is the down time? What about Botox for smile lines? Thanx, Beth, Boston
Dear Beth,
The good thing is that you are smiling, smile lines are definitely preferable to worry lines or frown lines. Keep smiling, worry about wrinkle removal later.
From the information you submitted it sounds as though you are taking the important skin care steps to prevent facial aging and photo aging, sun block, a healthy diet and lifestyle, and Retin A is an excellent anti aging skin care product.
The Palomar Lux 1540 Fractional laser is an exciting new laser skin rejuvenation technique which builds new collagen in the skin to replace collagen lost due to facial aging and photo damage or sun damage. But before I discuss the laser skin rejuvenation with the Lux 1540 Fractional laser let me explain how smile lines develop so you can better understand how the Lux1540 helps remove smile lines.
Smile lines, frown lines, worry lines, crow’s feet, and bunny lines (the little wrinkles around the base of the nose between the eyes) are called dynamic wrinkles or lines of facial expression because they are caused by the action of our muscles of facial expression. The only function of these muscles is to create our facial expression to reflect our emotions. When the muscles contract, for example when we smile, the muscle pulls the skin of the face into a smiling expression. After many years of facial expression, these dynamic wrinkles or lines of facial expression, the smile lines become permanent on the facial skin. The smile lines are a facial wrinkle caused by damage to the collagen in the deep layer of the skin beneath the smile line caused by a combination of repeated wrinkling during smiling and years of collagen loss from sun damage and photo aging. Think of the permanent folds or wrinkles that develop in a piece of paper which is folded over and over again.
While Botox can be very helpful for removing dynamic facial wrinkles like crow’s feet, Botox cannot be used to remove the smile lines. Botox works by weakening the muscle which causes the line, and the muscles causing the smile lines support the corners of the mouth. If you weaken the muscles causing the smile lines the corners of the mouth will droop and look unsightly. Thus the only non-surgical facial rejuvenation option available to correct smile lines involves the use of laser skin rejuvenation techniques.
The Palomar 1540 Fractional Laser is a non-ablative laser skin rejuvenation technique which removes facial skin wrinkles by stimulating new collagen production in the deep skin layer called the dermis. The dermis of the skin beneath a facial wrinkle is deficient in collagen, and the Palomar Lux 1540 Fractional laser helps remove the smile line wrinkle by plumping the wrinkle with new collagen production in the dermis. The Lux 1540 is a non-ablative laser skin rejuvenation technique which means the skin is not ablated or removed during the laser treatment, thus new collagen can be stimulated to grow and plump the wrinkle with a minimal down time or recovery time. To help understand the difference between the Palomar Lux 1540 Fractional resurfacing and traditional ablative laser wrinkle treatment a discussion of laser wrinkle removal techniques will help.
Smile lines are facial skin wrinkles and laser wrinkle removal is achieved by two methods:
- Ablative laser skin resurfacing involves actual ablation or removal of the wrinkled skin surface to smooth the skin, think of this as similar to sanding a scratch on a piece of wood to smooth the surface. This type of laser wrinkle removal is called ablative laser skin rejuvenation or ablative laser resurfacing. Ablative laser skin rejuvenation is usually done with the powerful CO2 or Erbium laser, and the laser beam is passed across the face and actually strips the outer skin layer and the wrinkles off of the face. While ablative laser skin rejuvenation is very effective, the disadvantage is that ablative laser resurfacing creates a wound on the face which must heal. Actually the healing results in new collagen formation in the dermis of the skin which provides tightening of the face and the growth of new wrinkle free skin. However healing takes at least 10 days to two weeks and the face is left red to pink for as long as 3 months requiring make up. In addition, long term following ablative laser skin rejuvenation, the pigment is lost from the facial skin, a condition called hypo-pigmentation, which creates demarcation lines between the treated skin and the non treated skin.
- Non-ablative fractional laser resurfacing is a very different laser skin rejuvenation technique from ablative laser skin resurfacing, as you point out by describing the recovery period your friend went through. Non-ablative laser skin rejuvenation does not ablate or remove skin, thus no wound is created and minimal or no down time or recovery time is needed. The Palomar Lux 1540 Fractional non-ablative laser removes smile lines and wrinkles by passing the laser beam through the surface of the skin into the deeper dermis where the laser energy creates inflammation and stimulates the dermis to make new collagen to “plump up “ the wrinkle. Think of a fresh plump plum, placed in the sun to dry until it forms a wrinkled prune. The reason the prune is wrinkled is because the water has been lost, the volume inside the skin of the plum is less, and the skin of the plum collapses and forms wrinkles. If you could re-hydrate a prune you could plump up the wrinkles and get back the smooth plum. The Palomar Lux 1540 laser stimulates new collagen production deep in the skin to plump the skin, restore volume and lessen smile lines and facial wrinkles.
What is new about the Palomar Lux 1540 Fractional laser is that the laser beam is fractionated, which means that the laser beam is broken up into many smaller laser beams so that not all of the facial skin area is hit with the laser beam. This fractional technique leaves small islands of skin uninjured by the laser so that healing is much quicker and no down time is experienced. Enough areas of the skin are treated to stimulate new collagen production and remove smile lines and wrinkles, but the treatment areas are so small that no down time is experienced by the patient.
The Lux 1540 is new and I am impressed with the results I am seeing both for wrinkle removal and the treatment of acne scars. Multiple treatments are required and final results take months but this is a small inconvenience to avoid the lengthy difficult recovery and long term hypo-pigmentation seen with ablative laser skin rejuvenation treatments for removal of smile lines and facial wrinkles.
For further information on laser skin rejuvenation, wrinkle removal, and non-surgical facial rejuvenation read Save Your Face or contact me.