Laser and Skin Procedures
Using several of the best and proven laser techniques and equipment (four on-site lasers and one IPL — intense pulsed light — machine), the plastic surgeons at Minneapolis Plastic Surgery, LTD. are able to reduce or remove wrinkles, birthmarks, age spots, freckles, superficial blood vessels, and tattoos, in addition to the other types of cosmetic surgery they routinely perform. Laser hair removal and other skin and body care services are available at our skin and body care clinic, Carillon Clinic, Ltd., and new laser techniques are being evaluated and perfected on an ongoing basis at our surgical facility. Our Minneapolis plastic surgeons provide superficial or deeper laser skin resurfacing, dermabrasion, chemical peels, spider vein sclerotherapy, and laser tattoo removal at our practice; other skin treatments, such as microdermabrasion and chemical peels, are available at Carillon Clinic, Ltd. Laser technology is utilized when it provides a distinct advantage over “standard” or more traditional treatment choices, or when it is the best choice for a particular need. Unfortunately, some clinics or physicians promote laser this or laser that as “more advanced,” the “latest and greatest,” “less scarring,” or just as a marketing tool to imply being up to date or technologically superior. At Minneapolis Plastic Surgery, LTD., serving the Minneapolis / St. Paul area, laser technology has been utilized for over 20 years whenever it has allowed treatments or techniques that truly represent a quantum leap forward in capability, results, or reduction of complications over older methods. Dr. Richard H. Tholen has been a local, national, and international speaker, instructor, and physician educator in advanced laser techniques at multiple wavelengths and power densities, and has made over 100 presentations regarding uses of lasers in cutaneous surgery. Minneapolis Plastic Surgery, LTD. remains one of few practices nationally to offer third-generation laser skin resurfacing with combination Erbium/YAG-CO2 wavelengths.
Over the past decade, laser resurfacing has become the most precise and effective technology available for treatment of facial lines, wrinkles, acne scars, and other skin injuries. Dermabrasion and chemical peeling can also treat fine lines, wrinkles, scars, and pigmentation irregularities, but have some limitations that make them appropriate only in select circumstances.
At Minneapolis Plastic Surgery, LTD., laser skin resurfacing is performed to remove and improve facial wrinkles and sun damage, as well as to minimize acne scarring, deep laugh lines, and frown lines. Many physicians have employed first-generation carbon dioxide laser skin resurfacing machines but have now found that, in addition to longer healing times and a prolonged period of redness, they have a tendency to produce hypopigmentation (lightening of skin color) or a visible line of demarcation between treated and untreated areas. Although wrinkles were indeed dramatically improved, these other side effects have reduced the initial enthusiasm this first-generation laser caused. Even second-generation Erbium-YAG lasers were found to have limitations that reduced acceptance of this technology. For over a decade, Minneapolis Plastic Surgery, LTD. has been involved with teaching about and evaluating laser technology as it arrives from the laboratory to the clinical setting.
After extensive use and testing, MPS obtained the latest third-generation combination Erbium-YAG/CO2 laser for facial skin resurfacing. This laser has been in use in our practice since 1998 and has proven to combine the best of both of the previous generations of laser technology while eliminating the drawbacks. During the laser skin resurfacing procedure, the topmost layer of skin is vaporized by the Erbium-YAG wavelength, allowing the lower-energy carbon dioxide laser energy to effectively contract and tighten the lower skin layers without the excessive heat damage that causes delayed skin color changes. Healing creates new collagen and elastic fibers in the dermis that smooth and tighten the skin, and a new, rejuvenated skin surface forms without the lines, sun damage, or age spots that were previously visible. Laser skin resurfacing is performed using sedation or a light anesthetic and takes about one hour. Healing takes about a week, with redness fading rapidly enough so that most patients can return to work or social activities in a week or two.
This laser technology is available in very few places other than at Minneapolis Plastic Surgery, LTD., and remains the best ablative skin resurfacing technology anywhere, giving superior results as compared to non-ablative techniques (Thermage™, Fotofacial™, GentleWaves™, etc.), and as compared to the present fractional laser treatments such as Fraxel™, or Pixel™. These latter machines utilize older CO2 or erbium/YAG laser technology in a different delivery method. Multiple surgical sessions are usually recommended when these devices are used, and although some improvements can be seen, the results are less dramatic and still require healing after each session.
In microdermabrasion, a special handheld wand with a rounded tip is used to buff away the surface layer of the skin, removing scars and blemishes and diminishing the appearance of fine lines. The microdermabrasion wand, or handpiece, is actually a hollow tube with a tiny hole in its tip that allows sterile crystals circulating through the tube to gently “sandblast” the outer dead rough layers of the skin. This technique was developed in 1985 in Italy and quickly became popular in Europe before its arrival in the United States.
Dermabrasion is entirely different, as this surgical procedure requires local anesthesia, and involves the use of a rapidly-rotating diamond-coated tip to “sand” away the outer layers of scarred or pitted skin, as well as a week of healing. Microdermabrasion cannot achieve the degree of improvement that deeply-scarred or pitted skin texture requires, but can create pleasing improvements in the rough, outer, dry, and sun-damaged layers of your skin without anesthesia or down-time.
Microdermabrasion is not painful, and the wand’s tip only feels slightly rough. No anesthesia is necessary. Some patients have compared the sensation to the feeling of a cat’s tongue. There is no recovery time associated with microdermabrasion; some patients may have reddened skin after the procedure, but this redness fades in a day or so.
The body interprets the loss of this uppermost layer of skin as a mild injury and works to repair the skin in the days after microdermabrasion treatment by creating fresh new skin cells. These new, younger skin cells contribute to a glowing, blemish-free appearance. Acne and wrinkles can be noticeably reduced during this time. Microdermabrasion relies on the natural ability of the skin to regenerate itself, and it is therefore excellent for people with minor skin imperfections. To maintain results, it may be necessary to have more than one microdermabrasion treatment. A skin care specialist at our Minnesota skin and body care clinic (Carillon Clinic, Ltd.), serving the Minneapolis / St. Paul area and beyond, can help you plan your microdermabrasion treatment and skin care regimen.
As people’s lives and tastes change, they sometimes find that they want their tattoos to change as well. Prior to laser techniques becoming available for tattoo removal, tattoos were permanent, and removal of tattoos meant permanent scars. Even with dermabrasion, chemical peels, or CO2 laser techniques, there was a 100% scar rate with tattoo removal. Surgical excision, tissue expanders, or skin grafts were other options that required surgery and always left scars.
Now there are newer lasers (high-power, fast shutter, specific wavelengths) for tattoo removal that offer patients complete or nearly complete tattoo removal without scarring or skin pigmentation changes in up to 90% of cases. There are still some tattoos that may be too deep, too dark or with difficult-to-remove coloration, or in patients with dark skin color, that cannot be removed without residual ink, scarring, or skin coloration change, but these are now in the 10% range.
More than one treatment session is necessary for maximum ink removal, and waiting 4-5 weeks between treatment sessions is necessary in order for the skin to completely heal before being re-lasered. Since each patient’s skin is different (and different in various locations on the same patient), and each tattoo is equally different (color, density, depth, or even tattoos on top of older tattoos), it is impossible to predict an exact number of laser treatments needed for maximum removal.
Any laser practitioner or center that quotes a specific number of treatments, or implies a close estimate, cannot be telling the truth, as the above individual patient and tattoo characteristics absolutely prevent this. We have seen patient quotes for low-number-of-sessions, high-cost-per-session treatments. When the specified number of treatments then fails to remove all of the tattoo ink, the dissatisfied patient then seeks other consultations, at which time it is discovered that a higher number of treatment sessions will be necessary. Since virtually all laser tattoo removal is done with the Q-switched YAG laser (rarely, the Q-ruby or alexandrite lasers may be used), every doctor or laser operator should require about the same number of session to remove a specific tattoo properly. Incomplete or “polka-dot” techniques are not necessary for “safety” or “reduced scarring,” they just increase the number of sessions necessary. Patients from the Minneapolis / St. Paul area and all over Minnesota who come to Minneapolis Plastic Surgery, LTD. for laser tattoo removal can be assured that the treatment is done only by our plastic surgeons, not a technician or assistant.
Careful wound care is as essential as choice of laser tattoo removal doctor. You should keep the treated areas clean and moist with Bacitracin (not Neosporin or Mycitracin) until healed. This should take no more than a week; if the treated area has not healed in this time period, contact your doctor. Since the laser energy is absorbed by the tattoo ink as well as the skin pigment (melanin) granules, suntanned skin or darker skin colors will absorb a higher proportion of energy that you would rather be absorbed by the tattoo ink granules. Avoid sun exposure or tanning for as long as laser tattoo treatment is being performed.
Spider veins are clusters of small red, blue, or purple veins that can develop on women’s thighs, calves, or ankles. Men can have spider veins as well, but they are more common in women, particularly after childbirth, weight gain, or leg injury. Larger dilated veins with damaged valves are called varicose veins, and these are treated with surgery (vein stripping or other techniques) rather than sclerotherapy, which is the injection treatment of spider veins.
Though spider veins are harmless, many women find them cosmetically bothersome. Varicose veins and sometimes spider veins can be uncomfortable, as the veins can cause aching, burning, swelling, and night cramps. Some women feel self-conscious about even revealing their legs in shorts, skirts, or dresses because of spider veins.
A simple procedure called sclerotherapy can eliminate many of these veins. In this technique, the veins are injected with sclerosing solution, which causes them to collapse and fade. One or two sessions are usually necessary to treat most patients. Elastic wraps and elevation are usually necessary for a day or two after treatment to maximize results and minimize bruising. Most patients return to full activity after 48 hours, but avoidance of sun exposure or tanning is recommended until any bruising has faded.
Although laser techniques are available for spider vein treatment, sclerotherapy remains the “gold-standard” for best results with the least side effects. Complimentary consultations are available at both Minneapolis Plastic Surgery, LTD. and Carillon Clinic, Ltd. so that you can learn more about this treatment and have your spider veins evaluated. Our sclerotherapy experts can advise you about which veins can be removed by this technique, and explain other options when necessary.
Chemical peels remove the damaged outer layers of the skin, causing it to regenerate new skin cells. The healing process takes several days to a week or more (depending on type and strength of peel), and during this healing phase new collagen and elastic fibers are being formed that tighten and improve tone of the skin, while giving a new skin surface which has a refreshed look and more even coloration. This new, younger layer of skin cells reduces the appearance of fine lines, wrinkles, sun damage, and blemishes. Chemical peels can also be used to improve textural irregularities or make acne scars less visible. Several chemical peels are available at Minneapolis Plastic Surgery, LTD. and our skin and body care clinic, Carillon Clinic, Ltd. These peels range from no-downtime "lunchtime" skin refreshing peels such as the glycolic peel, to more aggressive peels, including Jessner's peel, TCA (tricholoroacetic acid) peels, Obagi® Blue Peel, and phenol or buffered phenol peels. Each is best for treating specific types of skin problems, so it is recommended that you consult with our doctors to learn which would best address your concerns.
To receive a complimentary consultation at our Minneapolis, Minnesota practice regarding your laser skin resurfacing, spider vein removal, laser tattoo removal, or other skin care procedure, please contact our staff. A skin care regimen can be custom-made for you by our experienced clinicians at both Minneapolis Plastic Surgery, LTD. and Carillon Clinic, Ltd.
Please contact Minneapolis Plastic Surgery, LTD. if you have any questions about our procedures or would like to schedule a complimentary consultation with one of our plastic surgeons.
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Minneapolis Plastic Surgery, LTD.
4825 Olson Memorial Highway (Hwy 55) Suite 200
Minneapolis, Minnesota 55422
Phone: (763) 545-0443
Fax: (763) 545-2784