• Fully Ablative Laser Resurfacing (CO2 & Erbium YAG)

    in London and Surrey

INTRODUCTION

This is by far the most powerful skin rejuvenation technique available for facial skin.

It is performed in order to:

  1. Completely renew facial skin
  2. Tighten the skin to help reduce the consequences of laxity
  3. Remove wrinkles
  4. Improve elasticity and skin thickness

This is a facial laser surgical procedure performed under a special type of local anaesthetic. Treatment of skin laxity and wrinkles around the eyes can also be incorporated into the treatment.

Not all CO2 and Erbium YAG laser is the same. This is a fully ablative CO2 laser or fully ablative Erbium YAG procedure that is only performed by a handful of experienced laser surgeons worldwide. It needs to be performed using a surgical grade CO2 and Erbium YAG laser (not an aesthetic grade CO2/Erbium YAG laser which lacks the power and the ultra-short pulse width required to perform this procedure safely). Dr Hussein is one of the few laser surgeons worldwide who has the knowledge and the experience to offer this procedure and has performed numerous cases. He uses the Lumenis Ultrapulse CO2 and Sciton Joule X Erbium YAG laser. These are the world’s most powerful and state-of-the-art skin resurfacing lasers

As you will see from the photos below Dr Hussein is capable of performing what few others worldwide are capable of. The level of skin rejuvenation is simply outstanding.

This degree of improvement will however require 9 days of downtime.

Dr Hussein can perform a full-face treatment including eyes OR periorbital treatment (around the eyes only). Eyelid tightening treatment with fully ablative CO2 technique is the second most effective technique to reduce eyelid laxity after a surgical blepharoplasty. For clients who are not keen on surgical blepharoplasty, fully ablative CO2 eyelid treatment will give a considerable improvement for eyelid skin laxity and wrinkles. It actually improves lower lid wrinkles and skin surface texture over and above surgical blepharoplasty.

The greatest benefit of this procedure is that the results are permanent. Once healing is complete the skin you are left with is your new skin. The procedure doesn’t have to be repeated like other cosmetic treatments such as dermal fillers or BotoxTM. As long as the client takes good care of their skin results will last for many years before the need to consider doing anything further.

New type 3 collagen continues to be synthesized for up to 6 months post procedure meaning that there is further improvement after the immediate healing phase. Dr Hussein is capable of performing laser resurfacing with fully ablative CO2 and Erbium YAG laser on all skin types. In general darker skin types may encounter a higher chance of hyperpigmentation but this will eventually settle.

DR HUSSEIN’S CASE GALLERY – BEFORE & AFTER

PROCEDURE DETAILS

Once the client has seen Dr Hussein for a consultation and treatment has been deemed appropriate the client will be listed for the procedure. During the consultation a prescription for prophylaxis medications will be issued. These medications are to be used as instructed by Dr Hussein during the immediate few days recovery period following the procedure. Taking these medications minimises the risk of harmful side effects such as infection following this type of more aggressive skin laser surgery.

It is important that the client has somebody available to drive them home after the procedure is performed. Clients must not expect drive back home themselves.

Dr Hussein will see the client before the procedure in order to prepare and clarify things. A consent form will be signed giving Dr Hussein permission to carry out the procedure. Antiviral tablets will be then administered as well as an optional sedative. Pre-procedure photos will be taken and following this the face will be cleansed and prepared with a special type of topical local anaesthetic gel. Sometimes Dr Hussein will occasionally also use additional anaesthetic techniques such as tumescent anaesthesia or nerve blocks. These involve small injections of local anaesthetic under the skin.

Anaesthetic preparation will last for about 45 minutes. Following this the Client will be moved into the procedure room and prepared for the fully ablative CO2 or Erbium YAG laser procedure. If treatment around the eye area is to be performed then the client will have had anaesthetic eyedrops applied and metal contact lens style eye-shields will be inserted. If facial treatment only is performed then adhesive eye-shields that stick over the eyes will be applied. In most cases clients who opt for full face treatment usually will want to incorporate the benefits of eyelid treatment as well. It is therefore commonplace for clients to have both treatments performed in the same session.

Once Dr Hussein has commenced the procedure it will usually take around 45 minutes to complete. The level of discomfort experienced during the procedure is typically a prickly burning sensation that usually can reach up to a 5 out of 10 subjective severity. Dr Hussein has never encountered anyone who has been unable to cope with the procedure from a pain or discomfort point of view. Pain or discomfort form this type of laser surgery is best described as moderate at the most.

Following completion of the procedure the clients face will feel very hot. It is best described as a sun burn sensation. This burning sensation will last for up to 24 hours before settling. Following removal of protective eye-wear a barrier cream called CU3 cream or Eucerin Aquaphor cream is applied to the freshly treated skin. This cream acts as an impermeable barrier to protect the denuded skin from dehydration and infection.

Detailed aftercare instructions will be discussed and issued in a written format to the client. These instructions must be adhered to strictly. Strict sun avoidance will need to be maintained in the immediate recovery phase and up to a month at least post procedure. Use of a broad spectrum Sunblock SPF50 minimum is recommended for at least 3 months post procedure.

Clients are at risk of infection during the first few days following the procedure. It is important to keep the face clean and strictly adhere to the aftercare instructions to minimise this risk. Dr Hussein usually gives a once a day antibiotic dose to minimise bacterial infection risk. There will also be a three times a day antiviral tablet as well. These tablets are to be continued for 7 days after the procedure. There will also be a pack containing medications for use ONLY if instructed to do so by Dr Hussein.

Dr Hussein will typically monitor day by day healing through the use of ‘selfie’ photos taken by the client and sent to the contact details issued by Dr Hussein. Dr Hussein can then provide real-time advice during the recovery period. Any client having this procedure will have a direct line of communication with Dr Hussein at all times throughout recovery. Close monitoring of this nature allows any potential complications to be dealt with quickly and risks minimised.

After 9 – 10 days clients can return to work. There will still be some ongoing redness that will take a few weeks to settle. A light foundation can be applied to mask this redness. Use of perfume free gentle cleanser and appropriate moisturiser is recommended. A high quality SPF 50 sunblock must be used and steps to avoid sun exposure must be taken for the weeks following treatment. If these steps are ignored clients may find that they develop brown pigmentation on the treated areas of the face (post inflammatory hyperpigmentation). Although this will spontaneously settle or treated it is better to avoid it by observing the sun avoidance precautions.

POTENTIAL COMPLICATIONS

Fully ablative CO2 resurfacing is the most aggressive type of skin resurfacing procedure undertaken by Dr Hussein. As Dr Hussein is an expert in cutaneous laser surgery the incidence of side effects is low. In Dr Hussein’s hands fully ablative CO2 laser is a safe procedure.

However with any laser resurfacing treatment complications are possible. In fully ablative CO2 laser these include the following:

AFTERCARE

This treatment is designed to renew, tighten and improve the texture of the facial skin. It is an aggressive procedure and requires strict adherence to these aftercare instructions. Immediate and very visible benefits can be seen in the form of reduction in laxity (tightening), reduction in wrinkles, removal of sun damage, increase in elasticity and improvement in collagen density and thickness.

It is a procedure that is also used to improve acne scarring by causing contraction of the skin, a degree of direct physical vaporization of the acne scars and remodelling of the collagen within the deeper layer of skin (dermis). Fractional CO2 laser may also be used for acne scar remodelling.

What you will experience following the treatment:

  • You will experience a burning sensation following treatment and swelling of the face will develop over the next 24 hours. The burning sensation takes 24-48 hours to resolve.
  • Over the next three to four days the face will feel tight and swollen. There can be weeping of yellowish serous fluid for up to 4 days after the procedure.
  • Crusts may develop over the first few days post procedure and must not be removed. They will come away leaving fresh new skin underneath as healing continues.
  • It is not unusual to experience some degree of itching between 4-6 days following the treatment. Dr Hussein will advise on how to manage this.
  • At the end of 10 days the skin will have largely healed. There should be no further crusted areas. The skin will remain pink and this will settle progressively over the following weeks.
  • It will usually be safe to return to a simple skin care regime 10 days post treatment.

Never pick or remove skin flakes or crusts. Allow them to shed naturally. Picking will increase the likelihood of scarring.

Please note the time periods above may vary according to the strength of treatment. For example the duration of crusting may be longer in more aggressive treatments.

You will be issued with a skincare pack containing dermol facewash, CU3 cream and a pack of sterile gauze on completion of the procedure.

Skincare day 1 to day 10

It is imperative that you adhere strictly to the following skin care routine after CO2 laser treatment. The skin barrier has been temporarily impaired by the laser. Premature application of your normal skincare products will result in inflammation, irritation, slow healing and may increase the risk of pigmentation problems and/or scarring. You are more susceptible to contact irritant and allergic dermatitis during this first 14 day period.

After the first 10 days have elapsed you must use a sunscreen SPF50 for the following 6 weeks. You must minimize your sun exposure at all times throughout the treatment and for 6 weeks after treatment.

Morning

  1. Wash the face in the morning with Dermol face wash and allow to air dry OR pat dry gently with a clean face towel or clean kitchen roll (DO NOT RUB).
  2. Apply CU3 barrier cream to the face. This will protect the skin and stop it from drying out while the epidermal barrier is healing.
  3. Take any antiviral and/or antibiotic tablets according to instructions that Dr Hussein may have prescribed Complete the course of medication.

Throughout the day

  • Top up the CU3 cream at any point when the skin starts to feel dry and tight. This should be at least twice throughout the day. Allowing the skin to become too dry will slow the healing process.

Evening

  • Repeat steps 1 & 2 (and step 3 if your Doctor has prescribed the medication) before going to bed.

Dr Hussein will review you at 2 weeks following treatment but do not hesitate to contact him before this if you need earlier advice/review/information.
Remember to send healing ‘selfie’ photos at least every two days so that Dr Hussein can monitor your healing. Use the details on the contact card.

Skincare – Day 10 to week 6 post treatment

Your skin will have healed sufficiently by day 10 after treatment. You will now be able to return to work. You will notice that the skin will still be red. This redness will settle over the next 6-12 weeks. During this period your skin will be more sensitive than normal. It is important that very mild cleansers, moisturizers and make-up be used in this period. Some products contain acetyl alcohol, retinoids and alpha hydroxy acids that can potentially irritate the skin and delay healing. These should be avoided or minimized.

Sunscreen is also very important. High factor (SPF30+) is ideal. Sunscreens that contain physical filters rather than chemical filters are preferred as they are less likely to irritate the skin. Physical barrier sunscreens are sometimes less acceptable because they leave a prominent white residue on the skin.

I have recommended a basic skincare regime that can be used during this period that will minimize any irritation to the skin, speed the healing process and optimize the results of your CO2 laser treatment.

COST

Fully Ablative CO2 Laser & Erbium YAG:

  • Full face fully ablative CO2 OR Erbium YAG laser resurfacing including eyes – £2925
  • Eyelids (Upper and Lower) fully ablative CO2 treatment ONLY – £1575
  • Erbium Light epidermal resurfacing – £1575

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