Laser resurfacing in London
Laser resurfacing, also known as a laser peel or fractional resurfacing involves the removal of the outer layer of sun-damaged skin using Erbium laser. Subsequent healing results in smoother, softer, and more youthful looking skin. Laser resurfacing is another type of skin resurfacing alongside more traditional chemical peels. Laser skin resurfacing is used to treat many skin concerns including fine lines and wrinkles, facial scarring, coarse skin texture, hyperpigmentation, age spots, acne scarring and discolouration. Laser resurfacing is most commonly performed in the face and neck region. Laser resurfacing especially when performed at higher treatment parameters allows patients to achieve results in just one treatment and the results can last for many years. The average recovery after laser resurfacing is about 7-14 days on average and during this time, patients should minimise sun exposure, wear protective clothing and wear high SPF sunscreen to minimise the risk of hyperpigmentation. Our practitioners will also prescribe medical grade skin care products to enhance the healing process, your recovery and ultimately the final results.
Laser Resurfacing Expected Results
- Reduce or eliminate fine lines and wrinkles
- Treatment of age spots, sun spots and solar lentigo
- Treatment of acne scarring
- Treatment of dyschromia
- Eliminate coarse skin texture
- Skin tightening
- Remove freckles
The effects of sun damage and environment pollutants gradually take their toll on human skin, causing wrinkles to be formed, age spot and sun spot formation and thickened unsightly blemishes.
Choosing the right specialist for your consultation and laser treatment is key to getting the very best results from your treatment. We don’t use ‘aesthetic grade’ lasers which are very often under-powered and actually carry greater risks of complications than their surgical grade equivalents.
Whether it is non-ablative or ablative laser, fractional or full field laser skin resurfacing, we have all the treatment options to suit every skin type. Our practitioners have a wealth of experience and perform hundreds of laser procedures annually. It is extremely important to select specialists who have the in-depth expertise with powerful surgical grade lasers as well as having access to the most advanced laser technology.
RealSelf Top Doctors
RealSelf top doctor status is awarded to less than 10% of the RealSelf doctor community. This status is earned by achieving consistently high patient satisfaction (from RealSelf reviews), getting excellent feedback on expert answers to patient questions, and after investing significant time in Q&A and other doctor activity. RealSelf top doctors are rated among the very best surgeons in the United Kingdom and USA.
Trust a facial plastic surgeon
A facial plastic surgeon is trained to undertake aesthetic laser and surgical procedures in the face and neck region. They are dedicated sub-specialists. Compared with general plastic surgeons, facial plastic surgeons are inherently better trained to perform delicate laser and facial procedures. The extra years of surgical training by facial specialists focused on the facial region results in an exceptionally high degree of skill.
Our surgeons are full members of:
The laser surgeon will always take time to review all your options to give you an idea of how you may look after your procedure. Our high standard of ethics is reflected in our guidance to all patients to seek the opinions of several surgeons so they can feel totally comfortable with their ultimate decision to undergo laser resurfacing as well the right choice of surgeon.
Ideal candidates for laser resurfacing
This is a suitable procedure for those who are concerned about fine lines, wrinkles, skin texture or acne scars. It is suitable for those who do not wish to undergo a surgical procedure, do not want to use any chemicals .You will need to be at least 18 years old to undergo the laser resurfacing procedure.
You will need to attend a consultation with one of the surgeons who will be able to assess whether or not you are an eligible candidate for this procedure.
Good candidates for laser resurfacing
- Lighter skin types, Fitzpatrick types 1-3
- Those who would like to reduce fine lines around the periocular or perioral region
- Tightening of loose skin of the upper and lower eyelids as an alternative to a blepharoplasty
- Those wanting to reduce hyperpigmentation, age spots or freckles
- Treatment of facial scars including all types of acne scars
- Are in good overall health with realistic expectations of what laser resurfacing can achieve
Who is not an ideal candidate for laser resurfacing?
Laser skin resurfacing delivers outstanding results and will significantly improve fine lines and wrinkles and smoothen out acne scars. However it cannot completely remove very deep wrinkles or severe skin laxity with heavy jowl formation and saggy skin. In these cases, our surgeons will need to carefully assess you to determine if a surgical procedure such as a facelift would be more appropriate with your laser resurfacing procedure. For patients with darker skin types such as dark brown or black skin types (Fitzpatrick type 4-6), laser resurfacing may not be an ideal option. The risk of developing hyperpigmentation during the recovery process is higher in darker skin types. For all skin types, it is very important to commence a skin preconditioning regimen for at least 4-6 weeks prior to laser resurfacing. Preconditioning consists of prescription grade skin care products such as tretinoin and 4% hydroxyquinone. The preconditioning protocol prepares the skin for the effects of the laser and optimises recovery and treatment outcomes.
Benefits of laser resurfacing
At Centre for Surgery, laser skin resurfacing in London is performed using state of the art VSP Erbium technology. This involves the use of a high power surgical grade laser to resurface the skin with extreme precision. Erbium:YAG lasers with a of wavelength 2940nm create less injury to the deeper lying dermis and have less risk of inducing hyperpigmentation skin changes compared with the CO2 laser when the Erbium laser used in a pure ablation mode which leads to quicker healing.
In recent years, the fractional CO2 laser has been developed to reduce the impact of the thermal injury. Fractionation of the laser beam into lots of microcolumns lessens the impact of the skin.The disadvantage of fractional CO2 lasers is their effect of leaving areas of untreated and aged skin. The fully ablative Erbium laser allows for complete ablative skin resurfacing with much less imparting of energy to the dermis and therefore less risk.
There are numerous benefits for undertaking laser skin resurfacing, including:
- Able to rejuvenate the skin without surgery or the use of chemicals
- Suitable for any skin type
- Reduced downtime
- Allows for precise and accurate control during treatment, giving you the best results
Ablation and coagulation – how do these matter?
Er:YAG laser is very well absorbed in water. Water is the main chromophore for ablative lasers like the older CO2 lasers and the newer Er:YAG lasers. CO2 lasers have less ablation efficiency due to their lower absorption in water. Er:YAG laser is much more efficiently absorbed in water than CO2 lasers. This allows our lasers to vaporise the target tissue of skin with extreme micron level accuracy without undesired thermal coagulation effects. It is these collateral thermal effects seen with the CO2 laser which are very often responsible for post inflammatory hyperpigmentation or PIH, persistent erythema (redness) and prolonger recovery times. Coagulation will always accompany ablation with CO2 lasers – not so with Er:YAG technology.
The dual mode Erbium allows the operator to fine tine the ratios between Er:YAG ablation and coagulation all the way from ‘cold’ ablation to non-ablative coagulation. The versatile nature of dual mode Erbium laser technology is now the standard of care for laser skin resurfacing.
Erbium laser resurfacing is best suited for those patients with the lighter Fitzpatrick 1 and 2 skin types. As part of a skin preconditioning routine, all patients need to apply hydroquinone and topical tretinoin 2–3 times per week for 4–6 weeks and stop 7 days before laser treatment. A 1-week course of acyclovir 500 mg 4 times daily is started 1 day before the procedure.
Fotona SP Dynamis
The award-winning Fotona SP Dynamis at Centre for Surgery in London is our state of the art laser resurfacing system with dual Er:YAG and Nd:YAG capabilities. Er:YAG laser resurfacing is possible with both fully ablative and fractional modes for full treatment versatility.
Anaesthesia for laser resurfacing
We provide the most comprehensive range of anaesthesia options for laser skin resurfacing in the UK. Our dedicated outpatient surgical suite at 106 Crawford Street is fully equipped for all the methods below:
- Topical anaesthesia
- Cryo anaesthesia (cold air skin cooling)
- Inhaled anaesthesia – inhaled anaesthesia is a real game changer for optimising patient comfort with laser skin resurfacing. There are no sedative effects and patients can control the amount of pain relief by simply inhaling the mouthpiece which delivers a controlled mixture of 50% nitrous oxide and 50% oxygen.
- Injected local anaesthesia – direct infiltration, nerve blocks and tumescent anaesthesia – where a procedure a requires local anaesthesia to be injected perhaps because a large treatment area will be addressed often requires the laser surgeon to utilise a combination of techniques. A commonly used combination is a regional nerve block combined with ‘horseshoe’ tumescent anaesthesia to allow pain-free full face laser skin resurfacing.
- Systemic anaesthesia – if you prefer to be asleep for your laser skin resurfacing procedure, our expert anaesthetists are trained to deliver TIVA general anaesthesia. This means you will not be able to see, hear or feel any part of the procedure. When you wake up you may feel a hot sensation to your face which is common to all anaesthesia methods is related to the laser itself. There are many excellent treatments to reduce this sensation to give a cooling effect to the skin.
The laser resurfacing procedure
There are two approaches to laser skin resurfacing: fully ablative and fractional.
In fully ablative resurfacing, the entire surface area of the skin within the laser spot is treated by the laser beam. The laser beam is scanned across the treatment area using specialist lase scanners and precisely removes the superficial layers of the skin – micron by micron. During the healing phase, the old, aging and sun-damaged skin that was removed will be replaced with a fresh, healthy-looking layer. In terms of depth of penetration, treatments can range from superficial, light peels to deep peels reaching beyond 100 microns. Light peels are indicated to remove fine lines, sun spots and aged-looking skin; deep peels are applied to improve skin tone and texture and eliminate deep wrinkles, even notoriously hard-to-treat smoker’s lines and crow’s feet. Light peels have a shorter downtime but deeper peels have more dramatic treatment effects. It very much depends on your tolerance of downtime with some of the more deeper laser treatments.
In fractional resurfacing the laser creates tiny pinpoint columns of skin within each laser spot, leaving intact, unaffected tissue around each individual micro-spot. This promotes faster healing compared with fully ablative full field resurfacing, while the laser can be allowed to penetrate into the deeper skin layers to initiate collagen and elastin remodelling. This also works very well for acne scarring.
The laser skin resurfacing involves three steps:
- Conditioning: an Ng:YAG laser is passed along the surface of the skin twice, penetrating the tissue and conditioning the skin.
- Fractional therapy: the fractional Er:YAG laser is used to ablate old skin, allowing for new, tighter tissue to form.
- Peeling: the full light Er:YAG laser ablates the skin, removing any superficial imperfections on the skin.
Types of laser resurfacing:
Will I need more than one laser resurfacing treatment?
For most patients, laser resurfacing is able to treat most skin issues in only one treatment. The final results may not become apparent until six months after treatment particularly after deep laser resurfacing. Some skin conditions such as acne scarring or more severe skin aging are notoriously difficult to treat and may require a number of treatments to get good results. In many cases, skin resurfacing options include milder chemical peels as a second treatment after a first laser resurfacing treatment to ‘fine-tune’ the result. Prescription-grade skin care products after laser resurfacing (Obagi Nu-Derm) will help to enhance the result further. A single light erbium micro-peel is equivalent to six microdermabrasion sessions.
Preparation for laser resurfacing
Our surgeons preference is to pre-treat all patients for 4–6 weeks before laser resurfacing. This regimen includes topical tretinoin (0.05%–0.1%), hydroquinone (2%–4%), sunscreen with SPF greater than 30, and alpha hydroxy acid (4%–10%). The pretreatment protocol improves skin tolerance, regulates fibroblast and melanocyte function, improves dermal circulation, and allows for the treated skin to heal 3–4 days faster due to increased cellular division and new collagen formation. Modifications to this pre-procedure regimen (dosages and application intervals) are made as needed based on tolerance and skin types. A week before the laser resurfacing procedure, patients are started on a cleansing and toning protocol and encouraged to maintain adequate hydration and regular moisturising of the skin. Antiviral prophylaxis with Acyclovir is started 2 days before the chemical peel and continued for 5 days after the peel in patients with a prior history of herpes virus. Oral antibiotics may also be prescribed to be taken after the procedure to minimise the risk of bacterial infection.
Before laser resurfacing, it is important to remove all make-up and skin lotions from the face. You should avoid all tanning including tanning beds and excessive sun exposure for at least 4 weeks before the procedure. The aftercare instructions are based on the type of laser treatment administered and should be followed to the letter to avoid complications. Intense physical activity should be avoided for at least one week. You should exposure to the sun for at least 4 weeks after the laser resurfacing procedure and up to 6-8 weeks for fully ablative laser resurfacing. Check with your doctor before applying sunscreen as it can be irritating to the skin as the skin will be raw after treatment. Your doctor will be able to advise on the correct timing for sunscreen application.
Recovery after laser resurfacing
Common side effects:
A burning sensation of the face with associated swelling develops over the first 24 hours and takes about 24-48 hours to resolve. This is a non-invasive procedure, so there is very little recovery time. You will be able to return home the same day as the procedure. You may experience redness on the skin that may feel similar to a mild sunburn. This may last for around 48 hours. After around 36 hours the skin will begin to peel. After seven days you may wish to do a light exfoliation to remove any peeling skin.
You should avoid any exercise for the first 24 hours. Avoid any sun exposure and applying any makeup for the first 48 hours. Avoiding makeup will help reduce the possibility of any acne breakouts. During this period make sure to keep the skin moisturised and hydrated.
Laser skin resurfacing before and after
Fully ablative laser resurfacing with Erbium laser
Risks and potential complications of laser resurfacing
Laser resurfacing is a safe procedure when performed by appropriately trained practitioners. At Centre for Surgery, risks are minimised by meticulous patient selection and thorough pre-procedure preparation. It is very important to undertake skin preconditioning with tretinoin, hydroxyquinone, sunscreen and alpha hydroxy acids to reduce risks and enhance treatment efficacy.
Who is not suitable for laser resurfacing?
- Active skin infection
- Open wounds
- Inflammatory skin conditions
- Drugs with photosensitivity side effects
Potential risks of laser resurfacing
- Post-inflammatory hyperpigmentation
- Excessive burning
- Persistent itchiness
- Facial scarring
- Persistent redness
- Herpes virus reactivation
- Post-procedure milia
- Acne breakouts
The Centre for Surgery approach to aftercare
Our aftercare programme was recently described as ‘outstanding’ by our regulator, the Care Quality Commission.
Our postoperative support team phone all our patients the day after their laser resurfacing procedure and then every other day thereafter for the first two weeks. The proactive nature of our postoperative support gives every patient the best opportunity for a smooth post-procedure recovery free of complications. In many cases if complications were to occur, their impact is markedly lessened by early detection, prompt clinical assessment and correct treatment. Where a patient expresses concern to our team over the phone, then we often call patients in the same day for assessment with one of our expert nursing team. Even if there is no significant issue, the careful explanation and calm reassurance provided by our team can help to alleviate any worries you may have experienced.
Laser resurfacing cost
There are a number of a factors which will impact on the final cost of the laser resurfacing procedure:
- Type of laser resurfacing – fully ablative or fractional
- Type of anaesthesia – local anaesthesia or general anaesthesia
- Combination with other treatments such as facelift or blepharoplasty
Why not call 0207 993 4849 and speak to one of our expert patient coordinators who may be able to give you a rough costing prior to laser resurfacing.
Always remember that price should never be the determining factor when it comes to choosing your provider. We feel that safety and quality of service should be your number one priority and instilling in you the confidence that our team will look after you before, during and after your procedure to the best of their ability.
How to find us
Centre for Surgery is located at 106 Crawford Street in Marylebone. Crawford Street is just off Baker Street.
We are easily accessible by all major bus routes that pass through Baker Street as well as Baker Street underground station.
From the tube station, we are just a 5 minute walk southwards down Baker Street followed by a right turn onto Crawford Street. The clinic is about 200 yards on the left.
There is ample local pay & display parking in the surrounding area and an NCP car park is located further west along Crawford Street. Our local residential parking zone is the City of Westminster.
Address: 106 Crawford Street, Marylebone, London, W1H 2HY
What is the difference between IPL and laser resurfacing?IPL skin rejuvenation and laser skin resurfacing differ from one another in a number aspects.
Firstly, IPL is not a laser treatment. IPL skin rejuvenation involves the emission of broadband light of many different wavelengths at high intensity to address different layers of the skin simultaneously whilst sparing normal healthy skin cells. IPL is ideal for improvement of skin tone and texture and for the treatment of a wide variety of skin conditions such as hyperpigmentation, facial redness, broken capillaries, age spots, sun spots and unwanted hair.
Laser skin resurfacing differs from IPL treatment in that it involves the emission of a single wavelength of laser energy to one specific type of skin lesion. There are different types of lasers and each one is specific for treatment of a small number of similar skin lesions. For example, pulsed dye laser and Nd:YAG laser are for treatment of vascular lesions. Q-switched lasers are used for pigmented lesions and tattoos while ablative lasers such as CO2 and erbium lasers are good for treatment of photo-ageing, scars and removal of superficial skin lesions such as moles and warts.
At Centre for Surgery, we offer the full range of laser devices to complement our powerful IPL system. These include ablative erbium and CO2 laser for traditional laser skin resurfacing, non-ablative erbium glass and thulium fibre laser for pigmented lesions and for darker skin types as well as Nd:YAG laser for vascular skin lesions such as thread veins and spider veins occurring in both the face and legs.
Each type of laser has its advantages and disadvantages and your practitioner will advise of the correct type of laser to use for your skin concern at your face to face consultation.
What is the Fitzpatrick skin classification system and is it important for laser resurfacing?The Fitzpatrick skin classification system is used by dermatologists to decide upon the correct type of laser for use in laser resurfacing treatment. Selection of the correct laser helps to reduce the risk of complications occurring after laser treatment.
Type 1 - this skin type ever tans and always burns
Type 2 - this skin type tans very little and usually burns
Type 3 - this skin type tans to a mild extent and sometimes burns to a mild degree
Type 4 - this skin type always tans to a moderate brown and burns if any are very mild
Type 5 - this skin type tans to a dark brown and the risk of burns is very minimal
Type 6 - this skin type tans to deep brown and burns never happen
Skin types 1-3 are suitable for ablative laser treatments including CO2 and erbium laser. Skin types 3-6 are better suited for non-ablative laser treatments such as erbium glass and thulium fibre laser treatments.
Who performs laser skin resurfacing at Centre for Surgery?Laser skin resurfacing is performed both by our highly experienced aesthetic practitioners and also our consultant dermatologists. For the more aggressive and powerful laser treatments, these are performed by one of our dermatologists for optimum safety and effectiveness.
What is fully ablative laser resurfacing?Fully ablative laser resurfacing is an aggressive type of laser treatment performed only by experienced dermatologists and plastic surgeons with powerful surgical grade laser devices. There only a small number of laser surgeons in the UK with the qualifications and experience to carry out fully ablative laser resurfacing. The treatment is appropriate for a wide range of skin concerns including fine lines and deeper wrinkles, skin laxity, hyperpigmentation, acne scars, sun damage from prolonged sun exposure and pre-cancerous skin lesions such as actinic keratosis. Fully ablative laser resurfacing is a powerful treatment for the prevention of skin cancers of the face by removing actinic keratoses (which could develop into later squamous cell carcinoma). Fully ablative laser is the gold standard treatment for treatment of acne scars and facial skin rejuvenation. Full ablative laser produces the equivalent of a second degree skin burn during treatment and it is therefore vital that the procedure is carried out by an experienced laser surgeon. Our dermatologists and plastic surgeons regularly perform many fully ablative laser treatments each year. The results achieved after fully ablative laser resurfacing are permanent and is extremely effective for the treatment of severe acne scarring and severe photo damage from chronic sun exposure.
What is laser skin resurfacing?Laser skin resurfacing treats the skin on your face, making you appear rejuvenated, more youthful and healthier. This is done without the use of any chemicals or without any surgery.
Laser skin resurfacing is done by using Fotona’s TwinLight Fractional Rejuvenation system. This involves the use of two wavelengths – the Ng:YAG and Er:YAG lasers.
The Ng:YAG laser conditions the skin, while the Er:YAG laser ablates old skin and removes superficial imperfections.
Am I a suitable candidate?You will be a suitable candidate for laser skin resurfacing if you wish to improve the appearance of acne scars, fine lines and wrinkles without having to undergo a surgical procedure or resort to using chemicals.
Does laser skin resurfacing hurt?You should feel minimal physical pain throughout the procedure. A topical numbing cream will be applied to your face to minimise any discomfort.
What laser is used?At Centre for Surgery, we use Fotona’s TwinLight Fractional Rejuvenation. This has two different wavelengths – Ng:YAG and Er:YAG.
What is involved in the procedure?Laser skin resurfacing involves three steps.
First, the skin is conditioned, which involves the Ng:YAG passing along the skin.
Nex, the fractional Er:YAG laser is used to ablate old skin. This allows new tissue to form.
Finally, the full light Er:YAG laser is used to ablate the skin, targeting any superficial skin imperfections.
How long does the procedure take?Laser skin resurfacing will take around one hour to complete.
What will the recovery be like?As this is a non-surgical procedure, you will have minimal downtime following the procedure.
You may experience some redness on the skin similar to a mild sunburn. This may last up to 48 hours.
After 36 hours, you may notice the skin will start to peel.
How many laser resurfacing treatments will I need to obtain results?Most fractional laser resurfacing treatments require about 3 treatments to achieve great results but the exact number of treatments is based on the degree of photoageing you have. Your practitioner will advise you on the best treatment approach at your consultation.
How long do results take to appear after having laser resurfacing?The healing after laser resurfacing takes about 5-7 days but this is dependent on the aggressiveness of the laser treatment. More powerful treatments will result in a longer period of downtime. In most cases however, the skin will begin to look more rejuvenated almost straightaway. You should expect to see improvements even after one treatment. The quality of the skin continues to improve due to remodelling of collagen and elastin over the next 3-6 months.
Optimum results after laser resurfacing are seen patients undertake a full course of treatments resulting in often dramatic treatment results which may significantly reduce the requirement for more invasive treatment such as a facelift. Improvements in skin texture and tone along with a significant reduction in lines and wrinkles are commonly seen.
Will I have to avoid exercising?You will need to avoid exercising for the first 24 hours following the procedure.