Aging, sun exposure, heredity and lifestyle factors including nutrition, alcohol consumption and smoking all may contribute to facial wrinkling. Pigment changes of the skin, such as blotchy or brown spots, may also occur with age or as a result of birth control pills, pregnancy or genetic factors. Prior acne may have made the surface of your skin uneven. These problems, as well as certain other skin conditions, may be improved by skin resurfacing.

Dr. Rohrich is a *board-certified, world-renown, plastic surgeon and has spent over 15 years specializing in facial cosmetic surgery. He has written numerous articles for scientific journals and magazines and lectures internationally about plastic surgery. He is Chairman of The Department of Plastic Surgery at UT Southwestern Medical Center at Dallas and is on the Board of Directors for the Clinical Center for Cosmetic Laser Treatment at UT Southwestern.

If you're considering laser resurfacing the information provided will give you a basic understanding of the procedure, but it can't answer all of your questions since a lot depends on your individual circumstances. Please ask Dr. Rohrich if there is anything you don't understand about the procedure. For more information, please view the "Frequently Asked Questions" or visit his "Resource Library" for related articles, websites and video clips.

* American Board of Plastic Surgery

Am I a good candidate for the surgery?

Your visit with Dr. Rohrich will determine if you are a good candidate. You may have certain characteristics that make you a better candidate for one technique rather than another.  Individuals who have taken Accutane™ in the past 12 to 18 months or are prone to abnormal (keloid-like) scarring, or those with active skin infections on the treatment area, may not be appropriate candidates for this procedure. The best candidates for Erbium laser resurfacing have fair, healthy, non-oily skin and have fine wrinkles around the lip, eye and cheek areas. Patients with olive skin, brown skin or black skin may be at increased risk for pigmentation changes regardless of what type of resurfacing method is recommended. Patients may have their skin resurfaced at almost any age.

A laser resurfacing can make you look younger and fresher and may enhance your self-esteem but it won't give you a totally different look nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Rohrich.

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What should I expect from my consultation?

During your consultation, Dr. Rohrich will carefully examine your skin to determine which resurfacing technique, or combination of treatments, will provide you with the best result. Your skin type, the severity of any sun damage, the extent of uneven pigmentation and the depth of skin imperfections will be evaluated. Fine lines, coarse wrinkling or deep acne scarring may require different combinations of treatments including fat grafts and/or scar revisions. After your consultation a photographer will take photographs for your medical record and you will meet with Dr. Rohrich's patient coordinator to discuss surgery fees and scheduling dates. You may also schedule an additional consultation to view computer imaging so that you can visualize the results of the surgery.

Dr. Rohrich will review your medical history and check for conditions that may cause problems during or after the procedure such as medical conditions, drug allergies, previous surgeries, and medications that you currently take. Be sure to tell Dr. Rohrich if you have ever had x-ray treatments of your facial skin such as those used in the treatment of acne or if you have had a prior chemical peeling procedure. Current or past use of Accutane™, as well as Retin-A™ and other topical skin preparations, must also be reported.

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How is the surgery performed?

Prior to any laser resurfacing, Dr. Rohrich will recommend that you see his aesthetician for a complimentary skin care analysis and to begin a skin care regimen before surgery. This will help prepare the skin for laser resurfacing. Dr. Rohrich will place you on a skin pretreatment program during which you will apply special products to your skin for a few weeks or longer. You may also be given certain oral medications that you should begin taking prior to your treatment.

The most recent development in skin resurfacing is the Erbium dual mode laser. This unique laser developed by Sciton allows Dr. Rohrich to set the laser controls specific to his patient's skin type, texture and degree of skin damage. The laser removes skin layers by ablation rather than by thermal. The advantage of this new laser is that it is more precise and has less side effects such as hypopigmentation. There are many new lasers available for treatment of hair reduction, skin rejuvenation and spider veins. To learn more about these lasers as well as other non-ablative ones, visit the "Laser Skin Care Section" on this site.

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What happens the day of surgery?

Depending on the type of laser used and depth of treatment, your laser resurfacing will be performed at either one of our specialty hospitals or an accredited outpatient surgery facility.

Prior to the procedure, medications are administered for your comfort and to lessen the anxiety if need be. General anesthesia is used for patients undergoing laser resurfacing. The surgery usually takes 1 hour depending on the technique used and if you have any other procedures such as facelift or eyelid surgery. After surgery, you will awake in a recovery area where you will be closely monitored.

Be sure to arrange for someone to drive you home and stay with you to assist you the first couple of days while at home. The "Patient Care" section on this site will give instructions to prepare for surgery, including guidelines on eating, medications to avoid, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery.

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What is the recovery like?

The amount of time you can allow for recovery also may be an important factor in selecting a particular resurfacing method or determining the extent of treatment. A more superficial treatment will require less healing time, but you may need to have the procedure repeated more than once to achieve the same results as a deeper treatment.

The Erbium laser skin resurfacing will produce redness and swelling to varying degrees. You must avoid doing anything that might interrupt the healing process. Dr. Rohrich uses a dressing called Flexan to cover the exposed areas and protects your skin after surgery. The dressing is worn for up to 4 days. About 7 to 10 days after your skin resurfacing procedure, new skin will have begun to form. After the initial redness subsides, your skin may be pink for several weeks to months. Camouflage makeup can be used within a couple of weeks, but Dr. Rohrich will advise you on this. He will also place you on an individual skin care program for you to maintain after surgery.

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What should I know about my results?

Following all resurfacing treatments, it is important that you avoid direct or indirect exposure to the sun until all the redness or pinkness of your skin has subsided. Even after that, it is advisable for you to protect your skin by regular use of a sun block and, whenever possible, a wide-brimmed hat.

Because of the persistence of skin pinkness following many types of resurfacing procedures, it may take months before you can fully appreciate your new look. Patients feel that the results are definitely worth waiting for and, in the case of deeper treatments, the benefits are relatively long-lasting.

Your skin will, of course, continue to age. Also the type of wrinkles caused by movement of your facial muscles will eventually reappear. Some wrinkles may recur sooner than others, depending on their location as well as the type and extent of your resurfacing treatment.

You can expect that improvements in skin quality and texture achieved by resurfacing will make your complexion appear younger and fresher for many years to come.

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What does the surgery cost?

At the time of your initial consultation, you will be quoted a price that will include Dr. Rohrich's fee as well as hospital and anesthesia fees. Fees are due in full at least two weeks prior to your procedure if performed in the hospital. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for your surgery.

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