As the above figure shows, fractional laser therapy delivers a “grid” of energy pulses to the skin area being treated. These barely visible energy beams penetrate the epidermis, and pierce into the dermis at a depth decided upon by Dr. Durkin. This treatment catalyzes your own skin to produce new, vibrant collagen that bubbles up to the surface, and your skin auto-rejuvenates over the course of days to months as fresh collagen covers your entire skin surface.
So does this mean that fractional is better than full field ablative laser? The answer is yes and no. As with anything there are pros and cons to any type of laser procedure undertaken, and the comparison between full field and fractional laser therapy is no different. The primary benefit of fractionated laser therapy is that it allows Dr. Durkin to directly modulate your downtime while still producing a good skin result. Because the fractional platform at Ocean Drive Plastic Surgery allows Dr. Durkin to direct the percentage of skin treated per pass (5.5% to 30%), and directly control the depth of penetration to within 25 microns, we can effectively predict downtime following laser therapy. As well, our laser allows us to separately deliver coagulative energy and ablative energy, meaning that we can tailor the laser effect to an individual’s skin type.
Because of the ability to tailor the laser therapy to each individual patient, laser patients at Ocean Drive Plastic Surgery are given the option on how long they can afford to be away from work, travel, vacation, etc. This gives an incredible sense of safety and comfort to our laser clients, as they know that their overall life schedule will not be proverbially “thrown out of whack” because of their investment in their appearance. Downtime following fractional laser therapy can be tailored between 2 days to 12 days, depending on how much result you want from your initial treatment, and how much time you can spend on recovery. Most patients who opt for fractional laser therapy have very busy social or work schedule, and only have a few days or a weekend to recover.
The other major advantage of fractional laser therapy is that the chances of hyperpigmentation and hypopigmentation are markedly reduced as compared to full field ablative laser. This allows fractional laser to be used in women with olive, and deeper toned skin, making this procedure as popular amongst Asian, Hispanic, and Indian men and women as it is with Caucasian patients. This laser platform has been used safely in Fitzpatrick skin types I-IV without scarring or pigmentation changes. Comparatively, full field ablative lasers very commonly produce pigmentation changes when used on patients who have deeper skin tones.
The last, and without question, the most important benefit of fractionated laser therapy is its ability to induce the formation of new, healthy, type I collagen in the epidermis and dermis. Use of laser therapy is a direct investment in your skin quality. Patients will immediately see and feel a tightening of their skin, a reduction in pore size, and an improvement of texture throughout their face. Skin will feel softer, and look younger within days of treatment. However, the benefits of this therapy are far longer lasting than just the initial outcome. Over the course of months, the dermis will continue to produce new, healthy, organized collagen, leading to a marked reduction in the appearance of aging. As such, the best results that we see with fractionated laser are in those patients who undertake a series of these treatments, rather than those who only receive one session. By spacing out treatments over months to years, patients can maintain a youthful skin quality as they age.
With fractional laser, your result per treatment is directly proportionate to how much downtime you can afford. Full field ablative laser patients tend to undertake one treatment every 10-15 years, while many fractional patients receive ongoing treatment annually to maintain their skin quality. As comparison, a series of three fractional laser treatments traditionally produces around 70-75% of a full field ablative laser result with downtime after therapy decided upon by the patient’s schedule over time. Conversely, full field ablative laser treatments are best for patients who are willing to accept a “twilight” anesthetic, and want one treatment that will last years but require 1-2 weeks of downtime. Fractional laser treatments, on the other hand, are best suited for patients who want to incrementally improve and maintain their appearance without significant downtime, but are more amenable to ongoing therapy.