Different Lasers, Different Outcomes (Ep. 42)

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Dr. Hall: I want to talk a little bit about lasers and skin health, specifically, kind of how the different lasers work. Because there’s a lot of confusion out there. Laser is kind of one of these all-encompassing subjects that gets really confusing. And a lot of people that I see in the office come in and say, “You know, I’ve had lasers before and it didn’t work.”

And on investigation, you know, a lot of people don’t know what laser they had, which is super important. It’s important because different laser wavelengths do different things. So today, what I really want to do is kind of discuss what laser is and what lasers can actually do, and why some lasers don’t work and others do. I think first of all, it’s important to know what lasers actually are. So, what a laser is, is light, specifically a single wavelength of light. And that wavelength of light, depending on how long or short the wavelength is, will treat different things and does different things.

If you go back to the laser podcast, you know, I talked about the difference between ablative lasers and nonablative lasers. And that is a really important first distinction to make is, what type of laser that we’re using. Because the nonablative lasers essentially heat the skin and don’t do anything in terms of resurfacing. Nonablative lasers are really best used for either pigment—and those really technically aren’t lasers at all—but the other type of nonablative light treatment is laser skin tightening.

And when we say ‘laser skin tightening with nonablative lasers,’ you have to kind of put that in air quotes because it’s very subtle, it is not going to give you the kind of light facelift that a lot of people are looking for when they’re talking about laser skin tightening. So, you have to know that going into your treatment. Contrast that to ablative laser treatments. Ablative laser treatments not only heat the skin, but they cause injury to the skin, causes a thermal injury. So, a burn, essentially.

The depth of that can be very precisely controlled. We can adjust that to outcomes and downtime. When we’re talking about skin tightening with ablative laser treatments, which is the type of laser skin tightening that actually works, that shows demonstrable effects, what we’re talking about is fractionated ablative laser treatments. And what this is, if you kind of go back and listen to the primer in the first laser podcast, essentially the equivalent of aerating your lawn. That laser treatment, a fractional ablative laser treatment, what we do is, that laser beam goes down—there’s millions of teeny tiny little holes that get poked in your skin, and that causes an injury all the way through the epidermal layer of the skin into the dermis.

The dermis is what gives its skin its thickness, what gives the skin its elasticity, and really what keeps the skin—one of the two things—that keeps the skin looking young. A healthy dermis with lots of elastic fibers is going to make your skin look and feel youthful. With our fractionated laser treatments, there have been studies that have shown that fractionated ablative laser treatments quantifiably increase the amount of collagen and elastin fibers—and those are the two, kind of, elastic-y fibers that are in your dermis—it increases the amount of those two types of elastic soft tissue in your dermis. So, it physically makes your dermis more youthful. Nonablative laser treatments really don’t do that nearly as well, and so that’s why a lot of people who come and see me for skin tightening of one sort or another, whether it’s surgical or non-surgical, claim to have had laser treatments that didn’t work because they’re typically these nonablative, no-downtime laser treatments that are good for the 20-year-old who wants some prevention, the 30-year-old who doesn’t really have a lot of skin laxity to treat but were looking to maintain youthful skin, those are great patients for nonablative skin tightening. We use that a lot.

If you have a lot of sun damage, you’re in your 40s and above, the chances are nonablative treatments, if this is your first go around with any sort of skin treatment, a nonablative treatment is not really going to get you the results that you’re looking for. And that’s a reason that you need to go to somebody who, A, knows about the lasers, but then also has the surgical—or the ablative and nonablative laser treatments available so that you can kind of talk through what those different treatment options are and make sure that we’re tailoring a custom solution to your goals and to your skin.

That’s just a really broad overview of the laser skin tightening, which is always hot topic on social media and is one of these holy grail plastic surgery treatments of quick in-office procedure, relatively inexpensive, no downtime, but great results that rarely delivers what it promises. So, hope you guys have enjoyed this. If you have any questions, please feel free to shoot us an email, shoot me a DM on social, and we will see you in the next show.

Dr. Hall: Thanks for listening to The Trillium Show. You can keep up with the latest on the podcast at jhallmd.com. Be sure to follow us on Spotify, Apple Podcasts, or wherever you listen to podcasts. If you want to connect with us on social media, you can find us at @jhallmd on Instagram and Twitter and @DrHallPlasticSurgery on Facebook. Remember, be the change you wish to see in the world.