Richard O. Gregory, MD, is a plastic surgeon in private practice at the Institute of Aesthetic Surgery in Celebration, Fla. Gregory has served on the board of directors of the American Society for Lasers in Medicine and Surgery, including 12 years as its general secretary; the board of the American Society for Aesthetic Plastic Surgery; and committees of the American Society of Plastic Surgeons. He has lectured throughout the world and has performed pediatric surgery on missions to Brazil and Honduras. Gregory received his MD degree from Indiana University, Bloomington, and his surgical and plastic surgery training at Duke University in Durham, NC. He is a purchaser and user of the Fraxel® SR laser by Reliant Technologies Inc, and he spoke with PSP about his experience with this product.
How does Fraxel laser treatment fit into your plastic surgery practice?
The Fraxel laser fills a niche for those patients who want the benefits of ablative skin resurfacing—wrinkle reduction, skin tightening, textural improvement, and pigment removal—but who are not quite ready for the downtime that comes with treatment by carbon dioxide or Er:YAG lasers. The Fraxel laser gives my patients an alternative to ablative skin resurfacing and serves as an adjunct for my surgical patients who want improved texture, tone, and skin clarity to complement their surgical procedures.
Please give a brief technical description of fractional resurfacing.
Fractional resurfacing is unique in three ways: First, microscopic columns of thermal damage, called microthermal treatment zones (MTZs), approach depths of 1 mm with no superficial cooling and treat the epidermis and the dermis. Second, the Fraxel laser’s wavelength (1550 nm) targets water as its chromophore, preserving the stratum corneum, eliminating the risk of infection, and reducing downtime. Finally, each MTZ is surrounded by undamaged tissue, allowing wound healing to progress quickly; re-epitheliazation is complete within 24 hours. The laser’s patented scanning system allows the physician to adjust the amount of energy and total MTZ density for consistent, predictable dosage control.
What conditions does the Fraxel laser treat?
The Fraxel laser has received FDA clearances for skin resurfacing and treating acne scars, surgical scars, pigmented lesions, melasma, periorbital wrinkles, and brown spots. In my practice, the laser is useful for treating the thin, crepe-like skin that occurs on the neck and hands. After the treatment, patients experience collagen production for thicker and tighter skin.
Are there additional benefits of the Fraxel treatment?
A major benefit of the Fraxel laser is reduced pore size—the skin is tighter, fresher, and smoother. I also recently treated a patient with a nonvascular birthmark and expect a positive result.
Is the laser safe on all skin types and skin colors?
We treat all skin types in my practice, including Hispanic and Middle Eastern populations. It is important to manage patient expectations and stress proper skin protection after each treatment session.
How did you make the decision to purchase the Fraxel laser?
My philosophy is never to buy a device until I have tested it on myself. After my Fraxel treatment, I could see and feel the results. The texture of my skin was smoother and tighter, my pores were smaller, and my overall appearance looked refreshed. As a physician, I think it is important to understand a treatment from the patient’s perspective—physically and emotionally. PSP