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Laser Center
Magnolia Plastic Surgery Center is a multi laser facility. This facility is one of the few multi equipped centers in the Inland Empire.
- Laser Hair Removal
- Laser Resurfacing
- Spider Vein Treatment
- Leg Vein Treatment
- Tattoo Removal
- Laser Equipment
Laser Hair Removal
What is the Candela GentleLase? Laser has been used for many years for a variety of medical procedures. The GentleLase, which is a revolutionary long-pulse high-energy alexandrile laser system, emits a gentle beam of light passing through the skin to the hair follicle where it is absorbed. The energy is transformed to heat disabling the follicle without damaging surrounding tissue. A cooling process that sprays cryogen onto the skin, cooling the top layer also protects the skin.
What areas can be treated?
The GentleLase can remove hair from any area of the body. Most popular are the legs, bikini, face and underarms, but all areas can be done including the chest and back. Facial and bikini areas are usually completed in 10 to 20 minutes while other areas can take up to one hour. The laser is not completely permanent but is extremely effective in removing unwanted hair for long periods of time.
What does the treatment include?
First you will have a consultation, at that time a brief medical history is obtained and three test spots are done on the area in question. These will be done at different energy settings to see your skins reaction. Any questions can be answered at this time. You will then go home to observe the test areas for any adverse reactions for a couple days, after which if no reaction is noted, the treatment may be done.
Treatments are done every six weeks because the hair grows in cycles. You must avoid any sun exposure, waxing, plucking or electrolysis for 6 weeks before and after your treatment. Shaving is permissible. At your treatment eyewear will be provided and a small handpiece is selected. After the settings have been selected the treatment will begin. Some patients do experience mild discomfort, topical anesthetic may be applied. After the treatment is completed, the area may become pink or red and have mild swelling this can last from a few hours to a couple of days.
Who is the best Candidate?
The best candidate for this procedure is someone with light skin and dark hair because the laser is attracted to dark areas, the lighter your skin the more effective the treatment. Unfortunately if you are tan, or dark skin. You are not a candidate because your skin will absorb all the energy from the laser burn leaving your skin hyper pigmented.
How may treatments will I need?
Because your hair grows in cycles you will most likely need more than 1, maybe several. Everyone is different and it will depend on your skin, hair coloring and coarseness of your hair. The process is only effective on hairs during the growing cycle so repeat sessions will be needed to treat follicles as they enter the growth phase.
Laser Resurfacing
SKIN RESURFACING WITH THE DERMA-K LASER
Definition of skin resurfacing: Skin resurfacing is a term used as opposed to re-contouring and re- draping. Re-contouring means changing the contour of the tissue underneath the skin, Re- draping is tightening of the sagging skin with a face-left. Skin resurfacing amounts to making wrinkles less visible and improving the texture of the skin. Ten years ago the only tools to resurface the skin were chemical peels and dermabrasion. These two modalities work pretty well. However, a chemical peel can be either too superficial or too deep, because the depth of the burn inflicted to the skin cannot be controlled well. The result of the deep chemical peel was fraught with complications and a long recovery period. Dermabrasion has its merit, too, but again the depth cannot be controlled that well, cannot do certain areas on the face and the recovery period is also long.
Within the past 10 years, the CO2 laser has become useful. With technological advances it became the most popular tool for skin resurfacing. In spite of its improvements there were some adverse effects resulting from the thermal injury to the surrounding tissue inherent to the CO2 laser. That thermal injury was a source of complications as well as of a prolonged recovery. The main advantage the CO2 laser has over a chemical peel and dermabrasion is that we can control the depth of the skin ablation better, That's why we were waiting for a newer, more advanced laser that would cause less thermal injury, i.e. less complications with a more rapid recovery. In 1996, a newer more technologically advanced laser emerged: The Derma-K laser. The Derma-K laser delivers a combination of CO2 and Erbium wavelengths resulting in less thermal injury to the surrounding tissue as compared to the straight CO2 laser. This gives us a larger safety margin with accurate control of the treatment delivered to the skin. Therefore, the Derma-K laser provides more safety and a faster recov3ry than the CO2 laser.
For the same re4ason, a second treatment can be done earlier with the Derma-K laser than we could with the CO2 laser. The treatment with the Derma-K laser can be repeated at 3 months as opposed to 6 months with the CO2 laser.
During the laser treatment, the surgeon carefully passes an activated laser beam back and forth over the skin until the safest level is reached. Deep wrinkles and acne scars require more than one laser treatment to achieve the best results. Also, as your face continues to age after a laser treatment, you may repeat the treatment to maintain a more youthful appearance.
The factors that will influence the result, like with the CO2 laser, are technology dependent, technique dependent, skin dependent and patient dependent. Indeed, the patient like with the chemical peel and dermabrasion will have to be compliant and follow instructions in order to avoid complications and maximize the results.
The way to enhance the result of the laser resurfacing is as follows:
- At least 2 to 3 weeks of skin pre-conditioning with a laser prep cream is required prior to treatment.
There are 3 stages you will need to go through:
- Pre-conditioning of the skin before laser treatment, - This pre-conditioning will help obtain better and faster results from the laser treatment. It consists of applying special creams containing Retin-A, hydroquinone and kojic acid. It will be given to you and explained during your pre-operative visit.
- Laser treatment. Performed in the operating room, under general anesthesia to avoid any pain during the treatment. It takes about an hour. Afterwards, Vaseline will be applied.
- Post-laser treatment. - The acute phase of healing usually takes 10-14 days. During this time you will be applying Vaseline on the treated area several times a day to keep moist. Usually at about 10 days post-op make-up can be applied to camouflage the redness pf the skin that lasts about two months. Absolutely NO SUN EXPOSURE. You must wear a total sunblock and hat for at least 6 months after the laser treatment.
It may sound like a long process, but it is worthwhile. Another advantage the Derma-K laser has over the CO2 laser is the cost for treatments. The cost of treatments with the CO2 laser is more expensive than with the Derma-K laser due to the extended post-operative follow-up care with more risks for the patient and the surgeon that is inherent to that type of laser. At first, it was believed that the CO2 laser triggers more skin tightening, but further studies showed that the Derma-K (Erbium/CO2) laser does the same.
In conclusion, skin resurfacing with the Derma-K laser has definitely lowered the risks as compared to the CO2 laser with this advanced technology, complications have become very rare and are usually related to over-treating.
SUMMARY: CO2 laser vs. Derma-K laser
The Derma-K laser provides a more precise beam of laser energy for more control of the laser treatment, meaning less risks and a shorter recovery than the straight CO2 laser. I cannot over-emphasize the fact that it is far better treating a patient for 3-4 months without problems than spending 6 months or longer treating a patient with a complication resulting from technology that is less advanced than the Derma-K laser.
The skin is our bodies' largest organ. It protects us from infection and shields us from harmful substances. However, as we age, the effects of wind, time, and hormones begin to show. At first, fine lines appear, after which, as the collagen beneath our skin wears out, deeper wrinkles appear. Surface irregularities may also occur, such as pigment discoloration and acne scarring.
The Derma-K state of the art laser combines erbium and CO2. This laser is used for treatment of aging and sun-damaged skin. The Derma-K laser provides a safe, accurate, and less painful method of restoring softer, smoother, more youthful-appearing skin. This laser is designed to remove superficial and moderately deep lines and wrinkles on the face. It produces less heating or burning of the surrounding tissues than many other lasers used for resurfacing, allowing Dr. Carli to remove the damaged skin cells layer by layer. The procedure is done under general anesthesia and takes about 1 hour. After surgery the skin is red, and swelling is normal. Normally patients can return to most normal activities in about 2 weeks with make-up on to camouflage the redness that can last for over 3 months.
Sun block must be applied if you will ever be in the sun, and makeup can be worn after the first week or 2. Over the next few weeks, your fresh, new, pink skin will fade to a normal tone revealing a softer, smoother, younger look.
Spider Vein Treatment
Spider veins, those small clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles, but can also appear on the face, bother thousands of women. Today, many plastic surgeons are treating this condition with sclerotherapy, or a combination of sclerotherapy and laser treatments.
What are Spider Veins?
Spider veins, also known as telangiectasias are small, thin veins lying close to the surface of the skin. Although these veins are part of a larger venous system they are not essential. A number of factors can contribute to the development of spider veins including, but not limited to, heredity, pregnancy, weight gain, hormonal shifts and prolonged standing or sitting.
What is Sclerotherapy?
Sclerotherapy can enhance your appearance, but it is unrealistic to believe that every affected vein will disappear completely. After each session the veins will be lighter but it will not happen with only one session. The sessions are about 15 to 45 minutes long, depending on whether Dr. Carli is using only the infection therapy or a combination of injection and laser. The procedure is not extremely painful, but mildly uncomfortable.
Sclerotherapy will be used for the darker more purple veins. With one hand Dr. Carli will stretch the skin and identify the vein, then using a small needle he will inject the sclerosing agent into the affected vein. Once the procedure is completed you will need to wear support stockings on your legs for 3 days, day and night and the area must be out of the sun for a minimum of 3 months.
What is laser vein therapy?
Laser treatment is commonly used in conjunction with Sclerotherapy for the veins on the legs. Laser therapy treats the smaller red veins that may appear on the legs as well as the face. The advancement in laser treatments allows us to deliver a precise dosage of energy to each vein. During the treatment, after eye protection is provided, light energy is delivered through a special handpiece targeted at each vein in a series of brief pulses. The blood vessel but not the surrounding tissue absorbs the energy. It is this heat absorption that causes the coagulation of the blood vessel, which is then absorbed by your body.
How do I know if I need both treatments?
During your consultation with Dr. Carli, your veins will be identified and a treatment plan will be decided. For the leg area, most people have many small, red, "spider veins" and a few larger, darker, purple veins; these conditions will need a combination treatment. For the facial area, normally that is only done with the laser therapy.
How many treatments will I need?
The majority of the vessels may be gone in 1 to 3 treatments, but it is not certain that is all it will take. These treatments will only treat existing veins, not the ones that may appear later on. Therefore, for maximum long-term resolution, additional treatments may be necessary. The treatments are done in 6-week intervals, during which the area must remain out of the sun. Most patients are pleased with the difference sclerotherapy and or laser therapy makes. Many times the area will appear younger, clearer and healthier looking.
Leg Vein Treatment
There are millions of men and women that develop unsightly spider veins each year. These veins are recognizable as those small, red, blue or purple blood vessels that appear on people's faces and legs. Leg vein therapy can help make these unsightly veins disappear from patient's bodies. How the process works is light energy is delivered through a special handpiece with filters to the targeted vein. This is done through a series of short and/or long pulses. The energy is absorbed by the blood vessels and causes a thermocoagulation (clogging) within, and the vein closes down. The advancements in this treatment have allowed the doctors to give the right amount of dosage in the skin with minimal amount of risk. Thus the procedure is safe and effective, giving the patient's legs a better appearance.
The actual procedure for leg vein treatment is only a short while, however the final results may not appear for several months. Since the procedure is non-surgical, most patients can return to their normal daily routine immediately after undergoing leg vein treatment. However it is strongly recommended that the patient refrain from vigorous activities within the first 24 hours after treatment. In fact avoiding strenuous exercise, hot baths, and the short-term use of compression stockings are the keys to success with leg vein therapy. You may even be asked to wear special support hose to help keep pressure on the veins to keep them closed.
Now the word the "treatments" is being used because to achieve optimum results, more leg vein treatments are necessary. One or two treatments can show a great improvement in the patient's legs and additional ones can provide long-term results. However the possibility of more treatments may be necessary. This is due to the fact that new veins may occur. After the right amount of treatment patients can simply stop worrying about unsightly spider veins and painful varicose veins.
Tattoo Removal
At one time, maybe in your youth it was "cool" to have a tattoo, now maybe for one reason or another you no longer want it. The Ruby laser is used for tattoo removal and can be effective in removing many tattoo. After an initial consultation with Dr. Carli, your procedure would be scheduled.
How is the procedure done?
The procedure is done in Dr. Carli's office by his registered nurses. It can take anywhere from ten minutes to one hour depending on the size of the tattoo. Eyewear is provided and energy levels are selected. Once this is done the Ruby laser emits a small light that is traced over your tattoo using a handpiece. The procedure is mildly uncomfortable but no more so than the process of having your tattoo placed. Once the treatment is completed, antibiotic ointment and a small dressing is applied. A follow up appointment is provided as well. Your wound will appear red, bruised and scabby for several days and may look worse before it gets better, do not be alarmed, this is normal.
How many Treatments will I need?
The number of treatments will depend on the size of the tattoo, the color of ink used, and how deep the ink is in your skin. Black and green respond well, colored tattoo will need to be treated with two separate laser systems. The tattoo will not be removed with only on e treatment, it will take several.
What will my skin look like after the treatments are finished?
Your skin where the tattoo used to be may or may not look the same as the rest of your skin, pigmentation changes can occur as well as scarring. You need to be aware of this before the treatment begins.
Other General information
The treatments are done six weeks apart and during that time the area must stay out of the sun. You will apply some vaseline or antibiotic ointment to the area after the treatment as it heals but no other treatment is needed at home. No down time is needed, you can return to work and normal activities immediately following the procedure.
Laser Equipment
Laser systems have grown and advanced in recent years. Lasers can be used to treat a variety of problems or conditions. At the Magnolia Surgery Center, Dr. Carli has four separate lasers that we use to treat different conditions.
The Argon laser is used to treat spider veins to the legs and face. Using a small handpiece, the small beam of light is traced over the spider vein, the heat is absorbed by the vein which is destroyed without doing any damage to the surrounding skin. This treatment can be done on most any skin types. Often more than one treatment will be needed.
The Ruby laser is used for two separate conditions. The first is for brown spots on the skin, whether it is arms, legs or face. The areas are often pretreated with a laser cream if the spots are particularly dark. A handpiece and distance gauge is selected, and the treatment is fairly quick and there is no down time.
In addition to the brown spots, the Ruby laser is also used for tattoo removals. In much the same way as brown spots are removed, tattoos are also removed. The removal of the tattoo will not take only one treatment, often it takes several treatments, after which your skin may have slight pigment changes or a scar.
The Candela Gentle Lase laser system is used for hair removal. Although it is not completely permanent, we do see significant long-term hair removal with the laser. A small handpiece and distance gauge is used and can be done anywhere on the body.
This laser is only designed for people with light skin, dark skin will absorb the heat of the laser making the treatment ineffective and possibly damaging the skin. The laser targets the hair follicle where the heat is absorbed inhibiting hair growth. Several treatments may be needed to achieve your desired goals.
Finally, the Erbium Laser is used for facial resurfacing where chemical peers stop, this laser starts. It goes much deeper than any chemical peel, and is and is done usually under general anesthesia. Unlike the other lasers, there is some down time needed, as you will be significantly red and swollen for about one week, the redness will likely stay for up to three months, but after 10 days, makeup can be worn.
All these lasers are state of the art and are designed with built in safety checks. An initial consultation is needed with Dr. Carli before any treatment.
Dr. Carli performs the laser resurfacing using the Erbium laser and his Registered Nurses perform all other treatments. Safety eyewear and specific settings and guidelines are always initiated before any treatment begins. These treatments are all technology dependent, not technician depended, meaning that your results will depend on the technology of the laser system, not the technician performing it. For more detailed information on each specific laser system or treatment please see the web pages designed outlining the treatment in a detailed setting.
