Our perspective on skin tightening continues to evolve. In the past, standard carbon dioxide laser was utilized. While this gave remarkable results, the downtime was grueling at weeks to months and the procedure carried a high risk of complications such as infection/scarring/demarcation lines etc.
In 2006-7, fractional CO2 came about and this diminished the downtime to 4-5 days with an additional several weeks of prolonged redness (depending on how aggressive the settings used were).
Fast forward to today. How can we stimulate collagen with lower downtimes that are socially acceptable, while still applying ablative technology.
We decided to rewrite the protocol for ablative and did a series of patients with low level fractional CO2 and erbium. The results were very acceptable with peeling at 2 days. We recommend a series of 3 treatments for optimal results.
This is a patient who is status post 2 laser treatments with a nice change in texture and tightening to the skin.