Fraxel

Complimentary Consultation

At glow Medi Spa, we have had extensive experience and success with the FRAXEL re:store^TM Dual Laser System.   We are able to address your concerns with great effectiveness and minimal downtime.  Whether you require the deep penetrating 1550 nm or the more superficial 1927 nm, our treatments have achieved fabulous results with acne scars, photodamage, surgical scars, deep lines, melasma, wrinkles and any textured skin.

What is Fraxel Laser Treatments?

Fraxel is a non-ablative skin resurfacing laser which was introduced in Canada in 2006 (and four years prior in the United States).  The Fraxel is a safe and effective treatment that gives predictable results. Results are seen immediately and are cumulative and progressive with each treatment. Not only does it help aging skin, it also helps damaged skin. Here are some of the FDA approved uses of Fraxel:

• Skin resurfacing (to improve texture)
• Pigmented lesions: age spots / brown spots / sun spots
• Wrinkles around the eyes
• Acne scars and Surgical scars
• Melasma (irregular patches of brown skin on the forehead, cheeks, upper lip or nose)
• Actinic Keratoses

"What are typical results?"

• Smoother, fresher, younger looking skin
• Improved tone and texture
• Erasing of unwanted brown spots
• Reducing fine lines and wrinkles around the eyes
• Improved appearance of acne scars and surgical scars

Before Fraxel for Acne Scars                         After 3 Fraxel treatments

Before Fraxel for aging/sun-damaged skin                        After 3 Fraxel treatments on Chest

" How does it work?"

Fraxel Treatments are able to precisely treat thousands of microscopic areas of skin, using pinpoint laser beams that penetrate beneath the skin's surface to eliminate old, damaged skin cells.  The treatments stimulates the body's own natural healing process which replaces damaged skin with fresh, glowing, healthy skin.   By design, Fraxel treatments can target between approximately 5 - 50 percent of the skin's surface, leaving the remaining 50 - 95 percent available to quickly heal the treated areas.   A series of treatments (3-6) are recommended every 4-6 weeks for the best results.   Progressive results occur over the next 3 to 6 months as the deeper layers of the skin continue to heal. 

"What is the difference between traditional laser resurfacing (CO2 or erbium lasers) and Fraxel?"

There are two types of lasers available for "resurfacing" the skin. Resurfacing is like generating new skin, or turning back the clock, improving the texture, making it softer, smoother, and less wrinkled. 

The "traditional" technique uses ablative lasers. Ablative lasers (such as CO2 or Erbium lasers) take off the entire top layer of your skin, including the stratum corneum, the epidermis, and part of the dermis. It leaves a very red, raw face for a couple of weeks until your new skin grows back. Complex after-care is required. The ablative treatment requires about two weeks off, plus there are side effects like oozing and crusting. Other possible side-effects of ablative lasers include hypo-pigmentation (an abnormal lightening of the treated skin or lines of demarcation), scarring and a plastic-like sheen to the skin which may not look natural and can be permanent. You are at risk of infection since the underlying tissue is exposed so you would need to be on antibiotics by mouth. You also need to have a general anesthetic (be "put to sleep") so there are risks involved with that too. Although the end results are usually good, many people are not willing to go through this ablative procedure due to the side-effects and potential complications.

Fraxel Laser Treatment is the new way of getting similar results but it is a non-ablative laser. The epidermis and part of the dermis are treated though so results are comparable to ablative lasers. Although it does reach deep under the skin (250-1200 microns), it affects only a small fraction of the skin at a time without breaking the skin’s protective outer barrier. The stratum corneum remains intact. This means that there are very few side effects and risks and very little down-time. There is no oozing, crusting, bleeding or risk of significant infection. There is mild to moderate redness and swelling which may last 2-3 days.

About 15-20% of the total skin area is treated each time with microscopic laser spots evenly spaced apart. In between these treated spots is healthy skin that then repairs the tiny "MicroThermal Zones, or MTZs". The collagen then gets stimulated during the repair process and that’s how you see the improvements. The down-side to this fractional treatment compared to ablative lasers is that you will need multiple treatments instead of just one. We recommend three to six treatments, each about a month apart.

"How can it treat so many skin concerns?"

We adjust the settings to target the depth of the treatments. For instance, acne scars are very deep so we would adjust the settings to go deeper for acne scars compared to treatments for sun spots or melasma which is more superficial. Deep lines and wrinkles are treated at an intermediate depth. The treatment process and mild side-effects are the same for all treatment depths.

"Does it work for melasma?"

Melasma is often associated with hormonal changes such as with pregnancy, so it is often called the "mask of pregnancy". Melasma may resolve spontaneously after pregnancy but usually does so in the first six to 12 months. Melasma is often difficult to treat as it is a deep pigmentation (can go through the epidermis and into the dermis). Surface treatments for pigmentation such as IPL (Intense Pulse Light, or photorejuvenation) are often ineffective for melasma since they do not treat into the dermis. Sun spots are easier to treat with IPL since sun spots are in the epidermal layer and more superficial than melasma. Melasma can also recur despite treatment and it is important to identify and alleviate triggers and practice complete sun protection.

Fraxel Laser Treatment is one of the few treatments available to treat melasma. It is effective in treating melasma, however, melasma is more unpredictable in its recurrence. With future hormonal changes or significant sun exposure, there is a chance it may come back.

"Does it work for acne scars?"

There are very few treatments that are effective in treating acne scars because they are very deep scars generally. Traditionally, the options included surgery to cut the scar tissue, or ablative lasers. Both procedures involve significant down-time and possible side-effects.

Fraxel is extremely effective for acne scars. Fraxel is a deep laser treatment that can target the deep acne scars, even pitted scars. Fraxel can treat as deep as 1200 microns which usually will reach the depth of the scar. The depth of the laser beam is adjusted by the clinician and physician according to the depth of the acne scar. It repairs the scars from the bottom up, and improvement is seen with each treatment. We have experienced tremendous success with treatment of acne scars in all age groups and skin tones. Despite the age of the scar, we still achieve excellent results. Clients who have had previous treatments in the past with ablative lasers have noted how much easier, comfortable, and effective the Fraxel Laser Treatment is in comparison to the erbium or CO2 laser treatments.

It is important that any active acne is resolved prior to initiating Fraxel Laser Treatments. Many options for acne treatment are available and a consultation will determine the most appropriate treatment for you. Fraxel will reduce the scars permanently but if active acne is still persisting, new acne scars can occur.

"I’m scared. Will it hurt?"

It is normal to feel nervous and scared when doing any procedure. That’s why we take the time to inform you about the procedure in a consultation before the procedure so that you know what to expect and feel comfortable with every step.

We put a strong prescription numbing cream on you for an hour before the procedure and it works really well. You don’t need to be put to sleep and you don’t need to take any narcotic or sedative pills such as Percoset, Tylenol #3 or Ativan. A couple of regular Tylenols before the procedure is fine if you prefer. 

We have a cooling unit that you hold, which blows cold air on the area being treated during the treatment. That makes it feel very comfortable and gives you a sense of control as well. Afterwards most people say it feels a bit like a sun-burn, and that’s how it looks too. In general, most people do not have much discomfort. When rating on a pain scale of 0 (no pain) to 10 (worse pain), most people rate the majority of the treatment as 0 to 3, then in the final few minutes, it may go up to 4-6. It gets a bit tingly towards the end of the treatment but by the time you notice it, it’s done.

"What will I look like immediately afterwards? Do I need to tell my family? Do I need to take time off work?"

I don’t promote this as a "lunch-time" procedure. Although the treatment itself only takes about 30-60 minutes, I wouldn’t expect that you would want to go back to work that day, although some may choose to go back to work the next day. There is some redness and swelling involved that usually lasts two to three days and you can plan accordingly. 

Redness is present that day and the next but is able to be covered up nicely with make-up. We do a complimentary make-up application after each treatment. Swelling is more variable and a lot depends on your skin and how it reacts. You can reduce this edema (swelling) by sleeping upright for that first night. It’s not that you look awful or anyone on the street would notice. But those that know you well, like your family members, will probably notice so best to be honest there

Many of our clients like to do Fraxel on a Friday ("Fraxel Fridays"), so they take the weekend off and then are back to work on Monday. By that time, the swelling is usually gone and the redness is much less. There may be a bit of bronzing for the next week as the skin extrudes the treated debris. It just looks like you have a bronze tan, pretty even in colour so that’s not usually a concern. For the next week, the skin will be a bit flaky as the exfoliation process happens but moisturizers help that.

Overall, I would say most people handle the treatments very well when they know what to expect.

"What results can I expect?"

The nice thing about Fraxel is that everyone gets improvement and there is improvement with each treatment. With each treatment there is about 15-20% improvement. You do get the best results with more treatments. We typically are able to increase the strength of the treatment each time. I recommend three to six treatments depending on the severity of the condition being treated and the skin type. Most clients are very pleased with the results and it meets their expectations.

"How long do the effects last?"

The effects are permanent. However, if the treatments are done for aging skin, consider that you will continue to age so you may want to be on a maintenance programme. Some clients will choose to do the series of three to six initially, one treatment a month. After that, they may do a single treatment (not the series of six again) every six to twelve months.

 If the treatments are done for acne scarring, it is important to prevent any ongoing acne to prevent any new scars. Recurrence will depend on new acne scars.

Melasma can be hormonally-influenced so recurrence is more unpredictable, especially if there are ongoing triggers or sun exposure.

"What are the possible side effects?"

There are no significant or long-lasting adverse effects. Short-term there are some predictable effects that occur. Redness and swelling is present for 2-3 days usually, like a sun-burn. Bronzing also is normal for one to two weeks after. Bronzing results from the extrusion of Micro-Epithelial Necrotic Debris (MENDs), ie. The body gets rid of the treated tissue by pushing it outward to the surface of the skin. Some dryness and flakiness then follows for the next week due to the exfoliation.

Blisters can occur and are usually very tiny and not noticeable and resolve in 1-2 days. If they get infected, they can scar so it is important not to pick at them, keep them clean and dry and apply polysporin cream three times a day until they resolve. 

Unlike traditional resurfacing techniques such as CO2 or Erbium lasers, there is no oozing, bleeding, scabbing, or risk of serious infection with Fraxel. The skin will look normal, without an unnatural-looking sheen. There is no risk of hypopigmentation (light spots). There is a risk of hyperpigmentation (dark spots) in darker skin tones and so a lightening cream may be suggested before and/or after the treatments in clients with darker skin tones (ie. In Asian skin or darker).

There is a slight risk associated with the prescription numbing cream that we use for the treatment if someone is allergic or sensitive to the cream. We make sure you have no contra-indications to the procedure or the cream with a thorough medical history prior to the treatment. Remember, you are not under general anaesthetic (you don’t need to be "put to sleep") so you do not have those risks at all.

"My hands give away my age." "My neck and chest look leathery." "What areas of my body can be treated?"

Unlike older resurfacing ablative lasers, Fraxel Laser can also be used on other body areas other than the face. The most common areas are the face, neck, chest, hands, and arms.

"How does Fraxel Laser Treatment differ from IPL (Intense Pulse Light) or Photorejuvenation?"

IPL (Intense Pulse Light) or photorejuvenation is a light treatment (not a laser) that treats the superficial skin. It is a "lunch-time" procedure that involves no down-time. IPL treats brown spots, superficial redness of the skin, and stimulates the collagen too. Fraxel is a laser that treats deep into the tissues. It also treats superficial brown spots so you can have those benefits too. It is not designed to treat redness of the skin (although it may). It stimulates collagen too but to a much greater degree than IPL. Therefore, deep lines and wrinkles and pores are also improved with Fraxel. I usually recommend Fraxel if texture of the skin is the main concern.

Fraxel and IPL are different treatments and we can help you in deciding which treatment is best for you. They are not mutually exclusive treatments. Many people who have had IPL treatments in the past are now getting the added benefit of the Fraxel Laser too.

"Will I still need my Botox treatments? What about my dermal fillers?"

A combination of treatments can provide the best results. There are additive effects and once again, we don’t consider the treatments mutually exclusive. Botox treats fine lines and wrinkles and helps prevent them from progressing by relaxing the muscles which may cause these lines (eg. Frown lines between the eyes).

Dermal fillers such as Juvederm plump up the tissues and can soften lines and folds/grooves. Sometimes the wrinkles or lines/grooves (rhytids) have gotten so deep that the underlying dermal layer is creased. Botox and dermal fillers may not be able to affect the appearance of these deep lines. However, Fraxel laser is a deep treatment that can significantly reduce the appearance of these deep lines as well as the superficial lines. Fraxel also reduces brown spots and pores and improves the overall texture of the skin.

We recommend a personal consultation to determine which treatments are best for you. We usually recommend continuation of Botox for maintenance and prevention of dynamic wrinkles and Juvederm as needed after the Fraxel treatment for plumping up the tissue.

"Who cannot have Fraxel Laser Treatments?"

The following conditions are not recommended with Fraxel Laser Treatments:

"What is the difference between Fraxel and other Fractionated Lasers?"

Fraxel is a Trade Name for this dedicated fractionated laser. It is not a revision of an existing erbium laser that splits an existing erbium laser beam. Each laser beam in Fraxel is precise and exactly the same. There are about a million microscopic laser treatment zones that are created when a complete face is treated. Each of the million beams is a column that is exactly the same in width, depth, and energy. This does not hold true in all other fractionated lasers.

Also, a scanning technique is used, not a stamping technique. What this means is that the laser glides over the skin, giving even and complete coverage to the entire skin. There are no "missed" spots like there is in stamping.

"How much does it cost?"

We have very competitive pricing for our Fraxel laser treatments.  Special student rates are also available. Complimentary consultations are available to discuss costs.

"What should I expect?"

BEFORE THE TREATMENT

DURING THE TREATMENT

AFTER THE TREATMENT

"Why should I have Fraxel done at glow Medi Spa?"

We have been doing Fraxel Laser Treatments for over three years (as long as this laser has been available in Canada).   We have extensive experience with the Fraxel re:store and were one of the pioneers in Toronto.  It is true that results are reproducible yet it takes a lot of experience to match the client to the appropriate treatment level since Fraxel is so versatile.  We believe in getting to know you first, and your expectations.  From there, we will take the time to educate you so that you are completely comfortable.

Dr. Diane Wong, who is the owner and medical director of glow Medi Spa, supervises all Fraxel treatments.  Patients can reach her at any time if there are any questions following their treatment.  We follow up with all patients the following day by phone and are available for follow up appointments at any time.

Our medical clinic is designed to provide you with the highest technology lasers in a spa-like environment.  You will meet with highly trained medical staff in a clean, professional setting that is also tranquil and calming.  You will be in a comfortable, private room at all times.  We use the most effective anesthetic cream available so there is minimal discomfort.  After the treatment, we offer a complimentary make up application after we apply sun screen.  We attend to all your needs efficiently, thoroughly, and with great care.

Evening and weekend appointments are available for your convenience.  Consultations are complimentary.

Click here to watch a video on our Fraxel treatment

Click here to listen to a podcast on laser resurfacing featuring Dr. Diane Wong

  
 Call us at (416) 920-9998 for a complimentary consultation.

Copyright 2006 Dr. Diane Wong. All rights reserved.