Archive for June, 2009

Fractional vs Fraxel

At the Center for Facial Plastic Surgery and Laser Skin Care, I get alot of inquires about Fractional Laser Resurfacing and Fraxel skin treatments in particular.

It is important to understand the difference. Fractional Laser Resurfacing is a relatively new ground breaking concept in the field of laser skin resurfacing. Fractional means portional or partial skin resurfacing. By analogy it is the difference between let say mowing your lawn or aerating it with tinny little holes. Fractional resurfacing is the latter. Instead of peeling your skin surface all in one layer, fractional shows your skin with tinny little microbeams that result in small zones of skin turnover. This is good news, it means yes, less downtime, and less risk of complications like pigment changes and prolonged redness, but it also mean more treatments, because theoretically only a portion of the skin is resurfaced at any time.

Fraxel is a brand name, for the first fractional resurfacing device. Now, the fractional concept can be applied to different wavelength, erbium laser wavelengths which is the least aggressive and goes by the name of Fraxel-ReStore. CO2 a more aggressive resurfacing modality, goes by the name of Fraxel ReStore. At the Center for Facial Plastic Surgery & Laser Skin Care we are a comprehensive laser facility and own and operate a Fraxel ReStore laser as well as a CO2 fractional technology, different but conceptually similar to Fraxel RePair called SelectScan.

Select Scan has many versitle features that I prefer over Fraxel RePair. With this system I can control, dewll time, spot size and overlap. These are important paramteters that alow greater control over the treatment settings such that treatments can be individualize to each persons needs and preferences.

For more information visit us at the Center for Facial Plastic Surgery and Laser Skin Care in Albany NY>,

Laser Liposuction

Lipolase? What is it all about.

Well, let me tell you, lipolase or laser assisted liposuction is a big deal at the Center for Facial Plastic Surgery and Laser Skin Care. There are many versions of it out there like smart lipo, lipotherm, lipoform, but in principal they are all realy very much the same. The concept is to dissolve fat with a fine fiberoptic laser fiber. This fiber is inserted through a tinny tube or cannula which is then tunneled underneath the skin. Essentially, the laser enables the surgeon to accomplish more with less. It facilitates rapid in office procedures. We use smaller cannula than with conventional liposuction. But, it is not only about dissolving fat, it also is about shrinking or tightening skin. Tightening of the skin is accomplished through the controlled heating of the underlying dermis. This is great for small areas of the face , neck, and arms, as well as large areas of the body, in some instances eliminating the need for surgery. The recovery is rapid, and the results continue to improve gradually over a period of weeks to months.

Laser Skin Tightening

There is a lot of curiosity about laser based skin tightening treatments. Every manufacturer can come up with a couple of good photos, but across the board, both clinicians and patients have be dissatisfied with the inconsistencies. The goal of all of these treatments is to create uniform deep dermal and subdermal heating by selecting the appropriate wavelength (midinfrared spectrum) without injury to the epidermis.

It is difficult to do this consistently with laser and light based therapies. First, the skin has to be cooled and then, the heating element is activated. Titan by Cutera was the first of these devices. This was followed by Palomar IR and deep IR, which now sit on a shelf in my office gathering dust.

I have abandoned light based treatments in favor of radiofrequency skin tightening using a relatively simple device, called Radiage. Radiofrequency energy is naturally concentrated in the deep dermis and superficial subcutaneous layer. It is a relatively straight forward technique to heat the skin in this way which does not require elaborate cooling devices, and most people find comfortable if not pleasant.

I work small areas of the skin at a time, moving on when I see visible endpoints of immediate toning and mild transient redness. While some of the changes are immediate, there delayed effects are even more significant as a result of new collagen stimulation. There are many other more expensive devices on the market such as Thermage, although, in my opinon, they are not any more effective to justify the cost.

Better Botox

Botox anyone?

Well, I was recently at party and the host lightheartedly quipped: “Botox Anyone,” as she walled around with a tray of otherwise normal looking appetizers. We all had a good laugh, as it is kind of funny just how common place and well embraced Botox has become in our society. I have another client who refers to it as her “Serenity ins a Syringe”, which I think is just great. Why is it so popular, well because there are few legal substances that give as much immediate gratification as a little tweak here and a little tweak there, and off we are feel as if we won this round against Father time.

All kidding aside, Botox, or botulinum toxin, is a serious neruomuscular blocking agent, and at the Center for Facial Plastic Surgery and Laser Skin Care in Albany, Saratoga, and Kingston NY we treat it with the respect that is requires. For starters, I, Dr Falk, do all the Botox injections. Why, because I view injectables as a legitimate treatment in and of itself, no different from any others such as lasers or surgery. My patients, (and I use that word in earnest, not to be confused with the watered down term, client which may sound less threatening but is also in truth less accurate) appreciate physician directed and administered treatments. There are no cookie cutter solutions either. Botox is individually tailored. I believe in premarking, and we use dilutions that are appropriate for that specific subsite of the face.

The goal is to achieve natural looking results, not a mask like look. This is done through careful attention to detail including the location of injections and depth if infections. Patients walk out with minimal to no bruising and can return to their regular routines. We also encourage all patients to come in for follow up two weeks later for any minor touch ups. So look good and feel great, with physician directed aesthetic skin care.

Laser Hair Removal

I receive many questions about Laser Hair Removal. Not surprisingly, since laser hair removal is the most common laser procedure performed today. It is a highly effective treatment for removal of unwanted body hair. At the Center for Facial Plastic Surgery & Laser Skin Care located in Albany, Saratoga Springs and now Kingston, New York, we take laser hair removal very seriously.

Notice, that in descriptions for laser hair removal the word permanent never appears, or is often substituted for reduction. This is because there are very specific regulations concerning the use of the word permanent, which is limited to electrolysis. Nevertheless, laser hair removal is for all intents and purposes a permanent process, but, it does require multiple treatments. It is far more efficient than electrolysis.

I have a good chuckle when I see things on line or on the home shopping network claiming that a $150 hand held machine is somehow equivalent to a $100,000 laser at removing hair. The bottom line is that to make these devices safe for general public use, they have to be gentle enough not to cause injury which renders them not very effective.

Understanding just how the laser hair removal process works, helps illustrate who is the right candidate for this procedure and some of the limitations as well. The process requires the presence of the hair in the root of the hair or bulb. This is because the laser is not directly destroying the cells that generate new hair, but rather this is a byproduct of heating the actual hair shaft itself. Thus, it is the hair that is the target of the laser energy, and therefore, dark thick hair is naturally an easier target than light thin hairs. Another concern is competing pigment in the skin. The laser will heat up this pigment as well, which places people with greater natural skin color at greater risk for injury on account of these extra targets.

Not all lasers are the same and not all facilities ofter the appropriate spectrum of devices to treat hair most efficiently. Choosing the most appropriate laser wavelength reduces risks and maximizes results. Longer wavelengths (Nd-YAG 1064nm) are best suited for darker skin types, while shorter wavelengths ( 880nm, 755nm) are best for lighter skin types. As a comprehensive laser treatment facility, we at the Center for Facial Plastic Surgery, we can tailor our treatments to best fit each individual’s needs.

Arthur N.Falk, MD Facial Plastic Surgeon

Hello and welcome to the blog of Arthur N. Falk, MD. I am a board certified Facial Plastic Surgeon and Laser Specialist. It is my great pleasure to introduce this new interactive format for communicating with you about some of the latest activities and innovations at the Center for Facial Plastic Surgery and Laser Skin Care, located in Albany and Saratoga Springs, New York.

It is my desire to to use this format to provide answer common questions and discuss the latest trends in the field of facial aesthetics and laser skin care. We are bombarded with information from so many sources, and making sense of this information can be downright confusing. True to character, I think you will find my comments, honest, sincere and without unnecessary hype or extra spin.

Welcome to our blog

Welcome to our blog.