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Proud to bring you information via The Web since 1996

DONALD J. CAPUANO, M.D.
Plastic Surgeon


You are interested in information regarding laser skin resurfacing. This procedure involves the use of the CO2 laser using a SilkTouch/Scanner or a similar scanning laser to treat lines, wrinkles, and other skin problems.

Fine lines and wrinkles around the eyes and mouth can be smoothed. Deep laugh and frown creases can be softened. Some acne and surgical scars can be minimized, and some skin lesions can be removed by the use of the laser.

The surface of the skin can be "refreshed". The deeper layers are stimulated to form more plump and newer deep skin by stimulating a renewal of the skin's collagen.

Dr. Capuano will discuss the procedure with you. Your skin type plays an important role in your eventual result, and this will be discussed. You should inform the Doctor if you have a history of herpes (cold sores), healing problems, prior chemical peels or dermabrasions, sun sensitivity. Tell the Doctor what medications you presently take and especially if you have used Accutane for acne in the past year.

Your genetic background can be important. Individuals with American Indian, Asian or African ethnicity or heritage should note that the chances of increase scaring are greater. We don't know why but it is a fact.. If you have Native American Ancestry it is important to tell Dr. Capuano as you may be more susceptible to having persistent redness after laser treatment.

The procedure may be done in Dr. Capuano's office or on an outpatient basis. If done in the office, you will most probably be given prescriptions for medications to take and directions regarding when to take them before your treatment. Depending upon the medications prescribed and the extensiveness of the procedure, it may be advisable to have someone drive you to and from your appointment. The procedure itself takes from

30 minutes to 2 hours. In some cases local anesthesia is used.

You will be given instructions regarding wound care following the procedure. It is important to follow these instructions and call the office if you feel you are having a problem. You will be seen in the office in follow up.

The first few days after the procedure are the worst as far as the way you and your skin will look. There will be oozing from the outer layers. Crusts may occur. The use of ointments, creams, antibiotic ointments, will be recommended as your condition indicates. You will be seen during the first week as needed.

IMPORTANT - If you begin to develop little blisters - please call the office to be seen.

Do not pick off crusts that may form. Use saline soaks (salt-water compresses) to soften the crusts and allow the crusts to come off.

Healing usually occurs at different rates in the face. This depends on the depth of the treatment, quality of the skin, preoperative treatment programs, presence of infection, etc.

Some or most of the skin may be healed in about a week. Other spots may take more time, up to two weeks, rarely more.

After healing - that is when the skin is closed over and there are no more crusts or drainage - there will be redness. Usually this diminishes by the first month and the redness diminishes there after. In a few cases persistent redness may occur.

This is why one of the questions I ask a candidate for laser resurfacing is whether or not they ware makeup. Since there may be different areas of coloration, makeup may be very important! If the rare happing occurs that you have prolonged redness, various ointments may be needed. But in the mean time, make up can be very important. Even further laser treatments may be needed which can help the redness. Thankfully such conditions are rare.

Because women use make up on a routine basis in many instances, we have found that women are usually better candidates for laser skin re-surfacing.

Depending on the extensiveness of your situation and the results desired, more than one laser re-surfacing treatment may be indicated. This is especially true with deep lines. Dr. Capuano will discuss this with you.

If you have any questions, let us know.

The following is the consent form that is signed before laser resurfacing. You should understand it well before going ahead.

CONSENT FORM FOR SILKTOUCH LASER THERAPY

I have discussed in detail with the Doctor any questions I have regarding laser surgery. While the procedure is thought to be safe and severe complications have not occurred in Dr. Capuano's experience, I understand they could occur in my particular case. I understand:

- that possible problems and complications include tenderness, swelling, redness of areas treated, residual marks, bleeding, infection, thickened scars, delayed healing, and so forth.

- that there are potentially severe problems and complications involved with anesthesia and surgery, which, are extremely rare, but may occur.

- that the explanation I have received is not and cannot be exhaustive and that other, more remote risks could arise. I recognize that a more detailed explanation can be given to me at my request.

- that in some cases more than one procedure may be needed, and that Dr. Capuano has tried to explain to me the reasons for this.

- that no guarantees as to time away from work and/or social activities can be given.

- that the costs of further professional and/or hospital fees are not included in current estimates of the procedure.

- that failure to follow Dr. Capuano's instructions following the procedure may change the eventual result of procedure.

I acknowledge that I have had an opportunity to talk with Dr. Capuano about the procedure, and to my satisfaction I understand the procedure which is planned. I know the expected results, but I also understand that RESULTS CANNOT BE GUARANTEED.

I consent to photographing, videotaping, computer imaging and/or drawing of the procedure as indicated.

If I have any questions, or there is anything I do not understand, I will call these things to the attention of Dr. Capuano BEFORE MY SURGERY.

By my signature I state I have read, understand and agree to the above, and I request that the procedure be performed.

  • Signed _______________________________

and Witnessed _____________________________ DATE _______



INSTRUCTIONS FOLLOWING LASER SURGERY


It is very important that the treated skin be kept moist. Cool moist soaks - using gauze pads or cotton cloth (washed in bleach) placed over the treated area - are usually very helpful during the first 48 hours. Crush ice in a 'baggie' and place it over the moistened cloths in areas that sting and burn. You may also put petrolatum (see below) on the wound and then the cool soaks.

We recommend that you begin by using white petrolatum or Vaseline on the areas. Apply as often as needed but not too thick.. Do not use Vaseline with menthol or any additives.. Buy plain white petroleum. This can be used on most areas.

If this does not control the burning or stinging then you may want to have available one or more of the following available in the healing phase.
unscented A&D ointment or
aloe vera cream / ointment or
vitamin E cream / ointment or
Crisco - yes - lard - Crisco

When using these - begin slowly - and apply the cream / ointment to a small area to see how you tolerate it.

Bacitracin antibiotic ointment, can be purchased over the counter and should be used ONLY on areas of drainage and/or crusting. Do not apply heavily. Use sparingly and only in areas of drainage.

You may notice oozing from some areas and this is to be expected. You should refrain from wearing makeup on oozing areas for a few days, but this can be applied as long as there is no drainage or crusting.

You may also use wet cool compresses over the area for the first few days following the procedure. To help reduce swelling you can put ice over the moist compress. Do not apply ice directly to the treated skin. You will be given instructions on how to prepare a salt-water solution to use as the wet compress.

If you have a history of cold sores or herpes simplex, it is important to tell the Doctor. Laser surgery can cause an aggravation of this problem. You will be given a prescription for medication to take. This will reduce the possibility of a herpes outbreak. This medication should be taken before your procedure as well as after. When to take the medication will be written on the prescription bottle. The medication is 'Zovirax' or the generic equivalent.

Various other prescription medications may be given to you depending on your condition.

After the skin is healed you must wear sunscreens while outdoors. While we recommend the use of sunscreens for all patients, this is especially important after having laser treatment of the skin.

You must remember that the redness following your procedure can last for many weeks. Rarely (and we have not seen it), the redness will be very red for months. But in our experience the redness fades over two to four weeks, to a pleasant pink. Makeup will cover this, but you must be willing to ware makeup.

If you have any questions, our experienced staff will try to help you as many have had personal cosmetic enhancements including laser resurfacing. During your recovery it is important to call the office frequently to let us know how you are doing. You may ask as the staff questions when in the office or by calling the office.

Doctor Capuano usually sees patients one or two times during the first week after resurfacing, then about seven days thereafter, then at two weeks thereafter, then at one month thereafter. This will give you as sense of security to know that your condition will be followed.

This information is provided for your general information. How such information exactly applies to an individual would depend on a face to face history, examination, perhaps laboratory exams and individual treatment plan. Further because of the nature of electronic media and information - there is no doctor - patient relationship but merely a general information display - THANK YOU.

LASER FACIAL RESURFACING

INFORMATION REGARDING SILKTOUCH LASER SKIN RESURFACING


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