The Q-Switched ND:YAG and Alexandrite Lasers
These lasers emit the types of wavelengths of light that are absorbed by melanin, the pigment in brown and black colored lesions. Heat is absorbed by pigment particles which explode, resulting in much smaller particles that are more easily removed by the immune system.
Application
Because of its absorption profile, it is used to treat tan or brown "age" or "liver" spots, sun-induced freckles, certain dark birthmarks, and black, blue or red-colored tattoos. It is used to treat patients of all ages, including children.
Pain
Most patients do not require anesthesia. Although mild to moderate stinging or burning is experienced during the procedure, it is usually well tolerated. Application of a topical anesthetic, (EMLA cream or others), prior to treatment may help to decrease discomfort, especially when larger areas are being treated. Locally injected lidocaine anesthesia is administered when treating tattoos and certain deep birthmarks. Post treatment pain is relatively mild and usually not a significant problem.
Pre-Operative Instructions
Aspirin and products containing aspirin should be avoided for one week prior to this type of laser treatment. If you are taking anticoagulants or have blood clotting problems, please let your doctor know. Avoid excessive sun exposure, tanning, or hair removal procedures for several weeks prior to and following treatment. Do not apply makeup or astringent preparations, and avoid shaving on the day of your procedure. If extensive areas or multiple facial sites are being treated, we suggest that you arrive with a companion who can drive you home.
Post Treatment Appearance
Mild swelling, bruising and crusting occurs immediately post operatively. The swelling and bruising are generally short lived, but the crusting may last several days. This may be followed by mild redness which resolves within several weeks.
Post Operative Wound Care
Cleanse the wound twice daily with a mild soap and tepid water, apply an antibiotic ointment, and do not wear makeup until all crusting resolves. Specific wound care instructions will be provided.
Risks
All laser surgery procedures carry some degree of risk. The most common side effect with lasers that treat pigmented lesions is temporary redness and an increase or decrease in pigmentation which usually resolve within several months. Bleaching agents may be used to hasten resolution of any hyperpigmentation. Prolonged pigmentary changes (skin lightening or darkening) are uncommon. The risk of wound infection or scarring is minimal.
Result
Many pigmented lesions will disappear after a single treatment. Some, however, require more than one treatment to get the desired degree of lightening. Tattoos always require multiple treatments. Lesions can be treated and re-treated until the maximum achievable degree of lightening has been obtained. Unfortunately, some may never fully disappear. A six to eight week period between treatments is usually required before re-treating the same area, however, adjacent untreated areas can be treated at shorter intervals. Some patients will require a test treatment of a limited area to determine their response and appropriate dosage. Lesions that have improved or disappear occasionally recur.
Expectations
Laser surgery is a spectacular and exciting field, but it has its limitations. Unknown variables inherent in each lesion and each patient make it difficult to predict the result with absolute accuracy. Most patients are extremely pleased with the final results of their procedures. Every attempt will be made to achieve an optimum result; however, physicians cannot guarantee complete success in the treatment of each specific lesion. Significant improvement is a very realistic goal for which to strive. In reality, most patients are extremely pleased with the final results of their procedure.
Cost
Laser surgery involves the use of expensive, highly sophisticated, state-of-the-art medical lasers. The cost of each individual treatment session is also specifically dependent upon the size or number of lesions that are being treated.
As a rule, insurance plans do not cover cosmetic procedures. This includes the treatment of benign lesions by laser. Patients are therefore responsible for full payment of all fees. Costs will be quoted prior to treatment. A deposit, that will be applied to the total fee, is required in order to reserve the laser equipment, technician and physician time. If it is not received 2 weeks prior to your scheduled procedure date, the procedure will be cancelled. The deposit is refundable up to 48 hours prior to the procedure. The balance of the fee must be paid in full at the time of the procedure.