Lasers are used for cosmetic reasons to eliminate superficial wrinkling of the skin, remove scars, venous malformations, thread veins, pigmented lesions or hair. A laser is a high-energy beam of light that can selectively transfer its energy into tissue to treat the skin. Lasers contain a material that produces and amplifies light. Two mirrors cause the light to reflect back and forth through this material. The result is a light beam that is collimated and intense. This light is either one pure colour or several different pure colours. These properties which separate the laser from a light bulb are important to the medical application of lasers.

The choice of using a laser is carefully made by the plastic surgeon. Many procedures can be performed with different lasers. The choice of the laser depends upon many factors, including the surgeon's experience, the size of the area to be treated, and the expectations of the patient. We need to consider the possible results, the possible complications, and the alternatives in order to tailor the treatment to each individual patient.

 

We have started off by using the CO2-Laser to treat wrinkles and for skin rejuvenation in an ablative fashion. We now employ the latest laser technology to treat a spectrum of conditions:

 

• Er:YAG-Laser (2940nm) for skin resurfacing and to treat wrinkles, epidermal und dermal lesions and scars.
• The fractional technology allows for safe procedures with fast healing times.
• KTP Laser (532nm) to treat superficial spider veins and pigmented lesions like age spots or naevi
• Diode Laser (940nm) for epilation, safe also in darker skinned people, and treatment of deep vascular lesions

 

New non-invasive technologies:

Acoustic Waves System for Cellulite & Body Shaping

Provides non-invasive cellulite treatment for thighs and buttocks. The goal is to improve skin texture and elasticity by smoothening the dimpling effect of the skin, and stretching the connective tissue.  It delivers acoustic pulses to the area being treated. These create vibration in the connective tissue, loosening any rigidity. This leads to increased blood flow and the creation of a new, stronger band of collagen in the skin.

High-frequency radio waves for Skin Tightening & Wrinkle Reduction

The treatment involves sucking the skin up in between the electrodes by creating a vacuum, and cooling it at the same time. This procedure leads to a selective heating of the dermis. The result is a tightened contoured skin, with immediate success after the first treatments and a further improvement over the next two to four months.

 

Main areas of laser treatment at our Clinic in Köln-Merheim:

Skin rejuvenation and resurfacing:

Fractional Er:YAG Lasertherapy with MicroSpots
The fractional laser technology (Asclepion) or Fraxel ® Laser Therapy opens a new chapter in laser treatment for age- and sun induced wrinkles, age spots, acne induced and surgical scarring, stretch marks and other skin changes.

 Epilation:
Permanent removal of unwanted hair in the axilla- and bikini line, hair reduction on the chest, face, back and legs.

Vascular treatments:
Thread veins, spider veins on the legs or face, telangiectasias, hemangiomas, cherry angiomas on chest, back, legs and decolleté

Pigmented lesions:
Lentigos, Cafe-au-lait-spots, age spots on the face and decolleté

Acne and scars:
Superficial scars and operation marks

Ablation:
Ablative removal of fatty deposits near the eye (Xanthelasma), removal of dermal and epidermal skinlesions.

--> What to expect after laser surgery

Fractional treatments with Er:YAG

Fractional laser light treats only “fractions” of the skin, since the MicroSpots leave small portions of it untouched. This accelerates the healing process and enhances patient comfort. This procedure stimulates new collagen formation and tightens the skin immediately. Because the repaired areas are surrounded by healthy skin, regeneration is accelerated without the negative side-effects of traditional ablative procedures. This results in a long-lasting, healthy youthful look after a few days only.

This technique is well tolerated, making the use of local anaesthetics unnecessary. Minor reddening of the skin lasts for about 3-4 days. Most patients should be able to socialize again after about five days. A fractional laser therapy session lasts between 30 min and an hour, depending on the areas being treated, and generally needs to be repeated three to five times.

 Main areas treated:

• Wrinkles: Around the eye, superficial perioral wrinkles
• Skin rejuvenation (face, neck, decolleté, hands)
• Pigmented lesions: senile spots, solar lentigo, vitiligo
• Scars: acne scars, scars after operations
• Striae (stretch marks after pregnancies)
• Melasma (facial colour changes)
• Actinic keratosis

 Our Laser: Dermablade Effect from Asclepion mit MicroSpot Superfractional Extension

 
Epilation (Laser hair removal)

With laser hair removal, the energy of the laser light is used to specifically hinder hair growth. In this respect the laser penetrates the upper layers of skin and transfers its energy to the hair; the energy is absorbed by the melanin pigment in the hair and converted to heat. The entire follicle area is damaged by the heat, causing the hair to fall out without damaging the surrounding structures. We use a special diode laser which can be safely applied on darker skinned patients as well.

For the optimum and sustained removal of hair with the aid of a laser a number of individual treatments are generally necessary (as a rule 3 - 6 treatments). In addition to factors like skin and hair colour, hair thickness and depth, there is a further reason for the necessity for more than one treatment: Hairs constantly undergo various growth cycles; only hairs in the growth phase may be removed on a permanent basis with the aid of lasers. After each cycle of laser, the hair will grow back slower, thinner and more sparse than before. The lighter the skin and darker the hair, the better the results. Hair roots of blond or grey hair cannot be treated successfully.

Diode laser epilation is well tolerated and less painful than the Nd-YAG Laser. Changes in pigmentation are less of a problem compared to IPL (intense pulse light) therapy.

Main areas treated:

• Unwanted facial hair, especially on the upper lip
• Axilla and bikiniline
• Hair reduction on the face, chest, back, arms and legs.

Our laser: MeDioStar from Asclepion
 

Vascular Treatments

There is a multitude of vascular skin lesions which differ from each other in morphology, histology and prognosis. Because of that, diagnosing and treating these lesions should be reserved for specialists with detailed knowledge.

Vascular skin lesions such as telangiectasia of the face, thread veins on the legs and other vascular lesions are commonly regarded as cosmetic blemishes. With laser treatment, haemoglobin, the target molecule in the treatment of small skin blood vessels, is targeted. The target heats up and the tiny vessels disintegrate. Simultaneous cooling of the skin prevents damage to the surrounding structures.

Up to now, treating telangiectasia and thread veins was difficult as they differ in size, colour (red or blue) and depth. By using different types of laser which each target the lesions at their specific location, even difficult areas can be targeted.

The KTP laser offers an optimal spectrum for superficial telangiectasia and spider naevi, the diode laser is used for the deeper and larger caliber thread veins. Using this combination of technology, long-lasting results will be achieved.

Main areas treated:

• Superficial lesions like telangiectasia, spider naevi, senile angiomas
• Thread veins
• Rosacea: reddening and thin capillaries on the face and nose
• Thread veins on the legs
• Small hemaniomas
• Congenital port-wine stains

Our lasers: QuadroStar+ (KTP) and MeDioStar from Asclepion

 

 

Pigmented Lesions:

The skin on the face, the backs of the hand and the decolleté are most susceptible to sun exposure. Pigmented lesions, such as age spots, commonly cause cosmetic blemishes in these regions. Age spots occur with 50% of women and 20% of men from the age of 50 onwards.

There are many different types of pigmented lesions which differ from one another fundamentally in terms of their morphological and histological characteristics. For this reason the evaluation of and possible therapy for pigmented lesions should always be the reserve of doctors with specialist's knowledge. Some lesions need to be removed surgically and sent for patho-histological investigation to rule out malignancy.

Pigmented lesions are characterized by an accumulation of pigment cells (melanocytes), which can be targeted with a special double frequency laser. The laser treatment itself is straight-forward and conducted on an out-patient basis with or without a local anaesthetic. The laser light is specifically absorbed by the colour pigments of the lesions. The energy is transferred, and the coloured particles are fragmented from the connective tissue and degraded.

 

Main areas treated:

• Benign pigmented lesions such as lentigo senilis or solar lentigo (age and sun spots)
• Café au lait spots
• Different types of naevi
• Lentigo simplex

Our laser: QuadroStar+ (KTP) and Dermablade Effect with MicroSpot Superfractional Extension from Asclepion

 

 

Acne and scars:

Deep furrows, dimpling and unsightly scars after years of acne can have a tremendous impact on a patient’s life.

Healed acne scars can be removed by the latest technology, fractional laser resurfacing using the Erbium-YAG-laser. During this procedure, the skin is wounded using microscopic pulses of light. Over the course of several treatments scars are softened as the body regenerates the areas of microthermal wounding. In comparison to the old methods of dermabrasio or chemical peels, laser therapy is regarded as safe. When treating deep scars, these might need to be excised before laser therapy. The laser energy is then used to penetrate deep into the dermis, eliminating damaged cells and stimulating the growth of new collagen. Collagen is stimulated for up to 4 months and this new collagen regeneration lifts and supports the skin's surface. The generation of the new skin cells in combination with collagen stimulation will dramatically improve the appearance of acne scars. Depending on the depth of the scars, some patients may require anywhere from 1 to 3 treatments for acne scar removal.

Main areas treated:
 
• Acne scars
• Scars from operations
• Traumatic scars

 

Our laser: Dermablade Effect from Asclepion with MicroSpot Superfractional Extension

 

 

What To Expect After Laser Surgery

After the surgery, you will probably experience some swelling and skin redness for several days. Antibiotic ointments may be used during the healing process. It is important for the patient to follow all the post-operative directions of the surgeon, particularly in using sunblock and avoiding sun exposure.
The full impact of the laser may not be apparent for a month or two, especially with vascular deformities. Additional treatment sessions will not be scheduled until the healing process for a particular treatment is complete.
It is important for the patient to realize that lasers have specific applications. We as Plastic Surgeons are experienced in the use of the laser and we are the best source of information as to whether laser surgery is appropriate for your condition.
Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct or improve congenital deformities or accidental skin injuries may be reimbursable in whole or in part. It is the patient's responsibility to check with the insurance carrier for information on the degree of coverage.