Before Surgery

Dr. Bentkover will carefully evaluate your skin and suggest which procedure he thinks will be most effective for you. Your choice of procedure may also depend on how much time you can take off from work or your regular activities. He will often recommend that you establish a routine of deep cleaning, manual facials from a high quality aesthetician before either procedure. This will help prevent infection and the formation of milia (small white cysts) after the procedure. If you do not have an aesthetician of your own, we can usually recommend one.

If you are having laser resurfacing, we will recommend preparing your skin for at least 4-6 weeks before surgery with a bleaching agent plus a retinol or one of our Obagi systems. Since the major risk of laser resurfacing is hyperpigmentation (increased brown pigment in your skin), these regimens are designed to protect your skin from this possible complication.

If you are having Portrait® Plasma Skin Regeneration®, there is no significant skin preparation. But if you are on a retinol like Retin-A™ and Renova™ or any kind of frequent fruit acid treatments to your face (like glycolic acid or vitamin C), we will ask that you stop using these about 3-4 weeks before the procedure. The reason for this is that your epidermis acts as what is called a "biologic dressing" after the treatment, and these products thin the outer most layer of the epidermis, the stratum corneum. 
For both procedures, we recommend washing your face with a hexachlorophene soap starting two nights before surgery.
 

Method of Surgery

For laser resurfacing under local anesthesia or plasma resurfacing in the office, you will be offered prescriptions to calm your nerves before the procedure. With the laser, usually we will only treat small scars, the lower eyelids, crow’s feet, upper lip, lower lip and chin under local anesthesia. A full face procedure will be done in the operating room at St. Vincent Hospital under general anesthesia or local anesthesia with sedation.  With plasma, we routinely do the whole face in the office.
 

Recovery: What to Expect

The recovery for both procedures is very similar. The treated area is usually covered with Aquaphor™ ointment for 7-8 days after surgery.  This is readily available at you local pharmacy.  It is important that you keep a thick layer of the ointment on your skin at all times until the skin has resurfaced, usually 7-8 days. This protects new skin and prevents the treated epidermis from coming off prematurely. We will show you how to use the ointment. Your skin may be pink for 2-3 weeks, fading gradually. Sometimes we will prescribe a mild steroid lotion to help this subside.  The skin may also be itchy.  Cotton gloves at night will prevent you from scratching off new skin.  You can usually wear a mineral make up in 8-9 days.  We stock ColorScience™ make-up for this purpose. Your skin will continue to tighten for a number of months as your body produces new collagen.   Collagen production does not even start significantly, however, for about 30 days.  Please be patient.  You will notice color changes in the first two weeks.  You will start to notice changes in the texture of your skin (e.g. wrinkles and smoothness) at about 3-4 weeks. Neither procedure should be very painful afterwards. You will feel like you have a bad sunburn the first night after surgery and might take a prescribed pain pill or extra strength acetaminophen. The next day you will usually not require any pain medication.