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Ablative Fractional CO2
(Mosaic E-CO2 and Fraxel Repair) and
Non-Ablative Fractional Erbium Laser
(Fraxel 750, 1500 and Fraxel Restore)


CO2 ablative laser resurfacing has been the "Gold Standard" for non surgical facial rejuvenation and removal of facial skin wrinkles and photo aging since 1995. CO2 ablative laser resurfacing using the Ultra pulse CO2 laser can achieve very significant acne scar treatments, facial rejuvenation including wrinkle removal, skin tightening and removal of pigment and photo aging skin changes.

However CO2 laser resurfacing has several limitations including a prolonged and difficult recovery period, often lasting three or more weeks, prolonged facial redness that can last three or four months, hypo pigmentation or lightening of skin color, and the potential for infection which can lead to scarring. During the past three years new technology called
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fractional laser resurfacing has been developed which has dramatically shortened recovery time and lessened the occurrence of complications. The first of the fractional laser systems was the non-ablative Erbium made by Reliant called Fraxel Restore or Fraxel 750.

With fractional non-ablative laser resurfacing the laser beam is broken up or fractionated into many small micro beams which are separated so that when they strike the skin surface small areas of the skin between the beams are not hit by the laser and left intact. These small areas of untreated skin promote a much more rapid recovery and healing with less risk of complications.In the non-ablative treatment, small areas treated by the fractional micro beams, called micro treatment zones, cause sufficient laser injury(not removal) to promote new collagen production and resulting in facial skin rejuvenation.

Fractionated CO2 Diagram

In the above skin diagram, the first red area on the left represents traditional non fractional ablative CO2 and Erbium laser resurfacing (Ultrapulse CO2). To ablate means to surgically remove the skin tissue, the skin is removed by the heat of the CO2 or Erbium laser. Since these lasers were not fractional, all of the skin in the treated area is removed creating an open wound that takes a long time to heal. The second areas represents the non ablative fractional laser technologies (Fraxel 750, 1500 or Fraxel Restore) which heats but do not ablate the skin. These lasers use an Erbium laser to heat small columns of the deep skin layers to promote new collagen production and plump the skin wrinkles. Recovery time is much less than with traditional ablative CO2 and Erbium lasers. This laser is excellent for improving skin texture, plumping wrinkles, acne scars, and shrinking pores, multiple treatments are required.

More recently several new fractional ablative lasers- (see on right in diagram above) have been developed which actually remove the heated column of skin tissue and provide more substantial wrinkle removal, acne scar treatment and superficial skin tightening than the non ablative fractional lasers. This fractional ablative CO2(Mosaic E CO2 or Fraxel Repair) lasers reach deep into the skin, 600 to 1500 microns, and because it removes and significantly heats tissue it can produce much more dramatic results in fewer sessions. The recovery times are slightly longer than non ablative lasers but much shorter than the traditional ablative CO2 (ultrapulse). In Summary, the new fractional ablative Erbium and CO2 lasers resurfacing techniques are very exciting advances in the field of acne scar treatment, non surgical facial rejuvenation and wrinkle removal. Many new applications have been developed which will improve our ability to rejuvenate the skin and improve scars, stretch marks and remove pigment. We will use both of these lasers either individually or sequentially to produce better results.


Call now to schedule your complimentary consultation with Dr. Jeffrey Rapaport for healthy, better-looking skin. Tel: (201) 227-1555.

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