In Oscar Wilde's classic novel "The Picture of Dorian Gray", the title character sells his soul to the devil, winning for himself perennial youth in the form of a portrait that takes on the "lines of suffering and thought" that would have accrued on the 17-year-old's face as he aged.
In a modern variant of the 1870 novel, Dorian could sidestep a deal with the devil while still enduring as the picture of youth, by choosing from a menu of "skin rejuvenation" procedures developed in recent years. He could make a lunch-hour appointment with his plastic surgeon or dermatologist for a quick-fix microdermabrasion, or for a more dramatic result, might decide to take a couple of weeks out from his debaucherous lifestyle for laser resurfacing.
Of the many skin-refreshing options, laser resurfacing and microdermabrasion are among the most popular. They can help reverse the telltale marks of aging and sun damage—among them, smile and frown lines, forehead wrinkles, crow's feet around the eyes, brown spots, and dry, rough skin. Also, the skin rejuvenation treatments can be helpful in treating medical conditions such as precancerous skin lesions and acne.
But which procedure is best? "It's surprisingly easy to match the right procedure with a patient—just listen to the patient," says Rockville, Md.–based plastic surgeon Mark E. Richards, M.D. What bothers them? How far are they willing to go to get it corrected, in terms of risks, recovery time, and financial investment? "There's no free lunch," he points out. "The more downtime and the more inherent risks involved in the procedure, generally the more dramatic the changes are going to be."
Laser Resurfacing: More Pain, More Gain
Laser skin resurfacing offers the most striking results—"phenomenal," says Richards. "It can be a huge change, depending on how damaged your skin is to start with," says the surgeon, who has seen the procedure turn the clock back 20 years.
To achieve its dramatic—and long-lasting—results, laser resurfacing acts like a "souped-up microwave," Richards says, using high-energy light to vaporize the damaged outer layers of skin and de-emphasize wrinkles, superficial scars, and uneven skin pigmentation.
Two of the most commonly used skin-resurfacing lasers are the pulsed carbon dioxide laser, often referred to as the "CO2" laser, and the Erbium YAG laser. For advanced skin damage, doctors' technology of choice is the CO2 laser, based on its ability to penetrate deep into the skin.
Recovering from Laser Resurfacing: "No Picnic"
Richards chose the CO2 laser for Margaret Copeland (her name has been changed), a 74-year-old skin cancer survivor who wanted to rid herself of the health-threatening lesions that kept reappearing on her face.
