Our Philosophy
At the Plastic Surgery Clinic we perform approximately 100-200 laser procedures a year. This makes Dr Lista one of the most experienced laser surgeons in Ontario, Canada. Dr Lista’s philosophy is to make all his laser patients look soft, natural and well rested. The result should look natural with wrinkles improved but perhaps not completely removed. Patients look younger and more relaxed but not harsh or “operated on.”

If you're considering laser resurfacing...
There are two major types of laser treatments offered at the Plastic Surgery Clinic: CO2 laser resurfacing and Cool Touch Laser wrinkle removal.

In laser resurfacing, sometimes called "laser peel," a carbon dioxide (CO2) laser is used to remove areas of damaged or wrinkled skin, layer by layer. The procedure is most commonly used to minimize the appearance of fine lines, especially around the mouth and the eyes. However, it is also effective in treating facial scars or areas of uneven pigmentation. Laser resurfacing may be performed on the whole face or in specific regions. Often, the procedure is done in conjunction with another cosmetic operation, such as a facelift or eyelid surgery. Laser resurfacing is still a very new procedure. However, it has been shown that in some cases, this surgical method produces less bleeding, bruising and post-operative discomfort than is typically seen with other resurfacing methods.

With the Cool Touch Laser, a YAG laser is used to stimulate collagen production. The laser penetrates the skin without injuring the outer layers. This procedure is performed on younger patients with more mild wrinkles which are not deep enough to require the CO2 laser. The advantage of this procedure is that it is as simple as a facial. No recovery is required and patients do not need any time off after the procedure.

This website will give you a basic understanding of the laser resurfacing procedure - when it can help, how it's performed and what results you can expect. It cannot, however, provide all the details which may be relevant to your particular needs. Please Dr Lista if there is anything about the procedure you don't understand.

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A WORD ABOUT CO2 and Cool Touch LASER
CO2 Laser resurfacing is performed using a beam of laser energy which vaporizes the upper layers of damaged skin at specific and controlled levels of penetration.

It's clear that laser resurfacing may offer a number of advantages over other resurfacing methods: precision, little (if any) bleeding and less post-operative discomfort. However, laser resurfacing isn't for everyone. In some cases, an alternative skin resurfacing treatment, such as dermabrasion or chemical peel, may still be a better choice.

With CO2 Laser resurfacing the outer layers of damaged skin are stripped away. Then, as new cells form during the healing process, a smoother, tighter, younger-looking skin surface appears. Laser resurfacing is a new method being used by plastic surgeons to remove damaged skin. A number of studies using microscopic examination have shown that the physical changes that occur to laser-treated skin are essentially identical to those that occur with either dermabrasion or chemical peel.

For superficial or medium resurfacing, the laser can be limited to the epidermis and papillary dermis. For deeper resurfacing, the upper levels of the reticular dermis can also be removed. Varied penetration allows treatment of specific spots or wrinkles.

It's also important to consider the length of recovery when choosing among the skin-resurfacing alternatives. In general, the more aggressive the resurfacing procedure is, the more prolonged the recovery is likely to be. "Light" resurfacing procedures, such as superficial chemical peels or superficial laser resurfacing, offer shorter recovery times. However, these lighter procedures may need to be repeated multiple times to achieve results comparable to those achieved with more aggressive techniques.

The Cool Touch laser is different than the CO2 laser. The Cool Touch laser is a YAG laser with a special cooling head. This allows the laser to penetrate the skin without any visible damage to the top layers of the skin. In this way the laser penetrates the skin, heating dermal collagen. Skin collagen responds by becoming more organized and tightening. This tightens the skin and improves wrinkling. The advantage of the Cool Touch laser is that it does not result in any surface damage to the skin. For this reason there is no healing time required. The treatment is like a facial and the patient can go out in public immediately afterwards. The Cool Touch is only effective in milder cases of wrinkling. Because the treatment is less aggressive than the CO2 laser, several treatments are required and the results will not become apparent until several months later.

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THE BEST CANDIDATES FOR LASER RESURFACING
In many cases, facial wrinkles form in localized areas, such as near the eyes or around the mouth. The laser can be precisely controlled so that only these specific areas are targeted.

Patients with olive skin, brown skin or black skin may be at increased risk for pigmentation changes no matter what type of resurfacing method is recommended. Dr Lista will evaluate your skin characteristics and make recommendations accordingly.

Also, individuals who have taken accutane in the past 12-18 months or are prone to abnormal (keloid-like) scarring or those with active skin infections on the treatment area may not be appropriate candidates for this procedure.

Remember, having laser resurfacing can help enhance your appearance and your self-confidence, but it won't completely remove all facial flaws or prevent you from aging. Lines that occur as a result of natural movements of the face - smiling, squinting, blinking, talking, chewing - will inevitably recur. Your plastic surgeon can suggest ways to help you preserve your results by protecting yourself from sun exposure or using maintenance treatments, such as light chemical peels or medicated facial creams. Before you decide to have laser resurfacing, think carefully about your expectations and discuss them with your surgeon.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
When laser resurfacing is performed by a qualified, experienced surgeon, complications are infrequent and usually minor. However, because individuals vary greatly in their anatomy, their physical reactions and their healing abilities, the outcome is never completely predictable.

Risks associated with laser resurfacing include: burns or other injuries from the heat of the laser energy, scarring, and obvious lightening or darkening of the treated skin. Also, laser resurfacing can activate herpes virus infections ("cold sores") and, rarely, other types of infection.

Additional corrective measures and treatment may be required if healing seems abnormal or delayed or if there is any evidence of abnormal pigmentation or scarring.

You can reduce your risks by choosing a qualified plastic surgeon who has received special training in laser surgery.

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PLANNING YOUR SURGERY
Not every practitioner who offers laser surgery has the same level of experience and skill with laser use. That is why it is especially important that you find a plastic surgeon who is adequately trained in the procedure.

In your initial consultation, be frank in discussing your expectations with the Dr Lista and don't hesitate to ask any questions you may have. Dr Lista will be equally frank with you, explaining the factors that could influence the procedure and the results - such as any abnormal skin condition which has been diagnosed or previously treated, medications you are taking or have taken in the past, previous skin injuries or previous operations.

Dr Lista will discuss your medical history, perform a routine examination and photograph the area to be treated. He will explain the procedure in detail, along with its risks and benefits, the recovery period and the costs.

PREPARING FOR THE LASER PROCEDURE
Depending on your individual needs, Dr Lista may recommend that you begin a pre-treatment plan to prepare the skin for resurfacing. Treatment with the CO2 laser requires approximately one month of pre-treatment with prescription skin creams which Dr Lista will order for you. The Cool Touch Laser does not require any pre-treatment.

At the time of the procedure, you will be given specific instructions on how to care for your skin immediately following your laser treatment. Dr Lista may also instruct you to follow a specific maintenance regimen for long-term care of the skin to maximize the benefits of the procedure.

If you are undergoing CO2 laser treatment, you will need to make arrangements for someone to drive you home as you will be given tranquilizers or sedation for your laser treatment. The Cool Touch Laser, on the other hand, is as simple as a facial treatment and you can drive yourself back home or to work after this treatment.

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WHERE YOUR LASER TREATMENT WILL BE PERFORMED
Laser resurfacing is performed at our clinic, The Plastic Surgery Clinic. Dr Lista performs all CO2 laser procedures personally. Cool Touch Laser treatments are performed by a registered nurse specially trained in the Cool Touch Laser system.

TYPES OF ANESTHESIA
CO2 laser resurfacing is most commonly performed under local anesthesia with sedation, especially when it's used to treat localized areas of the face. You'll be awake but relaxed, and will feel minimal discomfort. For more extensive resurfacing, Dr Lista may prefer to use general anesthesia, in which case you'll sleep through the procedure.

Cool Touch Laser treatments do not require any thing more than a topical cream that gently numbs the skin.

THE PROCEDURE
CO2 laser resurfacing is a relatively quick procedure. It usually takes anywhere from a few minutes to 1 1/2 hours, depending on how large of an area is involved. Cool Touch Laser treatments usually take about 1/2 an hour.

During the procedure, the activated laser is carefully passed back and forth over the skin until the surgeon reaches the level that will make the wrinkle or scar less visible.

When the procedure is over, Dr Lista may choose to treat the resurfaced skin with applications of protective creams or ointments until healing is complete. Sometimes we may decide to apply a bandage over the treated areas which will cover and protect the healing skin for the first five to ten days.

AFTER YOUR TREATMENT
You are likely to experience some mild swelling and discomfort after CO2 laser resurfacing. However, this can be controlled with ice packs and medications prescribed by your surgeon. If a bandage was applied after your procedure, it may be replaced with a fresh one after a day or two. After about a week or so, your bandage will be removed and a thin layer of ointment may be applied to the skin. Once this stage is reached, Dr Lista will provide instructions on how to gently wash and care for your healing skin. During this phase of healing, it is very important that you not pick the crusts off the treated area or scarring may result. Most patients are free of crusts by about 10 days post-operatively. Redness may persist for several weeks.

With Cool Touch Laser treatments there is no damage to the superficial skin so there is no healing period required. Patients can return to normal activities immediately following the treatment.

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GETTING BACK TO NORMAL
After CO2 laser resurfacing, your new skin will usually remain bright pink to red in the weeks following the procedure. Your surgeon may prescribe medications to make this color subside more rapidly. After about two weeks or so, most patients can safely apply makeup to conceal this temporary color change. However, some pinkness may remain for up to six months.

Above all, in the months following treatment, it's important to protect the treated area from the sun until all the color has returned to normal. Using sun protection regularly will help to maintain your results and reduce the chance of any new sun damage to your skin.

If you must be in the sun, apply a strong sun block with an SPF of 15 or higher and shade your face with a hat or visor. If resurfacing was performed around the eyes, it's best to also wear good quality sunglasses with UVA and UVB 100 percent filters.

Cool Touch Laser patients can return to normal activities immediately.

YOUR NEW LOOK
The final result from laser resurfacing may take several months to fully appear. However, once the pinkness fades, patients usually notice a significant improvement in the quality of their skin and a fresher, smoother appearance.

It's important to understand that your results will be long-lasting, but not permanent. Remember, your new skin is not immune to the effects of aging. In the months and years following your laser treatment, your natural facial movements will eventually cause any "expression" lines to recur.

As with other methods of skin rejuvenation, laser treatments can usually be repeated. However, by protecting yourself from the sun and following a skin-care regimen recommended by Dr Lista, you can help maintain your rejuvenated look for many years to come.