CO2 laser skin resurfacing is a proven method for improving the appearance of sun-damaged and wrinkled skin. It represents one of the most innovative and exciting advances in cosmetic surgery. The CO2 laser emits light energy in the infrared portion of the electromagnetic spectrum, having a wavelength of 10,600 nanometers. This wavelength interacts with water molecules, in this situation - intracellular water. The laser pulses instantly vaporize the water inside the cells of the superficial skin layers thereby allowing these devitalized cells to be wiped away with unprecedented control over treatment depth. Additional treatment applications or "passes" of the laser are applied incrementally to the deeper skin layers until the appearance and desired tightening response is achieved.

While CO2 lasers have been available since the 1980's, their use was limited to making incisions. In 1995, superpulsed CO2 lasers were introduced. These new lasers were now capable of desiccating surface skin cells, but because they were superpulsed, were able to shut off very quickly thereby minimizing heat transfer with its associated undesirable damage to neighboring skin cells.

CO2 laser skin resurfacing can be used to treat a variety of facial skin conditions including fine wrinkles around mouth and eyes, lipstick bleed lines, weathered and aged skin, as well as a variety of benign skin lesions. Certain types of scars (acne, chicken pox, traumatic) can be softened or reduced. The skin resurfacing procedures works best in fair complected individuals. Very deep wrinkles can be improved, but generally do not go away completely. People with a tendency to heavy scarring or keloid formation are at greater risk of unpredictable healing and possibly, scarring. Accutane should be discontinued for 1-2 years prior to laser skin resurfacing so that the normal healing mechanisms can once again take effect. Individuals with a history of cold sores, or those with a large area to be resurfaced, should be treated with prophylactic antiviral medication by mouth.

Lesions which might be malignant should be biopsied and removed using traditional methods to include microscopic verification that no tumor cells remain.

In continuous mode (non-superpulsed), the CO2 laser has advantages for incisional blepharoplasties to reshape the aging upper eyelid, and to vaporize bulging fat pads within the upper and lower eyelids. Because the laser seals blood vessels and nerve endings as it makes an incision, there is little or no bleeding, swelling, or post-operative pain when compared with conventional "cold steel" scalpel incisions.

Dr. Gregory Barban has been performing blepharoplasty since 1978, and has been using his own "in house" superpulsed CO2 laser since 1996 for both cosmetic and visual/reconstructive blepharoplasty as well as for cosmetic skin resurfacing.