Lasers Procedures

Lasers are instruments that deliver energy to tissue through packets of light and have become the most popular form of minimally invasive surgical skin rejuvenation. They are safe, rapidly healing, and effective for a variety of issues. Laser rejuvenation is effective for the treatment of sun-damaged skin: brown and red spots, large pores, telangiectasias, and wrinkled skin. They are also effective in treating scars, especially acne scars, pre-cancerous growths, benign growths, and lax skin due to aging. The use of lasers for cosmetic surgery has made these types of procedures much more convenient for people to fit into their busy lives. Cosmetic laser procedures are performed in the physician’s office and most patients can return to their normal activities, such as work or exercise, immediately following many of the treatments.

MetropoltianMD offers several lasers for a variety of treatments and skin resurfacing. During your initial consultation, Dr Rachel will talk to you about each procedure’s benefits and risks and which device may be best for you.

CO2 laser resurfacing is the gold standard in skin resurfacing. Superior results in rejuvenating sun-damaged skin, reducing fine lines and wrinkles, and in tightening skin are obtained with this procedure. At the same time, prolonged redness of 6-12 weeks has limited its usefulness and the fractional lasers have largely supplanted their use. Nevertheless, for the optimal results in skin resurfacing, MetropolitanMD will continue to offer the CO2 laser resurfacing procedure for a variety of indications.

Fractionated laser resurfacing has a dual action of tightening skin and removing surface irregularities, contours, and superficial wrinkles – all at one time. This laser treatment produces multiple tiny columns of treatment in your skin, known as microscopic treatment zones. In these zones, unwanted pigment is removed, skin retraction occurs, and collagen production is stimulated restoring a healthy glow and feel to the skin. The normal skin surrounding these zones allow the skin to heal much faster than if the entire area was treated at once. This allows the body’s natural healing process to create new, healthy tighter tissue to replace skin imperfections. The treatment is usually performed after applying a topical numbing cream to the skin. A session can be completed in less than 30 minutes. Some swelling and redness can be seen immediately after the procedure and appropriate skin care is necessary. There is a potential risk of infection or scarring so patients should inform the staff of any history of cold sores if the area around the mouth is treated. Improvements after treatment are usually seen within a month and multiple treatments may be indicated. The results are long lasting but are not permanent so skin care after the treatment is important.

Non-ablative lasers and IPL rejuvenate skin from the inside, leaving the outer skin intact. Their virtue is that they have no telltale signs so patients can return immediately to work or play. These treatments must be repeated several times, often 4-6, in order to achieve the results of 1-2 ablative laser treatments, but the convenience of no downtime can outweigh the inconvenience of repeat treatments for busy patients. They are very effective for treating sun-damaged skin, smoothing rough skin, removing red and brown spots, and reducing raised and depressed scars. The non-ablative laser treatment essentially restores the skin’s youthful appearance by gently heating the upper layers of the skin. This triggers the formation of collagen and elastin, lighten pigment, and shrinks red capillaries. Candidates include individuals with light to medium complexions who are looking to improve areas of sun-damage, redness and/or hyperpigmentation

The procedure takes approximately fifteen to thirty minutes to complete. The treatment area may be with a very thin layer of gel. A hand piece is then passed over the skin, emitting gentle pulses of therapeutic light. Patients may experience some discomfort during treatment but this is usually very mild and easily tolerated. If need be, a topical anesthetic cream can be applied prior to treatment to numb the skin.

There is usually little to no recovery or downtime following nonablative or IPL treatments and patients are able to immediately return to their normal routine. Minor redness similar to a flushed appearance occasionally occurs but generally clears up within one to two hours. Multiple treatments are often needed to achieve the best results. Patients usually undergo a total of four to six treatments spaced at 2-4 week intervals.

IPL stands for Intense Pulsed Light and these instruments actually use the whole rainbow of visible light as well as some of the rays of infrared light. Because of its many colors the IPL can treat a variety of conditions at once. This lends it to be the vehicle for the Photofacial and PDT therapies noted below. Red spots, brown spots, telangiectasia (broken capillaries), and rough skin all respond to the IPL. These are quick, gentle, non-invasive treatments that can address the effects of photoaging and sun damage on the face, neck, hands and body. Patients return to work immediately while resolution of skin problems will take weeks. These treatments are usually repeated for maximal effect.


Unwanted hair can be effectively removed or thinned by targeting heat to the hair follicles. This treatment can be useful for removal of facial and body hair. Optimal candidates are lighter skinned with darker hair. Multiple treatments are usually necessary and there is usually minimal to no downtime.


Photorejuvenation also goes by the name photofacial and is now the most commonly used treatment for skin rejuvenation. This treatment is normally done over the entire face and neck with an IPL instrument. Depending on the particular laser the skin may be chilled or treated with a lubricating gel, but in either case discomfort is minimal and post treatment redness, if it occurs at all, lasts minutes to hours. Skin is smoother, softer; more even colored, and often has smaller pores and is younger looking. Rosacea patients have less redness and flushing and are easier to manage.


Photodynamic Therapy was developed for treatment of certain kinds of cancer. Patient’s treated for skin cancers were noted to have younger looking smoother skin and physicians realized the effectiveness for skin rejuvenation. Because it reduces the size of oil glands and superficial blood vessels it is an excellent treatment for acne and for rosacea. The PDT procedure also reduces inflammation for treatment for raised scars. It is effective for treatment of sun-damaged skin by reducing red and brown pigment and superficial wrinkles.

PDT is performed by applying a chemical called aminolevulenic acid (ALA) to the skin of the face and neck. Patients may then leave the office for 1-3 hours. Upon return, the skin is treated with IPL, which activates the chemical and produces the desired skin rejuvenation. Treatments are relatively painless and patients can return to work the next day. Patients will be photosensitive for 2-3 days after the procedure and sun precautions are necessary. This means no outdoor activities for 3 days and wearing protective clothing and hats when traveling to and from their home.


Radiofrequency skin tightening is a nonsurgical treatment for loose skin of the face and body. These skin-tightening procedures have become very popular in recent years because they provide a nonsurgical alternative to more invasive procedures for correcting skin laxity and improving skin quality. It can be used not only to improve loose skin with aging but also help to maintain the results of surgical procedures such as facelifts or thigh/butt lifts. MetropolitanMD offers the Accent by Alma Lasers as a new alternative in skin treatment based upon Dual-layer RF (radio frequency) Thermotherapy. The Accent system uses two individual types of radio frequency technology: Unipolar and Bipolar. This unique dual radio frequency technology provides controlled volumetric tissue heating to two distinct depths of tissue. The Bipolar module focuses on the surface layer of the skin, while the Unipolar module penetrates further for deep dermal thermotherapy. The Bipolar treatment is well suited for areas where the skin is thinner and more delicate, such as the face, helping to smooth fine lines and wrinkles. The Unipolar treatment generates alternating electromagnetic fields that cause friction and heating in the deeper tissues, which leads to improvements in overall shaping and firmness. Taken together, these dual-layer treatments can create contour improvements without the need for invasive surgery. The treatment is usually carried out over 3-6 sessions at 2-4 week intervals. Each session takes only 20-30 minutes. No needles or anesthetics are necessary. After a treatment, the skin will feel tighter and smoother. Over time, sagging or wrinkled skin will be replaced with smoother, tighter skin that has improved tone and texture. The effects may continue to improve for up to six months following the last treatment and can last for years depending on your skin condition and natural aging process.

MetropolitanMD now features Pixel®RF technology for skin resurfacing. It works to contour, tighten and rejuvenate the skin for a more youthful, healthier appearance. Using Micro Plasma Technology and In-Motion™ refractive radiofrequency, the PixelRF allows you to both ablate and heat skin through a controlled, focused delivery of energy. The result is fresh, smooth and radiant skin.

The PixelRF is highly effective on all skin types (Fitzpatrick I-IV) and treatments can be administered with no seasonal restrictions.

Get your free cosmetic surgery consultation with Dr. John Rachel, a board certified cosmetic surgeon.

American Board of Cosmetic Surgery FACS American Board of Facial Plastic and Reconstructive Surgery Alpha Omega Alpha Accreditation Association for Ambulatory Health Care American Board of Otolaryngology Phi Beta Kappa American Academy of Facial Plastic Surgery