What are the benefits of Skin Resurfacing?

Skin Resurfacing help improve the following conditions:

  • Acne Scars
  • Stretch Marks
  • Sun Damage
  • Fine Lines & Wrinkles
  • Hyperpigmentation
  • Trauma Scars

What are the advantages for this treatment?

At Vancouver Medi Spa the Er:YAG laser with longer and variable pulses allow our patients with deeper wrinkles and scars to be successfully treated. Full customizability allows you to precisely attain the clinical outcomes you desire.

Why Does Vancouver Medi Spa Use this Er:YAG laser system? Because it is equipped with a high performance laser system that maximizes ablation efficiency with proprietary (Variable Square Pulse) technology, which can be accurately tuned to varying “cold” ablation and non-ablative thermal ratios.

The fractional technique is based on a concept of producing an array of microscopic wounds on the skin surface that are rapidly re-epithelialized by the surrounding undamaged tissue thus sparing the epidermis.

The cutaneous absorption of the Er:YAG laser energy by water is 10-fold more efficient than of the carbon dioxide laser which allows for more superficial tissue ablation and finer control.

Indications include mildly photo-damaged skin lesions (e.g. solar keratoses), mildly atrophic facial scars (e.g. from acne or varicella), dyschromias (e.g. melasma, lentigines), and mild-to-moderate facial wrinkles in the perioral, periocular, and cheek areas.

Using fractional light to rejuvenate the skin can produce an effect that is perfectly graded to our expectations, and offers a degree of control and efficacy that allows for highly precise sculpting of the skin.

Treatments can extend from light touch-ups to deep collagen remodelling, it is ideal for our patients who want drastic rejuvenation effects but, are not inclined towards aggressive surgical or chemical alternatives.

What are the other basic ablative laser treatments?

At Vancouver Medi Spa the wavelength is a key factor in the suitability of any laser for ablative skin procedures in aesthetics.
In the late 1980s, laser technology applied to skin resurfacing was discovered to yield more predictable depths of injury when compared with chemical peels or dermabrasion.

The first laser used for skin resurfacing was a pulsed carbon dioxide (CO2) laser. Later, the erbium:yttrium aluminum-garnet (Er:YAG) laser was introduced, which has now become a standard tool for skin resurfacing

Practitioners have long used carbon dioxide (CO2) lasers for facial resurfacing treatments. CO2 laser devices can be effective for this purpose but, a considerable number of post-operative issues with the laser source have been reported.

The reason lies in the larger coagulation depth of the CO2 laser wavelength. Therefore, Er:YAG lasers have almost completely replaced CO2 lasers for skin resurfacing procedures. Recently, Er:YSGG lasers have also been introduced. But as previously demonstrated, they are indicated for warm and hot laser treatments only.

There are currently three medical laser technologies, namely Er:YAG, Er:YSGG (or Er,Cr:YSGG) and CO2, whose laser wavelengths operate in the regions of the major absorption peaks for water.

Since the skin consists of 70% water, these three laser types can be effectively used for skin tissue ablation treatments.

As discussed above, the laser light’s ablative energy must be delivered to the skin in a temporal pulse of appropriate duration in order to control skin heating and ensure the efficiency and safety of treatments.

In the case of a long laser pulse or continuous irradiation, the heat that is generated by the laser light has sufficient time to diffuse deeper into the tissue from the irradiated surface area.

This results in less heat being distributed to the surrounding tissue. On the other hand, a long pulse width will allow more heat transfer before ablation takes place resulting in a greater thermal effect on the surrounding tissue.

Skin resurfacing and rejuvenation treatments can be performed either in ablative modes with an Er:YAG laser or nonablative with a Nd:YAG laser, depending on the particular aesthetic outcome that the patient and technician wish to achieve.

In addition, ablative and nonablative treatments can also be combined into a comprehensive anti-aging treatments.

Why does Vancouver Medi Spa use this method for Skin Resurfacing?

The correct therapeutic ablation depth is the minimum depth needed to achieve the desired clinical result, whether it is for the effacement of rhytids, removal of photo-damage, or collagen tightening.

Generally, laser resurfacing is performed by treating the area completely, until the to-be-removed lesions have been ablated or until punctate bleeding appears, which indicates the papillary dermis has been reached.

At the papillary dermis level a maximum therapeutic effect is achieved with a minimum risk of side effects. Continuing to treat deeper than the papillary dermis has minimal clinical benefits, while the potential of complications and side effects may even exponentially increase.

With clinical experience it is advisable to select laser treatment settings that will give the desired result in 2-4 passes. Visual clinical end-points for the three ablative regimes.

The sequential laser-layering techniques have been successfully used in PWS and more recently in antiaging with good clinical results.

Since temperature seems to play a key role in stimulating neo-collagen and extracellular matrix production, we thought to sequentially combined two different laser wavelengths (1064 nm Nd:YAG and 2940 Er:YAG) in a three-step layering technique.

The Nd:YAG laser perfectly complements the Er:YAG laser ablative action with the ability to penetrate deeply into the skin to create thermal effects without damaging the skin surface.

Why Does Vancouver Medi Spa Use VSP Pulses Than Other Technology ?

Compared to conventional Nd:YAG technologies, this laser system has the VSP pulse which creates virtually instantaneous temperature increases that are limited to the targeted structures only.

To provide fractional treatments, this technology has developed unique Pixel Screen Technology (PST) that divides the basic Er:YAG treatment beam into parallel beam pixels based on the PST which has been compared to other fractional technologies that allows the laser beam quality and parameters within the pixels to remain unchanged compared to the basic beam properties

This enables the practitioner to perform all nine basic VSP Er:YAG ablative treatments and the smooth treatment with fully clinically tested laser parameters.

The only difference is that the skin is treated with pixelated Er:YAG laser beams. Other fractional technologies use focused beams with modified pulse fluences in the fractional spots and therefore with modified and relatively uncontrolled thermal treatment modalities.

The PST ensures that the laser fluence in each pixel is exactly as it would be with a standard Er:YAG laser hand piece.
This enables the practitioner to perform nine basic ablative and one non-ablative treatment at fully clinically tested laser parameters.

PST provides another dimension in the treatment of various skin conditions, avoiding some of the adverse effects of ablative laser procedures while improving the limited efficacy of the non-ablative treatments. No unnecessary energy is deposited into the skin.

Does Vancouver Medi Spa treat Stretch Marks?

Yes, in addition our Skin Resurfacing fractional modalities have been successfully used in the reduction of stretch marks. Significant improvements in stretch mark size, colour, and texture have been reported using treatment protocols consisting of a combination of VSP Er:YAG PST fractional and non-fractional modalities.

Stretch mark reduction of more than 50% in a single session is achieved without any significant side effects. Mild post-inflammatory erythema disappears within 24 hours.

Is this treatment safe?


The fractional technique is based on a concept of producing an array of microscopic wounds on the skin surface that are rapidly re epithelialized by the surrounding, undamaged tissue, sparing the epidermis in the untreated areas.

As a general rule, the final treatment outcome is more pronounced when more aggressive treatment parameters are used. More aggressive treatments are achieved with deeper ablation and coagulation parameters while our patients downtime and risk of complications increase.

An approximate relation of the nine treatment regimes with regards to the efficacy and downtime. Clinically obtained downtimes for cold, warm, and hot light peels are respectively 12-48 hours, 12-72 hours, and 4-5 days. The downtime for a cold medium peel (papillary dermis) is 7-10 days.

Many other skin lesions have been successfully treated with the Er:YAG laser at Vancouver Medi Spa, including compound nevi, sebaceous hyperplasia, trichoepitheliomas, miliary osteomas, syringoma, telangiectasia, rhinophyma, adenoma sebaceum, hidradenoma, xanthelasma, cutaneous manifestations of Hailey-Hailey disease, and Darier disease.

Indications for use of the Er:YAG laser are continuously expanding. For example, recently an Er:YAG laser operating in a non-ablative smooth mode for new collagen synthesis has been introduced.

Fractional laser photothermolysis is the latest in the broad range of Er:YAG laser techniques. This technique promises a novel means of providing treatments that would be as effective as traditional Er:YAG approaches while further reducing their downtime and risk. This treatment is suitable for all skin types and tones, with minimal patient downtime.

Are there any clinical studies to support this treatment?

Scientific & Clinical Research:

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