Fraxel Repair laser

In April, 2008, we became the first dermatology practice in middle Tennessee to have the newly FDA-approved Fraxel Repair laser. This remarkable device uses the same fractional thermolysis technology as its predecessor (the original Fraxel, which is now referred to as the Fraxel Restore), meaning that it treats only a fraction of the skin surface, sparing just enough to allow rapid healing and minimal downtime.


The significant difference between the two devices is that the laser used in the Fraxel Repair is a CO2 laser, allowing the removal of tissue instead of only coagulation as accomplished by the erbium glass laser in the Fraxel Restore. This makes the new instrument an ablative laser (one that destroys and removes unwanted tissue) which gives it a remarkable ability to vaporize and remove millions of microscopic cylinders of sun-damaged and abnormal collagen, the result being significant shrinkage of the skin with visible tightening and reduction of wrinkles. Up to 40-50% of the skin surface can be given these ablative impulses, thus giving significant correction of surface pigment and age spots with only one procedure. Redness of the skin which can be due to thinning of skin from sun damage is greatly reduced because of the coagulation of capillaries in the skin by the CO2 laser.


As mentioned, the desired results in terms of reduced wrinkling and improved skin texture and color can be achieved with a single procedure in most cases. If a significant enough degree of wrinkling exists, a few patients may need a second procedure, which can be done with no greater risk of adverse effects.


There is slightly more discomfort during the Fraxel Repair procedure compared with the Fraxel Restore, but the combination of effective topical anesthetic creams, oral and/or injectible analgesics and relaxants, and chilling the skin with the Zimmer cold air cooler during the procedure make it well within anyone’s tolerance level. We predict that most patients will have about 7 days of downtime after the procedure before they can return to their full routine of makeup, appearances, etc. While this laser does not replace the Fraxel Restore, which is still the preferable choice for treatment of acne scars, stretch marks, and melasma, it is much superior in the treatment of age spots, wrinkles, and redness of the skin. The slightly longer downtime is certainly acceptable to most patients since the Fraxel Repair procedure is usually done only once. Because the fractional technology allows treatment of areas off the face as well, many patients opt to treat their neck simultaneously with their face so that all visible areas achieve equal rejuvenation in appearance. With the use of stainless steel eye shields inserted at the time of the procedure, eyelid tightening can be safely accomplished to a degree only slightly less than surgical blepharoplasty. Of the five types of skin coloration, only Type 5 (African or African American) patients are not currently considered candidates for the Fraxel Repair procedure because of increased incidence of post-operative hyperpigmentation.


As with the Fraxel Restore and most other cosmetic procedures, the Fraxel Repair procedure is not covered by Medicare or any other insurance carrier. The cost incurred is based on the amount of area treated during the procedure and is paid at the time of the service.