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Fractional CO2 Laser Skin Resurfacing: Wrinkle & Acne Scarring Improvement

Home » Fractional CO2 Laser Skin Resurfacing: Wrinkle & Acne Scarring Improvement

January 16, 2018 by Beauty by Design Leave a Comment

Fractional CO2 Laser Skin Resurfacing:

Results Comparing Platelet Rich Plasma, Alastin, & Human Stem Cell Protein Cytokines to Conventional Post-Treatment (Presented at the American Academy of Cosmetic Surgery annual meeting 2017)

Robert J Troell, MD, FACS Beauty by Design, Las Vegas NV. Stanford University Medical Center, Facial Plastic & Cosmetic Surgeon, Diplomate of six medical specialty boards

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This clinical study was examining the goal of most aesthetic treatments:

  1. cosmetic results
  2. severity & length of the recovery period
  3. side effects & possible complications.

 

Study Hypothesis:

Can the topical application of autologous platelet rich plasma (PRP) improve the result from Carbon Dioxide (CO2) Facial Skin Resurfacing?

Can PRP reduce the severity and length of the recovery period with comparable laser energy settings?

Can the PRP reduce the incidence of side effects and complications, specifically scarring and hyperpigmentation?

Can adding Alastin and a Human Stem Cell protein cytokine product to the post-treatment skin regimen affect the result, recovery and complications?

This comprehensive laser clinical study evaluated of over 250 patients and has been evolving over the past ten years. I have been searching for the best skin resurfacing device and post-treatment regimen.

Dr Troell Laser Skin Resurfacing

Dr Troell performing CO2 laser skin resurfacing using the DEKA Smartxide Fractional Laser followed by Platelet Rich Plasma topical application & Alastin Tripeptide & Hexapeptide Pos-Treatment application

 

Background:

What currently available medical device is best in treating facial wrinkles and acne scarring?

Carbon Dioxide (CO2) laser.

I have compared radiofrequency devices, fractional erbium-YAG lasers, and Carbon Dioxide (CO2) lasers for wrinkle and acne scarring treatment. These procedures were performed alone or adding topical platelet rich plasma (also adding dermal needling with radiofrequency).

The Carbon Dioxide laser outcomes were superior for wrinkle and acne scarring indications. Another study has confirmed the superior results with the CO2 laser. They showed that an Erbium:YAG  laser (2940 nm) is superior for improving hyperpigmentation and revealed that these lasers are comparable regarding skin tightening (Preliminary Observations on Fractional Ablative Resurfacing Devices: Clinical Impressions: J Waibel, K Beer, V Narurkar, T Alster. J Drugs Derm, 2009, Vol 8(5), 481-485).

However, in patients with Fitzpatrick Classification type V and VII were preferably treated with a radiofrequency device (either Venus Viva, Matrix RF, or Fractora) to minimize the risk of post-treatment hyperpigmentation.

Does the specific CO2 laser produced by different manufactured make a difference?

Yes.

The DEKA laser revealed less discomfort during the treatment, more rapid recovery, and better aesthetic overall results.

DEKA, Equinox and Lutronic CO2 lasers were compared concerning aesthetic outcome, length and severity of recovery, and discomfort during treatment. All these study variables were followed by the Equinox and lastly the Lutronic CO2 laser.

Dr Troell now exclusively uses the DEKA Smartxide CO2 laser. From a previous conversation, according to the president of DEKA North America, Dr Troell has the largest clinical study in the United States with over 200 patients treated with the DEKA laser for skin resurfacing for solar damage creating wrinkles as well as acne scarring.

Another study confirmed the superiority of the DEKA laser for texture, rhytid improvement and overall appearance over all other studied CO2 and Erbium-YAG lasers (Preliminary Observations on Fractional Ablative Resurfacing Devices: Clinical Impressions: J Waibel, K Beer, V Narurkar, T Alster. J Drugs Derm, 2009, Vol 8(5), 481-485).

 

Current Study Findings:

Does the topical application of autologous platelet rich plasma (PRP) immediately post-laser treatment alter the studied variables?

Yes.

 

The advantages of PRP include:

  1. the duration and severity of erythema of the recovery process was shortened
  2. less skin hyperpigmentation was noted
  3. subjective and objective outcomes revealed better aesthetic outcomes (less wrinkles & much improved acne scarring). The objective outcomes were assessed by using Enhanced Image Pro system. It revealed 10-15% less wrinkles compared to conventional post-treatment occlusive treatments and moisturizers alone.

 

A previous study showed Platelet Rich Plasma (PRP) taken from each patient’s own blood applied after Carbon dioxide treatment resulted in:

  1. Faster recovery
  2. Less erythema index
  3. Less melanin index (hyperpigmentation)
  4. Induced more blood vessel formation (angiogenesis)
  5. Increased collagen production by biopsies.

 

(Rapid Healing and Reduced Erythema after Ablative Fractional Carbon Dioxide Laser Resurfacing Combined with the Application of Autologous Platelet-Rich Plasma, Jung-IM, NA, Jee-Qoong C, Hye-Ryung C, Jeong-Bok, J, et al. Dermatologic Surgery, 2011).

Is there any benefit adding Alastin as an extracellular matrix modulator to the platelet rich plasma (PRP) and post-treatment skin care regimen after CO2 laser skin resurfacing?

Yes.

The advantages combining the Alastin cream to the PRP after laser treatments:

  1. subjective improvement in aesthetic outcome
  2. shorter duration of the recovery period
  3. less erythema observed during the recovery period        The Alastin Skin nectar is a unique product of an anhydrous formulation of a tripeptide and hexapeptide with histological demonstration of ECM recycling with increased production of elastin and collagen.

 

Alastin Extracellular Matrix Modulator Proposed tissue mechanism:

The peptides and synergistic additional ingredients have been shown to recycle the extracellular matrix (ECM) and support skin structure and elasticity. They support the skin’s natural ability to produce new, healthy elastin and collagen.

The specific observations on skin biopsy from Alastin treatment include:

  • More organized, younger collagen fibers replacing mature older fibers
  • Increases in pro-collagen and collagen
  • Thickening of the outer skin layer (epidermis)
  • More functional cells observed in the skin (at dermo-epidermal junction)
  • Increases in elastin fibers

 

The laser tissue trauma produces fragments of collagen amorphous elastin agglutination and abnormal cross-linkages between collagen fibers. This tissue reaction impedes some of the extracellular matrix’s (ECM) normal complex repair processes. The tripeptide and hexapeptides incorporated in Alastin Skin nectar are designed to target ECM modulation. The stress induced oxidation, proteasome dysfunction, and non-enzymatic cross linkages involved in glycation end products are combated by peptides, known as “matrikines”. The Tripeptide is a “matrikine” which specifically activates the production of metalloproteinase and anti-proteases that remove damaged proteins from the ECM. The end result is upregulated neocollagenesis and elastin production. The Hexapeptide is a signal transduction cytokine that stimulates the generation of elastin.

 

Summary:

Carbon dioxide laser skin resurfacing yields the most optimal skin resurfacing results in patients with wrinkles and acne scarring. The DEKA CO2 laser appears to be the best currently available aesthetic laser studied for these indications. The addition of autologous platelet rich plasma (PRP) along with the Alastin tripeptide and hexapeptide extracellular matrix modulator system shortens the severity and length of the recovery period, lowers the incidence of hyperpigmentation, and improves the overall post-treatment result. Continued testing with the addition of Human Stem Cell protein cytokines (Stemulation Facial Serum by Stemulation or Regenica Dual Serums by Suneva Medical, Inc.) appears to further hasten healing and yield improved aesthetic outcomes.

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Dr Robert Troell, FACS Plastic Surgery
Dr Robert Troell, FACS Plastic Surgery
4.7
Based on 38 reviews
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Feven Genovese
Feven Genovese
23:59 17 Jun 20
Dr.Troell gave me hope and made me feel very comfortable. I was extremely happy with the results. His price is really... fair👍🏼 I live far away and he always makes time with my schedule. I would definitely recommend him to everyone.read more
leyextremo2008
leyextremo2008
19:13 18 Mar 20
I had a great experience with my face fillers and I am so happy with the results. Definitely 5 stars!
Andrew Mendoza
Andrew Mendoza
17:17 18 Mar 20
For years my double chin was unsightly and weighed on me, After a 45 minute vaser lipo procedure with Dr Troell I feel... and look like a new person Friends and Family can't believe the difference. There was very minimal pain,bruising and swelling Dr Rob Troell and his staff are the bestread more
sessia KOA TV
sessia KOA TV
07:02 18 Mar 20
I have known Dr. Troell since 2017. I had 2 major surgeries (tummy tuck and breast augmentation from ruptured implants... from the previous another doctor in Beverly Hills about 15 years ago). I was very nervous everytime I went in surgery room. As I get older, I had fear what if... what if I won't be able to wake up from anesthesia, what if.. what if the surgery goes wrong and comes out bad results and so forth. I had a lot of "what if"s. Dr. Troell was very knowledgeable and wise enough to answer all my detailed questions. He always comfort me either before or after the surgery. Most of all, both my surgery days were Christmas time. No body wanted to come out during holiday seasons. However Dr. Troell was always prompted to answer my call and come out to check even though late hours like 11 PM. I am so thrilled about both my surgery results and really happy! Thank you Dr. Troell for always considering me like one of your family members, not just a patient.read more
M DH
M DH
23:59 17 Mar 20
Dr. Troell and his entire staff (particularly Jessie), have gone above and beyond before, during, and after my surgical... procedures. I recently had revision rhinoplasty and cheek/lip implants. I felt thoroughly prepped with information and am healing quite nicely. Dr. Troell has followed up every step of the way, and continues to monitor my healing during this process. I feel blessed to have had such an amazing experience with Dr. Troell and his staff. I’m looking forward to my final results, and know I’m in good hands throughout this aesthetic journey!read more
Susana Williams
Susana Williams
21:22 17 Mar 20
I've been getting Botox for my wrinkles and lines with great results for 2 years. Happy wiht Dr Troell and his staff.
Ramin Sarshad
Ramin Sarshad
21:12 17 Mar 20
Attended many CME courses with Dr Troell for many years. He's always on top of the latests lipo and body countering... techniques. Great cosmetic and plastic surgeon to work with.read more
Linda Watkins
Linda Watkins
03:34 15 Jan 20
Dr Troell should No Longer have a Medical license or business license. He does not produce good results and will tell... you what you want to hear just to get money out of your pocket. He truly does not care about results, only taking your money. He only has 1 or 2 employees at a time, they are there a couple months and then gone. Good for them, they have a conscience and can not stand behind Dr Trolls work. I don't normally write reviews but people need to know the truth.read more
Linda W
Linda W
05:21 05 Dec 19
10+ years ago Dr. Troell was the doctor to go to. However in the last 10 years that is not the case. Don’t believe... the fake reviews. His website shows employees that have not been there in over a year. His videos are 13 years old. I know Firsthand as a patient and an ex office manager.read more
Crissie  Adams
Crissie Adams
17:37 28 Oct 19
Dr Troell is by far the best Dr I have gone to! He did the most amazing job on my lips and I couldn’t be anymore... thrilled with how they turned out, it’s EXACTLY what I was after. Dr Troell has been the most attentive to my needs and calls everyday to check in on me... I have never had a Dr do that, EVER. The whole procedure he made me feel comfortable and at ease and explained everything to me perfectly. He is the kind of Dr that I felt extremely comfortable asking questions to and not ever feeling like I was bugging him. I had an amazing connection with him! He get quadruple stars from me! Thank you so much Dr Troell for making me feel beautiful!!!!!read more
mamasita262 .
mamasita262 .
20:40 10 Oct 19
Dr. Troell and his staff are very caring, patient, informative and understanding. I was having my procedures done in... Las Vegas over a period of three months. I was recovering in my home alone. Dr. Troell went above and beyond all expectations I had. He personally contacted me daily to check up on me. He was very much involved in my recovery process, showing genuine empathy. Dr. Toell's bedside manner is a thing of the past, and warms my heart. It is greatly appreciated. He was there for me throughout.read more
jackie bussey
jackie bussey
19:05 27 Sep 19
I had a face lift and blepharoplasty expertly sculpted by Dr. Troell; the facelift in July, and the blepharoplasty in... September. I am so thrilled with both procedures and wish I had done this sooner. The recovery time was extremely fast as I was out and about in a few days. There was very minimal bruising and swelling And the results are beautiful!! my face and eyes are symmetrical and I feel and look younger and refreshed... like the girl I used to be. Dr. Troell is an amazing surgeon and has a wonderful bedside manner. He thoroughly and patiently explains everything that he can do for you and takes his time— Considering you and the results you want to achieve. After my procedure, He checked on me daily— sometimes twice a day to make sure my recovery and overall health was going smoothly. I believe that was the most incredible aspect of my experience. It is hard to find a doctor that really cares about you as a patient and your well-being. I would highly recommend Dr. Troell for any procedure you might consider, you will not be disappointed. A true professional, and artist. Thank you Dr. Troell!!read more
N H
N H
19:48 26 Sep 19
Great doctor. Meticulous in detail and explanations. Great bedside manner and follow up.
Elizabeth Smith
Elizabeth Smith
02:42 18 Sep 19
I have had a Great experience with Dr troell, he is a very hands on Dr. That explains very detail of which ever ... procedure that you are looking for, he also follows up with progress and is always available for any questions that you may have!! I would recommend him to use for any service in which you might be looking!! Very freindly environment.read more
Tracy Kruzan
Tracy Kruzan
18:11 13 Sep 19
I recently had lip and cheek implants. Although there's more to do to fix my injuries, the results to date have been... fabulous! The staff is kind and caring. Whatever your reason for going in, the staff listens. Dr. Troell is very knowledgeable, skillful and kind. I'm very glad I chose him.read more
Violeta D’Nero
Violeta D’Nero
19:53 21 May 19
Absolutely Freaking LOVE the work of Dr.Troell with his amazingly caring and companionate staff (Mrs.Coco and... Michelle). I had always wanted to fix a few things here and there but was always afraid of dying or coming out worse lol or just afraid in general but my heart and mind set and after about a year more or less I finally found a team I felt comfortable with and safe with. Words cannot express my gratitude to Dr.Troell. His expertise and talent are out of this world, not to mention his genuine care and concern for his patients is phenomenal. Not only is he extremely professional he calls to make sure all is good is always available and makes you feel safe and at home. His staff is the absolute best I felt such a connection and most importantly safe and very well took care of. Dr. Troell, Mrs.Coco, and Mrs.Michelle are most deff my go to from now on for EVERYTHING that comes to my beauty. From Vaser- Facials I have found my beauty home. 🙌Thank you so much for helping me accomplish my dreams!read more
Mirjana Radjenovic
Mirjana Radjenovic
04:16 03 Mar 19
My experience with Dr. Troell has been unsurpassed. From the initial consult where he was most detailed reviewing the... options, benefits, and limitations, the comprehensive preoperative workup and exam, the postoperative concerns calling me frequently, his superior training, being a trainer for fellow surgeons, and most importantly- my cosmetic results are natural yet awesome. I have no reservations with my care. I am fortunate to have been referred to him. I love my results. I was reluctant to undergo cosmetic surgery, because of my concerns of who to trust. I was referred to Dr. Troell from my sister who had a fabulous result from facial procedures. I had both a face and body cosmetic procedure performed at different times. People think my face makes me look over ten years younger. Thank you for your endearing care and wonderful results.read more
PatriciaM
PatriciaM
18:36 10 Oct 17
Dr. Troell is an excellent and caring plastic surgeon. Rose is the best esthetician in Las Vegas. She knows what she is... doing, considers all of your options and does what is best for your skin. She goes above and beyond to make you look and feel terrific. I have never met anyone so passionate about what they do.read more
Cathy Prather
Cathy Prather
22:12 28 Jul 17
I am SO pleased with my results! I have multiple surgical procedures performed by Dr. Troell. He has always been so... thorough explaining what to expect. He was caring and called to check up on me often. I put complete trust in him. I love my results and would highly recommend him!read more
Catherine Harlow
Catherine Harlow
00:47 25 Jul 17
Dr. Troell has done a few procedures on myself and both my sisters. They span over about a 12 year.. I've always been... happy with what he has done for me, I guess that is why I continue to go back to him as a doctor. I have sent three of my friends to him even though I do not live in his area but we do Fly to see him in one of his locations. I like that there is such a personal touch to his practice I believe he is probably the only doctor that still does house calls if you live in his area. Thank you Dr. TroellI appreciate all you have done for meread more
Snezana Bradic
Snezana Bradic
19:56 24 Jul 17
My experience with Dr Troell have been amazing. He come to my home to explain about my breast cancer . I had many... questions about cancer treatment and beast reconstruction after my cancer is treated successfully. He take time and tells me everything that I should be aware of and pitfalls to avoid. A positive mental outlook, he said, can assist your body to fight the cancer. Definitely i will go to see him after I finish my chemotherapy and other necessary breast treatments, like surgery and radiation to proceed with breast appearance enhancements. We is an empathetic and caring surgeon. Thank you Dr Troell .read more
Tina Kameron
Tina Kameron
22:11 10 Feb 17
I have know Dr Troell for over 10 years both personally and professionally. I have recommended both friends and family... to him for a wide range of procedures. As cosmetic surgery is an art form , technique ,training and experience play an important roll in outcome. A patients expectations and their compliance in post operative care also play a vital role in the outcome . I would not feel comfortable sending a friend or family member to a surgeon who I did not have confidence in his or her ability. I also would not feel comfortable sending a patient who I felt was non compliant or unrealistic to a competent surgeon who I have known and worked with in the past. It is important to have good communicating between patient and physician. I have recommended Dr Troell with confidence in the past and will continue to do so in the future.read more
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Las Vegas

Robert J. Troell, M.D., F.A.C.S. (Las Vegas, Nevada)

Robert J. Troell, M.D., F.A.C.S.
(Las Vegas, Nevada)

Address: 5375 S Fort Apache Rd
Suite 101
Las Vegas, NV 89148.
Phone: (702) 242-6488

Driving Directions Contact Us

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Robert J. Troell, M.D., F.A.C.S. (Irvine, California)

Robert J. Troell, M.D., F.A.C.S.
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Address: 113 Waterworks Way
Suite 105
Irvine, CA 92618.
Phone: (949) 220-0532

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