Dr. Michael A. Kremer - "Passion for Perfection"
Dr. Kremer featured as an expert in renowned business journal "European Business Report"
As we age, the effects of sun damage and environmental pollutants begin to take their toll on our skin, creating lines and wrinkles on our faces. Skin resurfacing can help minimize fine lines as they begin to occur, particularly those that form around the mouth and eyes.
Laser and radiofrequency resurfacing are relatively new methods of improving skin texture and appearance. In many situations, it can provide more control over the penetration of the skin than other resurfacing treatments, such as chemical peels and dermabrasion.
If you're considering skin resurfacing, the following information will provide you with a good introduction to the procedure. For more detailed information about how this procedure may help you, we recommend that you schedule a consultation with Dr. Kremer.
What are some of the most common benefits of these procedures?
CO2-laser and radiofrequency (Coblation®) are both used to remove layers of damaged and wrinkled skin so that new, smoother, and more vibrant looking skin can form. Depending on the amount of surface skin removed, you may also see a significant improvement in the tightness and firmness of the skin. This is mostly due to shrinkage of collagen as well as deposition of new collagen during the postoperative months.
What will happen at the initial consultation?
During the consultation, Dr. Kremer will advise you on the changes that you would like to make in your appearance. He will explain the different options available to you, the procedure itself, its risks and limitations, as well as the type of anesthesia required.
Dr. Kremer will begin with a medical history and will examine your face, both the skin and underlying bone. Dr. Kremer will determine if laser resurfacing , radiofrequency resurfaxing or another form of skin resurfacing like chemical peels is right for you. This decision may depend largely on your skin type and color, since laser resurfacing can cause uneven skin tone formation on people with darker skin tones.
Take this opportunity to ask all the questions you have about the procedure. Learning everything you can about your options, risks and benefits is the key to making an informed decision.
How is skin resurfacing performed?
Emissions of light from the laser or radiofrequency waves remove layers of damaged or wrinkled skin at precisely controlled levels of penetration. First, Dr. Kremer will cleanse your face to remove oils from the skin. A skin disinfectant is then applied.
CO2-Laser: You will be required to wear protective eye shields. A beam of laser light from a microphone-shaped instrument is passed over the skin to vaporize the outer layers of damaged skin. The laser can be can be programmed for varied levels of duration and penetration. As the laser works, you may hear it zapping, and smell smoke while the laser removes the upper epidermal layers and shrinks collagen. The smoke is immediately being suctioned away.
Radiofrequency (Coblation®): Coblation technology employs a novel bipolar design that converts normal saline in the gap between the handpiece and skin into a ionized layer, called plasma. Highly charged particles in the plasma layer accelerate towards the tissue with adequate energy to break molecular bonds - the result is low temperature cellular disintegration. Because the effect is confined to the tissue surface layer and achieved at temperatures below 100 °C, thermal damage to the skin is minimized, while simultaneous shrinkage of collagen is achieved. In multi-center clinical studies, this technology has been proven to yield statistically significant wrinkle removal with minimal associated pain and rapid patient recovery.
Finally, Dr. Kremer will apply a protective ointment or dressing to the treated area.
Will I be awake or asleep during the procedure?
To treat small areas of the skins surface, Dr. Kremer will most likely use a local anesthetic with or without an oral sedative. For complete facial resurfacing, intravenous sedation or a general anesthesia will be used.
How long does the procedure take?
The amount of time that the procedure takes varies, depending on the size of the area being treated, as well as the severity of the skin condition. It can last from just a few minutes to an hour and a half.
Will I need to stay in a hospital?
These procedures are most often performed in the office. Extensive resurfacing or treatments in conjunction other procedures, such as a facelift, are mostly performed in the hospital where you will be monitored overnight by a medical staff.
How much pain is there?
Even patients who remain awake during the procedure report feeling only minimal discomfort. Dr. Kremer frequently uses local anesthesia, if necessary with a sedative. After the surgery, the pain is mild to moderate.
What can I expect after the procedure?
After the procedure, you may experience some swelling and discomfort. Cold packs are usually recommended to reduce the swelling.
A clear bandage will be applied after the surgery as a dressing to assist healing. It will usually be removed in 2 days at which time an ointment is applied. You will thereafter need to wash your face several times daily. You will need to use caution in caring for the treated area. After each washing, you will need to apply an ointment, such as vaseline, to the treated area. Scabs may form, and last for about 10 days. You must not pick at the scabs. If you experience pain, oral pain medication can be taken.
What is the recovery period like?
The amount of time needed for recovery depends on whether a CO2-laser or the radiofrequency (Coblation®) was used, the depth of the resurfacing and the individual’s capacity to heal. After CO2-laser resurfacing, redness may persist for several weeks, or longer, sometimes up to 3 month or even longer, depending on each individual person. The redness gradually lightens to pink, and then to a lighter, more natural color. The redness is recognized to be one of the major disadvantages of the laser treatment.
The great advantage of the new radiofrequency (Coblation®) treatment is that the redness only lasts for a couple of weeks.
Make-up can be applied approximately two weeks after the procedure to cover-up the redness.
What is the long-term outcome like for most people?
Skin resurfacing treatments generally remove most of the fine wrinkles and imperfections in the treated area. During the following months after the resurfacing, the results will further improve, comfirming the regeneration of collagen. However, natural facial movements and expressions eventually cause some of the lines to reappear.
After skin resurfacing, daily sunscreen is highly recommended to protect the sensitive new skin from sun exposure. Ask Dr. Kremer to recommend a sun block with both UVA and UVB protection, and apply it daily. If resurfacing was done around your eyes, you should use sunglasses.
Like most other methods of skin resurfacing, those treatments may need to be eventually repeated to maintain the desired results.
Ideal candidate:
In general, the best candidates for skin resurfacing are:
The above is only a partial list of the criteria that Dr. Kremer will consider in determining whether or not this procedure is appropriate for you. Be sure to ask Dr. Kremer if he considers you an ideal candidate for skin resurfacing.
Other important information:
Sometimes skin resurfacing is performed in conjunction with a facelift. Loose, sagging skin can be tightened and firmed by a facelift, while the texture of the skin can be improved by laser resurfacing.
Other resurfacing options include chemical peels and dermabrasion. In general, laser and radiofrequency resurfacing allow a more precise control of the depth of penetration than these other two methods. However, peels and dermabrasion have advantages in certain situations. Dr. Kremer will consider your expectations, the size of the area to be treated, and other factors in deciding which method, or combination of methods, is best for you.
Risks and limitations:
Though the majority of skin resurfacing treatments are successful, you should be aware of the following risks:
Semi-permanent or permanent skin lightening may occur in the treated areas. This is unpredictable and hard to treat without permanent tattooing of the skin. The skin may also become hyperpigmented (darker) immediately following the surgery. Often this darkening treats itself, lightening on its own or responding to various skin care regimens that include hydroquinone (a bleaching creme) and alpha-hydroxy (fruit) acids.
Skin resurfacing procedures may not sufficiently tighten the skin, and surgical excision may be necessary to achieve the results desired. It is most often worthwhile the try to perform laser procedure first to avoid the possibility of scarring, so do not be dismayed if a secondary procedure is necessary.
Heat from the laser may cause burns or injuries. To reduce the risks involved in this procedure, carefully follow all of Dr. Kremer’s instructions, both before and after surgery.
Be sure to:
The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result.
The best method of determining your personal options is to schedule a personal consultation with Dr. Kremer. He will be able to answer specific questions related to your situation.
To schedule your personal consultation appointment, please call us at
+49 (0) 89 - 55 27 450
