CO2 Laser Resurfacing (Lumenis UltraPulse)

CO2 laser resurfacing using the Lumenis UltraPulse platform to address deep wrinkles, significant sun damage, and coarse texture. The UltraPulse offers Active FX (superficial), Deep FX (deeper dermal penetration), and Total FX (combined) settings. Ablative treatment with more significant downtime than non-ablative options but more pronounced improvement in a single session. Frequently performed as an adjunct to blepharoplasty.

CO2 laser resurfacing at Dr. Kolker's practice uses the Lumenis UltraPulse — a pulsed ablative carbon dioxide laser regarded as the gold standard for deep resurfacing of photo-damaged skin, deep rhytids (wrinkles), and acne scarring. Unlike non-ablative treatments that stimulate remodelling without removing tissue, CO2 laser ablates the outer epidermal and superficial dermal layers, creating a controlled wound that heals as new, smoother, and better-organised collagen replaces the damaged tissue. The UltraPulse platform offers three distinct energy delivery profiles. Active FX delivers large spots at moderate fluence in a fractional pattern across the entire face — covering the full surface with a moderate depth of penetration, producing a thorough superficial-to-mid-dermal effect with a recovery time of five to seven days. Deep FX uses a fractionated pattern of very high-fluence microscopic beams that penetrate deeper into the dermis — targeting deep scar tissue and more advanced textural changes, with slightly more localised downtime despite the smaller treatment footprint. Total FX combines both Active and Deep FX passes in a single session to simultaneously address surface-level texture and pigmentation as well as deeper structural remodelling — the most comprehensive setting with recovery typically ten to fourteen days. CO2 laser resurfacing is performed under topical anesthesia for lighter treatments, or local nerve blocks and sedation for full-face Total FX. A common clinical application at Dr. Kolker's practice is periorbital (around-the-eye) resurfacing performed as an adjunct to blepharoplasty — the fine crepey skin of the lower eyelid and outer eye area that surgery lifts but does not resurface can be dramatically improved by a single CO2 pass at the time of or shortly after surgical eyelid rejuvenation. Post-treatment skin care involves occlusive wound care during reepithelialization, followed by strict sun protection and gentle moisturisation.