Minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose.


A brow lift can help restore your brow position giving your eye an open and bright appearance.


Forehead sagging that causes drooping eyebrows and hooded eyelids can also be addressed with a brow lift.

CO2 Skin Resurfacing

Do you have dull skin and/or facial lines and wrinkles that make you look older than you feel?Do brown spots or other skin irregularities trouble you? Are you sick and tired of over-the-counter beauty products that never live up to advertised claims?Deceptive advertising and un-scientific, un-proven claims surrounding beauty products is terribly rampant.Billions of dollars are spent each year on skin care products that are not very effective or even healthy for your skin.If you have not been treated with medical grade skin care products and you are dissatisfied with the appearance of your skin or if you have reached maximum benefit using medical grade skin care and signs of skin aging persist, then schedule a skin care consultation with Dr. Mitchell.
One of the three “D’s” of the aging face is Deterioration.Deterioration is defined as the gradual decline, as in quality, or vigor.Deterioration of the skin results from both intrinsic factors including genetic makeup and hormonal influences and extrinsic factors like sun damage, smoking, and alcohol intake and pollution exposure.The deterioration of the skin presents as dull appearance, thin skin quality, fine lines and deeper wrinkles, brown spots and skin lesions. If you desire fresh, clear and radiant skin, then a consultation and treatment by Dr. Mitchell may be the answer for you. We offer medical grade, prescription, physician supervised skin care that’s proven to correct your skin health.We offer chemical peels and laser skin resurfacing to restore your skin to a healthier and more vibrant appearance.


1. What is facial skin laser resurfacing?

2. How are laser peels performed?

3. What is a CO2 laser?

4. What is DEEP FX?

5. Who is a candidate for a laser resurfacing?

6. What is the Fitzpatrick classification of skin typing?

7. What is the anatomy of the skin?

8. What are the benefits of skin resurfacing using a CO2 laser?

9. What are some of the considerations prior to undergoing facial skin resurfacing?

10. What are the risks and potential complications of CO2 laser skin resurfacing?

11. What is a Physician prescribed home skin care regimen?

12. I want to freshen up my skin but I don't want a long healing time. What are the options?

13. How do I prepare for laser resurfacing?

14. What is the post-operative care after undergoing CO2 laser resurfacing?

15. Why should I choose Dr. Mitchell to perform my CO2 laser resurfacing?




1. What is facial skin laser resurfacing?


CO2 laser technology is a method of resurfacing the skin.Laser peels have the ability to rejuvenate the facial skin unlike any topical skin care product. CO2 laser resurfacing involves the application of a CO2 laser wavelength to the skin to wound the epidermis and dermis in a controlled fashion. Fractional CO2 laser skin resurfacing is a revolutionary adaptation to the time-tested gold standard CO2 resurfacing procedure.CO2 resurfacing is a precise, effective and long-lasting method for skin rejuvenation.The carbon dioxide (CO2) laser ablates the skin, layer by layer, permitting clear definition and optimal depth control of the skin.Recent advances in the delivery of the CO2 wavelength has made it possible to deliver predictable results matched with an individuals desires, skin type and allotted downtime.The goal of CO2 laser resurfacing is to have the skin regenerate with an even surface and pigmentation.This treatment targets dyschromia (skin color variations), lines, wrinkles, scars, dermal lesions (deeper skin abnormalities) and stimulates long-term collagen remodeling.The clinical results clearly indicate the global improvement in the appearance of the skin, with a reduction in solar lentigines (brown or "sun spots"), actinic keratoses (pre-cancerous lesions) and rhytids (wrinkles). An improvement in overall pigmentation and skin tone (tightness) is commonly achieved.After treatment, microscopic examination typically demonstrates a more youthful and healthy appearing skin structure.



2. How are laser peels performed?

Laser skin peels are essentially divided into three categories, superficial, medium and deep, depending upon the depth of the wound created by the CO2 laser.The skin is divided into two main layers, the epidermis and dermis.The epidermis is itself a five-layer structure and the dermis is composed of two layers.Superficial depth peels penetrate into the epidermis only, while medium-depth peels damage the entire epidermis plus the papillary dermis to the level of the reticular dermis.Deep chemical peels create a wound to the level of the mid-reticular dermis.Each category of peel addresses a different aspect of patient dissatisfaction of sun damage and pigmentary abnormality.


Superficial CO2 laser resurfacing can be performed comfortably in an office-based setting.Although one peel will provide noticeable results, a series of superficial peels may be necessary in order to achieve additional benefit.Superficial peels offer improvement in skin texture, thickening of layers of the epidermis, as well as improvement of some melasma (dark irregular patches) and solar lentigenes (brown lesions).Medium depth and deep laser peels further improve the sign’s of aging that are located deeper in the dermis.Medium depth and especially deep peels typically require some level of local anesthetic or sedation.General anesthesia is also a good option for some skin resurfacing procedures.




3. What is a CO2 laser?


CO2 laser skin resurfacing is a time honored and predictable method for resurfacing the facial skin.Laser resurfacing of the neck is less predictable but can be performed with success.The CO2 laser beam wavelength is 10.64 microns and targets the water in the skin and causes a vaporization of the layers of the skin.Fractional CO2 resurfacing means that only the laser beam treats a fraction or portion of the skin.By leaving small "bridges" of untouched skin, the healing process is faster and patients can return to normal activities sooner.CO2 resurfacing not only results in an improved aesthetic component to the skin, but also results in clinically and microscopically healthier facial skin.



4. What is DeepFX?


DeepFx is a revolutionary fractional laser technology for aged, sun-damaged or scarred skin.This low-downtime procedure uses CO2 laser microbeams to precisely target the deep dermal layers of the skin in a single pass.This stimulates a cascade of healing responses that leads to tissue regeneration and new collagen formation throughout the entire treatment area.Each laser pulse removes a narrow column of tissue while simultaneously treating surrounding skin.This technology penetrates the epidermis and the dermis while leaving adjacent tissue (bridges) intact and viable.This deep heating causes immediate collagen contraction and long-term collagen remodeling.The result is softening and smoothing of deeper wrinkles and scars, and improved skin texture.Benefits of DeepFX include; significant results in a single treatment, low downtime, scar improvement, wrinkle reduction and texture refinement.




5. Who is a candidate for laser resurfacing?

Not all people are "ideal" candidates for CO2 skin resurfacing. Patients with darker skin (Fitzpatrick 4-6) are best suited for chemical peels. In general, performing resurfacing on whiter skin results in fewer potential side effects and complications versus darker skin types. Fitzpatrick skin types 1-3 are best suited for CO2 laser skin resurfacing. Depending on skin type, peel depth and skin conditions, 6 to 8 weeks of skin pre-conditioning may be prescribed in order to properly prepare the skin for the laser treatment and to reduce the incidence of side-effects and potential complications. The Fitzpatrick skin classification correlates skin color to sun exposure response and indicates to a good degree how someone will respond or react to facial resurfacing treatments. Compared to CO2 laser treatments, chemical peels are available to all patients and skin types.The type, aggressiveness and purpose of the peel are always taken into consideration and depend on many variables.Individuals treated with Accutane must wait 6-12 months after its discontinuation prior to engaging in skin peels.



6. What is the Fitzpatrick classification of skin typing?


The Fitzpatrick Classification Scale was developed in 1975 by Harvard Medical School dermatologist, Thomas Fitzpatrick, MD.This scale classifies a person’s complexion and their tolerance of sunlight.Many physicians utilize this categorization to help determine how someone will respond or react to facial treatments. In general whiter skin has fewer side effects and potential complications following more aggressive peels versus darker skin types.


Fitzpatrick Classification Scale

Skin Type

Skin Color



White; very fair; red or blond hair; blue eyes; freckles

Always burns, never tans


White; fair; red or blond hair; blue, hazel, or green eyes

Usually burns, tans with difficulty


Cream white; fair with any eye or hair color; very common

Sometimes mild burn, gradually tans


Brown; typical Mediterranean Caucasian skin

Rarely burns, tans with ease


Dark Brown; mid-eastern skin types

Very rarely burns, tans very easily



Never burns, tans very easily



7. What is the anatomy of the skin?


The skin is the human bodies largest organ.Human skin makes up 15% of our total body weight.Skin acts as a protective barrier to harmful substances such as bacteria, foreign bodies, chemicals and ultraviolet light.Skin also helps to retain water and regulate body temperature.The skin is made up of three distinct layers; the epidermis (top layer), the dermis (the middle layer) and the subcutis (the bottom layer).The epidermis is responsible for manufacturing skin cells and pigment.The dermis is deep to the epidermis and is the foundation for the epidermis.The dermis contains collagen, elastin, pilosebacous glands and blood vessels.The dermis supports the epidermis both structurally and physiologically with all the nutrients and vitamins it needs to produce an effective barrier.All skin resurfacing, whether done by traditional dermabrasion, chemical peeling, or laser resurfacing targets the layers of the epidermis or both the epidermis and the dermis.In general, Fitzpatrick skin types I-III are the best candidates for these treatments.Skin types I, II and III typically are at minimal risk of significant or prolonged complications.Skin types IV, V and VI are treated with caution and great care when applying any ablative laser technology.Fractional resurfacing is now allowing for more effective treatment of darker skin types using adjusted laser settings.When skin types IV-VI are treated with this modality, intensive pretreatment skin care is coupled with lighter CO2 treatments and followed by post-treatment skin care.Instead of using the CO2 laser, darker skin types are best treated with chemical peeling agents.


8. What are the benefits of skin resurfacing using a CO2 laser?

By inducing a controlled wound to the skin, laser resurfacing replaces part or all of the epidermis and none or part of the dermis, induces collagen remodeling which helps to reverse photodamage, wrinkles, pigmentation abnormalities and scarring.Light or superficial peels offer a minimal downtime procedure designed to refresh healthy but dull skin.A series of superficial peels will offer more dramatic results.Deeper peels are designed to target more severe photodamage and aged skin characteristics.While CO2 laser resurfacing is typically limited to the face and carefully applied to the neck, chemical peeling is useful and effective on multiple body areas including the arms, hands, neck and chest.



9. What are some considerations prior to undergoing facial skin resurfacing?


Prior to undergoing any cosmetic treatment or surgery, make sure your goals and expectations are reasonable.Except for superficial peels and in certain cases, a six to eight week skin preparation is required prior to undergoing skin resurfacing.The preparation includes the use of Retin-A, skin bleaching agents and regular use of sunscreen.A light chemical peel may be performed in the weeks prior to a deeper peel.Therefore you must allow enough time for this important step prior to having the actual resurfacing treatment. This preparation phase allows for better, more even penetration of the chemical peeling agent and less incidence of post treatment complications.A further consideration includes understanding the time period for post-treatment healing.While superficial peels have virtually no downtime, deeper peels are associated with downtime from 3 to 10 days.Erythema (pinkness or redness) associated from the procedure may last up to 14 days and occasionally longer.Cover up makeup can almost always be applied at 10 days post procedure.



10. What are the risks and potential complications of CO2 laser skin resurfacing?


While CO2 laser skin resurfacing is generally safe and significant complications are unusual, any procedure has associated risks and potential complications.In general the darker the person’s skin and deeper a peel is delivered, the greater the risks.Most complications are avoided by proper preparation of the skin for peeling and proper choice of agent or device and depth of peel for the patient.Some of the risks include; post-inflammatory hyperpigmentation (darkening of the skin), hypopigmentation, (lightening of the skin), infection, prolonged erythema (redness) and scarring,


11. What is a Physician prescribed home skin health care regimen?


Every adult is a great candidate for professional home skin health care.The results derived from physician prescribed and supervised skin care can be impressive and many times avoid more aggressive future treatments.Unlike over-the -counter skin care products, prescription skin care products typically contain more effective ingredients or higher active ingredient concentrations designed to target specific skin related conditions.An effective, well-planned home skin care regimen is analogous to exercise for your body.As exercise is healthy for your heart and muscles, a good skin care program is beneficial to your skin.The result is firm, clear and resilient skin.Utilizing a Physician prescribed and supervised skin health care regimen is like having a personal trainer for your skin.




12. I want to freshen up my skin but I don’t want a long healing time.What options are available?


Besides the regular and committed use of an excellent home skin health care program, superficial chemical peels are very popular due to their relative safety, ease of performance and cost value.There are many options when considering superficial chemical peels.More popular peels include; Alpha-hydroxy acids (glycolic acid), TCA (Trichloroacetic Acid) in low concentrations, and Jessner’s peel.Performed comfortably in an office based setting, superficial facial chemical peeling offers a great skin refresher option.




13. How do I prepare for laser resurfacing?


It is very important to follow the pre skin resurfacing protocol closely.By following the pre-peel regimen as prescribed, the effectiveness of the peel will be maximized and incidence of post-peel complications minimized.You will be asked to use a six to eight week home skin care system.This includes a gentle cleanser and toner; exfoliate, bleaching cream and sunscreen.These products are used for a distinct purpose.Using this program as prescribed is analogous to an athlete training for a big event.If an athlete did not prepare, train or warm up for his or her game, the chance for injury or under achievement is higher.The same goes for your skin.With proper pre-resurfacing skin care, your skin will be much more likely to have a top-notch result.



14. What is the post-operative care after undergoing CO2 laser resurfacing?


Downtime is predictable and should be balanced with patient expectations and skin type.It is important that you be sufficiently prepared for your post-peel recovery period.Complete written post-operative instructions will be provided prior to your chemical peel or laser resurfacing.In addition, our staff is available 24 hours a day to answer your questions. The discomfort experienced from CO2 laser resurfacing is temporary.Healing at home is painless. The burning feeling from aCO2 resurfacing lasts from one to three hours after the procedure. You will be instructed to wash your face twice daily without rubbing off any skin.Applying antiseptic compresses is instructed in some cases.A moisturizer or a thicker emollient will be used.You will be instructed to minimize facial expression and to sleep on your back for the first two or more nights.Deeper peels require more aggressive home care while superficial peels require little initial care.Healing time can be delayed by patient factors such as picking or rubbing the skin or by making too much facial expression that can lead to cracking of the scabs.The first stage of healing is complete when the epidermis has been restored(reepithelialization) and the skin can tolerate topical treatment with hydroquinone and tretinoin (Retin-A).In the next stage of healing, dermal changes, including collagen production and alignment and neovascularization take place for two to six weeks.For that reason, the results of the peel should not be judged until then. You will experience tightness in the face and/ or neck for the first week.For the first day or two you should eat a soft diet until the tightness improves. While looking at your face in the mirror is allowed, please do not obsess about your initial appearance. Everyone experiences a temporary surprise when viewing a reddened or swollen appearance in the mirror. Remember that a more attractive, youthful "you" will show through in several days. Ice bags should NEVER be used against the skin.Applying ice directly to the skin may result in skin death.Showering is allowed but avoid being struck on the face by the shower water while bathing.Remember, the face will be gently washed twice daily using a gentle cleanser and then patted dry. Gentle shampoo may be used. Glasses can be worn as long as the stems do not irritate your skin or ears.



15. Why should I choose Dr. Mitchell to perform my chemical peel or laser


Dr. Mitchell is a Board-Certified Facial Plastic and Reconstructive Surgeon.Dr. Mitchell has successfully treated hundreds of patients for both premature and mature aging of the face.Dr. Mitchell’s artistic ability and thorough knowledge of facial anatomy and physiology translates into reliable and consistent success using both medical and surgical forms of facial rejuvenation. From simple mole removal to full face and neck resurfacing, Dr. Mitchell is at the forefront of delivering the CO2 laser wavelength for skin rejuvenation. Dr. Mitchell has objectively documented numerous sequential successful cases and has been chosen by Lumenis to be a Lumenary Physician; selected to train other physicians on proper and safe use of laser and light based technologies.

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