CO2 laser resurfacing is a procedure used to rejuvenate and correct aging or damaged skin. The procedure is most commonly used to minimize the appearance of fine lines especially around the mouth and the eyes. It is also effective in treating acne scars or areas of uneven pigmentation. Laser resurfacing can also be done with other cosmetic operations such as eyelid surgery.

Laser resurfacing effectively removes the upper layer of skin in problematic areas. New skin is then formed in those areas. The new skin appears younger, more elastic, and with less wrinkles and other signs of age. We specialize in laser resurfacing around the eye and mouth areas.

Laser resurfacing can be a rewarding experience. However, it comes with a extended recovery time. It requires more pre-surgical preparation and after-surgery care than many other cosmetic procedures. After your CO2 laser skin resurfacing procedure you will experience, for a short time, a recovery process that will make your skin look and feel its absolute worst. You may even question why you decided to undergo such a procedure! But the final results of laser resurfacing can be remarkable.

This is why MN Ophthalmic Plastic Surgery Specialists have chosen to include surgery supplement packages, including SkinCeuticals and VitaMedica products, to help provide a quicken your recovery and increase your procedure benefits. In the next few pages there is a list of what those product packages include.

When you arrive for your initial consult at our office, a skin care program will be given to you as a part of your package plan for your procedure. In the next few pages there is a list of what some of those products might include.

Laser resurfacing won't completely remove all facial flaws or prevent further aging. We can suggest ways to help you preserve and maintain your results by protecting your skin from sun exposure and by applying other simple lifestyle changes.

As with any procedure, risks are involved including burns, scarring, and obvious lightening or darkening of the treated skin. Ask our doctors about your level of risk. Not everyone is a candidate for laser resurfacing. Our physicians can help direct you in your best treatment options. Call 952-925-4161 for a consultation.

There are several steps you will take in order to ensure optimal results of your surgery; these steps begin well before your surgery is even performed! To begin with, for the 4-6 weeks prior to your surgery you should maintain a well balanced diet as well as staying hydrated (6-8 glasses of water a day). To prepare your skin before the procedure, several products are included in your treatment plan. SkinCeuticals, a topical skin product line, should be routinely used beginning at least 30 days before the procedure. VitaMedica Healing Supplements, a vitamin supplement program, will begin the day of surgery and continue in your post-operative period.

Blood thinners, including smoking, should ideally be avoided two weeks prior to surgery. However, we understand that certain prescribed medications cannot be ceased or need to be gradually weaned off of. Always talk to your primary doctor before going off of any prescription medication as he or she is most familiar with your specific medication needs.

Finally, you will be given three prescription. These can be filled at your local pharmacy and will be started one day prior to your procedure or taken as directed.

These prescriptions include:

• Ciprofloxacin 500 mg- An anti-bacterial that is to be taken twice daily beginning one day before your surgery and continuing for fourteen days following the resurfacing.

• Acyclovir (Zorvirax) 400 mg- An anti-viral that is to be taken three times a day beginning the day before your surgery and continuing for ten days.

• Fluconazole 400 mg- An anti-fungal that is only taken once the morning of your surgery on an empty stomach with a small sip of water.

The SkinCeuticals surgery supplement packages can be started as soon as surgery is scheduled. For optimum results, start the regimen at least four to six weeks before you undergo your procedure. Continue the regimen beginning on the 15th day after surgery. Read all instructions that come with the product. IMPORTANT NOTE: YOU WILL USE RETINOL 0.5 BEFORE YOUR SURGERY, BUT YOU WILL NOT RESUME USE OF RETINOL 0.5 UNTIL 4 MONTHS AFTER YOUR SURGERY DATE.

In the Morning

Step 1: Cleanse Use the Gentle Cleanser to gently clean the face.

Step 2: Tone Tone with the Revitalizing Toner. Gently scrub your face with a cotton ball or cotton facial pad.

Step 3: Prevent Apply CE Ferulic on the face and Eye Gel around the sensitive eye area. Wait 3-5 minutes before applying the next product.

Step 4: Correct and Moisturize Apply Phyto + Gel on entire face to treat hyperpigmentation and to moisturize.

Step 5: Protect Always finish with SkinCeuticals SPF 30 sunscreen for daytime sun exposure. This includes during the wintertime.

At Night: Normal Regimen

Step 1: Cleanse Wash your face using the Gentle Cleanser in the evening.

Step 2: Tone Gently scrub using a cotton ball or cotton facial pad.

Step 3: Correct and Moisturize Exfoliate facial skin with the Intense Line Defense. It will also moisturize.

*If your skin is especially dry, you may use the Phyto + after the Intense Line Defense for additional moisture, or obtain a SkinCeuticals moisturizer.

Retinol is a Vitamin A derivative. Retinol is shown to work deep in the dermis to increase cellular turn-over and stimulate collagen. The result is fresher, smoother, more radiant appearing skin. Retinol has the same benefits of a Retin-A cream or tretinoin, but is more gentle and with less risk of the negative side effects associated with the latter products. However, use of the Retinol 0.5 needs to be integrated slowly into your routine. Overuse of retinol will result in temporary erythema, sensitivity, and dryness of the skin.

VitaMedica Healing Supplements

VitaMedica's Healing Supplements Program is a ten day supplement program designed to minimize bruising, swelling and general inflammation associated with many surgical procedures. It is ideal for less extensive procedures including blepharoplasty, injectables, forehead and brow lifts, and CO2 laser resurfacing.

VitaMedica's Healing Supplements Program contains several nutraceuticals. These include Bromelain with Quercetin, which are natural ingredients with anti-inflammatory properties, and Arnica Montana 30X, which is designed to reduce bruising and swelling.

DO NOT use VitaMedica Healing Supplements if you are:

• Pregnant or Lactating

• Diabetic

• Have a history of abnormal heart rhythms

• Are taking prescription blood thinners like Coumadin

• Are allergic to pineapple

To use Vitamedica Healing Supplements, follow these instructions:

Bromelain with Quercetin Begin taking Bromelain with Quercetin three days before surgery. After surgery, continue Bromelain with Quercetin until the inflammation and swelling have subside, usually 7-10 days. Take 2 capsules 3 times daily on an empty stomach.

Arnica Montana Begin taking Arnica Montana after surgery and continue until the bruising and swelling subsides, or about 7-10 days. To ensure proper absorption, do not brush your teeth, eat or drink anything but water 15 minutes before and 15 minutes after taking this product. This product is a sublingual application. Do not handle the tablets. Instead, drop tablets into the bottle cap, place tablets under tongue and let dissolve naturally. Take 3 tablets, 3 times daily.

Laser resurfacing effectively removes the surface layers of skin to allow new, younger skin to grow in its place. During the healing process, this new skin is especially vulnerable to sunburn, abrasions, and (more rarely) bacterial infections. It is important to follow these post-operative instructions to ensure a quality outcome. Use the instructions below as a guide to make your recovery a smoother process!

A post-operative appointment will be made for you within a week to ten days following your procedure. During the first 7-10 day period, keep physical activity and sun exposure to an absolute minimum. Do not touch the affected area unnecessarily, and never pick or scratch at the affected area as this could lead to scarring.

Remember: DO NOT EXPOSE THE SKIN TO THE SUN FOR 6-12 MONTHS FOLLOWING YOUR PROCEDURE. SKINCEUTICALS SUNBLOCK MUST BE WORN AT ALL TIMES WHILE OUTDOORS AND IN ALL SEASONS.

Most procedures go normally. However, risk of complication always exists and may include:

• A temperature exceeding 100 degrees

• Extreme swelling, stinging or itching, as this may be a sign of injury or allergic reaction.

• A flare-up of pre-existing cold sores or fever blisters.

If any of the above conditions occur, call our office. We are available outside of regular office hours through our 24-hour answering service at 952-925-4161.

After surgery, redness is expected over the targeted areas of CO2 resurfacing. In the beginning the redness can be very intense and appear like severe sunburn. This is very normal and will gradually fade over a period of 3-6 months. The target areas will weep a clear, reddish liquid for 3 to 7 days. It may be very pronounced within the first 24 hours. Keeping a towel around the neck at all times to absorb run-off may be helpful. However, the towel is only for any fluid that may drip and should not be used to pat or rub the area.

You may experience a mild pain or burning sensation after surgery. A mild pain medication will usually be enough to relieve this discomfort. This will usually be prescribed at the hospital following surgery.

Swelling is also expected during the first 24-48 hours after surgery. Sleeping with your head elevated by pillows is recommended.

It is vital in the first 1 to 7 days to keep the resurfaced area moist at all times with Aquaphor. Aquaphor is a hypo-allergenic ointment that is safe for use on the skin after resurfacing. Aquaphor will form a protective barrier over the sensitive skin, which allows the skin to remain moist and minimizes crusting and irritation. Aquaphor is available without a prescription at most drugstores. Aquaphor will be applied on the resurfaced area before you leave the hospital, but you will need to continue applying at home regularly in the next week.

Sun exposure should be avoided entirely for 7 days after the procedure. After one week, sunscreen should be worn whenever leaving the house.

At least three days should be taken off before returning to work. However, if your job is image conscious, such as sales, involves environmental dust or debris, or involves sun exposure, we recommend taking up to two weeks off of work.

Use the day-by-day guide below to properly use the products you have been directed to use. Follow all labeled instructions when administering prescription medications.

Day 1

• DO NOT disturb the Aquaphor that was applied to your face at the hospital for the first 24 hours.

Day 2

• Cleanse the affected area for several minutes with a solution of 1 tablespoon white vinegar mixed with 1 cup of cool water. Discard the solution after use. Cleanse 4 times, at regular intervals, using fresh solution each time.

• During cleansing, use gauze or a Q-tip to gently roll over the surface of your skin removing any excess debris that may have collected on the skin. DO NOT rub hard. Gently pat dry the area with a soft towel and apply a thick layer of Aquaphor after every cleansing.

• The Aquaphor should be applied 6-8 times a day or whenever the skin begins to dry out. Remember your skin must remain moist at all times.

• DO NOT PICK OR SCRUB AWAY DEAD SKIN OR SCABS. THIS WILL ONLY DELAY THE HEALING PROCESS AND MAY RESULT IN SCARRING.

Days 3-7

• Cleanse twice daily using SkinCeuticals Gentle Cleanser. Pat dry with a soft towel.

• Apply Aquaphor after each cleansing and continue to apply as needed throughout the day.

Days 8-14

• Continue to cleanse with the Gentle Cleanser twice a day.

• If a moisturizer is needed, apply Phyto +. If you experience any irritation, cease use until Day 15 and continue to use Aquaphor.

• Apply Physical Defense SPF 30 every day before leaving the house and reapply throughout the day.

Day 15

• On the 15th day, your normal pre-operative skin care regimen can resume as well as the application of cosmetics (hypo-allergenic or mineral based). DO NOT use Retinol 0.5 until 4 months after surgery.

• Remember you will need to keep your skin protected from the sun for at least one year. SkinCeuticals sunblock should be worn at all times when outdoors and regularly reapplied.

We hope this procedure will be a rewarding experience for you. Minnesota Ophthalmic Plastic Surgery Specialists we do everything we can to make your healing time as comfortable as possible. If you have any questions about the information you have just read, please do not hesitate to call our office at 952-925-4161.