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CO2 Laser


While surgery, Botox, and dermal fillers are powerful and effective treatments for a number of aesthetic concerns, CO2 laser resurfacing is the gold standard for skin rejuvenation.  A highly customizable treatment, CO2 addresses loose, crepey, lined, and sun-damanged skin, helping to turn a new page on your appearance.

CO2 Laser Resurfacing in Atlanta, GA

CO2 Laser:
Treatment Overview

CO2 laser uses precise and targeted beams of energy to create microscopic channels of injury in the skin; this stimulates collagen production leaving the treated skin looking smoother, tighter, and more even in color and texture. CO2 laser is an ablative laser which means that the top layer of the skin (the epidermis) is removed, and the underlying layer of skin (the dermis) is heated up. The skin’s reparative processes result in collagen production, a more plump blanket of support under the skin, and a smoother and more youthful appearance to the skin. CO2 laser is an invasive treatment with associated downtime, and it can address multiple concerns at once minimizing the number of treatments needed. With proper maintenance, the effects of CO2 laser treatments last for years.

I still look like myself, just brighter and better. My skin is smoother and looks more youthful. This was the perfect treatment for me, and my experience couldn't have been better.

Piezo ultrasonic rhinoplasty

What is CO2 Laser?

This treatment works through high energy, amplified light waves of the carbon dioxide (CO2) laser, with the energy of the light waves vaporizing the top layer of skin. CO2 laser allows for highly precise and targeted treatment of the skin, and the ability to vary lots of treatment parameters (including amount of heat energy delivered and how much of the skin’s surface is treated) allows CO2 laser resurfacing to be a thoroughly customizable treatment.  

Along with chemical peels and dermabrasion, CO2 is a skin resurfacing treatment, making it an effective tool for the improvement of skin aging; sun damage and sun spots; fine lines; crepey skin; acne scars and surgical scars.  Our facial plastic surgeon Dr. Inessa Fishman performs CO2 laser skin resurfacing as a standalone procedure, and frequently combines it with facelift surgery, blepharoplasty (also known as an eyelid lift), and an upper lip lift.

The Benefits of CO2 Laser Treatment

Confidence in appearance helps our patients look and feel their best every day, and this feeling extends to our patients’ professional and personal lives.  In addition to improved self-confidence, the benefits of CO2 laser treatment include:

  • Reduction in fine lines and wrinkles
  • Reduction in mild to moderate acne scarring
  • Improvement in skin tone and texture
  • Increased production of collagen
  • Correction of photodamage (sun damage)
  • Smother, more taut skin with improved complexion and texture

Am I a Candidate for CO2 Laser?

In general, men and women in good health and without severe skin or scarring disorders seeking to prove the appearance of their skin are good candidates for CO2 laser treatment. This treatment is not recommended for patients with darker skin types due to increased risks of pigment or color changes and scarring. Patients seeking CO2 laser treatment must be at least six months post-isotretinoin or Accutane use. Individuals bothered by fine lines and wrinkles, photodamage, acne scars, and uneven skin tone and texture may benefit from the skin rejuvenating effects of CO2 laser. Dr. Fishman thoroughly evaluates her patients prior to making a recommendation regarding CO2 laser or other appropriate treatments.

Frequently Asked Questions

CO2 laser treatment can occasionally cause infection (both bacterial and viral), acne flares, scarring, milia (or blocked oil glands also called whiteheads), cold sore reactivation, hyperpigmentation (or a darkened skin color), hypopigmentation (or a loss of skin pigment resulting in a lighter than normal skin color) and skin burns and injuries.

While most discoloration will fade over the first three months, your healing will continue for an entire year after CO2 laser resurfacing. We will follow you through your healing process; be patient with your body and healing time. 

What is Recovery Like After CO2 Laser?

Immediately after treatment, swelling and numbness will be noted within the treated areas. Swelling and bruising following treatment varies from person to person, but most of this resolves over the first 7-10 days after treatment. Patients are asked to gently clean the treated areas twice daily with warm water (plain or with a gentle cleanser like CeraVe or Cetaphil). Frequent cleanings are an important part of the healing process. There is to be no rough rubbing or scrubbing of the treated areas. Patients should apply a thin layer of Vaseline or Aquaphor multiple times a day to keep the skin moisturized during the healing process. Discomfort after CO2 laser treatments can be well-controlled with Tylenol and Motrin, and frequent moisturization of the treated skin.

CO2 Laser Treatment Care Instructions

Dr. Inessa Fishman and our staff are strongly invested in both beautiful treatment results and a smooth and uncomplicated recovery for our patients. We work with you before and after your CO2 laser treatment to ensure that you are comfortable with the treatment plan and are thoroughly educated about the best before and after treatment care.

We recommend reviewing the Pre- and Post-Treatment CO2 laser instructions several times prior to and after your treatment.  We want to provide you with the information and tools you need to have an excellent treatment experience.  Please contact our office should you have any questions or concerns about these instructions, your preparation for treatment, or post-treatment recovery. We are here to help!

Please read and familiarize yourself with these instructions before and after your CO2 laser treatment. By following them carefully you will assist in obtaining the best result from your procedure. If you have questions or concerns, please contact our office.

Fill your prescribed medications, but do not start taking them until after your CO2 laser skin resurfacing treatment.

Do not take any anti-inflammatories or multivitamins starting 7-10 days prior to your procedure (see list of anti-inflammatory medications below).  Avoid alcohol 48 hours prior to and 48 hours after your procedure.  This helps to decrease the risk of bruising after treatment.  

The following is a list of instructions for your care following CO2 laser resurfacing.  Please read them carefully several times, both before and after treatment.  Carefully following these instructions should help you get the best results from your treatment.


Swelling will vary patient-to-patient.  Swelling may actually increase the first three to four days before subsiding.  Most of your swelling should resolve over the first two to three weeks.  Do expect to have minor fluctuations in the remaining swelling over the course of the next two to three months. Things to do to minimize this swelling include keeping your head elevated as much as possible over the first two to three weeks, avoiding bending over or heavy lifting for the first three weeks, and avoiding prolonged and unprotected sun exposure for the first three months after treatment.

Bruising will vary like swelling from person to person.  Most bruising and discoloration should resolve over the first two weeks.  Make up, with Dr. Fishman’s permission, can be applied ten days to two weeks after surgery.

Your face will be numb following the procedure because of local anesthetics that we inject at the time of surgery.  Expect this to wear off during the first six to twelve hours.


It is not uncommon for patients to go through a period of mild depression or “the blues” after cosmetic surgery and treatments. This typically occurs within the first 2 weeks after treatment, while some of the swelling and bruising still persist and yet the patient is anxious to see a final result.  Realize this is a temporary condition and things will improve.  Focus on diligently following your wound care instructions as well as other activities to help divert your mind.  Listening to your favorite music, reading entertaining books, and venturing outside can be helpful activities to take your mind off worries.


  1.  Take the antiviral medication Valacyclovir 500mg by mouth twice daily for 5 days.
  2. Take the antibiotic Cephalexin 500mg by mouth three daily for 5 days.
  3. Take Tylenol and Motrin as needed for discomfort; these work in different ways and may be taken together.
  4. It is important for you to keep your head elevated the evening after treatment as well as for the first two weeks following treatment.  This can be done by either sleeping in a recliner tilted at approximately 30 degrees or sleeping with two pillows underneath your head.  Avoid rolling onto your face.  Sleeping on your back for the first two weeks helps to ensure this.
  5. Avoid ice or cold compresses. 
  6. Avoid makeup for the first 3-4 days after laser treatments/peeling, and contact Dr. Fishman before resuming your regular moisturizer and makeup. 
  7. Know that itching, tightness, and some patchy numbness are normal for several days to weeks after your treatment.
  8. You may shower and allow warm water (plain or with gentle soap) to run over the treated areas twice daily, starting today.  Use your clean fingers to gently go over all resurfaced/ treated areas two times a day. The goal with each cleaning is to remove the exfoliating skin and crusting that develops with this. This should be a gentle process with no scrubbing or abrading.  If you have pain or develop bleeding, you are scrubbing too hard.  Lots of water and frequent cleanings are important.
  9. After washing, gently pat the treated areas with a clean towel and apply a thin layer of Aquaphor or Vaseline ointment (provided) to the skin.  This will provide the moisture your skin very much needs during the healing process.  Following these directions and keeping your skin well lubricated will help quicken the healing process.
  10. Apply a thin layer or Aquaphor or Vaseline (provided) to the treated skin twice daily, and any time the skin feels dry or tight.
  11. Avoid picking at, scratching, or pulling off treated or peeling skin.
  12. Avoid strenuous exercise and sweating for 2 weeks after treatment. 
  13. Please call our practice with any questions or concerns.  Please notify us should you develop a fever, spreading rash or redness, pain, or any other concerns. 

The healing time for laser treatment is often less than expected and the results are worth the wait.  While most discoloration will fade over the first three months, your healing will continue for the entire first year.  Dr. Fishman and our practice will follow you through your healing process; be patient with your body and healing time.

Trust Our Expert Staff for Best Skin Laser Treatments in Atlanta and Sandy Springs, GA

Our mission at Aviva Plastic Surgery is simple – help patients achieve greater confidence and their best, most vital appearance.  By offering a wide variety of surgical and non-surgical aesthetic treatments in a welcoming, professional environment, our experienced and expert staff have helped many individuals put their best face forward.  To learn more about our services and treatments, call our clinic at 678-974-8435.  We look forward to taking care of you!

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