Fraxel Restore(1550nm) and Dual Lasers (1550/1927nm)

Acne Scarring                

Gentle Scar Subscision using cannulas

Topical Stem Cell Derived Growth Factor

Manual Powered Microneedling

Cannulas for Injection & Scar Treatment

*See also Skin Tightening Page

When patients have darker skin,  care must be taken to avoid techniques that may overhead the surface and cause excessive pigmentation.  For skin of color,  Fraxel 1550nm laser and bipolar fractional radiofrequency microneedling are preferred over more aggressive downtime procedures.   Published studies continue to support the notion of combining treatments for better overall results.   The type of acne scarring will dictate what combination of treatments might fit best.   

Multiple treatments will yield gradual results.  The skin produces collagen and elastin slowly and gradually remodels the surface.  In some cases surgical excision or punch excision of deep pitted scars is sometimes necessary, TCA (acid) application to deeper pitted scars, or ablative resurfacing with the fractional CO2 laser.

Scar treatment, whether caused from acne, surgery or otherwise,  typically requires mulitple treatments and treatment modalities in order optimize the outcome.  Rarely is only one type of treatment (laser, chemical, radiofrequency, manual subscision) adequate.  The Fraxel 1550nm erbium glass laser though remains one central part of the treatment paradigm for more superficial scars and rejuvenation of skin in younger individuals.

Click for Acne Scar Study

Fraxel® Restore - Non-ablative Laser For Acne Scars and Skin Aging

Fraxel is non-ablative technology - this is in contrast to the Mixto CO2 laser,  which an 'ablative', laser,   Fraxel is considered more gentle than the CO2 laser, but less effective. How Fraxel Restore works is well understood and the result of extensive medical studies. Below are details on the treatment and the science behind it. Remember, every patient's circumstances are different, so for specifics, it's best to consult with Dr. Dannaker.  If you have acne scars and darker skin, or wish to avoid the greater downtime found with fractional CO2 lasers, the Fraxel Restore may be right for you.  Fraxel results can vary widely based on the physician's experience.  Dr. Dannaker while  always keeping your safety as sacrosanct, is experienced with advanced treatment protocols for resurfacing lasers such as Fraxel.  For  treatment of acne scars Dr. Dannaker often combines Fraxel with micro needling, and scar subscision.

Safety and Side Effects

"Smart scanning" hand piece ensures consistency and safety Fractional lasers penetrate top skin layers Fraxel light energy stimulates collagen, and resurfaces the top skin layer Your skin's natural rejuvenation process smoothes wrinkles and scars by stimulating collagen With a track record of over 800,000 treatments, Fraxel technology is proven to be safe and effective for multiple indications. But because skin types and conditions can vary, some side effects are possible.

Fraxel Restore Patient Brochure  

Fraxel Dual

Click on Picture for Treatment Video  

Click Pic Below for 6 month follow-up!

Age / Sunspots

Age spots are due more to sun exposure than an aging effect. These spots,  also commonly known as sunspots, brown spots, liver spots—are flat, uneven dark patches on the face, neck, chest, hands and arms and other areas that are regularly exposed to the sun. Though usually harmless, these blotchy brownish patches can make you look and feel older than you really are.

In the sun, your body reacts by producing a pigment called melanin to protect your skin from ultraviolet rays. If you spend a lot of time in the sun, your skin may overreact by producing too much melanin. That increased pigmentation can result in age spots, which fall into a broad medical category called "pigmented lesions." Fraxel Dual can combine the restore wavelength (1550nm) with the Thulium (1927nm) to improve the deep and superficial layers of the skin.  

The Dual treatment results in peeling of the skin to better remove surface blemishes and brown spots.  The use of two wavelength's to simultaneously treat the skin, can be synergistic.  Some patients may desire improvement in the surface blotchy pigmentation.  The 1927nm wavelength can be used alone and sometimes in combination with the Yag laser (q switched yag for brown spot section) to maximize your results and minimize the number of treatments necessary.

Dr. Dannaker will try to customize your treatment to your desired results, number of treatments and degree of downtime whenever possible.

Skin Resurfacing Chest

Fraxel 1550 : 3 treatments


In the decade since Fraxel first pioneered true fractional laser technology, physicians around the world have treated more than 800,000 patients. That’s nearly a million treatments for women and men of all ethnicities, each with their own reasons for wanting to look and feel younger.

(Content courtesy of


Manual Powered Microneedling

Microneedling is a popular treatment.  Some would call it a "poor man's resurfacing". and indeed there is some truth to that statment.  Using a vibrating device, multiple needles are utilized to puncture the skin, thus stimulating some collagen formation.  Dr. Dannaker feels this treatment as a stand alone is tedious and requires multiple treatments 3-6+ for mild results.     Microneedling devices should generally deliver the needles vertically into the skin.  The depth needed to remodel skin usually requires a medical needling device that is able to penetrate deeply and result in some temporary bleeding.  This will result in some downtime, short lived pinpoint bleeding and minimal swelling for no longer than 1-3 days.  Dr. Dannaker combines powered microneedling with other treatments.    Reference



      Gentle Scar Subscision with         cannulas

           Video: Subscision with Blunt Cannulas

Subscision is the process of breaking up scar tissue that tethers and pulls scars resulting in a depression at the skin's surface.  Traditionally a sharp instrument such as a scalpel or Norkor needle is used to slide under a scar and rub back and forth to free up scar tissue.  Now cannulas have been found very effective for subscision too. Using cannulas is less traumatic,  gentle and minimizes bruising.  Subscision of  depressed scars with a cannula is usually combined with laser resurfacing and/or radiofrequency microneedling.

                Published Study: Cannula for Subscision

Topical Stem Cell Derived Growth   Factor 

After a laser, radiofrequency and/or microneedling treatment topical application of PRP (platelet rich plasma) or laboratory synthesized Growth Factor may be applied to the skin.  Any of these substances, although lacking in unequivocal study results, likely adds to the stimulus for collagen growth.  At the very least these substances have been shown to speed skin healing after injury.  Dr. Dannaker feels there are very few clinical trials showing strong evidence that topical PRP (platelet rich plasma) or lab synthesized growth factors have a large impact on the skin with the exceptions of improving fat transfer and hair transplantation results.  After laser, radiofrequency or microneedling treatments, growth factors, PRP or stem cells may help with the post treatment skin collagen response.  

One of the several growth factors we use:

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Results may vary