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Laser Treatments for Liver Spots

Dear Dr. Reichel,

Do you layer IPL and Fraxel Dual during the same visit to treat liver spots on face? If so, what would be the price range per visit?

Thank you for your inquiry. That is a good question.  To start a good response, I should let you know that there are two types of "liver spots" that one can get (on the face, or elsewhere).  In younger patients (under 40), most of the pigmented spots on your face are sun freckles (called solar lentigines in medical terms).  These can be treated with either the IPL, or with the Fraxel Dual.  I usually recommend a maintenance schedule with topical medications such as Retin-A, and hydroquinone to keep the sun freckles from returning.

The other type of liver spot, is called a seborrheic keratosis (SK).  SK's can come in many different shapes, sizes, and colors.  SK's are actually very hard to treat with lasers, but are very susceptable to liquid nitrogen treatment, or freezing.
Regardless of what type of liver spots you have, we definitely have all the technology availabe here to treat you.  I don't usually layer the IPL and the Fraxel Dual over each other as I am concerned about it being too risky and might result in a burn to the skin.  However, if you have the SK type of liver spot, I will often freeze these at the same time as the laser treatment - at no additional cost.
The best thing to do would be to make a cosmetic consultation appointment for me to evaluate your skin and see what would be the best treatment regimen for you.  Prices vary based on what we decide, treatments costs can range from a few hundred dollars, all the way up to a few thousand.
I would be so happy to see you, and, if possible, we can often do treatments at the same time as consultation if wanted.  Please call my office at your earliest convenience, to schedule an appointment.  I look forward to meeting you.
Dr. Jennifer Reichel at Pacific Dermatology & Cosmetic Center

PDCC can Treat those ugly "Brown Spots" and "Lip Wrinkles" with the Fraxel Dual

CO2 Laser in Seattle

Hello Dr Reichel, I am a 52 year old female living in Vancouver b.c. I am interested in the active co2 laser for my entire face. Could you please advise me of the amount of visits this would require as well as the price for the procedure. Thank you..

Again thank you for your question.You are not the first person to come from a distance. So, if you do not find yourself in Seattle for other reasons, we could schedule a virtual consultation over Skype or Face Time. If you don’t skype, or have access to Face Time, then it would be best to see you in person before we schedule the procedure. Perhaps we could do a phone interview, which would allow me to know what you would like to have treated – and whether you are the right candidate for the Active FX, and how aggressive we want to be. . . We would, of course, need you here for the procedure, and then, depending on how deep we are going, the number of follow-ups after that vary. We have had a few patients that spent the night in Seattle, came in the next day for a wound check, and then we did the rest of the follow-up via phone/photos.

Hope all that makes sense. The cost is between 2500$ and 3900$ depending on how involved the treatment is.

I look forward to hearing from you. Please call my office at your earliest convenience to schedule a consultation with me. 
Dr. Jennifer Reichel

Dear Dr. Reichel:

Thank you for your response to my questions. I have not replied until now as I have been battling menopausal acne and have recently started on minocycline 100mg per day I have been taking it for 4 weeks and there is a slight improvement with oil reduction and cysts.I was hoping to have all the acne cleared up before considering the active fx procedure. What are your recommendations when on antibiotics and having acne breakouts, does this need to be cleared before the procedure? Looking forward to hearing from you.

Thank you,

Response from Dr. Reichel:

Yes – you would need to wait until your acne is under control to consider the laser resurfacing procedure. In fact, the laser treatment can cause outbreaks, so we want everyone really well controlled, and then we watch like hawks after the procedure to make sure that there are no acute outbreaks (we can usually control this with stronger antibiotics).

 On the minocycline – I like to have people stay on it for at least 2 months before deciding whether it is the right medication for you. 

Thank you again for your follow-up question, I look forward to meeting you. 

Dr. R

Fraxel re:pair vs CO2 laser

Dear Dr. Reichel:

I'm in my early 40's and am not happy with how my skin looks.  I pride myself on wearing good sunscreen and taking care of my skin, however I feel as though the fine lines and brown spots are getting the better of me.  I have looked into lasers and read about both the fractional Co2 and traditional Co2.  A friend of mine had a great experience with you and suggested I come see you.  Can you tell me what the difference is between the two lasers?

Thank you. K.C

Dear K.C.

I very much love the Fraxel, as I have the new Fraxel dual re:store; but what I can tell you about the Fraxel re:pair is that compared to the traditional CO2 it has less versatility.  It can only do fractional, meaning only to one depth, vs my Lumenis CO2 that has two depths, deep and active, which I can use to treat the really deep wrinkles.  I would really like to see you in consultation to determine what would be best for you.  I can tell you that my patients who have been treated with the CO2 love their results and I have some great before/afters to show you.

Please call my office to schedule an appointment for a cosmetic consultation, 206.859.5777, I look forward to meeting you.

Thank you,

Dr. Jennifer Reichel

Dear Doctor,

I have Xanthelasma and have read that TCA peels are great for treating it, would you agree?  Or can you recommend other treatment options for me.

Thank you. D 

Dear D:

I have not had great luck with TCA for xanthelasma, but it can be an option, I do have high % TCA available . I also have a Total FX Lumenis CO2 laser I have used with good success on Xanthelasma. Or as another option I have also had really good luck with surgical removal.  I would like to see you in consultation first and then decide, together, on the best treatment options.

Please call 206.859.5777 to schedule a consultation with me, either Melissa or Sara can set that up for you.  I look forward to meeting with you to discuss your treatment options.
Dr. Jennifer Reichel of Pacific Dermatology & Cosmetic Center

Hello Dr. Reichel.......I thought I should touch base with you since my last appointment.  I saw you last July 2010 for treatment of my Syringomas with the Fraxel laser; after a couple weeks of healing I came in for a follow-up.  Neither of us were particulary satisfied with the results as the syringomas were still pronounced.  You offered another round of treatment but I haven't followed up on that, yet. I just wanted you to know that after a year, the tumors have reduced in size significantly. Having looked at a picture from a couple of years ago, the difference is quite noticable. I figured you'd be interested in hearing of this. Also, I still plan on getting another round of treatment - maybe in a year. Thank you so much for your help and excellent care.  N.Y.

Hi N.Y. 

I have been wondering how you are doing. Thank you so much for the follow-up email. That is super that your syringomas have gotten less noticeable. I remember very clearly how you looked at the follow-up appointment. They say it can take 6 months to a year to really see the results of the resurfacing laser – so that’s great to hear that yours are so much smaller.
Again thanks for the email. It is always valuable to hear from my patients. I look forward to seeing you again for another round of treatment when you are ready. I will always honor the follow-up treatment cost for you (even if it is in 4 years).
Dr R

Is CO2 the best laser to remove wrinkles around my eyes?

Dear Dr. Reichel,
I am not happy about the wrinkles around my eyes.  I am very interested in the fractional CO2, but would like to know how much it would cost, and more importantly, what would I be getting myself into as far as downtime after the procedure?
Dear Katie,
Thank you for your inquiry about cost and recovery time for fractional CO2 laser around the eyes.
It is a great procedure and can give long lasting improvement for wrinkles, pigment, and loose skin around the eyes. Here at Pacific Dermatology & Cosmetic Center, we have the Lumenis Total FX CO2 laser. I believe strongly that it is the best fractional CO2 laser on the market. Remember that not all “fractional” CO2 lasers are made the same, and results will vary based on who the practitioner is that is performing the laser treatment. I have done hundreds of Fractional CO2 treatments, and trained in traditional CO2 resurfacing prior to that. I absolutely LOVE the results.
The cost to have a treatment done around the eyes is around $1900.00. Most patients have about 4 full days of down-time. On the fifth day, you should be able to put on make-up and go out into public, but you may still have bruising and redness. A small subset of patients will need more down-time. Keep in mind, that you won’t be ready for any special events for at least 4 weeks after your treatment.
I see all patients in consultation prior to treatment. At the consult, we sit down and evaluate what is best for each individual patients. We then go over all aspects of the treatment including pre-op and post-op expectations. We will look at my before and after images, and discuss cost. I try to be very informative and give you an honest assessment that is tailored to you. You will leave with a written cost estimate and a written description of what we discussed at your consultation.
I look forward to seeing you.

Dr Reichel.

Can you treat a darker complexion with CO2?

Dear Doctor

I am interested in setting up an appointment for a consultation for Co2 laser resurfacing to reduce acne scars and fine lines from sun damage. How much is the consultation? Also I have a dark complexion, would this be appropriate for me?

Thank you for the email inquiry. I would be very happy to see you in consultation for acne scarring. I treat a lot of acne scarring on all types of skin. It is possible, if you have a dark complexion, that the CO2 may not work for you, however, the Fraxel laser may be a great option. We can discuss it in consultation. I do very comprehensive consultations and spend time talking about ALL options for whatever your condition or concern is. I feel that, from a laser standpoint, Pacific Dermatology and Cosmetic Center has all of the very best lasers for acne scarring. There are many other lasers out there, but many of them are not as good as the real Fraxel Restore and the Total FX Lumenis Fractional CO2 laser. We can also consider other options if they are right for you (such as fillers, surgical excision, scar subcision and face lift (not done here, but I have great recommendations for fabulous plastic surgeons in Seattle)

 As far as cost, we charge 80$ for the cosmetic consultation. Again, I will personally spend 30 minutes with you discussing the options and writing out a plan to take home with you. We will give you brochures and personally written information on the different options – it’s a great starting point to know what is best for you.

Thanks again for the email, and I look forward to seeing you.

Dr. Jennifer Reichel of Pacific Dermatology & Cosmetic Center in Seattle

How do I get rid of those "pucker" lines around my mouth?

Dear Dr. Reichel

I am interested in co2 resurfacing for perioral wrinkles and that "puckered" look. Part of it is that my family has a puckering habit. I swear it is genetic. Also, I did smoke. So I would like that look GONE. But I certainly am not rich. Thank you.  K.R.

Dear K.R.

This is a very common occurrence both from genetics as well as smoking.  I can absolutely treat this area using the Co2 for approximately $1,500-2,000.  Of course it is best that I see you in consult first to give you a more accurate fee estimate and assessment of this area.  Please call my office at your earliest convenience, I look forward to meeting with you.

Dr. Reichel 


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