LAM FACIAL PLASTICS

Does plasma clean out your pores? Or should you get a pore extraction, e.g. getting all the gunk out of your pores by a facialist before plasma?

plasma does not clean out the pores but in my experience they can be made smaller with plasma. no facial for 30 days prior to plasma. i need the "stratum corneum" outer layer intact before the procedure. that also means no chemical or mechanical exfoliation for that time window.

Dr. Lam, in your personal experience with plasma resurfacing, how many percent of the patients with initial enlarged/scarred pores get the following levels of improvement with portrait?

improvement level 0: no effect on radius of pores visible with naked eye
improvement level 1: slight tightening of pores visible with naked eye
improvement level 2: obvious tightening of pores, pores are at least 50% smaller in diameter
improvement level 3: pores look just like very small dots with naked eye, improvement at least 75% in diameter
improvement level 4: naked eye doesn't see pores on skin anymore, totally poreless skin

I recently got one mild levulan + blue light peel, and although it smooths out skin bumps, it is like improvement level 0, on actual enlarged scarred pores. That is very different from the marketing claims it 'tightens pores'.

I just want to know how Portrait is really doing in this department apart from the marketing claims.

from my honest experience with blue peels versus plasma (at high energy settings NOT low), here are my opinions:
blue peels for pores: absolutely zero. no question zero. in fact, read any of my blogs on 35% TCA. it will clean up the superficial skin but nothing deeper. wrinkle improvement is transitory and useless for anything other than fine crepiness.
plasma at at least 3.5 J: very poor for deep wrinkles around the mouth. same results as TCA for superficial damage. however, here is where high-energy plasma diverges from a blue peel: pore reduction, texture, and tone. now, many people that are obsessed with pores may not see enough difference but i truly see nice changes. does it get rid of pores, no. is it consistent? i don't know. i would say that in many many patients the texture tone and pores look much better. remember that takes 8 months to a year to see that change. here is another confounding variable. about 95% of my plasma is done with fat transfer, which alone can benefit texture tone. so i can't make a perfect read on my results. as far as giving you a number on your scale, i would say a 2.
best,
sml

By 'blue peel' you mean levulan activated by blue light or the Obagi peel (which is TCA with blue dye)?
What about levulan activated by IPL on pores? Any experience with that?

I think fat grafting can improve the pores even only because the skin is filled with more volume so its more taut and pores tend to elongate and become less visible when skin is stretched - I can make the pores on my cheeks almost disappear if I pull and stretch the skin. On the other hand, I am not sure skin really stays in stretched state long - it always relaxes to hold the new volume without tension like when someone gains weight.

Is the pore reduction result with plasma visible at all with a single treatment at lower levels or it has to be done as a single treatment at level 3 ( that was the highest yes?) ?
I am a little bit afraid of side effects on such high treatment level like scarring or hyperpigmentation although I'm white.

blue peel i am referring to tca alone. i have only done a handful of levulon so i don't know.

as far as stretching the skin with fat or with anything, that really does not happen. when people pull their skin back with their fingers and say, "Doc, can you make (something or another) look like this?" the answer is always no.

i don't do a lot of low energy settings so i can't say with certainty. my patient care coordinator looks great though, but my experience with low energy is not extensive.