Short Biography | My Experience with Facial Surgery

My Experience with Laser Skin Resurfacing

1. Just before surgery, September 17, 1999.

2. Anesthetizing.

3. Frying me with the laser.

4. Much of my face Is fried.

5. Closeup Fried

6. Silon TSR (Temporary Skin Replacement). Applied

7. Elastic net applied.

8. Gauze pads inserted.

9. Removing the net the next morning.

10. Netting is off.

11. Day 3 postop: Silon TSR is off and a thick coat of Aquaphor gel is applied.

12. Day 7 postop.

Three months later, December 11, 1999. No makeup and no retouching.

I had laser skin resurfacing (LSR) done by a Harvard Med dermatologist, Jeffrey Dover, MD, at his private practice in Wellesley, MA, September 17, 1999.  Cost was about $5000.  This was a good choice for me, and, four years later, I’m still very happy with the outcome.

Though I posted pictures of the steps in the procedure shortly after it was done, I’m only just now, four years later, getting around to adding this text, cutting and pasting it from numerous contemporaneous letters to friends, describing my experience.

Me, the Patient

At the time of the procedure, I was a 48-yo post-operative TS woman. I had a fair amount of ‘orange peel’ texture around my chin from electrolysis and also some general imperfections (blotchiness, crepe texture, etc.) that represented the accumulation of age.  I also had a barely visible scar at the hairline from the facial feminization work Doug Ousterhout had done for me.

The Procedure

Laser skin resurfacing is done on an outpatient basis under what’s called "twilight sleep" in the doctor’s office.  It’s not general anesthesia, but you won’t remember any of it.

The whole procedure takes about two hours and you will need someone to drive you home afterwards and to your first follow-up appointment the next morning. I strongly recommend you have someone with you to help during recovery, especially the first two or three days.  I suppose it could be done alone in a hotel room, but I wouldn’t recommend it.

Expect to remain in the area for about 2 weeks for follow-up visits to monitor your healing.

Recovery

It looks frightening but surprisingly, it was not all that uncomfortable.  I was taking Vicodin and Valium the first 3 days or so and found that fully adequate for controlling both the pain and the general nuisance of being covered by all that goop while I healed.

During the first few days, your skin ‘weeps’ constantly (think of the liquid that collects in a blister just dripping off your face), you have to do ice water soaks every two hours, and in between, you’re constantly troweling on fresh layers of Acquaphor ointment (a lot like Vaseline), all to be sure you don’t end up forming scabs as you heal.  By about day 7, I was feeling really quite okay though my skin did remain quite fragile (like a newborn’s) for about another month.

My Results

Laser was a great choice for me.  It erased virtually all my skin defects excepting just a (barely perceptible) area of orange peel (that’s continued to fade in the years since.) Also, I had a tiny area of dimpling in my chin due to muscle adhesion left over from Ousterhout’s work; obviously, laser did not fix that, though time has helped on that also.

Was I satisfied? You bet!  It completely erased any pigmentation marks and even a scar I’ve had on my chin since childhood, leaving my skin almost glass smooth.  I remember day 7 when I drove over to pick up my kids from my ex. She was busy as I walked in but then looked up and, in a moment that probably ruined her whole day, blurted out, “Ohmigosh!  They took YEARS off you!”

One very pleasant surprise was how the general softening of my appearance turned out to be quite feminizing.  Women are expected to have nice, smooth skin and this procedure gave me that.

For a long while, my skin was so totally flawless that it was a bit unnatural. People would stare.  I’m not making this up.  I’d have lunch with some friends, and midway through, I’d catch one of them staring in a haze.  They’d wake up, stumbling as if still dreaming, “Your skin is so ... so ... smooooth.” That lasted for at least 6 months.

It kept getting better over the whole next year as the skin continued to build collagen.  The surface gave up a tiny bit of smoothness (only enough to become very natural) but the texture and the ‘wholesomeness’ continued to improve.

Between the LSR and of course, the facial surgery I had with Dr. Ousterhout, I find most people tend to guess me at about 10 years younger than my true age.  For me, LSR was a really good decision and recommend it wholeheartedly.

The Risks

But I should warn you that if you would like to do it, you need to be extremely careful about who you have do it.  For example, one doctor I interviewed crowed that he was a surgeon, not some wimp dermatologist, and thus, not afraid of open wounds. (Were these going to be on me or him?) He promised he’d do 4 passes of the laser when most people would barely have the nerve to do more than 2.  It sounded like he thought I was buying this by the bucket.

But the really scary part was when this quack proudly introduced me to a nurse on his staff he’d done 3 years earlier.  Her entire face was marked by blotchy hypopigmentation (loss of pigmentation) and had an odd pink color.  Myself, I don’t bother wearing makeup most days and for me, his blasé acknowledgment that if I let him resurface me that I’d probably need to wear makeup every day was just plain unacceptable.

Hypopigmentation and hyperpigmentation (too much pigmentation) and scarring are real, serious risks if you choose the wrong doctor.  You do need to meet with several and you do need to see their patients in person.  Laser skin resurfacing, done right by someone who knows what they’re doing, works wonders.  But done by anyone else, it can be grotesquely disfiguring.

My attitude is that one should never make a choice about something as serious as surgery based on location.  Find out who’s best, then go there, no matter where they are on the planet.  (Travel costs are usually incidental compared to the cost of treatment anyway.)

Jeffrey Dover, MD

I went to Jeff Dover because, so far as I could determine, he’s the best there is.

Jeff Dover literally wrote the book on LSR, Illustrated Cutaneous & Aesthetic Laser Surgery.  He’s sufficiently well-known as an authority to have appeared several times now on Good Morning America.  (The first time he was on was just a couple days before he did me.) But most important, I’ve by now had the chance to see his results on me and also on three friends who stayed with me in my home (back when I still lived in Boston) through their recoveries.  Two of them, Lynn Conway and Becky Allison have posted their own accounts, which I encourage you to read.

Here is Jeff Dover’s contact information:

Jeffrey Dover, MD
Skin Care Physicians of Chestnut Hill
1244 Boylston Street, Suite 302
Chestnut Hill, MA  02467
Tel 617-731-1600
Fax 617-731-1601
http://www.skincarephysicians.net/dr_dover.html

My sense is that the real skill in LSR is in knowing precisely how deep to ablate the each area of skin with the laser.  The pulse width and power level has to precisely adjusted each time the laser has fired.

With any surgery, there’s always risk.  So the problem is to minimize that by selecting someone who’s shown he can produce consistently good results.  Jeff gets it right every time.