Jason Emer, MD, FAAD, FACS

Fully Ablative Erbium Laser For Deep Acne Scars What The Treatment Actually Does

Fully Ablative Erbium Laser For Deep Acne Scars: What The Treatment Actually Does

How Dr. Jason Emer uses fully ablative erbium resurfacing to blend and improve severe acne scarring and texture, even in sensitive or pigmented skin.

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Still from the filmed session. Individual results vary.

THE DETAIL IS THE DIFFERENCE.See the results ↓

Dr. Jason Emer MD · FAAD · FACS

MD, FAAD, FACS: board-certified dermatologist and cosmetic surgeon
Former Chief Resident in dermatology, Mount Sinai, New York
More than 10,000 patient encounters
Male facial sculpting longer than anyone in the United States
The highest filler volume on the West Coast
West Hollywood and New York

The practice's own photographs

Before. After.

Patients of the practice, from Dr. Emer's published before and after gallery. Each case is one patient. Individual results vary.

Before and after, Acne Scars Treatment, patient 240803 — Acne Scars TreatmentPatient 240803

Before and after, Acne Scars Treatment, patient 240818 — Acne Scars TreatmentPatient 240818

Before and after, Acne Scars Treatment, patient 240845 — Acne Scars TreatmentPatient 240845

Before and after, Acne Scars Treatment, patient 240846 — Acne Scars TreatmentPatient 240846

Before and after, Acne Scars Treatment, patient 240847 — Acne Scars TreatmentPatient 240847

Before and after, Acne Scars Treatment, patient 240876 — Acne Scars TreatmentPatient 240876

See the full before and after gallery

Fully ablative erbium resurfacing over silicone micro droplet and Sculptra foundation, performed awake with nerve blocks on Fitzpatrick II skin with pigmentation, blending severe acne scarring in one session.

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From the filmed session

Inside the treatment. With Dr. Emer.

FULLY ABLATIVE ERBIUM TRL CONTOUR LASER FOR ACNE SCARS IN FITZPATRICK II LIGHT SKIN | Dr. Jason Emer

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What Dr. Emer did · CELESTA

Every procedure. In order.

01

Silicone micro droplet filler placement

Silicone micro droplets and Sculptra injected beneath depressed acne scars to raise the base and create a foundation before surface resurfacing.

“underneath that is silicone micro droplet and sculpture”
Dr. Emer, in the film
02

Fully ablative erbium laser resurfacing CELESTA^™

Fully ablative erbium TRL contour laser passes at 90 degrees to remove the entire top layer of skin, blend texture, and cauterize as it resurfaces. Specific settings for pigmented skin with aggressive post care protocol.

“we're using the fully ablative herbium to blend the surface and try and get a big improvement on the overall texture of her skin”
Dr. Emer, in the film
03

Nerve blocks and topical anesthesia

Nerve blocks and topical anesthetic applied to allow the patient to tolerate the fully ablative treatment awake without sedation.

“It takes a lot of strength to do this awake. I don't know how she did it, but she did a great job.”
Dr. Emer, in the film

Why patients fly in

What Dr. Emer does differently.

Fully ablative erbium on pigmented skin

Dr. Emer performs fully ablative erbium resurfacing on patients with pigmentation and sensitive skin tones using specific laser settings and aggressive post care protocols that most practices avoid.

“Not a lot of people are able to do sensitive skin tones with stronger lasers. And she has a little bit of pigmentation, but with the right postc care and settings, which we're doing very specific ones right now, she'll do really, really well.”

Erbium over CO2 for safety

Erbium laser is chosen over CO2 for patients with any pigmentation because it carries lower risk of post-inflammatory hyperpigmentation while still delivering fully ablative depth.

“herbium's a lot safer anyways than like a CO2 laser for example”

Meticulous 90-degree technique

The laser is held at exactly 90 degrees and moved in methodical passes to avoid leaving lines, grooves, or uneven texture, with continuous blending throughout the treatment.

“the key is with this laser very meticulous. You don't want to leave lines or grooves. And so you got to be very very very 90° methodical.”

Combination filler and laser approach

Silicone micro droplet and Sculptra are placed under the scars first to raise the depressed areas from beneath, then the laser blends the surface on top of that foundation.

THE THINKING BEHIND THE TREATMENT

The story.
The decisions.
The details.

Follow Dr. Emer’s approach through the stages described in this case.

Back to the video ↗

01Before
The starting point
She had silicone micro droplet filler and Sculptra placed under the scars first. This session blends the surface.
The patient in this video has severe acne scarring and texture irregularities. Before this laser session, Dr. Emer placed silicone micro droplet filler and Sculptra beneath the depressed scars to raise them from underneath. This session is the surface layer: fully ablative erbium laser resurfacing to blend the texture on top of that foundation.
02The session
In the room, in order
Fully ablative means the laser removes the entire top layer of skin in the treated area. It is one of the most aggressive resurfacing treatments available, and it requires strength to tolerate awake. She did it with nerve blocks and topical anesthesia, no sedation, and the result is a more even skin surface than either filler or laser alone could produce.
- Prepare the skin
- Resurface in passes
- Blend the surface
- Follow aggressive post care
03The result
What changed

Read the complete story +

The patient story

A treatment for scarring that does not respond to gentler options

The patient in this video has deep acne scars and texture irregularities that have already been treated with silicone micro droplet filler and Sculptra placed under the skin. This session is the surface layer: fully ablative erbium laser resurfacing to blend the texture and improve the overall appearance of the skin.

Fully ablative means the laser removes the entire top layer of skin in the treated area. It is one of the most aggressive resurfacing treatments available, and it requires strength to tolerate awake. This patient did it with nerve blocks and topical anesthesia, no sedation.

Why erbium instead of CO2

Erbium is safer than CO2 laser for patients with any pigmentation or sensitivity. The patient in this video has a light skin tone with some pigmentation, and Dr. Emer chose erbium with specific settings and aggressive post care to minimize the risk of pigment changes after the treatment.

The technique is meticulous: the laser must be held at 90 degrees to avoid leaving lines or grooves, and the entire surface is blended in passes to ensure an even result. Early in the session there is visible bleeding as the top layer of skin is removed; by the end the tissue is cauterized and the surface is uniform.

What happens under the surface first

Before this laser session, the patient had silicone micro droplet filler and Sculptra placed beneath the scars to raise the depressed areas from underneath. The laser then blends the surface on top of that foundation, addressing texture and scarring together as one plan.

This is a combination approach: filler lifts the base, laser smooths the top, and the result is a more even skin surface than either treatment alone could produce.

Who this treatment fits

Fully ablative erbium is not a first line treatment. It is for patients with significant scarring or texture issues who need a more aggressive option and are prepared for the recovery that comes with it.

Dr. Emer performs this treatment on a range of skin tones, including patients with pigmentation, using specific laser settings and post care protocols. Candidacy depends on your skin, your scarring, and your tolerance for downtime, which is exactly what a consultation covers.

The treatment, explained

What is fully ablative erbium laser?

Also called erbium laser resurfacing, erbium TRL, acne scar laser treatment, ablative laser resurfacing, laser skin resurfacing for scars, erbium YAG laser.

What it is: Fully ablative erbium laser resurfacing is an advanced treatment for severe acne scarring and texture irregularities. The laser removes the entire top layer of skin (epidermis) to blend deep scars and improve overall skin texture. In this case, silicone micro droplet filler and Sculptra were placed beneath the scars before the laser session to raise the depressed areas from underneath, and the laser then blended the surface on top of that foundation.
How it works: The erbium laser is held at 90 degrees to the skin and moved in meticulous passes across the treatment area. The laser energy vaporizes the top layer of skin while cauterizing as it works, removing scarred tissue and blending the surface. Multiple passes are performed with continuous blending to ensure an even result without lines or grooves. The treatment is performed with nerve blocks and topical anesthesia, allowing the patient to remain awake. Specific laser settings are used for patients with pigmentation or sensitive skin tones to minimize the risk of post-inflammatory hyperpigmentation.
Who it is for: Fully ablative erbium resurfacing is for patients with severe acne scarring, deep texture irregularities, or scarring that has not responded to gentler treatments. Dr. Emer performs this treatment on a range of skin tones, including Fitzpatrick II through IV, using tailored settings and post care protocols. Patients must be able to tolerate significant downtime and follow aggressive post care instructions.
Recovery: Fully ablative resurfacing requires significant healing time. The skin will be raw immediately after treatment and will form a new surface layer over the following weeks. Aggressive post care is required to protect the new skin and minimize the risk of pigment changes. The specific recovery timeline and post care protocol are determined during consultation based on your skin tone and the depth of treatment performed.
When results show: Results develop as the new skin layer forms and matures. The treated area will show improved texture and blending of scars as healing progresses. Final results are typically visible several months after treatment once the skin has fully remodeled. The timeline and degree of improvement are discussed during consultation based on your scarring and skin type.

Signature procedures

Only at Emer.

Peptides / biologic optimization

RECODEX^™

Peptide and biologic protocols for recovery, body composition and longevity, with epigenetic testing. RECODEX^™ peptides are available to purchase through the practice after consultation.

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From Dr. Emer's Instagram

The work, as he shows it.

@jasonemermd @recodexsystem

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Why Dr. Emer

Scarring is a craft. He set the standard.

Two decades of results, a global patient base, and techniques other physicians travel to learn.

Dr. Emer built his reputation on outcomes that read as natural and precise, even in the most challenging cases. He performs advanced scar revision and laser resurfacing on a range of skin tones, including patients with pigmentation or sensitivity, using specific settings and post care protocols that other practices avoid.

Patients come to him when the scarring is severe, when gentler treatments have not worked, and when the result has to be both aggressive and safe.

MD, FAAD, FACS: board-certified dermatologist and cosmetic surgeon
Former Chief Resident in dermatology, Mount Sinai, New York
More than 10,000 patient encounters
Male facial sculpting longer than anyone in the United States
The highest filler volume on the West Coast
West Hollywood and New York

About Dr. Emer Schedule Consultation

EMER METHOD^™×RECODEX^™

Less risk of pigment changes

Erbium is safer than CO2 for patients with any pigmentation or sensitivity, when used with the right settings and post care.

Meticulous technique required

The laser must be held at 90 degrees and moved in careful passes to avoid leaving lines, grooves or uneven texture.

Combination approach

Filler placed under the scars first raises the base, and the laser blends the surface on top of that foundation.

Asked plainly, answered plainly

What patients ask before they book.

Is fully ablative erbium safe for pigmented skin?+

Yes. Dr. Emer performs fully ablative erbium resurfacing on patients with pigmentation and sensitive skin tones, including Fitzpatrick II through IV, using specific laser settings and aggressive post care protocols tailored to each case. Erbium is safer than CO2 for patients with any pigmentation because it carries lower risk of post-inflammatory hyperpigmentation while still delivering fully ablative depth.

Can this treatment be done awake?+

Yes. The patient in this video had nerve blocks and topical anesthesia and tolerated the fully ablative treatment awake without sedation. Dr. Emer notes that it takes significant strength to do this awake, and sedation is also an option for patients who prefer it.

Do I need filler placed under my scars first?+

Many patients with deep, depressed acne scars benefit from silicone micro droplet filler and Sculptra placed beneath the scars to raise the base before the laser blends the surface. This combination approach addresses both the depth and the texture of the scarring. Whether you need filler first is determined during consultation based on your specific scarring pattern.

What is the downtime for fully ablative erbium?+

Fully ablative resurfacing requires significant healing time. The skin will be raw immediately after treatment and will form a new surface layer over the following weeks. Aggressive post care is required to protect the new skin and minimize the risk of pigment changes. The specific downtime and post care protocol are discussed during consultation based on your skin tone and the depth of treatment.

How is this different from fractional laser treatments?+

Fully ablative erbium removes the entire top layer of skin in the treated area, while fractional treatments create columns of injury surrounded by untreated skin. Fully ablative resurfacing is more aggressive and delivers more dramatic improvement for severe scarring, but it also requires more downtime and stricter post care. The choice between fully ablative and fractional is made during consultation based on your scarring, skin tone, and tolerance for downtime.

Why does the technique matter so much?+

The laser must be held at exactly 90 degrees and moved in meticulous passes to avoid leaving lines, grooves, or uneven texture. Dr. Emer continuously blends the treated area throughout the session to ensure an even result. Poor technique can leave visible lines or create new texture irregularities instead of improving them.

How many sessions will I need?+

The number of sessions depends on the severity of your scarring and your skin's response to treatment. Some patients see significant improvement in one session, while others may benefit from additional sessions spaced several months apart. Your treatment plan is determined during consultation based on your specific case.

What kind of post care is required?+

Fully ablative resurfacing requires aggressive post care to protect the new skin and minimize the risk of pigment changes. The specific protocol is tailored to your skin tone and the depth of treatment performed. Dr. Emer provides detailed post care instructions at the time of your treatment.

Discuss your plan

A consultation reviews your anatomy, goals and history, and maps which options apply to you.

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West Hollywood and New York City