Scarring that required a plan, not a single pass
The patient in this video flew to Dr. Emer from Kentucky for a multi-stage treatment plan she had been waiting for. She had already completed Halo laser, micro droplet silicone injections to fill volume loss from scarring, and Reneuva to build synthetic fat in depressed areas. This session was the final layer: fully ablative erbium laser combined with deep fractional passes.
This is not a treatment most practices offer at this depth. Dr. Emer uses two erbium modalities in one session: deep fractional to drill thousands of holes without excessive heat, and fully ablative contour mode to remove the entire top layer of skin in the areas of heaviest scarring. The combination allows aggressive remodeling with controlled healing.
Why erbium instead of CO2 for this case
CO2 laser is a hot laser that coagulates tissue and stops bleeding as it works. Erbium is a cool laser that drills holes and leaves them open. That difference matters when treating multiple levels in one session: less heat means Dr. Emer can go deeper and wider without the prolonged redness, pigmentation risk, and extended downtime that come with excessive thermal injury.
The deep fractional erbium creates thousands of microscopic channels that stimulate collagen without removing the surface. The fully ablative erbium removes the entire top layer of skin in targeted areas, forcing complete resurfacing. Both were used in this session, layered and blended across the face so no area looks different from another.
What the session looked like
The patient was awake for the entire procedure. Dr. Emer started with deep fractional passes, visible as thousands of bleeding pinpoint dots across the treatment area. He then switched to fully ablative contour mode for the areas of deeper scarring, removing the top layer of skin entirely and blending the edges so the transition is invisible.
Each pass was angled and overlapped to follow the architecture of the face. The nose, cheeks, and areas near the eyes were treated with the same depth as the rest of the face to ensure uniform texture and tone. The session ended with air cooling and immediate wound care protocols.
Healing and aftercare
Healing from fully ablative erbium takes five to seven days for the skin to peel, followed by another five to seven days of redness. The patient is placed on antibiotics and antiviral medication to prevent infection and breakout while the skin is open. Skincare is applied two to three times daily using Dr. Emer's Reskin Stabilis regimen: anti-inflammatory botanicals, peptides, and stem cells designed to stabilize healing.
The microscopic debris that forms after treatment are micro scabs that peel off to reveal new skin. Patients can return to normal activity, including exercise, once the skin has fully peeled, typically within five to seven days. Sleeping with the head elevated helps reduce swelling during the first few nights.
Who this treatment fits
This is for patients with deep acne scarring, trauma scars, or significant texture irregularities who want aggressive improvement and are willing to commit to the downtime and aftercare. Dr. Emer has treated patients as young as 16 with parental consent for trauma scars, and the treatment is appropriate for any age depending on the condition being addressed.
Skin type matters. Lighter skin tolerates higher settings with less risk of pigmentation issues. Darker skin can be treated with modified protocols, and Dr. Emer regularly treats ethnic skin tones, but candidacy and settings are determined during consultation based on individual risk factors.