Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
Resurfacing works by injuring skin in a controlled, patterned way and letting it repair. An ablative laser vaporises microscopic columns of the surface; a non-ablative one heats the layer beneath while leaving the surface intact. In both cases the repair response lays down new collagen over three to six months, and the skin that grows back is smoother, more even in colour and slightly tighter than what was there.
Fractional treatment is what made this practical: rather than removing the whole surface, the laser treats a fraction of it in a grid, leaving untreated skin between the columns to heal from. That reduces the downtime from weeks to days and the risk substantially, at the cost of needing a course rather than a single dramatic session. Almost everything done here is fractional, and we will explain the trade in the room.
Two things decide whether this treatment suits you, and neither is what people expect. The first is your calendar: the skin is genuinely raw for three to seven days after an ablative treatment and pink for weeks, and it must stay out of sun for months, which is why we book these in autumn and winter. The second is your skin tone: heat in skin with more pigment can leave it darker for months, so richer skin is treated with different settings, more preparation and a test patch, and sometimes we recommend microneedling instead.
Ablative and non-ablative, side by side
Two treatments with the same name and very different demands.
Fractional ablative
Removes microscopic columns of skin. The strongest thing we offer for texture, acne scarring, deep sun damage and the fine lines around the mouth and eyes. One or two sessions produce a real change. It costs you three to seven days of looking as if you have been badly sunburned and several weeks of pinkness.
Fractional non-ablative
Heats beneath an intact surface. Milder, safer on more skin types, and you can go to work the next day with a little redness. It needs three to five sessions a month apart and the result is a clear improvement rather than a transformation. This is what most people should have, and what most people here do have.
What each is actually for
Ablative for depth: scarring, deep lines, weathered skin that has had thirty years of sun. Non-ablative for quality: tone, fine texture, mild pigment, early lines and general dullness. Asking the milder one to do the deeper job is the commonest way people end up disappointed.
What neither can do
Neither lifts a sagging jawline, removes deep folds, or replaces volume. Resurfacing changes the quality of skin, not the structure underneath it. If what you dislike is loose skin or lost volume, the honest answer is different treatment or, sometimes, a surgeon.
The fortnight afterwards, described properly
For an ablative treatment. Non-ablative is much milder — expect the first two entries and none of the rest.
Days one and two
Hot, swollen and weeping in places, comparable to a bad sunburn. The face is greased with an ointment and left alone. Sleep propped up. This is the stage people are not adequately warned about and it is worth arranging to be at home for it.
Days three to seven
Peeling and flaking in sheets, itching, and a bronzed sandpapered appearance. Do not pick anything. The new skin underneath is fragile and picking is how a mark becomes permanent.
Weeks two to six
Pink, then gradually less so. Makeup is usually fine after a week. Absolute sun protection is not optional during this period — new skin pigments very readily and a single careless afternoon can undo the treatment and leave a patch.
Months two to six
The actual result, arriving as collagen remodels. Judging this treatment at three weeks is judging it before it has finished. Most people see the change they paid for somewhere around month three.
Risks and reasons we decline
This is a treatment that can leave a lasting mark if it is done to the wrong skin at the wrong time of year.
Pigment change
The main risk, and higher on richer skin tones. Skin can darken for weeks to months after treatment, and occasionally lighten. Preparation with pigment-suppressing skincare for several weeks beforehand, conservative settings, and rigorous sun avoidance afterwards all reduce it substantially. A test patch tells us more than a conversation does.
Infection and cold sores
Broken skin can become infected, and anybody who gets cold sores will very likely get one after facial resurfacing. Antiviral cover starts before the treatment as a matter of routine, and we will ask about it even if you have not thought about it in years.
Scarring
Rare with fractional treatment and correct settings, more likely if a treated area is picked, infected, or exposed to sun. It is also more likely in anybody who scars enthusiastically anywhere else, which is a question we ask.
We will not treat
Anybody with an active infection or inflammatory skin condition in the area; anybody who has taken certain oral acne medication within the last six months; anybody pregnant; anybody with a recent tan; anybody unwilling to stay out of sun for the following months; and, most often, anybody whose diary does not have room for the recovery.
Laser Skin Resurfacing in western Queens
Controlled removal of the surface of the skin so that it heals back smoother, or controlled heating beneath it without breaking the surface. The first works better; the second costs you nothing in downtime.
Every treatment here starts the same way: a full hour at a table in a room with no treatment couch in it, a proper medical history, your skin looked at in daylight, and then a plain statement of what we think would achieve what you described. You are told what it costs, how many sessions it usually takes, how long it lasts, what the recovery looks like and what can go wrong — on paper, to take home and read somewhere other than a treatment room. If the honest answer is a different treatment, or nothing, or a dermatologist, that is what you get instead, and it costs exactly the same.
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
No before-and-after photographs, and no promised outcome. There are no before-and-after photographs on this website and there never will be. Every set you have seen somewhere else was chosen from a much larger pile, and the second picture is usually taken in different light, at a different angle, at a different time of day, often with makeup and frequently after retouching. Even an entirely honest pair shows you what happened to somebody else's face. What we publish instead is what a treatment typically changes, by roughly how much, how long it lasts, how many sessions it usually takes and how often people are disappointed. We do not guarantee an outcome, we cannot, and anybody who does is either guessing or selling.
The risks, plainly. Every treatment on this site has side effects and some carry real risks. The common ones are minor and short-lived — redness, swelling, tenderness, bruising, a day or two of looking like you have had something done. The uncommon ones matter more: burns, blistering and long-lasting pigment change from light-based treatment, which is a greater risk on deeper skin tones and on recently tanned skin; infection anywhere the skin is broken; and lumps, asymmetry and, very rarely, a blocked blood vessel from injectable filler, which is the one true emergency in this field. We screen for what makes each of these more likely, we tell you your own risk rather than the average one, and we decline to treat when the answer should be no.
What a med spa does not treat. We treat the appearance of healthy skin, hair and body. We do not diagnose or treat disease. If you bring us a mole, a changing mark, an unexplained rash, a sore that will not heal, skin that has become hard or numb, psoriasis, eczema, an autoimmune skin condition, or hair loss that came on suddenly or in patches, what you will get is the name of a doctor rather than a treatment plan. Aesthetic treatment applied on top of an undiagnosed skin problem can mask it, delay the diagnosis and occasionally make it worse. We would rather lose the booking.
Questions
Laser Skin Resurfacing — the questions we are asked most
How much downtime is there really?
For fractional ablative: three to seven days when you will not want to be seen, and several weeks of pinkness that makeup covers. For non-ablative: a day of redness. Anybody describing ablative resurfacing as a weekend treatment is under-selling the recovery, and being surprised by it is the commonest complaint about this treatment anywhere.
Can I have this if I have darker skin?
Often yes, with adjusted settings, several weeks of preparation with pigment-suppressing skincare, a test patch, and a clear commitment to sun avoidance afterwards. Sometimes the honest recommendation is microneedling or radiofrequency microneedling instead, both of which achieve much of the same thing with far less pigment risk. We will tell you which category you are in.
Will it get rid of my acne scars?
It improves them, often considerably, and it does not erase them. Realistic improvement across a course is meaningful rather than complete, deeper ice-pick scars respond least, and combining resurfacing with other treatment usually beats either alone. Anybody promising to remove acne scarring is over-promising, and /acne-and-scarring.html goes through this properly.
Why will you only book this in autumn and winter?
Because treated skin pigments very easily for months afterwards, and a summer of ordinary daily sun in New York is enough to undo the result and leave uneven patches. Booking it between October and February is a practical decision about your outcome rather than a scheduling preference of ours.
How many sessions will I need?
One or two for fractional ablative; three to five spaced a month apart for non-ablative. You are assessed before each and you can stop at any point. There is no package, so stopping costs nothing further.
Does it hurt?
Numbing cream for forty-five minutes beforehand makes the treatment itself tolerable — hot and prickling rather than sharp. The two hours after an ablative treatment are the uncomfortable part, described by most people as a strong sunburn. Ordinary painkillers and something cool handle it.
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Laser Vein Treatment
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Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.