Dr. Gavin Chan: How a Ray

of Light Changed My Life -

VCI – Beautiful You Expo

My name is Gavin Chan, I'm from the Victorian Cosmetic

Institute and today I’ll be talking about how a ray of light can

change your life.

Imagine taking a single wavelength of light, amplifying it and

then focusing on some skin, and imparting changes on the

skin, which make a huge, dramatic difference in the way the

skin appears. This in turn, makes a huge change to how

people perceive you and also how you feel from within and

how confident you are in your skin.

Today, I’ll be talking about that topic which is lasers. Lasers

are essentially a single wavelength of light. Lasers can make

dramatic changes to your skin and I'll put together a few

cases today illustrating this.

I first got into lasers about 10 years ago. I’ll tell you a bit about

my journey. I started off with a single laser. I bought it at a

conference, a cosmetic and laser conference run like this one

and it cost a hundred and eighty thousand dollars at that time.

The laser did virtually one thing, which was it treated blood

vessels. So it was a laser which was highly attracted to

oxyhaemoglobin which is present in the blood and what it

could do is shut down blood vessels.

Now here is the man who came to see me, and this fellow

was rather unfortunate. He only had one arm and everyone

thought he was an alcoholic because he had a red face, but

he actually didn't drink really much at all. He has a condition

called rosacea which is quite a common condition affecting a

lot of our population. The type of rosacea he had, were a lot of

broken capillaries and facial capillaries. So we treated him

with our laser that I had, my first laser and this was the result.

Afterwards, he was in here for a second treatment but you

can see there is a dramatic difference between the first and

second photos. This changed the way people perceived him.

They didn’t think he was an alcoholic anymore and they

thought he had better skin obviously.

Here's another interesting case, a young guy with a port-wine

stain. A port-wine stain is a congenital birthmark that afflicts

quite a number of people in our population, especially on the

face.

Now this poor kid, when he was young, he didn't have any

photos taken of him. Usually when you're a little kid you have

multiple photos taken of you. He showed me one photo. I

asked him to show me a photo of when he was young, I

wanted to see what his port-wine stain was like. He showed

me one photo of himself. I think he was angry, so his Dad

said, I'll take a photo of you if you don't stop having a temper

tantrum. He's got this photo of him throwing a temper tantrum

when he was three years old.

Anyhow we used the same laser on him the vascular laser,

the Gemini laser and that cleared a lot of his port-wine stains.

You can see a huge difference between the first and second

photos. There were multiple treatments involved in this and

we didn’t ever get it down to nothing. The nature of most port-

wine stains, is that it will actually not be able to be fully

treatable, but nonetheless this made a big difference for him.

He had a huge improvement in his confidence because his

appearance was less dramatic.

So the laser bug bit me and I went on to purchase more

lasers. Lasers are very specific in their use. One laser will be

used for blood vessels as you've seen and then another laser

may be used for pigmentation or other skin problems.

I make two analogies, one for men and one for women. For

men, I might say it’s like having lots of different lenses for your

camera and they can relate to that. For women, it’s like saying

you know, you have to have multiple pairs of shoes. You can't

just have one pair of shoes, because you can't do everything,

in runners. You have to have high heels, you have to have

runners, you have to have all sorts of shoes and just some for

everyday use. So lasers are a bit like that. Each laser does a

specific job on the skin.

Now in this case, we have a demonstration of a ruby laser.

This lady I actually met in the park, walking my dog. I watched

her walk by quite a few times then I told her what I did. Then

she said "What do you think, can you fix up this brown spot for

me?" She actually had this for twenty years and even with

makeup on, you weren’t really able to cover it up.

So we did one treatment, and within 10 minutes, this spot was

in the process of being removed. After a week, you have this

appearance. So she went on to have further treatment of

some other brown spots and some further treatment of the

remainder of that brown spot. You can see a huge difference,

and this lady no longer has to worry about putting on makeup

everyday.

Another example, an Asian patient, this lady couldn't cover up

her face even with stage makeup, she couldn't cover up these

dots. So we erased them using a pigment laser again and you

can see a dramatic difference in her skin. She could just put

on light makeup now and get away with covering all the spots.

So my laser obsession kept going on and on, I kept buying

more and more lasers, the laser bug really hit. I went and

bought some different lasers. Some lasers have different

properties. Some lasers are able to fire laser pulses at a very,

very short interval of time. So we're talking in the order of one

billionth of a second. These lasers can break down even

things like tattoo ink.

We have a patient here who has an unfortunate tattoo across

his forehead and this has stopped him from doing virtually

anything. He had no job, he couldn't go anywhere without

people making a serious judgment about him. Actually this

case came to me as a pro bono case. I was asked to do this

one at no charge and I did oblige because he couldn't afford

to do it at that time and we ended up about doing six

treatments on him and the result was this. So it virtually

disappeared.

The lasers used was a Q-Switch Nd:Yag Laser which

basically is attracted to the pigmenting. The laser is able to

break down those pigments into such small particles that the

body can them take away. Normally tattoos stay there

because they're too big for the immune system to take away.

So once they're broken down, they’re fine.

Now we move on to another laser. This is an interesting case

here of a fellow who has had this big nose. It got bigger and

bigger as time went by. He had an unfortunate situation where

his wife passed hadn't had time and things got away and he

just let it go. He said he used to go to shopping malls and little

kids used to be scared of him. He said he used to shake his

nose at them and scare them off.

He's a nice fellow actually. Again, with this sort of nose,

there's lot of association with alcoholism and other problems

and really that’s not the case here. This is a complication of

rosacea which is a skin condition. So I used another laser

called a CO2 laser or carbon dioxide laser. This laser is

attracted to the water in the skin. We were able to shave down

the nose back to this level here so he looked much more

normal than the previous picture. The CO2 has to be one of

my favorite lasers because you really can do so much with it

in terms of skin rejuvenation.

This is Margaret, one of our nurses and she's a lovely lady, I

work with her quite a lot. Every week in the operating theatre I

stand opposite her. She's a lovely lady with a heart of gold,

but people used to think she was tired or angry at them. At

times that could be true. But she's got this very interesting

expression she does with her one eyebrow where she can

look at you and raise one eyebrow and it just sees right

through you. If she wants to make you uncomfortable she can

do that.

One day, whilst I was operating opposite her I said to her,

"Look Margaret, we’ve really got to do something with your

skin". Of course she gave me the eyebrow and I was slightly

uncomfortable. I said, "We’ve got to do a laser resurfacing for

you". I planted the seed and I kept talking to her for days, and

I think months and eventually I talked her around to doing it.

So we do a carbon dioxide laser resurfacing. The carbon

dioxide laser is able to remove wrinkles by vaporizing a very

fine layer of skin as well as tightening the skin through

shrinkage. The skin basically shrinks through the thermal

energy. This is her before and after; now, what a difference

eh? You can see there are far fewer wrinkles, pigmentation is

improved also. We just basically took that top layer of old skin

off and regenerated her skin. One of the anesthetists she

works with, who had been working with her for twenty years

didn't recognize her. He said, "Oh, that's you Margaret." He

didn't recognize her after the treatment.

Here's another example of a lady who has had carbon dioxide

laser resurfacing. You can also remove little moles by

focusing on the mole and shaving it down to the level of the

skin, but certainly there's a lot of skin tightening around the

eyes and a lot of reduction in upper lip lines.

Now we have a final case here. Now, we actually have the

after shot here, she's right in front of me, so would you like to

come to the stage Alana? This is Alana, give her a hand. I

thought, the best after shot ever. This was her. Alana sent me

this photo, not long after she initially contacted me by email.

She asked me, do you do laser resurfacing? I said yes. She's

from Mildura, so I said, send me some photos and this is what

she sent me. You weren't too happy about those photos.

Dr. Chan: What did you title them? You said...

Alana: Ugly.

Dr. Chan: She titled them 'ugly'. That was the folder that she

put them in. She was really worried about her skin and you've

had this since... how old were you when this first started?

Alana: It started when I was around thirty and just got worse

and worse, mainly sun damage. I've been to three plastic

surgeons, they wouldn't touch me because it was just too, too

many wrinkles.

Dr. Chan: So, in essence, a face lift or a surgical intervention

is not the ideal procedure for this sort of skin. What needs to

be done is a resurfacing of the skin. So poor Alana went

through this. She had the procedure, we put her through

sedation, so it was relatively comfortable, for the procedure.

We injected a lot of local anesthetic into her face, and now I

have to pre-warn you that these next pictures are going to be

quite graphic. This is her journey afterwards. This is before,

this is immediately after the procedure, you can see there's

little bit of bleeding, her face is very swollen from the local

anesthetic. How did that feel at that stage, was that painful?

Alana: Um, no. I had no pain. No.

Dr. Chan: And it gets worse, Day 2, you could see quite a lot

of crusting and bleeding. Now Vaseline is applied to the face

everyday, you get pretty sick of Vaseline after a while. So at

this point, how did it feel? How did your face feel at this point?

Alana: I had no pain. I just felt normal. There was nothing.

Member of the audience: Were you scared?

Dr. Chan: Were you scared?

Alana: (Shook her head)

Dr. Chan: I guess this is Day 3 and Day 5, and Day 6 and 7

and I think 8 days on, 9 days, 11 and 18 days. So we've gone

from this to this, which is quite a nice change, and here she is.

Give her a hand.

Audience: (Applause)

Dr. Chan: Well now, how do you feel after your procedure?

How do you feel within yourself?

Alana: Oh heaps better. People are noticing a difference. I

feel better about myself. Yeah, I just yeah, completely

different.

Dr. Chan: Did many people made any remarks or comments?

Alana: Yep. A lot of people say that they can see that I look

different but they can't put their finger on what it is. And they

say that I look refreshed.

Dr. Chan: So you don't look overdone, like plastic surgery.

Alana: No.

Dr. Chan: Okay, so thank you Alana for coming all the way

from Mildura to be part of this talk. I hope it’s made a nice

difference for you, in your life.

Alana: It has.

Dr. Chan: And I think, that's what really gives us a bit of a

buzz, when we have patients like Alana who are not only very

nice but who have great results. You know it gives us a bit of a

buzz that we've looked after you and helped to make a

difference in your life. Thank you.

Question time. Do you have questions?

Dr. Chan: Alana stayed in Melbourne for one week. We see

her everyday after the procedure to check on her, to make

sure there are no signs of infection, or any issues. She had an

uncomplicated course, there were no side effects or

complications with her treatment.

It does take a good one week to get over the majority of it,

and up to a month to two months to get over the redness and

the swelling. How far out are you now again? It’s about six

weeks out. So the improvements continue for six to twelve

months afterwards as the collagen remodels. From other

patients as well as Alana, I’d say the experience is not painful.

It’s slightly itchy and uncomfortable, and you look terrible, you

look really terrible, that's the main issue for people.

Pain wise is not bad, at worse it feels like a bit of sunburn but

you have to be secluded at home, you can't really go out and

do your shopping or anything. You have to get all of your

shopping and videos and everything done before, borrow your

videos and do your grocery shopping and just stay at home

for a week. So you did very well. Vaseline gets in your hair

and everything, but it’s a very good procedure. In terms of

resurfacing, this is the gold standard. So there's nothing really

that surpasses this.

The only other thing is, it’s only available for people with fairer

skin types. So people with olive skin or Asians, darker skin

types, cannot have the procedure. It's only for fairer skin

types.

Any other questions? Thank you for listening, and good to

have all of you. Yes, come visit our stand, it's around the

corner there. We’ll just do a plug there for our stand. I think we

have some offers as well so come by. Otherwise, thank you

for coming to listen to me.

Visit our general information page to

learn more about the different kinds of

lasers used in skin treatment.