Light to Deep Skin Resurfacing

Dr. Macdonald offers you three ablative laser treatment options to revitalize your skin with renewed evenness of color and tone, plus youthful smoothness and resiliency of texture:

  1. NanoLaserPeel™ or MicroLaserPeel® - for light resurfacing up to 4x that of microdermabrasion
  2. Pro-Fractional™ and Pro-Fractional-XC™ - for fractioned resurfacing with remodeling, and scar removal and repair
  3. Contour TRL™ - for deep resurfacing tuned to your specific skin needs

The depth and intensity of your laser resurfacing is finely tuned to your:

  • Skin type
  • Skin condition
  • Overall improvement goals
  • Available downtime for healing

We are able to address a broad range of your life-long skin needs, from subtle to dramatic, with superior consistency and customizable skin-rejuvenating effects.

Am I A Candidate for NanoLaserPeel™ or MicroLaserPeel®?

Is your skin looking dull and lackluster with some blemishes and fine lines? Are you seeking more substantial or faster results than you may be achieving with microdermabrasion or chemical peels alone?

NanoLaserPeel™ and MicroLaserPeel® are the next level of aggressiveness in the continuum of treatments to improve your skin tone, texture and color. Fortunately, either of these cosmetic laser skin procedures only takes 30 minutes, and can even be done over your lunch break. If these benefits sound suitable to your goals, you may be a great candidate for either NanoLaserPeel™ or MicroLaserPeel®.

When considering either of these cosmetic laser peels, it's important to understand the wide variance of treatment intensity and downtime you can choose from, depending on your needs. For example, the patient shown above underwent one 30-micron MicroLaserPeel® treatment and the photos show her skin before treatment and 5 months after treatment. The downtime associated with this highest strength MicroLaserPeel® is typically 5-7 days as it's essentially a light (meaning a relatively shallow skin depth) full skin resurfacing procedure.

A MicroLaserPeel® can range in intensity from >10 to 30 microns. At the 4-10 micron low-intensity level, this procedure is termed a NanoLaserPeel™, and downtime is 24-72 hours. Results and downtime of a NanoLaserPeel™ are similar to what you might experience from four microdermabrasion treatments done all at once. Thus, you are more likely to want to do a series of treatments at this intensity level or use it as a quarterly skin maintenance program.

The Science of NanoLaserPeel™ and MicroLaserPeel®

The science is the same whether you opt for a NanoLaserPeel™ or the more intense MicroLaserPeel®.  With both treatments, a laser beam scans your desired treatment area to precisely ablate (i.e., vaporize) a very thin layer of skin, as it removes old, damaged tissue. This eliminates some of the old cells that can give skin a tired, aged look with superficial blemishes and pigment irregularities.

Laser Peels for Light Resurfacing

Superficial skin resurfacing with a NanoLaserPeel™ or MicroLaserPeel® is a quick, safe and effective treatment. Most patients compare it to microdermabrasion at 2-4 times the strength and intensity.

Popular treatment areas are face and neck, though some people also treat the chest and backs of hands. Our Sciton Laser Peels effectively treat the following skin conditions:

  • Mild wrinkles
  • Scars
  • Keratosis (i.e., looks like "goose bumps")
  • Sun damage (i.e., brown spots)
  • Other pigment irregularities

How Do I Prepare for My Laser Peel?

Plan your calendar for recovery time. You probably want to be out of sight for at least a day or two while you’re looking slightly red (like a sunburn). Otherwise, there’s not much to do to prepare for your light laser peel treatment. We highly recommend purchasing our Post Laser Healing Kit to soothe or protect your skin in the immediate days of healing.

What Happens During My Laser Peel?

  • You or your clinician will cleanse your skin areas to be treated and if appropriate, may apply topical numbing cream to alleviate any mild discomfort.
  • A cooling air blast blown directly on the areas being treated throughout the procedure serves as further anesthetic to soothe and cool the skin.
  • Your eyes are protected with safety shields.
  • Dr. Macdonald or his nurse positions the laser handpiece above your skin and holds it in place as the computer-guided scanner moves the laser beam around the treatment area.
  • You should have minimal pain or discomfort because of the light depth of this peel.
  • Treatment usually lasts 15-30 minutes, depending on the size of the area being treated.

What Happens After My Laser Peel?

See what to expect after treatment with our very popular NanoLaserPeel™ and MicroLaserPeel®.

When Do I See Results of My Laser Peel?

Because only a thin layer of your outermost dermis is treated, you see obvious improvements in tone, texture, and color evenness as soon as your skin heals. Typically, this is within 3-5 days of your procedure.

Generally, the stronger MicroLaserPeel® requires only a single treatment to yield excellent results. However, results vary by patient, skin type and condition. Additional treatments or a series of treatments may be required to achieve your goals, particularly if you opt for the lighter NanoLaserPeel™.

How Do I Intensify My Laser Peel Results?

For an additional boost to the skin rejuvenation you get from a MicroLaserPeel®, consider combination laser therapy. The benefits of well-planned combination treatments are: maximum skin improvement results, in the least amount of time, and achieved most cost-effectively.

MicroLaserPeel® is frequently combined with Pro-Fractional™ or BBL™ photofacial procedures. If deeper resurfacing is your goal, the tunable nature of the Contour TRL™ enables specific targeting of treatment depth and intensity, to meet your specific skin conditions and objectives.

Am I A Candidate for Contour TRL™?

Does it seem that your face no longer reflects on the outside the energy and vitality you still feel on the inside? Do you appear tired and drawn with deep-set forehead wrinkles and crow’s feet? Are you frustrated by sagging cheeks that are hiding the contour of your jawline, or deep smile lines and wrinkles around your mouth?

If this sounds familiar, are you wondering what options you have to restore the face you’ve always known? Are you specifically looking for non-surgical cosmetic enhancement alternatives?

If so, then you may be a great candidate for Contour TRL™ deep resurfacing (i.e., tunable resurfacing laser). Even if you’re considering facial rejuvenation surgery, you may want to consider adding on Contour TRL™. Laser resurfacing, in combination with facial plastic surgery, maximizes your overall result.

How Does the Science Behind Contour TRL™ Work?

Because Contour TRL™ resurfaces tissue with micron precision, your skin is treated with the exact amount of energy needed—no more, no less.

This laser procedure stimulates growth of new collagen, which improves your skin’s thickness and resilience. Your skin's surface re-grows with fresh, healthy cells, which gives your skin a younger, rejuvenated appearance.

Contour TRL™ for Deep Resurfacing

Contour TRL™ is widely regarded as the safest, most effective laser available today for light to deep full resurfacing. This procedure can be used to treat:

  • Deep wrinkles (even in hard to treat areas around mouth and eyes)
  • Scars (including acne scars)
  • Actinic Keratosis
  • Poor skin tone/texture

If pursuing facelift surgery, ask Dr. Macdonald about combining it with deep laser resurfacing—particularly around the mouth and eyes—to maximize your full facial rejuvenation. The TRL™ procedure complements your facelift surgery by jumpstarting your own natural collagen production. It removes layers of tired, worn-out skin, which is replaced with newly regenerated healthier skin.

How Must I Prepare Before Contour TRL™

Avoid sun exposure and use of aspirin. Prepare for needed medications and downtime, and schedule a friend or family member to drive you to and from your appointment. For more specific things to do before laser treatment, you can read our Patient Prep section.

What Happens During Resurfacing?

  • Sedation and pain medication are offered prior to treatment, along with topical numbing cream.
  • For deeper treatments, Dr. Macdonald may also administer regional anesthetic blocks and/or subcutaneous local anesthetic to ensure the highest possible patient comfort throughout the procedure.
  • A cooling air blast blown directly on the areas being treated throughout the procedure serves as further anesthetic to soothe and cool the skin.
  • You wear protective eye shields for the duration of your procedure.
  • Dr. Macdonald positions the laser handpiece above your skin, holding it in place as the computer-guided scanner moves the laser beam around the treatment area.
  • Depending on the size of the treated area, the procedure usually lasts from 15-30 minutes. 

What Happens After Deep Resurfacing?

You might be surprised to learn of all of the expectations after treatment for this ablative laser therapy. Because a full deep layer of skin is being removed, your skin needs tender loving care while it heals. Be sure to plan conservatively for the maximum recommended downtime.

When Do I See Deep Skin Resurfacing Results?

  • The top layer of your skin re-epithelializes (re-grows) and can be covered with makeup in about 7 days, at which time you can see noticeable improvements in your skin’s texture, tone and wrinkle appearance.
  • Deeper laser treatments also stimulate the growth of new collagen over the next 4-6 months. During this time, your skin shows increased improvements in color, clarity, tightness, and resilience.
  • Because Contour TRL™ peels off a deep layer of damaged skin, excellent results are typically achieved in just one treatment.

Michael R. Macdonald, M.D.

Facial Plastic Surgeon located in San Francisco, CA

Michael R. Macdonald, M.D., is a skilled facial plastic surgeon with significant experience in the most advanced cosmetic procedures, including facelift and neck lift surgery, brow lift surgery, blepharoplasty (eyelid surgery), rhinoplasty, BOTOX® injections, microneedling, liposuction, and chemical peels to help women and men look and feel their best at every age. At the Aesthetic Surgery Center in San Francisco, California, Dr. Macdonald uses state-of-the-art techniques and technology to achieve customized results focused on each patient's unique goals and needs.

After earning his medical degree at Queen's University, Dr. Macdonald completed an internship at New York General Hospital followed by residencies at Dartmouth-Hitchcock Medical Center and University of Toronto and a fellowship at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). As a board-certified plastic surgeon, Dr. Macdonald is dedicated to providing patient-centered care that draws from both his surgical and artistic skills to achieve optimal results focused on each patient's facial anatomy, needs and treatment objectives.

Dr. Macdonald and the Aesthetic Surgery Center welcome new patients from throughout the San Francisco region. Dr. Macdonald speaks both English and French.

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Aesthetic Surgery Center

Michael R. Macdonald, M.D., is a skilled facial plastic surgeon with significant experience in the most advanced cosmetic procedures, including facelift and neck lift surgery, brow lift surgery, blepharoplasty (eyelid surgery), rhinoplasty, BOTOX® injections, microneedling, liposuction, and chemical peels to help women and men look and feel their best at every age. At the Aesthetic Surgery Center in San Francisco, California, Dr. Macdonald uses state-of-the-art techniques and technology to achieve customized results focused on each patient's unique goals and needs.

After earning his medical degree at Queen's University, Dr. Macdonald completed an internship at New York General Hospital followed by residencies at Dartmouth-Hitchcock Medical Center and University of Toronto and a fellowship at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). As a board-certified plastic surgeon, Dr. Macdonald is dedicated to providing patient-centered care that draws from both his surgical and artistic skills to achieve optimal results focused on each patient's facial anatomy, needs and treatment objectives.

Dr. Macdonald and the Aesthetic Surgery Center welcome new patients from throughout the San Francisco region. Dr. Macdonald speaks both English and French.


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  • Jodi   Landi
    Jodi Landi
    Practice Manager, Patient Coordinator
  • Lamai  Walker
    Lamai Walker
    LVN, Medical Esthetician
  • Erica  Shelton
    Erica Shelton
    Aesthetic Laser Specialist, Registered Nurse
  • Thao  Duong
    Thao Duong
    Semi-Permanent Cosmetics, Skin Artist
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    "Dr. MacDonald is truly the 'plastic surgeon's plastic surgeon'. Totally professional, great listener, and the ultimate Artist."

    Richard L.
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Michael Macdonald, M.D.
500 Sutter Street
Suite 430
San Francisco, CA 94102