Facial plastic surgery in Salt Lake City, Utah
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ConsultationsLaser skin resurfacing is a non-surgical treatment that uses a focused beam of light to remove or heat the outer layers of skin in a controlled way. The precise thermal injury prompts the skin to build new collagen — a process called collagen remodeling — softening fine lines, fading sun damage and pigmentation, and improving acne scarring and texture. Dr. James Manning performs the procedure in Salt Lake City, Utah.
Laser resurfacing works by delivering controlled heat to the skin. That heat does two things — it can remove the damaged outer layer, and it signals the deeper tissue layers to lay down new collagen as they heal. This is collagen remodeling, and it is the reason results continue to improve for months after the skin surface has healed.
Lasers fall into two broad categories. An ablative laser — such as a CO2 (carbon dioxide) laser or an Er:YAG (erbium) laser — vaporizes the surface layer of skin, producing a stronger result in fewer sessions with more downtime. A non-ablative laser heats the deeper layers while leaving the surface largely intact, which means less downtime but a series of treatments to reach the same goal. Most modern devices are fractional — they treat the skin in microscopic columns rather than the entire surface at once, which leaves untreated skin in between to speed healing.
Good candidates for laser resurfacing are patients bothered by fine lines and wrinkles, sun damage and uneven pigmentation, acne scarring, or rough skin texture and tone. Laser resurfacing also produces mild skin tightening through collagen remodeling, though it does not replace surgery for significant laxity.
Skin type matters more here than with most treatments. Patients with darker skin — higher Fitzpatrick types, the scale that describes how skin responds to light and tends to pigment — carry a higher risk of post-inflammatory hyperpigmentation, which is darkening of the skin after the inflammation of treatment. That does not rule out treatment. It changes how treatment is done — more conservative settings, sometimes a test spot in a discreet area first, and skin preparation beforehand.
Active infection, certain medications, and a recent history of isotretinoin are assessed at consultation. Candidacy is determined by your skin, not by a one-size protocol.
There is a real trade-off here, and it is worth stating plainly. Neither is better in the abstract — the right choice follows your skin, the depth of what you are trying to correct, and how much downtime you can take.
| Ablative | Non-ablative / fractional | |
|---|---|---|
| How it works | A CO2 or Er:YAG laser vaporizes the surface layer of skin in a single, stronger session. | Heats the deeper layers while leaving the surface largely intact, usually in a series of sessions. |
| Best suited to | Deeper lines, more sun damage, and more textural change addressed at once. | Patients who want a lighter touch on a busier schedule, reaching a comparable result over three to five sessions. |
| Downtime | Real downtime — often one to two weeks of healing. | Far less — often a few days of redness. |
| The result | A stronger correction in fewer sessions, with more required recovery time. | A comparable result reached gradually, with far less schedule disruption. |
The fear that brings most people to this conversation is the look of skin that has been over-treated — shiny, lightened in patches, or visibly “done.” That outcome is real, and it is almost always a function of settings that were too aggressive for the skin in front of the laser:
Dr. Manning matches the laser and its settings to the individual — skin type, the depth of the concern, and the downtime the patient can realistically take. The settings are not pulled from a template. They follow the skin, which is why a consultation and, where appropriate, a test spot come before any full treatment.
Because he specializes exclusively in the face, laser resurfacing sits alongside the full range of facial treatments and surgery. That matters when laxity or volume loss is part of the picture — laser addresses the skin surface and texture, and he can tell you honestly when a different tool, or a combination, would serve you better.
Day 0
Treatment session
Thirty minutes to about an hour, depending on the area and laser used. You go home the same day.
Days 2–5
Non-ablative redness
After a non-ablative or light fractional treatment, expect redness and mild swelling, similar to a sunburn.
1–2 weeks
Ablative healing
After a fully ablative CO2 or erbium treatment, expect redness, swelling, oozing, and crusting as the skin heals.
Weeks–months
Pinkness fades
Residual pinkness fades over several weeks to a couple of months. Daily sun protection is not optional during this stretch.
3–5 sessions
Series complete
Non-ablative and lighter fractional treatments are typically staged as a series, spaced weeks apart.
Laser resurfacing addresses the skin surface — texture, tone, fine lines, and scarring. It is often combined with treatments that address the layers it cannot reach.
Dermal fillers restore lost volume, and neuromodulators soften the dynamic lines created by muscle movement. When laxity is more significant, surgery such as upper blepharoplasty or a deep plane facelift addresses structure that resurfacing cannot.
Dr. James Manning is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology–Head and Neck Surgery. He specializes exclusively in the face.
Laser resurfacing is a treatment where matching the device and settings to the individual skin determines both the result and the safety. Dr. Manning sets those settings conservatively, accounts for skin type, and uses a test spot where appropriate — and because he treats the full range of facial concerns, he can tell you when laser is the right tool and when it is not.
Medically reviewed by Dr. James Manning, MD · July 2026
Laser skin resurfacing is a non-surgical treatment that uses a focused beam of light to remove or heat the outer layers of skin in a controlled way, prompting new collagen formation — collagen remodeling. It is used to soften fine lines, fade sun damage and pigmentation, and improve acne scarring and skin texture.
An ablative laser — such as a CO2 or Er:YAG (erbium) laser — vaporizes the surface layer of skin and typically produces a stronger result in fewer sessions, with more downtime. A non-ablative laser heats the deeper tissue layers while leaving the surface largely intact, which means less downtime but usually a series of sessions. In a randomized split-face trial of 40 patients, both fractional CO2 and fractional Er:YAG significantly reduced facial wrinkles, though discomfort was more pronounced after the CO2 treatment. (Robati RM, Asadi E. Lasers Med Sci. 2017;32(2):283-289. PMID 27885522)
Yes. Fractional laser resurfacing can improve the texture and depth of atrophic — depressed — acne scars by stimulating collagen remodeling. A systematic review and meta-analysis of randomized trials found fractional CO2 laser therapy effective for facial atrophic acne scars. (Zhang J et al. Lasers Med Sci. 2023;38(1):214. PMID 37723352)
It can be, but it requires caution. Patients with darker skin — higher Fitzpatrick skin types — have a higher risk of post-inflammatory hyperpigmentation, a darkening of the skin after treatment. A review of CO2 laser outcomes reported that up to 92% of patients with Fitzpatrick skin type IV and above developed this pigmentation after ablative treatment, which is why conservative settings, skin preparation, and a test spot are used. (Bin Dakhil A, Shadid A, Altalhab S. Dermatol Reports. 2023;15(4):9703. PMID 38205425)
A single ablative session can deliver a full correction. Non-ablative and lighter fractional treatments typically require a series of three to five sessions spaced weeks apart. The right plan depends on your skin type and the depth of the concern, and is determined at consultation.
The new collagen is durable, so improvement in lines, texture, and scarring lasts. But skin keeps aging and sun exposure adds new damage, so results are lasting rather than permanent. Consistent sun protection and a sensible skin-care routine are the most important factors in how long the result holds.
The collagen you build does not disappear, so the improvement in lines, texture, and scarring is durable. But your skin keeps aging, and sun exposure keeps adding new damage — so results are best thought of as lasting, not permanent. Many patients maintain their result with periodic lighter treatments, a sensible skin-care routine, and consistent sun protection.
A single ablative session can hold for years. A non-ablative series typically calls for occasional maintenance sessions over time. The honest version: the laser corrects what is there now, and how long that lasts depends in large part on how you protect your skin afterward.
The skin is numbed with topical anesthetic cream, and local anesthetic is added for deeper ablative treatments — there is no general anesthesia. Most patients describe the sensation as heat with a prickling or snapping feeling, manageable with the numbing in place.
If you are considering laser resurfacing, we would love to see you in consultation to determine if laser resurfacing would best fit your needs — including a read of your skin type and the right laser for your goals.
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