Active FX

Active FX is not the name of a summer blockbuster movie targeted to the teenage boy demographic.

I know. Last month, I was part of an experimental group of women who underwent a new-ish procedure. (And no, that is not why I slowed the frequency of posts here at MM.)

In a sentence: I had the skin on my face burned off.

The easiest way to understand this is to recall an episode (Season 5, Episode 71) from Sex and the City, when Samantha had a chemical or laser facial peel, she looked into the mirror, and shrieked when she saw her red, oozing face.

The procedure is intended to slough off micro-layers of dead skin to reveal the younger-looking skin below. The argument goes that afterward, the appearance of fine lines is greatly reduced, and that the results last for at least a couple of years - if not more.

The Active FX laser renders almost identical results to the more intense and longer-recovery chemical and full-laser peels, except that it is supposed to take not more than five days to recover, allowing folks to return to their busy lifestyles faster.

In truth, the office that arranged the procedure is familiar to me. I figured that offering myself as a guinea pig was the least I could do.

Here's how it was explained to me:

It will take three to five days to recover.

The procedure itself will take less than an hour.

The office will take photographs before the treatment.

A follow-up visit will be needed to take the after-pictures.

Okay, that sounded simple enough. I signed up for a Friday afternoon appointment. I took the subway and arrived on time. The office was running behind, and I took a seat in the waiting room. A woman, wearing a light aqua-colored, gel face-mask was chatting away on her telephone. I tried not too look, thinking that people in a plastic surgeon's office prefer privacy.

I was told that she had just had the Active FX procedure. Well, I thought, she seemed animated, not in obvious pain.

They called me in to the pre-treatment room. The attending nurse asked if I preferred Vicodin or Valium. In addition to Tylenol or Motrin.

Boing. Huh? Warning signal. Vicodin or Valium? I needed a sedative? In addition to...?

My mind raced. Don't people get instantly addicted to Vicodin? I asked for Valium. And aspirin.  I can count on one hand the number of times I have taken prescription painkillers.

The nurse reclined the chair and my feet came up from the floor. She gave me the pill and a paper cup of water. Then she smeared a cold gel or cream all over my face. Sure enough, in about twenty minutes, I felt stoned. Whee. Someone came into the room and wiped the gel off my face. My lips felt numb, as if I had applied Novocaine lip balm. Turned out my whole face was Novocained or something like it. Whee.

I was high and giggling. The nurse walked me into another room and sat me in another recliner. People were talking and I either did not understand what they were saying or I didn't care. I remember "We'll take two passes under the eyes."

The eyes. Right. I am so queasy about my eyes. I cannot watch people insert contact lenses. My knees go all squidgy. It's probably because I've worn glasses since I was two years old, essentially a protective shield between my eyes and the world.

The doctor was there, suddenly, very close to my face. "Look up," he said. And I did. Then he did two things to me that when I reflect on them now, I just shudder.

He lifted my top lid and sprayed a stinging solution into one eye, and before I could yell "No! Are you nuts?" he lifted the other and sprayed the same.

Blink, blink, blink. What??? Sting. Blink.

The next part is still too unreal to me.

While high, semi-oblivious, blinking, and stinging, the doctor then popped in a little suction cup device right onto my eyeball. Oh shit. Oh, holy shit. The stinging spray had numbed my eyeballs and now they were covered by suction cups. Oh, holy shit.

An image went fleeting across my mind's eye (since my actual eyeballs were in shock). I must've looked like an alien or a hell-demon from a science-fiction-horror-slasher film.

A small voice in the back of my fuzzed mind broke through the haze, "Your eyes have to be covered because they are going to laser your face. Otherwise, you may go blind."

And laser they did - although by then I had given up control and let it rip. It felt like a million little stinging pin pricks. The only weirdness was along may hairline, ouch. I wiggled my feet and made small squealing noises. The nurse told me to hold her hand tight - and I did.

The whole thing lasted not more than fifteen minutes, after which the doctor popped those nasty little eye cups out of my head, someone wrapped me in a blanket, and walked me back to that first room. There, they put one of those cold gel face masks on me. Frozen, actually. Oww. At first, and then my body warmed it up. And then they replaced it with a new, fresh, frozen one. Again, oww.

At some point, I was returned to the waiting room, whereupon I started shivering. I felt cold down to my core. I could not get warm.  They gave me a cup of tea and saltine crackers. It took an hour or so, but I managed to regain the feeling in my fingers and toes.

I was given a bag of various creams to apply continuously. I figured I was recovered enough to return home. And so I left. I walked back to the subway, and standing on the platform, it appeared that no one looked at me in a strange way. I supposed I looked a bit sunburned, nothing more. The tail-end of summer, not too out of the realm of possibilities.

At the Grand Central transfer, however, I tripped going up the stairs, and broke the tips of both my big toenails. Damn. Must've been a residual effect from the Valium. So how do people take that crap on a regular basis?

I was more concerned about my feet than my face, and after switching two more trains during rush hour (everyone must have been staring at my shredded feet, never mind my face), I hightailed it to the local mani-pedi salon, and got the toenails fixed and repainted.

Some time later, when I went to sleep, I laid my head gingerly on my pillow. It hurt a little.

The next morning, when I woke up and looked into the mirror, I had another oh-shit moment. My face was angry-red and swollen. Thank god it was Saturday. I could not leave my loft. I would scare small children.

After I applied the cream, I read the label. It was a copper-based ointment, And I thought, wait, burns are often treated with something called Silvadine. Copper, silver, there had to be a connection. I had to use Silvadine once after I fell off a bicycle, which resulted in wicked road rash on one forearm - a kind of burn. Ergo.

Full facial burn. I tried to quell the little fear ticking in my mind: Would I ever get my nice, normal skin back? Would I be scarred forever? I signed a waiver, didn't I? Breathe, be calm, I told myself.

The next day, I saw tiny, perfectly patterned dots all over my face. Angry, crimson dots. Over the next two days, the dots turned brownish, dried, and hardened. At a slight distance, it looked like snakeskin. Now I was lizard face. The tiny scales did peel away, first around my nose and mouth - the moving parts - and then more gradually outward. Funky. Fascinating.

The area under my eyes felt tight. In fact, it felt as though my skin was pulled back from the center of my face. Maybe this thing was working.

Four days later, I returned to the plastic surgeon's office for after-pictures, and a luscious facial, where the last of the brown scales were planed away. Planed = razored off. I cannot make this stuff up.

Then, wow: I had new, pink baby skin - and a lot of sun protection factor lotion since. We'll see how this turns out. They say the full effects don't really kick until six or so weeks later.

Good thing fall is here. The radiator started to hiss yesterday. My nose is stuffy. but I need to get back on the wheel, back to the gym, regular.

My face looks normal again, maybe improved and updated. Time will tell. Whew.

Comments

[Loudlush]

I was holding onto my gut, rocking and whimpering whilst reading about the "eye thing". I can't even bear getting a stray eyelash outta there. Can't wait to hear about the longer term (six weeks, huh?) results of the procedure. Do we get to see any before and after pics??

[RA]

HI,
I am about to have this procedure done on 12/8 and wonder if you would recommend it. Fortunately I wear contacts and have been warned about that part.
Thanks, RA

[HH]

RA - Would I recommend Active FX? Hard to say, really, now that it is two months later. It may depend on the condition of your skin, and the most factual expectation you can have of the result. The biggest change I saw - after the initial recovery period - was the loss of my summer tan. I use sunscreen, but the sun has a way of leaving its kiss nevertheless. I have been told that I have very good skin, so all I can say right now, is that I see little, if any visible change. I'm supposed to go back for a follow-up treatment, one that does not require the scary eye-cups. In truth, and in contrast, the results from Botox are fast and real. I guess I prefer Botox.

[HH]

Oh - and to Loudlush. Apparently my "before" pics are not a useful comparison instrument. They were taken after the application of the gel/cream anesthetic. I was told that this "plumped" my features, negating the usefulness of a before-and-after comparison. Hmmm...

[S.]

Hi, I just had this done last Tues.. so today is day 5. They said it takes 5-7 days to recover & on day 5 you can wear makeup. um.. NO! Not me! I drove 3 hours to have this done & when I got there they asked where my driver was.. stating they needed to give me valium or percocet & that I could not drive then. Well.. no driver = no pain meds. So I did it w/o the pain meds. I have never had this procedure before but I have had IPL. Anyway, yes, the eye things totally freaked me out. & yes, it felt like millions of tiny bee stings. I had my face & neck & chest done. The doc took a break after my face. I was shivering uncontrollably. They wrapped me in a blanket but I was still shivering. The doc kept telling me to relax & breathe!.. HA! She said the shivering might be my reaction to pain.. my mucsles were contracting. Anyway, day 5 & I still have not peeled. The snakeskin is still there & it is very tight. It burned like hell right after it was done & they said that would go away in 3 hours. It did.. by the time I drove myself 3 hours home, no more burn. But I did stop to use the restroom on the way home.. & the little girl standing in line in front of me could not take her eyes off my face! I looked like a burn victim. My face was bright red w/ this thick clear gel all over. So I have been doing as they said.. washing 3 times a day & putting that cream on. Still, I wonder how much longer til I peel!? Right now, it is tight& w/ the dark brown dots all over.. & it itches! Sure hope it is worth the $3500 + antibiotics & antiviral meds & gas to get there & back! Oh.. I go back Tues for my check up.

[HH]

Dear S., Incredible story, and thanks for telling it. I was interested to read that someone else had the shivering reaction. There must be some kind of biological reason. It's been four months for me now, and I do not see any discernible changes, although it may be difficult to tell, since any improvement may be subtle. Perhaps the benefit occurs below the surface. Do return and update your progress in the coming weeks.

[jan]

hi, I just had the procedure done 5 days ago, mainly to be rid of my brown spots. I had valium and vicodin; however it was still very painful. I experienced extreme jaw pain for a day because of clinching my jaw during the procedure.On day 5, I am sluffing off skin and the brown spots have disappeared in some spots already. I will let you know the long term effects.

[HH]

Jan, thanks for your comment. It seems as though there is a range of similar experiences among the different stories. And please do update once the brown spots slough off. I hope the results are what you hoped for.

[Robin]

I'm considering this procedure to smooth out or eliminate the fine lines/orange peeling. Did any of you find that the FX peeled enough skin to show that result?

[HH]

Robin, I hope some of the other commenters weigh in on your question. For myself, I do not believe I've ever had "orange peeling." As for fine lines, I cannot, in truth, see any real difference. Right after the procedure, however, I did feel a tightening, but I expect that was from the sloughing off of the brown spots.

[priscilla witham]

I'm getting the active fx done on March the 12 would you recommend geting local anaesthesia or Vicadin?

[HH]

Priscilla, I think it's up to you: which anaesthesia you choose to use. I think it has to do with how you react to Vicodin. The gel-like topical (local) anaesthetic would never have been enough for me, on its own. But as it turns out, I have a pretty severe reaction to orally ingested anaesthesia. It took me a while to get out from under the drugs I took. Bon chance!

[DeBias]

Would you do it again?

My father (Glenn DeBias, D.O. / www.ilamed.com) innovated this procedure in 2004. Although we normally do not dispense pain medication, we use a topical anaesthetic and an air cooling device to pre-cool.

For everyone who had ActiveFX (fractional laser skin tightening) and would like to share the experience, please email your story kdebias@ilamed.com. I'm very interested to hear from you and your perspective.

Have a great weekend.

[Cathy Weise]

I'm scheduled for the procedure on the 13th. Selected it because of the representation that it will improve texture, remove lines, lift and tighten. Should last 4 to 7 years. What I'm reading is that it really doesn't provide these results - no noticable change at least after a couple of months. Anyone notice that time makes a noticable difference? Thanks for the feedback - I still have time to cancel.

[jd]

I had the proceedure yesterday, March 16 and they forgot to tell me how much it hurt. I took a valium and two vicodin plus the numbing cream, but oh my god. It felt like someone was constantly shocking me with a lazer gun - oh wait, they were. We finally discovered that 2-5 at a time was easier for me to tolerate. Yes my face was hot for a few hours, but small ziplock bags of peas helped. Today I look rather scarey with little brown dots, but my goal is to remove brown spots and soften up the wrinkles. I hope it works because it was very painful.

[HH]

Thanks for the comment, JD. I hear you about the pain and recovery. It's been three days since your procedure, right? I hope you are feeling better. My question is this: Did the office that conducted your procedure adequately advise about the range of pain you could feel? My experience was painful for a few seconds here and there, overall not so much. Later that night, my face hurt. I was less prepared for the recovery process. In truth, I was unprepared for the eye protection, or for the after-reaction to the painkillers. Now, I find my own reactions weirdly funny. I wonder if more advance information would be useful.

[HH]

Oops - I made a gaffe in my last comment. I meant it for "JD," not "Cathy," as I had originally written. I hope everyone is recovering well and rapidly.

[fificat]

I had the treatment yesterday, March 29th and they did explain everything to me and I had a Valium and a Vicodin prior to the prodedure. After that they applied the numbing cream and the procedure itself took about 30 minutes but the prep time before that was about 45 minutes. I had arranged for a ride home as I knew in advance that I could not think of driving and I was a little sleepy after the procedure and lay down for a while. My face was sore in the car on the way home, particulaly on the areas where they did two passes. I used the copper cream when I reached home and thwn I fell asleep. My friend picked up my prescriptions for me but I never took either the Valium or Vicodin inthe end as I had no pain after I woke up - just tightness and a little discomfort. I look horrible today - like a puffy lizard but I am going back on Monday top have the peel and I hope to be wearing make up by Tuesday. I'm going away next Thursday and I am hoping to look normal by then. The reason I had the procedure was to correct a little slackening in the chin area. I hope it works as I had absolutely no problems with my skin ever and had no noticeable wrinkles to begin with, as I had my eyes done in 2005. I would have opted for liposuction of the chin area but the doc suggested this procedure instead. I will let you all know how I get on from day to day.

[HH]

Dear Fificat, please do let us all know how it turns out. It's been six months for me, and in all truth, I see no difference. There may be benefits well below the upper layers of skin, and if there is, well then: terrific.

[fificat]

I look much worse today than yesterday. Now I am not only red and lizardy but I'm also swollen. The said day 3 is the worst and I'm not sure if this is day 2 or 3, being that I had the preocedure on Thursday - do they call the day of the procedure day 1 or is it the next day?. I cannot imagine looking any worse but the tightness is not so bad. I am expecting to be able to wear make up by Tuesday but unless this whole thing goes away overnight I very much doubt it. Now I keep thinking that I did'nt look bad to begin with. The only benefit I wanted from this was a little more tightness in the chin area but this is a lot to go through just for that and I feel that tightness is not the primary result of active fx in the first place. Keep your fingers crossed for me as I'm more than a little worried.

[HH]

Fifcat, incredible: After the procedure, I thought I would be able to go out in public within three days. Nope. It was more like five or six days (an entire week, actually). I had a facial and planing (akin to a straight razor scrape) on the fourth day, after which my skin felt hypersensitive and tender. It reads as though you are experiencing the same timing, at the very least. Tell more as the days pass.

[fificat]

Well its now Sunday and I've been in the house since Thursday. Today I am flaky and itchy but still red and swollen. There is hardly any improvement since yesterday and I am going back to the doctor tomorrow to get the mask and planing that you described. Unless there is a miracle I would be amazed to be wearing make up by Tuesday. Turns out all my friends feel that I was a bit rash to go for this procedure. Speaking of rash, I look like I have a bad case of measles and brown measles at that!!!! I hope that it will be worth it in the end and nothing would make me happier than to let you know next Tuesday that I am out and about and looking great but somehow I doubt it.

[fificat]

Today I went for the facial with dermaplaning and the oxymist. Now the brown flaky parts are all gone, thanks to the dermaplaning which is definitely akin to a shave. The doctor and staff all think I am doing very well but I guess my idea of downtime is different to theirs. I never expected to look this ugly for so many days
and even today, although it is much better after my doctor's visit, I still look like a pink pig. My face is still swollen and I will be lucky to look normal by the week-end. I will try some make up tomorrow but normal make up could not cover this face as it is right now. I think the downtime of this procedure is downplayed and the severity and radical nature of the procedure are also glossed over. There were two other post laser patients in the doctors office at the same as me and we all looked like burn victims!!!. I will check back tomorrow with my progress, if any.

I am wondering ... I heard that this procedure works very well for fairly old people, like around 70 or so. Are you all that age? If so, then maybe it takes longer to heal than if you are younger? Can you help me out here as I am having a consult tomorrow. Thanks much.

[HH]

As ever, thanks for the comments.

Fificat, without question, it took an entire week for the initial healing process. I was irked on two counts. The first goes to exactly what you wrote: I was told the recovery process would be much faster than it actually was. Second, I was warned off of my regular workout for at least a week - something about controlling the amount of sweat. And my daily workout is fairly intense. My face didn't feel close to normal again for another three weeks. And, a smallish after-effect was my hairline. The laser has burned off the hair around my scalp line, and that needed to re-grow.

As for the second comment today, unless I knew for certain that I was a "good healer," I would not risk the procedure. I am not fifty, and I know I would not do it again.

Keep the stories coming...