1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Directions in Seattle, WA to Dr William Portuese

Using procedures like chemical peels, lasers, and various injectable chemicals to generate improved facial aesthetics is a significant aspect of facial plastic surgery that is always improving. These office-based operations have a significantly shorter recovery time than the majority of cosmetic surgery procedures.

Cosmetic Peels

Glycolic acid, trichloroacetic acid, and phenol are a few examples of chemical peeling agents (listed from mildest to strongest). When doing a chemical peel, the substance passes through the epidermis and into the top dermal layer. There are four histologic grades for different agents, each of which has a variable depth of penetration. The chemical substance damages the skin at different depths and activates poorly understood skin regenerating pathways in the dermis.


Another method for removing deeper scars and wrinkles is dermabrasion. Under the guidance of a local anesthetic and/or a freezing substance, this method is carried out.
To remove the epidermis, a high-speed rotating brush, sandpaper, or some equivalent abrasive tool is employed. You can use this method on a single blemish or a big portion of your face.


Scarring, photodamaged skin, facial rhytides, and other aging symptoms can all be treated using laser technology. Little to no bleeding and minimum skin harm are brought on by laser treatments. The method enables exact control over the depth of ablation. Ablative and nonablative laser therapy are both available.

Ablative lasers heat the dermis and encourage fibroblasts to produce new collagen, which causes the dermis to vaporize, removing the top layers of skin. Two laser wavelengths used most frequently by ablative lasers are pulsed carbon dioxide (CO 2) and erbium:yttrium-aluminum-garnet (Er:YAG). With each pass, CO 2 systems typically vaporize 20 to 60 m of tissue, with subsequent passes causing residual thermal damage to reach a depth of 20 to 100 m.

The 20–50 mm zone of residual thermal damage is left behind by the Er:YAG pulse laser systems after vaporizing 2–5 mm of tissue per pass. Erbium laser systems are advantageous for precision, carefully regulated, light to medium ablations because they can be tuned more precisely than CO 2 systems. Deep ablations benefit more from CO 2 systems.

Novel systems are now being developed to deliver simultaneous irradiation from dual ablation/coagulation Er:YAG laser, variable-pulse Er:YAG, and combination Er:YAG laser and CO 2 laser. With fewer skin wounds to induce granulation tissue and fibroplasia, but with tiny zones of thermal injury, these novel techniques seek to accomplish a significant degree of therapeutic improvement. Pain, edema, prolonged erythema, infections, postinflammatory hyperpigmentation, and hypopigmentation are some of the side effects of ablative lasers.

View Dr William Portuese on Google Maps.

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self