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Active FX, Deep FX, and Total FX Fractional CO2 Laser Resurfacing

Active FX, Deep FX and Total FX for Skin Tightening, Wrinkle Reduction and Sun Spot Removal

As we age, our skin loses its youthful appearance and develops wrinkles and brown spots. Fortunately, fractionated CO2 laser treatment with Active FX, Deep FX and Total FX offered at Zimmet Vein & Dermatology can rejuvenate your skin and reduce signs of aging in one treatment.

What is the difference between Active FX, Deep FX and Total FX?

Active FX, Deep FX and Total FX are terms used to describe fractionated CO2 resurfacing with the Lumenis Ultrapulse laser. Active FX is typically used to treat the entire treatment area. The columns of light are larger and more superficial compared to the Deep FX hand piece. Deep FX uses narrower columns of laser light that penetrate to deeper layers of the skin. When Active FX and Deep FX resurfacing is done to the same area, it is referred to as Total FX.

How Does Active FX, Deep FX, Total FX Work?

The fractional resurfacing procedure uses a high-energy laser beam to remove the damaged upper layer of skin. During the healing process, the skin tightens, pigmented spots improve, and new collagen is made to help firm the skin and reduce fine lines and scars.

Unlike old CO2 lasers, the Active FX, Deep FX, Total Fx laser treatments uses fractionated beams to treat columns of skin rather than whole areas. The benefits of this new technique include a much shorter recovery time and less patient discomfort during the procedure. Typical recovery time for fractionated CO2 resurfacing lasts 4-6 days, during which patients are advised to rest at home.

Active FX, Deep FX, Total FX Results

Active FX allows patients to remove wrinkles and other skin blemishes that appear with age. Patients begin to see improvement in their skin texture a few days after the procedure. However, new collagen production and skin revitalization can last for months and patients may continue to notice improvements for up to a year.

Ideal Candidates

The best candidates for  fractional resurfacing are patients seeking to reduce and remove signs of aging such as brown spots, lip lines, crow’s feet and sagging skin. It is not recommended for patients seeking to treat broken capillaries or rosacea.

Treatment Videos

Follow one patient’s Active FX treatment at Zimmet Vein & Dermatology from start to finish.

Part One

Part Two

Part Three

ActiveFX Survival Guide: Read about one of our aesthetician’s personal experience with ActiveFX treatment as well as her tips for recovering quickly.

To learn more about Active FX, Deep FX, and Total FX fractional CO2 laser resurfacing and schedule an appointment with Dr. Zimmet, call us today at  (512) 485-7700.

My Laser Resurfacing Diary, Going to Do It

Here I am before laser resurfacing.

Friday, July 16

I’ve been wanting the laser FX treatment since the day that Dr. Zimmet walked into the treatment room and I could immediately tell that he’d had something done to his skin. The skin on his face looked tighter, smoother, and with a finer texture than the last time I’d seen him. I asked him and he readily told me that he’d had the Active FX procedure done a couple of weeks earlier. He showed me the pictures—before, during the healing process, and after—and they were pretty dramatic.

I’ve been seeing Dr. Zimmet for at least 20 years. I first went to see him for leg vein treatment, his longtime specialty. I was in my 20s, and had noticed a spider vein and a few other minor broken blood vessels on the backs of my legs. Determined that my legs would never look like my mother’s, I had sclerotherapy and have had it several times since, and know that I will continue to have it every few years. I’ve had a variety of other procedures at Dr. Zimmet’s, including a series of photofacial treatments, laser hair removal, microdermabrasion, thermage on my eyelids, etc. In the last few years I’ve been on a regular regime of these anti-aging treatments: for me it’s very practical and worthwhile maintenance, along with having my teeth whitened and hair colored, lifting weights and watching the scale. The momentary discomfort and the expense is so well worth the results. I am often told that I look younger than my 49 (yikes!) years.

So, after thinking about it for months I’ve decided that I am going to have the (official name) fractionated C02 laser resurfacing procedure done. It takes some planning, as I won’t be able to leave the house for about five days. I work from home, so that makes it easier for me than it is for many people. I’ll be able to work, although not to go to meetings or to run errands. I’m going to have to find someone to walk my dog a few times. I’ll need to buy plenty of groceries and have lots of movies and books stocked up. I’m actually kind of excited about the “snowed-in” aspect/challenge of being stuck in the house for that many days. I’m not sure yet who among my friends I’m going to let see me with a crusty, peeling and oozing face.

My Laser Resurfacing Diary, Consultation

Monday, July 19

I went to Dr. Zimmet today for the initial consultation. He looked at my skin with a very bright light (I can only imagine what my skin—or anyone’s, for that matter—looks like with that level of scrutiny). He asked what my goals are. I’m most interested in overall tightening, improving my skin’s texture, and shrinking my pores. He said that it would definitely improve the size of my pores, and since they really bug me, that was good news. He also told me that they will perform the treatment on my eyelids, which I didn’t realize. I had thermage on my eyelids a couple of years ago, and while I could see the results I still consider my eyelids the best candidate for surgery if I ever decide to take that step. So I’m happy to learn that this treatment might improve my eyelids too; that’s a big bonus.

Dr. Zimmet describes laser resurfacing as one of his favorite treatments because of the really good results that his patients see.  There are some pretty dramatic before and after photos on the Lumenis (brand of laser equipment Dr. Zimmet uses) website.

Here’s the official description of the procedure from the Lumenis website:

What is ActiveFX “fractional” laser resurfacing?

“ActiveFX is a fractional laser procedure performed in a single treatment with minimal patient downtime. During the procedure, a high-energy beam of laser light is used to smooth out lines, wrinkles and scars, remove brown spots and other irregularities. It also stimulates formation of new underlying collagen to continue improvement over time. With fractional laser treatment, only a fraction of the skin’s surface is treated by the laser, leaving small “bridges” of untouched skin. This technique makes the healing process much faster and enables you to get back to normal activities sooner.”

Four days before my Fractionated Laser Resurfacing

Thursday, July 22

Four days away and have to admit, I’m getting a bit nervous. Will it hurt? Will I be totally grossed out by what I look like? Will I look OK when I finally do venture out on the sixth day after the procedure? It has been challenging to keep all meetings and social activities off my calendar for five days without disclosing why. I made the mistake of telling a couple of people that I was going out of town. It just seemed easier than coming up with another excuse for people I didn’t want to tell. Now I’m worried that I won’t remember who I said that to, and that I’ll slip up later. “What a tangled web we weave . . . “ Also, as I’m pretty active on social media and it’s conceivable that they could wonder where my vacation pictures are. OK, that’s probably going too far with the worrying.

As I only have three days after today, I need to make my list of everything to do before I’m shut in. Groceries, of course. Movies. I have tons of books. I’ve also thought about a couple of productive projects I might get done during the post-op, such as re-writing some of the copy for my website. I’ve gotten more and more interested in raw food, and thought I might go totally raw for the five days I’ll be home as another fun project. After perusing my two new raw cookbooks I think that was a little too ambitious, but I am planning on trying some of the recipes. Predictably the desserts sound the most delicious but there are some other things that don’t sound too complex and don’t require a dehydrator, mandolin, or juicer, none of which I have. I sometimes get all carried away with new projects; buy cookbooks and ingredients and then move on to something else. I have a pantry full of chickpea flour, red and yellow lentils and Indian spices from the vegetarian Indian phase I was in after getting a wonderful cookbook for Christmas. The raw food project could get quite expensive if I bought any of the equipment. I think the Vita-Mix blender that aficionados prefer is at least $300. Anyway, eating raw food during the post-op would go with the whole health and beauty theme of having the laser FX done. I definitely believe that beauty starts with good health, including nutrition. And lots of water. Which I’m pretty terrible at. I saw somewhere that a doctor recommended 100 ounces of water a day in the Texas summer. Maybe I should try that too . . .

Procedure Evening

Here’s one of my “before” shots.

Another “before.”

The first “after.” Dr. Zimmet took this one in his office.

Still Tuesday, July 27

See the Active FX Laser Resurfacing Video, part 1.

It’s the evening of the procedure day and I want to give a quick recap. First we shot some “before” pictures. At about an hour before the actual procedure began Dr. Zimmet’s aesthetician, Hadley, covered my face with a topical anesthetic and gave me a Xanax (mild tranquilizer) and a Vicodin (pain reliever). After about 30 minutes my face started to feel quite numb. After 60 minutes, Dr. Zimmet came and in and administered shots (nerve blockers) to my forehead, near my eyes, and near my mouth. The shots weren’t too bad; Dr. Zimmet “shakes” the area so the shot doesn’t pinch much. And by this time I was feeling the Xanax, which tends to make everything easier. I tied my hair back and Hadley gave me a headband to get all of my hair off my face. They started the chiller—chilled air was blowing on my face the entire time, which felt really good, because the primary feeling from the laser was heat.

Dr. Zimmet started the laser treatment around the edges of my face—he called that “feathering,” I’m not sure why. I think he starts there because the sensation is the least strong. The most sensitive place was around my mouth. It reminded me a little of the sensation with Thermage, which is kind of like being zapped with something hot. He did my eyelids last, and I think using a different tip. I expected that area to be the most sensitive but it wasn’t bad at all. The whole procedure took maybe 30-35 minutes. Afterwards, they gave me a mirror. My face was already kind of brown with little spots all over my skin. We took some more pictures, and then Hadley covered my face with ointment. Dr. Zimmet had told me that it would feel like a major sunburn, and having had some bad sunburns in my teens I remember what that feels like, but I think this may have been even hotter. They gave me some ice to hold to my face, and I did so all the way home. (I went through P. Terry’s–best veggie burgers in Austin!–drive-through on the way home, and I’m sure the guy thought I looked freakish, but I was starving and didn’t really care).

When I got home I felt very sleepy, probably from the Xanax. (And I’m still sleepy now, so will post the recovery directions tomorrow.) When I woke up it felt like most of the ointment had soaked in, so I put some more on and took a close look at my face. It’s pretty puffy, which is normal for the first couple of days. It’s quite brown, like someone with really terrible sun damage. You can see the little dots created by the machine. I took a few pictures. I don’t really feel pain unless I touch my face; the right side feels a little bit sore. I’m supposed to put the ointment on four times a day and not let my face get dry, and I think I might need to apply it even more than that because it feels like it’s soaking in. It still feels kind of hot, and tight. All of which I expected. Can’t wait to see what I look like when I wake up in the morning!

Day 2, Ewww

Still puffy, a little sore, and my face feels slightly hot. It’s not terrible, but I took an aceteminophen w/codeine earlier. My face is reddish/brown and swollen. I washed my face for the first time with the extra-gentle cleanser that they gave me. The directions are to wash, but not to wash off the Hydrobalm ointment, and then to re-apply more ointment. I could see some skin coming off already. I’m a little itchy in places. I keep touching my face and getting ointment on my fingers.

My assistant was here and said that it wasn’t as bad as she expected—I guess I over-prepared her. I haven’t seen anyone else yet, although I sent a picture to a friend and she also thought it didn’t look so bad. I look exactly like I remember Dr. Zimmet looking in the pictures he showed me after his Active FX procedure, so I’m sure this is all par for the course. I’m seeing him two days from now so that he can gauge my process.

The thing that has surprised me most is how tired I was yesterday. I guess it was unrealistic to think that I’d come home and get right to work as if nothing had happened. It makes sense that your body might be somewhat fatigued from working to heal. I’ve been eating very healthy stuff—a “green” smoothie with spirulina, some kombucha, a raw broccoli salad. Tomorrow I’m going to make the raw cheesecake and raw corn chowder. I have watched MANY episodes of CSI (I rented the first two seasons, which I’ve never seen) and read some of my book.

Post-procedure Day 3

If anything I look worse today. The white area around my eyebrows is very visible in the sea of red/brown that is my face. Pictures are not doing it justice. I’ve tried to get close-ups but with or without the flash it’s just not showing how crusty I really look. I can totally see why the instructions repeat several times to use old sheets and pillowcases. My pillowcases are totally gross when I wake up. I’m going through lots of washcloths and towels as I’m washing my face four times a day as instructed. My face feels a little bit sore, mostly when I touch it. My skin is tight—I can really feel the tightness when I frown or wrinkle my nose. Also itchier today.

Here is a video about the procedure:

Here is the Active FX post-procedure regime (given to me in writing the day of the procedure):

  • Apply hydrobalm (ointment) three to four times a day until your skin peels (at least four days). Do not let the area dry out.
  • A heat sensation is common the first day. Apply cool compresses (such as frozen washcloths) if desired.
  • Swelling is common, and typically begins to reduce by the third day.
  • Sleep with your head elevated the first two nights to reduce swelling.
  • Oozing may occur. Blot as needed and reapply Hydrobalm.
  • Use old pillowcases and sheets while using the ointment and wear old T-shirts.
  • You can shower the next day but avoid hot water on the treated area.
  • The following day, wash the area gently with Cerave (a gentle liquid soap provided by Dr. Zimmet) morning, afternoon, evening and bedtime (four times a day). Do not attempt to remove Hydrobalm when washing.
  • Reapply Hydrobalm immediately after cleansing
  • Avoid “picking at” and scrubbing of the exfoliating skin—allow it to peel with the gentle washing process.
  • Avoid sun exposure.
  • Finish prescribed Valtrex.
  • Itching is common. Use Benadryl as needed but don’t drive after taking Benadryl.


The weather is overcast and sprinkly so that makes it easier to be inside. And it’s the weekend now.

One friend dropped off DVDs of Ugly Betty and Pushing Daisies, so if I get sick of CSI (still have all of the second season!) I have something else to watch. There’s also my iPad, with lots of movies on Netflix that I could stream if I had the attention span to watch a movie. I’ve read most of a book (The Chelsea Whistle—it’s OK, not great but I started it for one of my bookclubs and feel like I have to see it through to the end). My friend Jane is coming over tonight with takeout, wine, board games and her 10-year-old son, who my dog will be most excited to see. This is only day 2 without a walk for him, and he seems a little restless. I need to get him racing up and down the stairs, which isn’t hard to do as he loves to play hide-and-seek and another game that involves my throwing one of his toys down two flights of stairs.

Three Months After My Laser Active FX Resurfacing: A Patient Diary

by Clare Sargent

It’s been a little more than three months since I had the laser Active FX resurfacing procedure at Dr. Zimmet’s office. I am happier than ever with the results. My skin has never looked better. It has continued to improve since I had the procedure. The thing I notice most is that my skin is tighter overall than it was before. Because the treatment stimulates collagen formation, it should continue to improve for a year. Friends who know that I had the treatment and who don’t see me every day have remarked that they can see the difference from month to month. It’s been very gratifying to receive lots of nice compliments on my skin.

The only regret that I have is that I didn’t have the treatment done on my neck at the same time. A friend of mine is about to have the laser FX treatment on her face, neck AND chest. We are about the same age, and one of her main complaints is sun damage including large freckles and brown spots on her skin. I look forward to seeing her results. I sort-of jokingly told Dr. Zimmet that if money were not an object I would have had the treatment on my entire body. That would have made for an interesting recovery!

Clearly, I would recommend the laser FX treatment to almost anyone. The discomfort was minimal, and the results have been totally worth it. Seven days in the house was an investment, but I was prepared for it and it went by quickly. I would definitely do it again. Thank you to everyone for reading my laser FX diary and for your comments. This has been a fun and rewarding adventure.

Skin Vein Skin Vein

Austin, Texas

1500 W. 34th Street
Austin, TX 78703
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