High-impact resurfacing demands high-level complication management
Expert Consensus Addresses Complication Management in Ablative Facial Resurfacing
03/23/2026
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KEY TAKEAWAYS
- Fully ablative laser resurfacing remains the gold standard for wrinkle reduction but requires advanced expertise and careful risk management.
The "Consensus Statement on the Prevention and Management of Complications of Fully Ablative Laser Resurfacing of the Face" emphasizes clear differentiation between expected healing responses and true complications, with proactive prevention and early intervention strategies.
Expanded use in younger patients and focal treatments highlights the need for individualized protocols aligned with patient goals and downtime tolerance.
Fully ablative laser resurfacing of the face continues to deliver unmatched results for wrinkle reduction and photodamage, even as less invasive technologies proliferate. However, its power comes with complexity and risk. The need for standardized, practical guidance led me to participate in a multidisciplinary panel to publish the “Consensus Statement on the Prevention and Management of Complications of Fully Ablative Laser Resurfacing of the Face” in the August 2025 issue of Lasers in Surgery and Medicine.1
The consensus process combined an extensive literature review with expert surveys and a Delphi methodology to address real-world challenges clinicians face when performing fully ablative resurfacing. The goal was not to discourage use of these devices but to support safe, confident adoption across appropriate patient populations.
A key theme of the statement is that fully ablative resurfacing is a “black belt” procedure—one that demands deep understanding of laser physics, tissue interactions, patient selection, and postoperative care. Expected sequelae such as erythema, edema, and transient bruising are clearly differentiated from true adverse events, including infection and delayed healing. The consensus emphasizes early recognition, appropriate culturing, and targeted antimicrobial therapy when complications arise, alongside thoughtful prophylaxis strategies.
The article highlighted that modern practice has expanded beyond treating only advanced photodamage. Lighter or localized resurfacing can now be tailored to younger patients or focal areas such as the perioral or periocular regions, provided clinicians carefully match treatment depth to patient goals and downtime tolerance.
Ultimately, complications are an inherent reality of high-impact procedures. As my mentor, Tina Alster, MD, FAAD, taught me early in my career: it is not how good a laser physician you are, but how well you manage complications. This consensus statement serves as a practical roadmap—encouraging collaboration, consultation when needed, and a proactive approach to patient safety so clinicians can continue delivering transformative results with confidence.
1. Kang BY, Cohen JL, et al. Consensus statement on the prevention and management of complications of fully ablative laser resurfacing of the face. Lasers Surg Med. Published online June 11, 2025. doi:10.1002/lsm.70035
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