SpaMedica can remove or reduce the visibility of stretch mark scarring; mainly through the use of laser treatment. Patients usually require 4-6 sessions over a four to six month period.
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Are You A Candidate for Stretch Mark Removal?
Laser removal is one of the most common treatments performed at the SpaMedica Dermatology Centre in Toronto. While stretch marks often occur to pregnant women, they can also affect adolescents during puberty and people who have gained or lost weight rapidly. These marks are characterized by striae which initially appear red but may gradually fade to a silver, white colour.
It is recommended not to have an active tan on the area you wish to be treated. Your SpaMedica expert will discuss all pretreatment requirements during your consultation.
Before & After
What are stretch marks and what causes them?
Commonly found around the breasts, hips, thighs, arms, abdomen, buttocks, and back, stretch marks can be difficult to conceal. Patients start their body perfecting journey with a complete consultation explaining what they are, the causes, and how to treat them.
These are areas of skin that have been stretched beyond the elastic recoil potential of the skin. This stretching, or tensile load, results in micro-tears in the fibrous structure of the skin; collagen, elastin, and the ground substance. The most common causes are expansion or rapid growth of the skin as a result of pregnancy, weight loss, weight gain, pubertal growth spurts, growth of breast tissue, or even from weight training and expansion of the underlying muscle (made worse by anabolic steroid use).
Once the skin is overstretched a microscopic inflammatory response is created. The inflammatory response leads to the increased presence of blood vessels and a process called neovascularization or new blood vessel formation. This leads to two types of marks: red or purple, and white, silvery or greyish, atrophic stretch marks.
Contraindications would include those individuals who may be pregnant at the time of treatment; individuals with inflammatory lesions or infective lesions; skin cancers in the areas of treatment; and those individuals with very dark skin who have a history of keloid scar formation.
How are Stretch Marks Treated?
Toronto patients can be treated with a number of different technologies at SpaMedica that result in the reduction of the appearance of stretch marks. In general, patients will receive a combination of treatments that work from both underneath and above with collagen-forming and skin-tightening technology and fractional resurfacing technology. There are also a number of blood vessel reduction and vascular lasers that can be deployed to reduce the purple and red colour of your stretch marks. A combination of treatments will yield the best possible outcome.
Purple or red stretch marks usually occur during the expansion phase of the skin and in the early stages of the micro-tears in the collagen and elastin. The purple or reddish colour is due to the increased presence of blood vessels in the newly-injured skin. This discolouration may persist for several months or, rarely, several years. Marks that are red or purple in colour are treated with vascular lasers.
SpaMedica is Canada’s largest private laser centre and the vascular lasers deployed at SpaMedica include a wide range of options to give Toronto patients the best possible reduction. These include: Perfecta VBeam pulsed dye laser, the Synergy long pulsed Nd:YAG 1064nm and pulsed dye synergy laser, the Elite Long pulsed NdYAG 1064nm laser, as well as various intense pulsed light (IPL) systems, such as the Palomar Max G, the Lumenis IPL, the LUME ONE and TWO, the Sciton BBL, and the Inmode Lumecca. The application of these vascular lasers is usually performed once every three to four weeks. Over a series of four to six treatments, generally all the redness from your stretch marks can be removed. A thin layer of ultrasound gel is placed on the skin and the pink and purple vessels are treated with the flash of laser and light. The treatments are comfortable and are performed as an outpatient procedure under topical anesthesia. After each treatment, red marks may appear darker in colour for 1-2 weeks before they start fading (as the treatment will often induce a bruise). Treating marks when they are red or purple will also stimulate new collagen and elastin production, which will help minimize the progression into a white, or atrophic, stretch mark.
Figure 1. The Max G is one of the many vascular laser and light based devices used at SpaMedica to treat toronto stretch mark patients whose stretch marks are RED and PURPLE in colour
White or silvery stretch marks (atrophic stretch marks) are more mature than the purple and red ones. White marks occur after the blood vessels have faded and the inflammatory response has died down. In general, the red inflammatory response is the body’s attempt to repair the torn collagen and elastin and the failure to do so results in a permanent whitish mark. These silvery, shiny marks may be very wide and wrinkly or very thin and wrinkly. White stretch marks are a version of a hypotrophic scar (an injury to the skin which healed without enough collagen, elastin or ground substances) and can make skin look thin, old, waxy and insubstantial. These older marks do not have the same elastic properties of the skin and can be quite unsightly when positioned next to normal, smooth, untraumatized skin. Generally, these stretch marks do not tan the same as the normal adjacent skin and and can accompany skin laxity.
There are two revolutionary approaches to treating white stretch marks at SpaMedica. The top down / bottom up “sandwich” treatment has been pioneered by Dr. Mulholland and SpaMedica.
The “top down” approach uses fractional resurfacing lasers and radiofrequency devices, including the Fraxel® CO2 laser, erbium fractional lasers, the fractional radiofrequency resurfacing Fractora™, InFini RF, IntensiF, INTRAcel™ and eMatrix. These fractional ablative lasers create small columns of injured tissue from the top right through into the skin. The fractional nature of these devices leaves some of the stretch mark untreated between the columns of fractional injury, allowing for a reservoir of tissue to produce new collagen and new elastin to smooth the appearance of the wrinkly, white stretch mark. Patients at our Toronto clinic would undergo a series of these fractional ablative laser and radiofrequency device treatments once every four to six weeks.
Figure 2. Patients are treated with “top down” Fractional lasers and fractional radiofrequency devices, which create a proportional thermal injury in the skin that will then heal with new collagen, elastin and ground substances from the surrounding undamaged skin. This will smooth the top down appearance of the thin, damaged stretch mark.
At SpaMedica, you have access to the widest array of Fraxel-like fractional Co2 lasers (carbon dioxide), fractional erbium lasers, and fractional radiofrequency devices to ensure you get the best possible results. By combining these different fractional laser and radiofrequency ablative devices during your treatment program, Toronto Plastic Surgeon, Dr. Stephen Mulholland can ensure you receive the best possible improvement in the appearance of your stretch marks.
Figure 3. One of the fractional technologies that Dr. Mulholland has pioneered in the treatment of stretch marks has been silicone coated radiofrequency needles. The silicon coated RF needles are able to penetrate the surface of the skin and, without surface thermal injury, deliver a very deep fractional ablation. This results in optimal collagen, elastin, and ground substances deeper in the stretch marks without over heating the surface of the skin. Overheated skin can result in even whiter discolouration. Dr. Mulholland will often deploy a superficial fractional device to improve surface texture and then, using coated technology, deliver strong ablative treatments to smooth and tighten the stretch mark from its depths while protecting the delicate pigment on the surface.
Figure 4. Intracel is another fractional coated bipolar radiofrequency device, which like the Intensif and Infini Fractional RF systems, provides deep collagen improvement in the stretch mark and more collagen and elastin.
Figure 5. The eMatrix and Matrix RF are other fractional radiofrequency resurfacing devices that SpaMedica will use to provide a gentle fractional ablation and sublation for texture and tightening improvement in stretch marks on patients of all skin types.
Dr. Mulholland also deploys some of the best fractional infrared “non-ablative” lasers for the treatment of stretch marks. The non-ablative lasers, unlike the Carbon Dioxide fractional lasers and fractional RF needle resurfacing devices, do not “burn a hole” in the surface of the skin. Rather, they send a micro thermal fractional beam into the skin, resulting in a “thermal column” that will help stimulate new collagen, elastin and ground substances without the downtime of the ablative devices. These non-ablative lasers, like the Fraxel Renew, Clear and Brilliant, Lux 1540 and the Matrix IR can be used on patients with darker skin (where ablative lasers may lighten the surrounding skin) or patients with lighter skin tones that do not want any downtime.
One of the most exciting innovations in the “top down” SpaMedica treatment is the Enerjet. This device can propel solubilized dermal fillers, such as Restylane and Juvederm, across the skin. It will distribute the dermal fillers evenly within and just under the stretch marks to make them smoother and tighter. Instead of a needle, it uses a propulsive liquid infuse with soft tissue filler to migrate the product throughout the depths of the skin far more evenly than could ever be done with a needle and without pain or discomfort. This needleless filler approach has added even more options for treatment in Toronto.
Figure 6. The Enerjet uses propulsive kinetic solubilized products such as Restylane and Juvederm and propels under gentle high pressure directly into and through the stretch marks without the use of a needle. The Enerjet has been a tremendous additional technology in the ability to reduce the appearance of stretch marks by facilitating the introduction of the fillers and bio-stimulation of the barotrauma more superficially and accurately than hand injections could ever accomplish.
The “bottom up approach”: Patients can also benefit from Dr. Mulholland’s pioneering work on a bottom up approach to the treatment of stretch marks. In combination with the “top down” is a “bottom up” approach. Using under-the-skin heating technologies, such as the FaceTite™, Precision TX and ThermiRF and ThermiTite as well as subdermal heating with a SmartLipo laser™. These devices, which are radiofrequency or laser devices, heat the skin from underneath, for a “bottom up” thermal stimulation, resulting in new collagen and elastin and tightening of the otherwise lax-appearing stretch mark. These “bottom up” heating devices also provide a lift effect on the marked skin without having to undergo the knife, or a surgical excision. This “top down” and “bottom up” approach gives the best possible improvement that one can achieve without any invasive surgery.
Figure 7. Subdermal heating devices such as FaceTite (above) and ThermiRF radiofrequency systems, or Pricision TX SmartLipo laser heating, thermally stimulate the tissue just under the skin providing a tightening effect.
Figure 8. After heating the sub-dermal skin, it results in new remodeling dermis providing a thickening and tightening effect which improves the appearance of stretch marks.
Figure 9. Patients who undergo the SpaMedica combination of “top down” and “bottom up” treatments will see the best results in stretch mark reduction or elimination.
How are the stretch mark reduction and removal procedures performed?
In general, the SpaMedica “top down” fractional laser and radiofrequency devices, such as Enerjet, are performed using topical anesthetic cream. The treatment involves the device being applied over the skin and blending into the uninjured skin. This takes generally between 30 and 45 minutes, depending on the size and number of areas that are being treated.
The “bottom up” approach to stretch mark treatment, using the radiofrequency under-the-skin heating FaceTite™, ThermiRF and/or the under-the-skin heating laser SmartLipo™ Precision TX device, is performed under local anesthesia and by Dr. Mulholland personally. The treatment takes between 30 and 60 minutes and generally one to two treatments, separated by three to four months is required.
What if you have darker skin, can you treat your stretch marks?
If you are a Toronto patient who has a darker skin type, you would typically not be a candidate for some of the more aggressive non-ablative fractional lasers. However, at SpaMedica Dr. Mulholland has acquired and developed many fractional devices and under the skin “bottom up” thermal devices that can safely and effectively treat the stretch marks of darker skinned patients.
Figure 10. An example of a darker skinned patient that can be treated by the SpaMedica stretch mark program. Non ablative devices are employed such as the Lux 1540, the ematrix and the Fractora silicon coated devices, as well as the sub-dermal heating systems such as the Fractora, ThermiRF and Smartlipo Precision Tx.
Are there any maintenance treatments required following my stretch mark removal program?
For the mature white and silvery marks whose appearance has been improved through fractional radiofrequency, fractional laser devices, and/or under-the-skin heating devices, there will be some degeneration in the new collagen and elastin with age and time. Normal degenerative enzymes continue to break down normal skin as well as the new collagen and elastin that has been produced. Over time, the stretch marks will again progress to looking withered and unattractive. It is therefore recommended that a simple maintenance treatment with a fractional radiofrequency or laser device be performed once every four to six months. Alternatively and additionally, non invasive RF (radiofrequency) devices, such as Venus Freeze, FORMA, Exilis, Pelleve, or Thermage can be used to maintain the collagen production and the smooth appearance of the treated stretch marks. A simple “protect your investment” treatment is recommended once every 2-3 months. It will have little downtime and will protect your collagen and tightening effects. These devices are bulk skin heating technologies, that are moved gently and painlessly over the skin heating it to 43-45 degrees Celsius and sustaining this heat for 10-20 minutes. This can be a relatively mild to moderate treatment with some redness and less than a week of downtime. Treatment with the bulk heating RF, non ablative devices once a week for 4-6 weeks can result in 20% more collagen and a “protect your investment” result for your stretch marks.
Figure 11. Following the treatment of your stretch marks, there are maintenance “protect your investment” treatments with non-invasive RF and fractional devices such as the FORMA, Thermage, Venus Freeze, Exilis or Pelleve, that will continue to keep the collagen, elastin and ground substances active and your skin tight and smooth.
Risks/Is It Safe/Side Effects
Is stretch mark reduction and removal painful?
The treatment, whether “top down” or “bottom up,” is very tolerable. Topical anesthesia makes the “top down” treatment of red and white stretch marks with laser and fractional devices comfortable. The “bottom up” approach, performed under local anesthesia, is also very comfortable once the local anesthetic has been instilled.
Stretch Mark Removal Results
How long does the procedure and program take?
Each stretch mark treatment, whether “top down” or “bottom up” takes approximately 45 to 60 minutes, depending on the size of the region and number of regions treated. Generally, the program itself requires three to six months to complete, as each treatment is performed every four to six weeks and a series of four to six treatments are required.
How long is the recovery?
There is little to no recovery following stretch mark removal and reduction treatment. There is some mild, burning discomfort and bruising following the treatment but, in general, most stretch marks are in easy-to-hide areas and the mild redness and swelling subsides over one to two weeks. The pinkness following the treatment with fractional radiofrequency devices and fractional lasers can take four to six weeks to completely disappear. Some patients may be prone to hyperpigmentation following this fractional treatment so intense pulsed light treatments and topical bleaching creams may be required to fade the pigmentation. Most patients can return to activities of daily living the following day. It may take one to two weeks to resume high-impact aerobic activities, depending on the location and number of stretch mark regions treated. In general, the redness and swelling will take four to six weeks to completely subside and before bathing wear that does not cover the region can be worn
What kind of results can I expect from my non-excisional reduction treatments?
The results of your stretch mark reduction and removal with the use of fractional radiofrequency and fractional laser devices and under-the-skin radiofrequency and laser heating devices can be quite noticeable. Up until the last several years, there had been no treatment that was effective for stretch marks. However, with these new approaches to combination treatment, both treating from above and below, patients can see 30% to 75% improvement in their red, white, or silvery mature stretch marks after a series of treatments.
Figure 12. The right side of the patient’s abdomen showing stretch marks. The left side of their abdomen (circled in the image) was treated with the SpaMedica techniques described above and one can see that the treated side showed significant improvements.
Figure 13. A close up of the stretch mark removal before and after improvements.
For those individuals with low abdominal, upper inner thigh, or upper inner arm problem areas, excisional techniques can completely remove the stretch marks. However, with excisional techniques a patient is then exchanging a small scar for the removal of the marks and the scar itself may need to be treated with vascular reduction lasers to minimize its appearance or remove any discolouration.
Occasionally, some patients with extensive stretch marks require excisional treatments in combination with non-surgical treatments beyond the area where an excision can be performed. This is an option for patients with more extensive concerns.
How long will the results last following my program?
The improvement in the appearance of your stretch marks through the production of new collagen and elastin should last one or more years following treatment. However, the normal aging process of the skin sees the degeneration of collagen and elastin. In order to maintain and prolong the improved appearance indefinitely, a simple maintenance program is generally recommended.
For purple and red marks, if the goal is reduction of the red and purple colour, once that has been achieved this is a permanent improvement and no subsequent maintenance treatment is required.
Benefits of Treatment
The benefits of stretch mark reduction treatment are
- Greatly reduce the appearance of unaesthetic stretch marks which can take years if left untreated
- Improve self confidence. Although stretch marks are not physically dangerous they can cause issues with self confidence. Stretch marks can affect people’s day to day living, such as how they dress and what activities they may undertake (eg swimming, going to the beach)
Additional Procedures to Enhance Results
How can I prevent my stretch marks from coming back?
Patients can help to keep their condition under control with regular SpaMedica maintenance programs, maintaining a healthy weight, and keeping the skin healthy and well hydrated. Fractional treatments and PXL treatments can be performed throughout the year when necessary to keep the stretch marks under control and to continue to stimulate new collagen formation. Bi-yearly Zerona laser slimming treatments will help assist you in keeping and maintaining a healthy weight.
SpaMedica has been serving Toronto stretch mark patients since 1997. SpaMedica is Toronto’s and Canada’s oldest, most recognized and reputable laser skin care and cosmetic dermatology centers. Patients also have the advantage of seeing one of SpaMedica’s experienced cosmetic dermatologists for difficult to treat skin conditions.
How much does it cost to get stretch marks removed?
The cost of the nonsurgical program depends on the size of the area treated and the number of treatments required. In general, most stretch mark reduction treatments start at approximately $799 per treatment.
Treatment packages of multiple treatments are available. The pricing for each package is customized to suit your needs and as such it can be discussed during your free consultation.
Why choose SpaMedica and Dr. Mulholland?
Dr. Mulholland and SpaMedica continue to be at the forefront of pioneering new technologies that improve the appearance of stretch marks. Toronto laser patients will benefit from the Vascular laser technology developed by Dr. Mulholland which includes intense pulsed light and combination pulsed Nd:YAG technology. Additionally, Dr. Mulholland has helped pioneer radiofrequency fractional devices and subdermal, under-the-skin heating devices, all of which have contributed significantly to our ability to offer nonsurgical treatment. In selecting SpaMedica, you are getting the best possible expertise and technology used in combination to get the best possible reduction in the appearance of your stretch marks.
Excisional treatments at SpaMedica will be performed personally by Dr. Mulholland, one of Canada’s foremost plastic surgeons. His experience and skill will optimize the surgical removal of your stretch marks.