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A Patient's Story

Skin Deep

Before & After photos provided by Lisa Porter (scroll to bottom or click here)


There’s no getting around it. It’s what we do over the course of a lifetime. Aging naturally is best. Aging naturally & gracefully is even better. However we choose, it depends on our outlook and how we live every day. A body, heart and mind free from impurities is a lifetime of work as we’re hardly perfect – and when we’re broken physically, mentally, or spiritually – it can take every cell of our being and every thought in our mind to stay centered. In doing so, we gain wisdom.


The fear of aging is allayed when we realize the wisdom that comes with it.



Written by our patient, Lisa Porter

Aging beautifully

A woman’s relationship with her body is sacred. It’s the ultimate garment. How she views herself has everything to do with how she feels about herself. If she’s unhealthy, unhappy or unsure, it shows. If she’s strong, content and confident, it shows. If you were to ask me what lies below the surface of my skin, I would tell you my heart and soul, a lifetime of love and lessons; and my deep desire to grow physically, mentally and spiritually stronger. If we were to spend time together you’d come to know all of that and more.



Life comes with wrinkles

Being healthy and taking good care of ourselves is important at every age and it shows. Attention sons and daughters; the way you care for your skin in your 20’s will determine what it will look like for the rest of your life! Aging gradually & naturally is flattering – and those “crow’s feet” and “laugh lines” – they tell many stories. This doesn’t mean that we know everything there is to know. I believe that if we stop looking for new opportunities, or imagining new possibilities, then we stop aging gracefully.


Personally, I can tell you that aging prematurely with deep pronounced lines – due to years of sun damage – does not feel particularly graceful. Good thing wisdom brings choices to those of us who don’t embrace the damage.


There are many benefits that come with being kind and self-nurturing to ourselves.


Some are visible and some are not. Rejuvenation is one. Courage is another.  By rejuvenation, I’m referring to improving my skin by smoothing the lines & stimulating the growth of new collagen. By courage, I mean finding the courage to undergo full face CO2 laser re-surfacing.





“Having full face CO2 laser resurfacing has given me a fresh start and the confidence to wear my years gracefully. As a thank you to my friends & family, my hand-holders & cheerleaders and to those who were kind enough to share their journey with me, I’m sharing my journey with you here “~


The layers of my life; childhood, adolescence, college, career, marriage & motherhood have played an integral part in who I am today. They’ve also left their calling cards; health, happiness & love, wisdom, worry & wrinkles.


Yes indeed, life does come with its share of wrinkles. This shouldn’t mean that I have to embrace each and every one of them, especially the ones on my face. At fifty-five, I’m wise enough to know that my age has only caused half of them. I’m also wise enough to know that I can do something about them. Join me as I share my open & honest personal journey through Full Face CO2 Laser Resurfacing.




Here Comes the Sun

Growing up in the “Valley of the Sun,” I was the quintessential freckle-faced Arizona girl. When we moved to southern California, I stopped tanning and became the queen of sunscreen. Little did I know to what extent the sun had already damaged my skin. By the time I turned forty, “crow’s feet” and “laugh lines” had appeared. At fifty, deep pronounced lines and pre-cancerous anomalies had become a reality. The years of sun damage – coupled with age-related hormone challenges – had accelerated the degenerative changes in my complexion. I’d become concerned, but not consumed.




The Other Side of Worry is Wisdom

For the next twenty years, I maintained a positive attitude and healthy regimen. I kept up to date on the latest & greatest skin products, procedures and a few Photoshop techniques, aimed at preventing, protecting and correcting. I made lifestyle and dietary changes to improve my health. With guidance from my dermatologist, I made smart choices in skincare and she kept me melanoma-free. I knew I could slow down the hands of time, but I was always going to look older than my age.




Are You Okay

The face is a funny thing. Even when you’re silent, it speaks volumes. It displays your feelings, elicits the feelings of others and sometimes it even betrays. I resented being asked if I was “okay” when actually I was just fine. Then, I wasn’t fine! Deep down inside, the dramatic effects of premature aging had begun to take an emotional toll. As I became more and more self-conscious, I began to disappear. Self-consciousness isolates. It cancels social engagements and shies away from new opportunities. I became reserved. I began to disappear from family photos. I became depressed.



Inner Strength & Outward Appearances

For the most part I kept my feelings about cosmetic surgery to myself – on the back burner – at the bottom of the list and in a “personal” file on my computer. The idea that it was only for the self-absorbed women who lived in rarefied air and had their lives seamlessly pulled together, had been laid to rest. My focus had shifted from outward appearances to inner strength. A new journey of self-fulfillment was about to begin.




Courage & Faith

When I remain true to my faith and trust the wisdom of my heart, I tend to make good choices. I knew that over the years I’d done all that I could to prevent, protect and correct. Due to the rapid progression of premature aging, I also knew that it was not ever going to be enough. The findings in my “personal file” suggested that what I needed was going to require the skilled hands of a professional. After careful consideration, it was apparent that the non-surgical procedure known as CO2 Laser Resurfacing, was the right option for me. With the full support of my husband and children, I consulted with Dr. David E. Cowen of Oculoplastic & Orbital Consultants in Lexington, Kentucky.




More Than Meets the Eye

Dr. Cowen is board certified in Ophthalmology. He is a Fellow of the American College of Surgeons, American Academy of Cosmetic Surgery, Kentucky Chapter American College of Surgeons, American Society of Ophthalmic Plastic & Reconstructive Surgery and a member of the European Society of Ophthalmic Plastic and Reconstructive Surgery and International Society of Cosmetic Laser Surgeons. Dr. Cowen also holds the commission of Colonel on the staff of the governor of Kentucky in the Honorable Order of Kentucky Colonels.


He’s a wonderful family man who, is blessed with a unique combination of quiet, calm, precision and skill. During our consultation I told him what my primary concerns were. What I wanted to correct and what my expectations were of the final results. We discussed my physical & mental health and my lifestyle. He examined my skin & facial structure from every angle, and took photographs for his review. Taking into consideration my skin type and age, he determined that I was an excellent candidate for full face CO2 laser resurfacing.


Dr. Cowen explained how the laser vaporizes the skin, one layer at a time. This stimulates the production of new collagen fibers that give the skin its elasticity resulting in a healthy new complexion without ever making an incision. He also explained that he would administer Botox two weeks before surgery. This is done to temporarily paralyze the muscles below the skin where facial expressions had produced the deepest lines. This would help in keeping my face as relaxed as possible during the healing process. I left our consultation feeling confident, in that I could make my own educated decision on whether or not to go forward.



Timing is Everything

I called Dr. Cowen’s office to let them know that I’d made a decision. My next appointment was with two very important members of his team.


First, I met with Robin Hammond who assists patients with the entire surgical process. She has extensive knowledge of treatments, procedures & products, and is a hand-holder who provides the kindest of care and attention. I’d asked my husband to join me since he was going to be my primary caregiver while recovering at home. I wanted him to know first-hand what he and the children could expect. During this appointment, we went over detailed pre and post-operative instructions. Every one of my questions was answered, and any concerns were addressed.


Next, I met with Danielle Despard who is a licensed esthetician and professional make-up artist. She has extensive experience and knowledge of corrective cosmetic treatments and cutting-edge pharmaceutical grade products. She tailored a proper skin regimen for me to follow through pre and post-surgery and during my recovery.


To better prepare my skin for the procedure, I began using SkinCeuticals Gentle Cleanser to exfoliate and keep my skin clear, calm and hydrated. After laser resurfacing, it’s imperative to provide a protective barrier on the skin to prevent moisture loss and scabbing while it’s healing. SkinCeuticals Hydra Balm to the rescue. This soothing balm literally rescues traumatized skin. I fell in love with it!


Before we left Dr. Cowen’s office, a date had been set. I chose February, a time of year here in Lexington when our weather is less than impressive and I knew I wouldn’t mind being indoors. This also gave me three months before spring when I would be outdoors, entertaining, at the races & in the garden.




You Have my Full Attention

Full face CO2 laser resurfacing is a really big deal. First and foremost, Dr. Cowen made sure that I was physically prepared for the procedure, which required anesthesia. He sent orders to my general physician requesting a check-up, blood work, and electrocardiogram.


Recovery is relatively simple but not for the faint of heart. I highly suggest those children – or anyone – who might be troubled by your appearance, stay with a friend or relative. Typically, days 3, 4, and 5 are the most challenging. To have the smoothest recovery, this procedure should be done at a time in your life when waters are calm and your calendar is clear. Dedication to proper pre and post-procedure care is imperative for proper healing and optimum results. You, your primary caregiver, your family, and even the dog should be healthy and stress free.


Believe me, I prayed for this to be a positive and rewarding experience for everyone. I have two adult children and a very supportive husband so I had plenty of help with transportation, cooking, laundry, errands, and more. I was very fortunate. All I had to do was heal.




Botox Baby

One week before surgery, I arrived at my appointment with Dr. Cowen for Botox. I was more nervous about the Botox than the CO2 laser! While waiting, I noticed the patient before me was called back for her visit and then came out 15 minutes later. I discreetly scanned her face looking for any visible sign of botulism but saw nothing – I was going to live! It was my turn and suddenly I felt like a two year old. 25 units of Botox were administered across my brow line, into my worry lines, and around my “crow’s feet.” I blinked away the watery eyes, and was on my way.





The day before surgery found me already looking a bit smoother and more relaxed due to the Botox treatment. I received a call from Lexington Surgery Center confirming my arrival time & reminding me to have nothing to eat or drink after midnight. I treated myself to a fresh haircut, manicure & pedicure before heading to our favorite spot for dinner. I was nervous but very excited!


I woke up the morning of surgery feeling rested, ready and very grateful. I knew that my Heavenly Father was watching over me. I knew that my family was supporting me and that soon I was going to be in the excellent care of Dr. Cowen. This was going to be the best day ever – even without coffee!


We arrived at Lexington Surgery Center and my family settled in while I tended to a few administrative details. Quite possibly the nicest nurse I’ve ever met, greeted me and my family and then welcomed me back to pre-op. I changed into a gown, hopped up on the bed and crawled under a warm blanket. With no wedding ring or make-up, I felt very plain & pale. I was allowed to have my iPhone but who was I going to call? My rumbly-tumbly tummy started in. I was officially nervous.




On Cloud Nine

Dr. Cowen’s entire medical team went out of their way to comfort me. My nurse gave me something to calm my stomach & nerves, checked my vitals and hooked me up to a monitor. Dr. Cowen arrived and introduced me to the anesthesiologist who would be assisting him during my procedure. She was wonderful and comforting and she assured me that I was in excellent hands. I was starting to feel relaxed, even sleepy. I put my head phones on and settled in-to some Yo Yo Ma and Gabriel’s Oboe from The Mission.


Before surgery, Dr. Cowen brought my husband back to pre-op, to be with me. He was very reassuring to us both. He told us approximately how long the surgery would last and where my family would meet me afterwards in recovery. And then, we prayed. I was on cloud nine as I was wheeled away, to a brightly lit, freezing cold operating suite. Dr. Cowen’s surgical team and my anesthesiologist welcomed me. I was comforted by the positive & professional atmosphere. The time had come, for some long overdue beauty sleep.




Sleeping Beauty

An hour later I was in recovery. Once I was somewhat coherent, I saw my family standing around me and I could hear my nurse going over post-op instructions with them – “No strenuous activity, heavy lifting, or bending over for the next 2 weeks.” I smiled inside. I was feeling no pain; however, I was aware of something lightweight on my face. It was a masque made by SkinCeuticals for compromised skin after laser procedures. It provided cooling relief and a protective barrier against the elements for the ride home. My daughter helped me dress and wheeled me out to the car where my husband and son were waiting. I was thankful that I had brought along a pillow and blanket.




Bedside Companion

Day 1

We arrived home late that afternoon and I crawled into bed. I was propped up in a reclining position with several extra pillows for support. My face was still numb. Looking back, I’d wished that coming out of surgery I had been wearing some sort of headband to keep my hair away from my face.


My husband – wearing sterile gloves – carefully removed the cooling mask as per post-op instructions. He then covered my entire face with a thin coat of the Hydra Balm, making sure to cover up into the hairline and also under the chin & jaw line. Dr. Cowen did some “feathering” with the laser in these areas to eliminate any chance of their being harsh lines between treated and untreated skin.


As expected, my skin looked very blotchy. I was pink & white and almost muddy in some places. Swelling had begun and was causing my face to look pulled in some areas while heavily creased in others. I only know this because my husband documented everything by photographing me at the beginning and end of each day. While he and my daughter were being amazing nurses, my son was taking care of everything else. He would constantly check to see if I was alright, but did not spend a lot of time at my side. He was nervous. It was okay. Of course, Dr. Cowen had called to see how I was doing.


I was very thirsty and had a sensitive tummy, so my daughter brought me a cold ginger ale and fed me crackers. I took my first dose of prescription pain medication, because I was so afraid of waking up in the middle of the night in pain. I recommend having your caregiver be in charge of all your medicine during recovery. This will eliminate any confusion and help you stay on schedule. My husband double checked to make sure my face was completely covered with Hydra Balm, before we all went to bed.




What is That Stuff?

Day 2

I slept well but woke up with an uncomfortably warm and swollen face. It also felt wet, and something was in my eyes. Was it the Hydra Balm? Well, yes and no. My skin was starting to do what it was supposed to do – it was weeping yellow sticky stuff – my husband suggested a rinse off.


I was looking forward to a shower – and washing my hair – however, I was extremely nervous about washing my face. I caught a glimpse of myself in the mirror (my first) and immediately became light-headed. I was going to need to sit down for this. This is where my safe little swivel shower stool came in handy. I sat and let the warm water rinse over me, but not on my face. My husband rinsed my hair with gentle no-tears baby shampoo just in case.


Now for the fun part: I’m being honest when I tell you that washing my face for the very first time, was what I had dreaded most about the whole experience. I was just sure it was going to be excruciating and that I would pass out. My husband sat tub side with a stack of sterile 4×4 gauze pads and tons of praise. Using only tepid water the first time, I cautiously pressed the wet gauze to my skin. My skin was sensitive & pain was minimal. I allowed my face to air dry for a second while I toweled off. Then, I immediately re-applied a fresh layer of Hydra Balm.


I spent most of the day on the love seat at the foot of my bed dozing, snacking and staying hydrated. Drinking tons of water every day was an important part of the healing process. I was mildly uncomfortable due to some swelling, but still not in any pain. Dr. Cowen called again to see how I was doing and my husband reported that all was going well. That evening I had another bath. Fresh linens, hearty soup for dinner and ice-cream for desert made everything better. I asked for ice packs for the swelling & a movie for distraction. By the end of the day I was ready for my second dose of pain medication. My husband slathered on an additional layer of Hydra Balm before I fell asleep.




Roses Are Red

Day 3

A gentle reminder: The appearance of your lasered skin during the many stages of recovery is another reason to carefully choose your primary caregiver. He/she must be kind, resilient and strong in more ways than one. They’re going to see you at your very worst, before they see you at your very best!


Although I’d been sleeping on an incline, I woke up with significantly more swelling, accompanied by tingling, stinging and of course more weeping. My face felt so tight, that I could hardly move my mouth. My eyes were so swollen, that I could hardly see and my hair was covered in Hydra Balm. I looked and felt dreadful! I didn’t really want my family to see me this way. While everyone was downstairs, I made my way to the shower. Surely if I got up and moving, the swelling would subside. And, once I rinsed all the sticky stuff off, I would look more normal.


Unfortunately, washing my face was becoming more uncomfortable. I sat in the shower on my little shower stool with my big swollen face and had a good cry. Then, I called my husband for help.


This was going to be his true “caregiver” test. When he walked into the room I searched his face, for a reaction to my face. The man didn’t even flinch. With a good morning smile, he told me he was proud of me for trying to get the morning started on my own. Then he said, “Happy Valentine’s Day!” I remember wanting to crawl back into bed, to hide under the covers till this was all over and done. Even with a dozen roses on my bedside table, I was completely out of sorts. I was teary and feeling distressed. What on earth had I done to myself? I did my best to forget what day it was.




Putting On a Brave Face

Day 4

Knowing that days 3, 4 & 5 could be tough, Dr. Cowen’s assistant, Robin called to hold my hand. I told her my teary story and she assured me that this was all perfectly normal. I was so glad that she had called, as it was a relief to know I was doing everything right. This was just going to take some time.


Washing my face was beginning to sting – a lot – the kind of stinging that if you hang in there long enough, it becomes so numb that it almost doesn’t sting anymore. The SkinCeuticals Gentle Cleanser was creamy and helped to calm everything down. My daughter sat tub-side with me during those tough days. Along with her encouraging words, she handed me clean gauze pads and held a mirror so I could actually see what I was doing. Looking back, I’m not quite sure how she managed, but she did. The reward for hanging in there was saying goodbye to the weeping.




Awakening of the Senses

Day 5

Thank goodness the swelling finally began to subside, and I felt like I had survived the worst of it. At long last, I could open my mouth wide enough to eat real meals. And, the shadows that I’d been seeing out of the corners of my eyes had disappeared. Turns out, those were my cheeks! Standing at my vanity sink for a mid-day cleansing, proved to be a poor decision. Looking in the mirror at myself was making me woozy. Bending over, was a big no-no!


Day 5 was when my face began to itch. For obvious reasons, I could not scratch. Rather, I would gently tap the itch with a Q-tip and that was that! A few extra curly eyelashes that had caught the laser’s attention were making way for brand new ones. I also started feeling random electric-like “zingers” and warm tingling sensations. This was all good stuff. Blood circulation was helping all of the nerve endings start to reconnect. My face was waking up!




Seeing is Believing

Day 6

Just when I had figured out how to manage the itching, I started peeling! I could hardly believe how quickly things were changing from morning to night. I remember during my pre-op consultation, Robin told me that in order to achieve the results that I had prayed for; I absolutely had to make sure of two things. Number one was to keep a layer of Hydra Balm on the healing skin at all times. Number two was not to pick, or peel anything off the surface of my skin. Even if a flake was barely hanging on, I was not to pull it off! The new skin underneath is so “new” that if you pick or barely even scratch it, it can bleed and possibly scar.


This is why it’s so important to use a satin pillowcase and sleep on your back. Even your favorite super soft 500 count Egyptian cotton pillowcase will scratch your face! Keep your fingernails manicured down to nothing and allow the old skin to come off on its own. Hydra Balm continued to be my best friend.




That’s One Way to Look at It

Day 7

It was time for my first post-op visit with Dr. Cowen. After a week in the house my goal was to make this outing last as long as possible. I remembered reading in my post-operative instructions not to expect to “look good” during the early part of my recovery and to stay “under cover.” I opted for comfortable yoga pants and a lightweight windbreaker. It had a huge hood that I could pull forward to shield my face from the elements and curious passersby. Keep in mind; the way I looked one week after full face CO2 laser re-surfacing was to be expected by my doctor, but not the general public. I appreciated being welcomed through the private entrance to the office.


Dr. Cowen was thrilled with my progress and his entire staff was so supportive. I especially appreciated everyone giving high praise to my husband for being an amazing caregiver! It was a relief to know that I was right on schedule with my recovery. Since my full face re-surfacing included the peri-orbital (around the eyes) and peri-oral (around the mouth) area, I could also see how the healthy amount of new collagen was beginning to provide a mini face-lift. It was such a great day!




Balmy Nights & the Days of Our Lives

Week 2

I finally felt like I was more in control of my daily routine. My face was bright pink and continued to peel, but the swelling was beginning to subside. It was good to be downstairs hanging out with my family. Cozy evenings by a roaring fire had to wait though as any kind of heat had me wanting to run outside and bury my face in the snow.


My family continued to be incredibly supportive. Lucky for all of us, my husband is a great chef and my son now knows how to do laundry! When I started to climb the walls, we would go and grab coffee and take a long drive through the Bluegrass.  My husband continued to use the flashlight on his iPhone in the middle of the night to see if I needed more Hydra Balm.





Week 3

I was completely amazed at how my body had shed (on its own) every last layer of old skin. My reflection in the mirror revealed a pink – and still a bit round – “baby” face. The deep crevasses had become smooth and the fine lines had disappeared. I could sense my family’s relief and see their amazement in the daily transformation. Even though I’d been imagining how I would look, my brain needed time to become familiar with the image staring back at me. The Hydra Balm was beginning to feel like the icing on the cake!




Face to Face

Week 4

By the end of week four, most all of the swelling was gone, and my features had returned. The bright pink was slowly fading into my natural olive complexion. It was time for my one month post-op visit. On that day I arrived at Dr. Cowen’s office sporting my best sun hat and sunglasses. I received a “glowing” report and permission to officially say bye-bye to Hydra Balm!

It was time to sit down with Danielle, to learn how best to take care of my new skin. Her skincare philosophy is built around prevention, protection, correction, & helping women feel beautiful. Through her extensive product knowledge, I received professional advice and practical information on the best skin care products – with sunscreen being the first line of defense. She sent me home with SkinCeuticals Physical Fusion UV Defense. I love the lightweight texture & tint. After a relaxing mini facial and make-up application, I left Dr. Cowen’s office feeling beautiful!




Comfortable in My Own Skin

It has now been six months since my procedure and my skin continues to improve. My skin tone is consistent, creamier, lighter and brighter. The deep pronounced lines, discoloration & dark under-eye circles have disappeared. Skin that was once lax is now firm and resilient due to the rapid growth of healthy, new collagen.  Full face CO2 laser resurfacing has given my complexion a second chance.


I could not be happier!



October 2014

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