Fraxel Repair

Fraxel CO2 Fractional Ablative Laser

Fraxel created the technology behind fractional laser applications. By treating skin with microscopic laser columns instead of full surface tissue removal, patients can access the benefits of the gold standard in skin resurfacing – CO2 Laser – without the lengthy downtime and recovery.

How Important is the Doctor in Using CO2 Laser?

Dr. Pilest was selected as one of the initial physician trainers for Fraxel CO2 Repair because of his extensive experience with lasers over the last two decades. His close affiliation with the University of California’s world-renowned Beckman Laser Institute, as well as his ongoing Associate Professor position with UCI, means you can count on safe, expert treatment.

CO2 lasers are extremely powerful in their ability to improve skin – or damage skin when used incorrectly. Always carefully select the physician who will be performing any laser procedure.

*Individuals Results May Vary.


Aging & Sun Damage

FDA clearance for treatment of wrinkles, furrows, fine lines, textural irregularities, pigmented areas, and vascular discoloration. Treatment for sun damage and aging. Just as with standard Fraxel, the new Fraxel Re:pair leaves untreated areas around each treatment zone to accelerate healing. The big advantage of the Re:pair is the use of carbon dioxide laser beams which not only diminishes wrinkles, rough skin, and discoloration, you will enjoy tightened skin as the result of increased new collagen in the skin found in the dermis.

Acne Scarring

Indented Acne Scars involve several layers of tissue; requiring a depth of treatment that is often not possible with other technology. Fraxel Re:pair for Acne Scarring is indicated for those patients who wish to have more aggressive procedures for their scarring issues. Typically Acne Scarring is treated with Fraxel Restore over a period of months. In special cases, Dr. Pilest will be able to accommodate scar patients who prefer fractional CO2 for this problem. Although potentially more quickly effective, there is downtime with the Fraxel Re:pair and increased costs.

“It’s had an amazing effect on my skin–particularly around my eyes, both texture and firming! Total lifting all over from chest to forehead. For the first time in my adult life I do not need foundation makeup. People have noticed a difference–saying I look really good; but no one has asked what I have had ‘done’”!*

Deborah – Patient at Total Dermatology

Fraxel developers Reliant Technologies (now Solta) featured Dr. Pilest in a training webinar for Advanced Users of the Fraxel Re:pair Laser. Dr. Pilest is a recognized industry leader in the use of laser technology. The seminar was a professional medical level discussion covering specifics in Advanced Treatment Protocol, Patient Pain Management, and Complication Prevention.

PR Web News Release Fraxel Re:pair featuring Dr. Pilest



The Fraxel Family for Resurfacing

Fraxel Re:pair | Fraxel Re:store / Dual | Clear + Brilliant – Which One is for Me?

Fraxel’s family of resurfacing lasers work by treating only a percentage of skin at one session. This speeds healing, lessens complications, and spares the skin from pigment loss.

The different levels of laser accomplish different tasks. Our lightest laser, Clear + Brilliant is an excellent first-time laser. Laser levels increase to Fraxel Repair which is used for more aggressive improvements and tackles more severe problems.

Fraxel Re:store / Dual

Fraxel Dual-wavelength specifically targets pigment and actinic keratosis (pre-cancers). Treatments can be performed on the face and chest where most AK’s occur, as well as other body areas with excessive pigmentation.

Fraxel Restore is an excellent laser for both acne scarring and skin resurfacing for smoothing rough or sun-damaged skin. Both laser wavelengths can be used when you have pigmentation and rough skin.

Fraxel Repair

Fraxel Re:pair is the procedure of choice for age-related deep lines, hard-to-erase lip lines, more pronounced photodamage and sagging face and neck skin. Because the technology behind the Re:Pair allows for deep dermal laser penetration, the benefits of this CO2 based resurfacing system have greater response potential.

Fraxel Re:pair treatment does involve healing downtime, usually 3 to 5 days depending on the energy strength and depth of laser delivery required. There may be slightly more social downtime while skin coloration and any swelling are resolving.

Clear and Brilliant

Clear + Brilliant is what Dr. Pilest refers to as “baby Fraxel”. Clear and Brilliant is the introductory laser levels for those who are newer to advanced skin treatments and younger patients who simply want to get a jump on pre-empting the effects of aging and sun exposure.

Fraxel Repair Before & After Irvine, CA
Fraxel Repair Before & After Irvine, CA
Fraxel Repair Before & After Irvine, CA

*Individual results may vary.

View More Patient Results

Optional Fraxel Repair Treatment Protocol

Getting the results you want, and the results we want for you, demands a level of treatment energies that may sometimes require anesthesia. Although many patients can tolerate the procedure with pain control offered in our office, some patients may require or desire to choose a pain-free experience.

If You Need Aggressive Treatment

If the treatment level required is aggressive, your Fraxel Repair procedure can be performed under anesthesiologist care in a surgical suite within our building.

With a certified anesthesiologist, Dr. Pilest can provide the treatment levels which have been established to give the best results – without the anxiety and associated discomfort. You will be asleep during the short procedure, bypassing all treatment-related pain and allowing a full level treatment uninterrupted by unexpected heat sensations.

Fast Healing / Tolerable Downtime

Healing is quick with most patients experiencing on average a 3 to 5-day healing downtime. Following 2nd treatments, healing has proven to be even quicker. Redness lasts from 1 to 4 weeks on average, though varying levels of pinkness may last longer which can be balanced by the use of mineral makeup. With the Fraxel Re:pair there has been no scarring and no hypopigmentation (pigment loss) which was a problem with older laser technology.

The most frequent noted side effect has been transient hyperpigmentation which is more common in patients with darker skin types such as those with Asian, Mediterranean and South American ancestry. Post-treatment pigmentation is managed with melanin suppressors which typically include hydroquinone.

Feathered Treatment – No More Demarcation

The new Re:pair system allows area treatments without the telltale demarcation, so even having a small area around the lips means there is no “white-out” that told the world you’d had a skin laser procedure.


We love our patients at Total Dermatology! Read what our satisfied patients have to say about their experiences with Dr. Pilest and our team.

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*Individual Results May Vary

Combining Fillers With Fraxel Repair

Note: Because the Fraxel Re:pair affects deep dermal tissue (this is what makes it so effective) this laser treatment is not usually performed immediately after dermal wrinkle fillers. Be sure to discuss your recent dermal filler placements with Dr. Pilest prior to any laser treatment. Usually, we recommend waiting a week between having fillers and laser treatments.

How Fraxel Technology is Different

The Fraxel Re:pair system treats a portion of the skin’s surface and leaves the surrounding areas intact to allow for rapid healing. With FDDA treatment, the skin is ablated and coagulated in deep (up to 1.6 mm) columns called Microscopic Treatment Zones (MTZ). The Fraxel re:pair laser’s high-speed optics allows these MTZ to be spaced across the skin’s surface to provide even, thorough tissue coverage for effective resurfacing.

Safety for Off-Face Treatments

Fraxel Repair treatment is safe to treat even delicate areas such as the neck and chest due to its tissue sparing design. In contrast, conventional bulk ablative laser skin resurfacing ablates 100 percent of the epidermis and therefore is too aggressive to treat the neck and chest, which often leaves patients with an undesirable line of demarcation and can lead to hypopigmentation (loss of pigment).

Extensive Clinical Study “The Fraxel re:pair laser system is the most technologically advanced tool available for a physician today. Reliant’s rigorous scientific development of the Fraxel re:pair laser is backed by data from more than 400 treatments conducted at 10 top clinical centers nationwide,” said Anja Krammer, vice president of marketing for Reliant Technologies.

Take the First Step – Request A Consultation

Schedule your consultation with board-certified dermatologist Dr. Nissan Pilest at Total Dermatology in Irvine, CA today by calling (949) 727-3800

*Individual Results May Vary