The skin surface. What surgery and injectables don't address.
Facial rejuvenation lives in three layers. Surgery repositions the deep tissues that have descended with age. Injectables restore volume and soften expression lines. Neither addresses the third layer — the skin surface itself: sun damage, pigmentation, fine wrinkles, uneven texture, enlarged pores, acne scars. That's what laser resurfacing does.
At NCSS, laser resurfacing is performed under sedation or general anesthesia in our AAAHC-accredited operating room. This changes what's possible: a clinically effective laser intensity can be safely delivered, with proper corneal eye protection in place (an OR standard), and with your Rest-Assure nurse and physician anesthesiologist present throughout. Patients typically need fewer sessions overall — and each session delivers what the technology is actually capable of producing.
The laser program is anchored by Dr. Douglas Hendricks, whose regional recognition as a laser leader is part of what makes his practice one of the reference points for refined resurfacing in Southern California. Laser resurfacing is also frequently combined with facelift, blepharoplasty, or brow lift in the same surgical session — the anesthesia is already in place, and combining surface treatment with tissue repositioning produces a more complete rejuvenation than either alone. The consultation is where the right modality, depth, and pairing are chosen for your specific goals.
Who this procedure is designed for.
Laser resurfacing addresses the skin surface — the layer that surgery and injectables don't reach.
Sun damage and photoaging
Age spots, uneven pigmentation, textural roughness from years of sun exposure. Responds well to a range of laser modalities depending on depth of damage.
Fine lines and wrinkles
Static fine lines that injectables and neuromodulators don't address — the etched-in surface wrinkles that come from cumulative skin aging.
Acne scars
Rolling scars, boxcar scars, and ice-pick scars can all improve significantly with the right laser modality, sometimes combined with subcision or other techniques.
Uneven skin texture
Enlarged pores, rough surface, general 'unpolished' quality. Fractional and non-ablative lasers address this without the deeper recovery.
Melasma and hyperpigmentation
Selective laser modalities and IPL (intense pulsed light) can address pigmentation concerns — though melasma specifically requires careful modality choice to avoid worsening it.
Redness and vascular concerns
Broken capillaries, rosacea-related redness, and vascular lesions respond to specific vascular lasers and IPL.
Fitzpatrick skin type matters
Darker skin types (Fitzpatrick IV–VI) require specific modality selection to avoid post-inflammatory hyperpigmentation. Not every laser is safe on every skin type; consultation determines the fit.
Realistic understanding of recovery vs. results
Deeper treatment produces more dramatic results but requires more recovery. The consultation walks through the tradeoffs.
Two devices, one delivery model.
NCSS keeps the laser program focused on the two devices that do most of the work of modern resurfacing — and delivers every treatment in the OR under anesthesia. The device choice depends on the concern; the delivery model is constant.
Fully ablative CO2 (Alma Hybrid)
The deepest resurfacing available — removes the outer skin layer to reveal newer skin beneath. Most dramatic results, longest recovery. Best for significant photoaging, deep wrinkles, or severe acne scarring. Only clinically viable at effective intensity when performed under anesthesia.
Fractional resurfacing (Alma Hybrid and Alma Harmony)
Treats microscopic columns of skin rather than the entire surface. The balance point between results and recovery — better tolerated than fully ablative CO2, still producing meaningful improvement. Available in ablative and non-ablative variants depending on your goals and recovery constraints. The multi-modality Alma Harmony platform also supports additional light-based treatments matched to specific skin concerns beyond resurfacing.
Intensity chosen for clinical effect, not tolerance
Because every treatment is under sedation or general anesthesia, the treating physician selects intensity based on what will produce the intended clinical result — not on what a conscious patient can bear. This is the technical reason surgical-center laser produces different outcomes than office-based laser.
Proper corneal eye protection
Internal corneal shields are placed under anesthesia when the treatment area involves the eyelids or periorbital skin — the OR standard for periorbital laser work. This protects the eye during full-intensity treatment near the lid margin, where dermatology-office laser typically has to stay further from.
Combined with facial surgery
Laser resurfacing is frequently combined with facelift, blepharoplasty, or brow lift in a single session — the anesthesia is already in place. Laser during blepharoplasty (for lower-lid crepiness) is a particularly common pairing.
Sun-damage vs texture vs scars
Different concerns respond to different depths. The consultation matches your primary concern to the right device and depth — not the other way around.
Two sites. One recovery.
Recovery from laser resurfacing varies dramatically by depth of treatment. Realistic expectations for each category:
Redness for 24–48 hours; makeup can be worn within a day or two. Results appear gradually over subsequent weeks; typically delivered as a shorter series than office-based fractional laser thanks to the higher per-session intensity.
Skin looks and feels sunburned. Peeling and flaking through days 3–7. Prescribed post-procedure ointments support healing. Most patients stay home from public settings.
Pink skin gradually returns to normal color. Makeup can typically be worn at day 7–10. Strict sun protection essential.
Significant skin healing. Requires occlusive dressings or careful wound care per your surgeon's protocol. Most patients stay home for the full recovery period. This is the depth that delivers the most dramatic result.
Pink skin progresses to normal color over weeks. Aggressive sun protection required for months to protect the new skin surface.
Strict sun protection is essential for all laser treatments — both immediately after (to prevent hyperpigmentation) and long-term (to protect the results). Broad-spectrum SPF 30+ daily, physical avoidance during peak hours.
Laser results are durable with appropriate sun protection. The skin continues to age normally; maintenance treatments extend the improvement over time.
Dr. Hendricks anchors the program. Others contribute their specialties.
Laser resurfacing at NCSS is anchored by Dr. Hendricks, whose laser leadership is regionally recognized and who owns the Alma Hybrid and Alma Harmony platforms that power the program. Because every treatment is performed in the OR under anesthesia, laser at NCSS is delivered by physicians — not by aestheticians or laser technicians — with physician anesthesia and Rest-Assure nursing continuity throughout. When another affiliated surgeon's facial procedure would benefit from laser in the same OR session, the pairing is coordinated with Dr. Hendricks as part of the surgical planning.
Dr. Hendricks
LASER LEADER · PLATFORM OWNERTriple-boarded; regionally recognized as a laser leader; owns the Alma Hybrid and Alma Harmony platforms that anchor the NCSS laser program.
View surgeon →Coordinated with Dr. Hendricks
When another affiliated surgeon plans facial surgery that would benefit from laser resurfacing in the same OR session, the pairing is coordinated with Dr. Hendricks — efficient because the anesthesia is already in place and the equipment is right there.
Call to discuss →The right starting point is a conversation.
Every consultation at NCSS begins with time — time to understand your skin concerns, your goals, and which modality and depth is the right fit for your specific situation.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Related procedures.
Injectables
Neuromodulators and fillers — address different problems than laser resurfacing; often combined for comprehensive facial rejuvenation.
Learn more →Blepharoplasty
Eyelid surgery — commonly combined with laser resurfacing on the lower lids for crepey skin texture.
Learn more →Facelift
The deep tissue repositioning — when combined with laser resurfacing, both the underlying architecture and the skin surface are addressed.
Learn more →