An Aesthetic Transformation Without A Single Incision

One look at Gray ONeill’s before and after photos would convince any woman with deep wrinkles and pigmentation to shout: “I WANT WHAT SHE HAD!”

                          Gray before

What 69-year-old Gray had was a CO2 laser treatment with the Lumenis UltraPulse,  the most powerful CO2 laser in aesthetic medicine. Dr. Gilly Munavalli performed the two-hour procedure in his Charlotte, NC, office nine months ago, and both he and his patient are mighty pleased. “She just keeps getting better and better,”  he said.

Gray’s dry aging skin, lined with wrinkles and ridges from solar elastosis, made her a perfect candidate for the UltraPulse resurfacing treatment,  said Dr. Munavalli, who has done hundreds of CO2 treatments during the last 18 years. “Lumenis has been a consistent market leader in this category.  I can always count on it for sound technology,” he added.

Firing a 10,600 nanometer wavelength of infrared light to heat the water in the skin, UltraPulse vaporizes the skin surface and removes the aged and damaged skin. “I like its high peak power and its speed. And, it can penetrate deeper than any aesthetic ablative CO2 laser I’ve used,” Dr. Munavalli noted. After a short healing period, the new skin has normal collagen, normal color and normal texture, and is often tighter,  he explained.

UltraPulse offers a range of treatment modes, including DeepFX for wrinkles, acne scars and other deep cosmetic lesions; ActiveFX/MaxFX for full and fractional treatment of texture and pigment inconsistencies; ScaarFX for deep, thick lesions, and IncisionFX for clean, precise incisions.  


Interestingly, Gray met Dr. Munavalli through her daughter, who happens to be a dermatologist in Greenville, SC, about two hours away. “She often visits a professional dermatology site where doctors share questions and stories, and even though she didn’t know Dr. Munavalli she was really impressed by his comments about everything,” Gray explained.

“I asked my daughter about the lines around my mouth and down my cheek, and she said a heavy-duty laser was the only thing that would work on my skin and satisfy me,” Gray explained. Her deep wrinkles and uneven skin texture were no surprise, considering how much time she spent in the sun when she was growing up in Charlotte in the 1960s. “Oh yeah, I went out as much as possible to get just as tan as I could get. We even went up on the rooftops and rubbed iodine mixed with baby oil all over our bodies,” Gray chuckled.  

“When I was almost 60 years old a decade ago I’d look in the mirror and go ‘ew.’ My skin definitely made me feel older and less attractive,” said the mother of five and grandmother of seven.

“My mother was a freckled redhead who also had deep wrinkles, and I remember going with her when she had a dermabrasion treatment at a famous, and recently deceased, New York dermatologist back in the 70s,” Gray added. “She even flew back the same day of the procedure, with her face entirely covered and oozing. But mom’s treatment was too aggressive and it took over a year before she looked completely normal because they removed so much color from her face. Eventually she looked amazing.”

Aside from skin peels, a series of light laser treatments when she was in her 40s, and an eye lift, Gray hadn’t had anything substantial done to her face. Although her mother’s experience made her a bit apprehensive about a “heavy-duty laser” treatment, “I knew it was going to be worth it when I met Dr. Munavalli and saw his B&A photos.  He’s a sweet and gentle man and extremely smart,” she said.


“When I arrived at Dr. Munavalli’s office I was prepped for the procedure, placed on monitors and put right to sleep in the office (with conscious sedation).  When I woke, they put lots of cream on my face and I went home! My wrinkles were gone and my skin felt as smooth as silky as a baby’s bottom, even if was too pink to look normal,” Gray recounted.

“Pleasantly surprised” by the minimal pain she felt, Gray said her face felt warm and looked red and swollen. She was glad to have the fan and ice pack Dr. Munavalli recommended. She also suggested an electric toothbrush for anyone having the treatment because “you don’t want to open your mouth to clean your teeth.”  And, if you don’t feel like going out, make sure you have a friend or relative who can get takeout for you, she added.

Content to stay home in her PJs and watch TV while she healed, Gray took a nap every afternoon for about two weeks, which was “really odd” for her.  As instructed, she washed her face very carefully every day and applied Vaniply ointment to help protect her skin while it healed. “It took awhile for my natural color to return, but I could tell my skin was getting better and better. I could apply mineral powder if I didn’t want to go out looking, pink,” she noted. She’s still supposed to use Retin-A to avoid getting milia on her cheeks, which are tiny white bumps that develop when tiny skin flakes become trapped in small pockets near the skin’s surface. “The aesthetician in Dr. Munavalli’s office told me the epidermal cells are still healing and milia are a normal part of the healing process,” Gray said.


No matter which way you look at it, Gray looks stupendous after her Lumenis treatment with Dr. Munavalli

“Gray healed very well,” Dr. Munavalli said. “Dermatologists really know the skin, and Gray needed extreme rejuvenation and resurfacing to eliminate the aging. Plastic surgery (a cutting procedure) wouldn’t have helped her skin texture and appearance.  Plus, she got an added benefit of some contraction of the jowls so it almost looks like she got a lift. If you have a great deal of sagging skin, plastics is the only way to go. But even if Gray had had a facelift, she wouldn’t have seen this kind of result since a facelift can only do so much to improve wrinkles in the central face. And, the damage from the chronic sun exposure is not something a facelift can improve.  Facelifts can’t improve skin quality or texture. Resurfacing can.”

         Dr. Gilly S. Munavalli

If Gray’s skin was any darker, Dr. Munavalli would have been much more hesitant to have performed the treatment, he said. “Her skin was on the cusp for doing CO2. You can’t do it on darker skin because it can likely cause more hyperpigmentation, but other lasers like the Erbium may be an option.”

Dr. Munavalli believes a core doctor should have advanced training on the UltraPulse so he or she can feel completely comfortable using it. “You have to push the envelope a little to get the kind of result we saw with Gray. It’s easy to go too far when you’re resurfacing to this depth, which you definitely don’t want to do. It will take three to six months for you to see if you made a mistake during treatment, and by then additional treatment might be necessary to fix the problem if that’s even possible,” he explained. “I really needed to hit a home run because Gray’s daughter is a dermatologist!”


“My close friends told me ‘you look like a little girl.’ My children said I look great. I was getting tired of looking in the mirror and being really dissatisfied with those wrinkles around my mouth and cheeks. The experience was so worth it. It’s almost like I have teenage skin.” 

To My FOFriends, Please visit Dr. Munavalli’s Facebook, Instagram and practice Instagram pages. You’ll love the work he does!

0 Responses to “An Aesthetic Transformation Without A Single Incision”

  1. Nithya Sivakumar says:

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    • Nithya Sivakumar says:

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