A vertical cavity surface emitting laser (VCSEL) includes independently definable current and optical confinement structures that provide unique forms of drive current and transverse mode confinement, respectively. The optical guide may be formed from an upper distributed Bragg reflector (DBR), as an etched mesa structure and/or as an intracavity optical guide. The current guide may include an ion-implanted region within the upper DBR. A dielectric structure is formed over the upper DBR and surrounds the optical guide.