ABSTRACT
BACKGROUND: Laser resurfacing with high-energy, short-pulsed lasers is generally a safe and cosmetically rewarding procedure. Nevertheless, the aggressive use of these instruments has the potential for unpredictable, undesirable complications. It has long been held that multiple passes are needed to achieve dermal tightening (collagen shrinkage), which will result in a cosmetically desirable appearance. The observation of skin tightening after one general pass has not been previously reported. OBJECTIVE: To look at the long-term results after only one general pass and of focal multiple passes over lines, with particular attention to the degree of tightening and quality of the skin. METHODS: Fifteen patients with varying degrees of photodamage and resulting skin laxity, and with at least eighteen months follow-up, were evaluated. High quality photographic records were compared between pre- and postoperative pictures at three different angles on each. RESULTS: Cosmetically significant dermal tightening was observed in all of these patients. This was noted in some patients after six months and continued for several months after. All patients were pleased with the cosmetic improvement obtained. Of note were fast healing and the absence of significant complications in these patients. CONCLUSIONS: The appearance of dermal tightening as a late occurrence in the postoperative course after one single general pass has not been previously reported. When numerous general passes are done, dermal tightening is quite impressive and appears much sooner; however, much of this result is due to edema and the resulting skin quality in these patients is different. A more natural look is achieved if only one pass is done. The procedure is safer and has a faster recovery period.
Subject(s)
Laser Therapy/methods , Rhytidoplasty/methods , Skin Physiological Phenomena , Female , Follow-Up Studies , Humans , Patient Acceptance of Health CareABSTRACT
Erythema after laser skin resurfacing is seen by many as a necessary evil in order to get good results from the procedure. A critical review of widely accepted concepts may lead to diminishing the length of postoperative erythema in patients undergoing laser resurfacing. The authors report on two previously unrecognized factors in the causation of this problem.
Subject(s)
Dermatologic Surgical Procedures , Erythema/etiology , Face/surgery , Laser Therapy/adverse effects , Skin Aging , Erythema/pathology , Female , Humans , Rhytidoplasty/adverse effects , Rhytidoplasty/methodsABSTRACT
BACKGROUND: The main question in the mind of a physician about to treat a Hispanic patient for facial cosmetic improvement using laser resurfacing is: How safely can I predict an even pigmentation after the procedure? Specific studies in Hispanic patients to establish the safety of laser skin resurfacing with the UltraPulse carbon dioxide laser do not exist. OBJECTIVE: To establish the degree of safety for this procedure in this patient population. METHODS: Thirty-six volunteer patients were treated for facial rhytides and acne scars. A Coherent UltraPulse 5000c carbon dioxide laser was used. The guidelines for the minimal mechanical trauma technique were followed. Monthly follow-up for 6 months was done, except in three patients. RESULTS: Cosmetic improvement was achieved in the vast majority of patients. No cases of persisting erythema, hyperpigmentation, or hypopigmentation were seen at 90 days or at the completion of the study. CONCLUSION: This appears to be a safe procedure for this patient group following the criteria of minimizing mechanical trans-operative trauma and close follow-up as described in this paper.
Subject(s)
Dermatologic Surgical Procedures , Hispanic or Latino , Laser Therapy , Skin Aging , Adult , Aged , Female , Humans , Laser Therapy/adverse effects , Laser Therapy/methods , Male , Middle Aged , Pigmentation Disorders/etiology , Prospective Studies , RhytidoplastyABSTRACT
A 74-year-old woman underwent UltraPulse laser skin resurfacing of the dorsal aspect of both hands. The procedure was done to improve chronic actinic changes for cosmetic reasons. A satisfactory cosmetic results was obtained without untoward complications. Persistent erythema was seen at the last follow-up evaluation in the hand that had two passes. Cosmetic improvement was similar in both hands. The details of the treatment laser parameters and postoperative management are the subject of this report.
Subject(s)
Dermatologic Surgical Procedures , Hand/surgery , Laser Therapy , Skin Aging , Aged , Female , HumansABSTRACT
A new mask (N-Terface Mask) for interpositional placement in a layered dressing was evaluated. The dressings were applied to 46 patients following facial skin resurfacing with the UltraPulse carbon dioxide laser. Remarkably low postoperative pain, rapid healing, absence of crust formation, painless removal of dressing, and excellent visualization of wound bed were observed in all patients. This dressing affords the best of both open and closed wound management after laser skin resurfacing, because the mask is removed 48 hours later. Early visualization of the wound takes place allowing the surgeon to detect potential problems early enough while taking advantage of reduced pain and increased patient comfort postoperatively typical of closed wound care.
