Combined Cervicofacial Rhytidectomy and Laser Skin Resurfacing

Abstract

To determine the safety and efficacy of simultaneous cervicofacial rhytidectomy (face lift) and laser skin resurfacing. A retrospective study of 100 consecutive patients who underwent simultaneous face lift and carbon dioxide laser resurfacing procedures was performed. Patients received regional (periorbital and/or perioral), "T"-shaped (forehead and central face), or full face laser skin resurfacing, and were classified on this basis. All patients were assessed for flap necrosis, delayed reepithelialization, reactive hyperpigmentation, persistent erythema, scarring, or other unsatisfactory results postoperatively. One of 10 patients receiving full-face resurfacing, including the entire subcutaneously undermined flap, suffered full-thickness skin necrosis of the distal segment of one flap. Six of the 100 patients developed reactive hyperpigmentation postoperatively. One patient evidenced an imprint of the laser footprint over nonundermined skin, requiring a secondary procedure. Aside from the one patient with scar, no cases of delayed reepithelialization were identified. Carbon dioxide laser skin resurfacing combined with face lift procedures can achieve dramatic cervicofacial rejuvenation. Laser resurfacing over nonundermined skin during the face lift procedure does not appear to increase the risk of postoperative complication. Laser treatment over an undermined distal face lift flap appears to increase the potential for skin necrosis, and should not be considered a routine modality for facial rejuvenation.