Lower energy and pulse stacking. A safer alternative for skin tightening using fractional CO2 laser.

Marcos Matias Motta,Rafael Fantelli Stelini,Davi Reis Calderoni,Rovilson Gilioli,Paulo Kharmandayan

doi:10.1590/s0102-865020160010000005

Marcos Matias Motta, Rafael Fantelli Stelini + Show 3 more

Open Access

https://doi.org/10.1590/s0102-865020160010000005

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Abstract

To evaluate the effect of different energies and stacking in skin shrinkage. Three decreasing settings of a fractional CO2 laser were applied to the abdomen of Twenty five Wistar rats divided into three groups. Group I (n=5) was histologically evaluated for microthermal zones dimensions. Groups II and III (n=10 each) were macroscopic evaluated with freeware ImageJ for area contraction immediately and after 30 and 60 days. No statistical significance was found within microthermal zone histological dimensions (Group I) in all settings studied. (Ablation depth: 76.90 to 97.18µm; Coagulation depth: 186.01 to 219.84 µm). In Group II, macroscopic evaluation showed that all settings cause significant immediate skin contraction. The highest setting cause significant more intense tightening effect initially, contracting skin area from 258.65 to 179.09 mm2. The same pattern was observed in Group III. At 30 and 60 days, the lowest setting significantly sustained contraction. Lower fractional CO2 laser energies associated to pulse stacking could cause consistent and long lasting tissue contraction in rats.

Highlights

Treatment of photo aging with CO2 laser resurfacing had been considered the gold standard for decades[1,2]
With the concept of fractional photothermolysis[2,3], treating photo aging with CO2 fractional laser became popular in recent years due to its potential to deliver consistent results coupled with shorter recovery time and low complication rates
We found no significant difference between the three settings studied in terms of ablation depth, coagulation depth, superficial tissue damage, and calculated cone-shaped microthermal zones (MTZ) volume

Summary

Introduction

Treatment of photo aging with CO2 laser resurfacing had been considered the gold standard for decades[1,2]. Having very impressive results, it was nearly abandoned by doctors and patients over time due to its prolonged recovery time and high rate of complications. Among these complications stand out hypertrophic scars and dyschromia. In fractional mode CO2 laser creates an array of micro treatment zones in the epidermis and dermis surrounded by healthy tissue. This has been considered to be responsible for the significant shorter recovery time[4]. Another study demonstrated that a higher penetration into the dermis causes a greater clinical efficacy in skin texture and rhytides[6]

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