Periorbital Carbon Dioxide Laser Resurfacing

Abstract

Recent advances in carbon dioxide laser technology have been brought into the forefront of cosmetic surgery. Carbon dioxide lasers are used for resurfacing photoaged skin, reducing rhytids, and improving acne scarring. These resurfacing lasers vaporize intracellular water in an explosive fashion at the site of impact, minimizing heat conduction and thermal damage in the surrounding tissue. Selection of the appropriate patient for laser resurfacing will avoid undesirable results. One of the most important factors in patient selection is the degree of skin pigmentation and its response to sun exposure, known as Fitzpatrick Classification. The higher the Fitzpatrick class, the greater the risk that the patient will develop postlaser hyper-pigmentation. Pretreatment of patients with Retin-A and hydroquinone may decrease the incidence of hyperpigmentation. Checking for eyelid laxity is paramount and, if noted, it must be treated before or concomitant with the laser resurfacing to avoid postlaser ectropion. Saf...