Preoperative and Postoperative Care for Laser Resurfacing Patients

Abstract

Steven M. Hoefflin, MD, Santa Monica, CA, is a board-certified plastic surgeon and ASAPS member. The age of advanced technologic gadgetry has certainly arrived in plastic surgery. One cannot open a journal or attend a meeting without exposure to advanced office computer systems, new digital photography, higher resolution endoscopy equipment, supercharged monitors, emerging ultrasonic liposuction units, and precision-guided lasers. However, is this new technology outpacing adequate science? CO2 laser resurfacing is a positive technology that works, but will it prove to be better than the chemical peel or dermabrasion in the long run? Sufficient scientific data are not yet available to answer this question. The CO2 laser is a “controlled burning” instrument. The manufacturer's literature and early certification courses claimed that heat is not a significant factor, whereas common sense and emerging scientific studies tell us that it is. The laser vaporizes tissue at 100° C and shrinks collagen at 60° C; this is how it produces its benefits. Yet unexpected burns are possible, even in the best of hands. What is happening between the margin of 100° C superficially and 60° C in the dermis? I believe that prolonged cutaneous redness is due to second-degree dermal …