Use of endolaser associated with fractional CO2 laser for facial rejuvenation: Clinical experience in Brazil

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Background: The Endolaser used in aesthetic procedures in Brazil is characterized by the use of equipment that emits wavelengths of 1470 nm and 980 nm. Its main therapeutic action is to generate intense heat in the subcutaneous tissues to damage adipose tissue and heat the skin to stimulate collagen production. The CO2 laser is recommended for different dermatological and aesthetic conditions and is a great resource for skin rejuvenation. The association of these two resources is viable due to their therapeutic actions on the skin. Objective: Considering that the Endolaser is already associated with several therapeutic resources, including fractional lasers, this study aimed to describe the clinical experience of the authors in Brazil regarding its use associated with the fractional CO2 laser for the treatment of facial aging. Material and Methods: This study is characterized by exploratory research presented through a narrative review, to describe the action of the Endolaser associated with the fractional CO2 laser in the treatment of facial aging. In addition to the literature review, some clinical findings obtained through a retrospective analysis of medical records were added to describe the authors' clinical experience in Brazil of using Endolaser associated with fractional CO2 laser in the treatment of facial aging. Results: The association of the Endolaser with the fractional CO2 laser proved to be effective and safe under the conditions described in this work. The Endolaser is the first resource to be applied, followed immediately by the fractional CO2 laser. After using the lasers, drug delivery is carried out with a cosmeceutical solution, and in order to accelerate the product’s drying on the skin, we cooled the skin with a jet of cold air. Then, with the skin dry, we sealed the treated region by applying 10% retinoic acid. The treatment is completed at home with the application of dexamethasone acetate, moisturizing cream and sunscreen. Conclusion: The combined treatment of Endolaser and fractional CO2 Laser proved to be efficient and safe, as long as the parameters and protocols suggested in this study are followed. Mainly respecting dermal tolerance to skin heating in order to enhance the results, as with this laser equipment we can optimize performance in different layers, as we understood that they are complementary therapies.