Laser Skin Resurfacing Research Articles

Laser Resurfacing for the Management of Periorbital Scarring.

Laser (light amplification by the stimulated emission of radiation) skin resurfacing is currently one of the most widely adopted technologies in facial rejuvenation. While most often used for aesthetic purposes, lasers also have applications in the management of scars. Since the introduction of the CO2 laser for skin rejuvenation in the 1990s, the last three decades have seen significant growth in the number of laser devices available to the physician. More recently, promising alternatives to light-based resurfacing technologies have emerged that include radiofrequency and intense focused ultrasound. To help the physician navigate the most current laser technologies as they apply to periocular scars, this review discusses the available treatment modalities, pre-treatment assessment of periorbital scars, treatment selection, and reported outcomes and complications. The recommendations described herein are based on published literature and the authors’ experience in an academic oculoplastics practice.

Pre-/postprocedure measures for laser/energy treatments: A survey.

Laser and energy-based devices may be used for many cutaneous indications, including facial resurfacing, improving skin conditions, and reducing signs of photoaging. Currently, no consensus papers or guidelines exist concerning peri-operative agents and specifically their use for laser skin resurfacing and their potential/possible role in prevention or treatment of side effects. To explore current practice using laser and energy devices, a survey was developed to identify the trends in pre- and postprocedural treatment measures. The survey was sent out digitally to 300 randomly selected US dermatologist and plastic surgeon physicians practicing medical esthetics using laser and other energy devices treatment for facial rejuvenation. The survey gathered information on demographics, types of devices used in the clinic and pre-/postprocedural measures for facial laser, and other energy-based devices treatment. The survey was active from June 15, to July 15, 2018, and fifty-eight dermatologists and plastic surgeons completed the survey (19.3% response rate, 58/300). The results showed inconsistency in skin preparation strategies and postprocedure wound care. The majority of survey participants (55/58 [96%]) reported prophylactic oral antiviral use pre- and post-treatment; however, there was inconsistency about when to start and when to stop the use. A similar inconsistency existed in the recommended period of post-treatment sun protection before and after treatment. The results of the survey confirmed the lack of consistency in the types and duration of pre- and postprocedural measures-emphasizing the need for evidence-based recommendations to optimize outcomes, prevent infection, enhance comfort, and reduce downtime.

Predicting Public Interest in Nonsurgical Cosmetic Procedures Using Google Trends

Google Trends (GT) provides cost-free, customizable analyses of search traffic for specified terms entered into Google's search engine. GT may inform plastic surgery marketing decisions and resource allocation. The aim of this study was to determine GT's utility in tracking and predicting public interest in nonsurgical cosmetic procedures and to examine trends over time of public interest in nonsurgical procedures. GT search volume for terms in 6 ASPS and ASAPS nonsurgical procedure categories (Botox injections, chemical peel, laser hair removal, laser skin resurfacing, microdermabrasion and soft tissue fillers [subcategories: collagen, fat, and hyaluronic acid]) were compared with ASPS and ASAPS case volumes for available dates between January 2004 and March 2019 with the use of univariate linear regression, taking P < 0.01 as the cutoff for significance. Total search volume varied by search term within the United States and internationally. Significant positive correlations were demonstrated for 17 GT terms in all 6 ASPS and ASAPS categories: "Botox®," "collagen injections," "collagen lip injections" with both databases; and "chemical skin peel," "skin peel," "acne scar treatment," "CO2 laser treatment," "dermabrasion," "collagen injections," "collagen lip injections," "fat transfer," "hyaluronic acid fillers," "hyaluronic acid injection," "hyaluronic acid injections," "Juvederm®," and "fat transfer" with just 1 database. Many search terms were not significant, emphasizing the need for careful selection of search terms. Our analysis further elaborates on recent characterization of GT as a powerful and intuitive data set for plastic surgeons, with the potential to accurately gauge global and national interest in topics and procedures related to nonsurgical cosmetic procedures.

The Evidence for Adjunctive Facelift Procedures.

Facelift surgery is a popular treatment but exhibits high variation among practitioners in terms of both core technique and adjunctive measures. This review identified significant evidence addressing the role of pre-infiltration, drains, fat grafting, fibrin tissue adhesives, hilotherapy, and other miscellaneous adjuncts. Based on the authors' assessment of the current literature, there is reasonable supportive evidence for pre-infiltration, fat grafting and laser skin resurfacing, which appear to be safe and effective in appropriately selected patients. Drain use is not mandatory but may confer some benefit. Conversely the evidence for the use of fibrin tissue adhesives and hilotherapy is not compelling.

Comparative Evaluation of Clinical Outcomes of Laser Skin Resurfacing Using an Ultra-Pulse Carbon Dioxide Laser and Manual Dermabrasion Using a Medium-Grit Drywall Sand Screen for Scar Revision in Adults: A Split-Scar Prospective Study

The purpose was to evaluate the clinical outcomes of laser skin resurfacing using an ultra-pulse carbon dioxide (CO2) laser and manual dermabrasion with a medium-grit drywall sand screen for scar revision in adults with Fitzpatrick skin type III to V. A total of 20 postsurgical and post-traumatic scars in individuals with Fitzpatrick skin type III to V were included in this study. Preoperative evaluation of the scars was performed by 3 blinded observers using the Manchester scar rating scale. Each scar to be treated was divided into 2 equal halves, and each half was randomly allotted to either ultra-pulse CO2 laser resurfacing (group A) or manual dermabrasion (group B). Postoperative clinical evaluation was performed by the same observers using the Manchester scar rating scale at the end of the first month, third month, and sixth month. This study showed that both methods were effective in improving the appearance of the postsurgical and post-traumatic scars. No significant difference was found between them (P=.978). Hyperpigmentation occurred in 4 scars in both the half treated with manual dermabrasion and the half treated with laser resurfacing; however, it had resolved by the end of the sixth month in all 4 scars. CO2 laser resurfacing and manual dermabrasion are equally efficacious and safe methods for scar resurfacing in adults with Fitzpatrick skin type III to V.

Editorial introductions

Editorial introductions

Laser skin resurfacing: an overview of treatment options and outcomes

Considered the gold standard procedure for atrophic acne scarring, photoageing and dyspigmentation, laser resurfacing achieves more superior results than peels and has a safer profile than more traditional methods such as dermabrasion. Lisa Mason describes the mechanisms of action of various laser types, explores expected outcomes, and outlines short- and long-term complications

Laser skin resurfacing: an overview of treatment options and outcomes

Laser skin resurfacing: an overview of treatment options and outcomes

Microneedling: A Review and Practical Guide.

Microneedling is a relatively new treatment option in dermatology and has been touted for a broad range of applications including skin rejuvenation, acne scarring, rhytides, surgical scars, dyschromia, melasma, enlarged pores, and transdermal drug delivery. The significant increase in minimally invasive procedures that has been reported over the past several years suggest that microneedling may occupy a specific niche for patients who desire measurable clinical results from treatments with little to no recovery. To review the published medical literature relating to microneedling in dermatology and provide a practical guide for its use in clinical practice. A thorough literature search of microneedling in dermatology using PubMed was conducted, and all references pertaining to skin scarring and rejuvenation were reviewed. Based on the information presented in these publications and the authors' clinical experience, a microneedling technique is outlined for clinical practice. Pretreatment recommendations, intraoperative technique and treatment end points, and postoperative considerations are outlined. Microneedling produces substantial clinical improvement of scars, striae, and rhytides with expedient recovery and limited side effects. Controlled dermal wounding and stimulation of the wound healing cascade enhances collagen production and is likely responsible for the clinical results obtained. Microneedling is a safe, minimally invasive, and effective esthetic treatment for several different dermatologic conditions including acne and other scars, rhytides, and striae. Given its expedient post-treatment recovery, limited side effect profile, and significant clinical results, microneedling is a valuable alternative to more invasive procedures such as laser skin resurfacing and deep chemical peeling.

Current Trends in Upper and Lower Eyelid Blepharoplasty Among American Society of Ophthalmic Plastic and Reconstructive Surgery Members.

To assess current practice patterns for management of upper and lower eyelid blepharoplasty by active American Society of Ophthalmic Plastic and Reconstructive Surgery members. An invitation to participate in a web-based anonymous survey was sent to the active American Society of Ophthalmic Plastic and Reconstructive Surgery membership via email. The survey consists of 34 questions, both multiple choice and free response, regarding upper and lower eyelid blepharoplasty surgery. Practice patterns for both aesthetic and functional blepharoplasty are assessed. Thirty-four percent (161/472) of American Society of Ophthalmic Plastic and Reconstructive Surgery members polled responded to the survey. Members perform an average of 196 upper eyelid, 46 lower eyelid, and 53 four-eyelid blepharoplasty procedures per year, with 70% of cases being functional and 30% purely aesthetic. Most members prefer monitored care (71%) to local (21%) or general (8%) anesthesia. Eighty-nine percent of surgeons use topical antibiotics after surgery, erythromycin being the most common (51%). Fourteen percent of members use postoperative oral antibiotics, with cephalexin (81%) being most common. In upper eyelid blepharoplasty, orbicularis muscle is excised by 86% of respondents. Orbital fat is excised, when deemed appropriate, in 97% of cases, with nasal fat excised most commonly (88%). Less commonly, fat repositioning (36%) and adjunctive fat grafting (33%) are performed. In lower eyelid blepharoplasty, surgeons report using one or more of the following approaches: transconjunctival (96%), transcutaneous (82%), and both transconjunctival and transcutaneous (51%). Common adjunctive procedures include orbital fat excision (99%), fat repositioning (80%), and lateral canthal suspension (96%). Less common adjunctive procedures include laser skin resurfacing (36%) and chemical peels (29%). This report outlines contemporary practice patterns among active American Society of Ophthalmic Plastic and Reconstructive Surgery members in the management of upper and lower eyelid blepharoplasty. It is important to quantify such data periodically to update the membership as to how this common surgical procedure is approached. This also allows eyelid surgeons to compare their practice patterns with a national group specializing in such surgery.

Peri-orbital Aesthetic Rejuvenation Surgical Protocol and Clinical Outcomes

The aim was to examine the validity of a peri-orbital rejuvenation protocol with clinical surgical results evaluating patient satisfaction and complications. Retrospective patient data and chart review was performed on 367 patients who underwent a blepharoplasty procedure. Outcome measures were dependent upon direct patient responses on postoperative visits, photographic documentation, and physical examination findings. The other outcome measure was termed a successful surgical outcome. This definition included the procedure goal was met, no postoperative complication was observed, there was no need for a revision, and the patient was satisfied with the outcome. From a cosmetic result standpoint, 99.5% (365 of 367 patients) were satisfied with the outcome. There were a total of 456 blepharoplasty surgeries: 203 upper, 75 lower, and 89 quad blepharoplasties. The patients defined with a successful outcome totaled 94.0% (345 of 367 patients). There was a complication incidence of 2.5%. Revision surgery occurred in 3% of upper blepharoplasties and in 1.8% of lower blepharoplasties. Adjuvant procedures performed either at the same time or as a staged procedure to complete the peri-orbital rejuvenation protocol were as follows: browlift surgery 24, brow or hairline dermal filler placement 4, facial silastic implant surgery 9, mid-facelift 16, lateral canthopexy 7, facelift 41, laser skin resurfacing 53, trichloroacetic acid peels 19, radiofrequency skin treatments 19, lower eyelid fat transposition 10, and facial fat transfer 25. The peri-orbital rejuvenation surgical protocol, surgical blepharoplasty techniques, and adjuvant procedure techniques performed revealed a high benefit to risk profile and high patient satisfaction rate.

Brimonidine tartrate 0.33% gel for the management of posttreatment erythema induced by laser skin resurfacing

Brimonidine tartrate 0.33% gel for the management of posttreatment erythema induced by laser skin resurfacing

Laser skin rejuvenation: common complications and risk management

Cosmetic interventions are continually developing to help consumers find risk-free solutions to their appearance woes. Although laser skin resurfacing has been a successful treatment of this kind, the risks associated with any procedure should be investigated fully. Naomi Di-Scala outlines the types of laser skin resurfacing and discusses the potential side effects for all practitioners to be aware of

Fractionated photothermolysis and its role in laser skin resurfacing

Non-invasive surgical procedures are available to treat a variety of skin complaints, as well as skin ageing. Due to advances in technology over the past four decades, laser resurfacing can compete with and complement procedures such as anti-wrinkle injections, dermal fillers and chemical peels. Lucy Millar-Hume explores different types of laser resurfacing and reflects on two case studies

Pretty as a website: examining aesthetics on nonsurgical cosmetic procedure websites

Nonsurgical cosmetic procedures have increased 356 per cent from 1997 to 2011 (American Society of Aesthetic Plastic Surgeons, 2011) and are now one of the fastest growing medical specialties in the US. Although these procedures may seem deceptively simple, they harbor serious potential for health complications. Yet, even though the majority of patients report turning to media, particularly websites, as a significant source of procedure information, little scholarly research has been devoted to nonsurgical cosmetic procedure marketing. Because these websites sell beauty, the elaboration likelihood model (ELM) suggests that aesthetics may play a crucial role in swaying potential patients. Sampling from the top 10 cities for nonsurgical cosmetic procedures, this study conducted a content analysis of 285 nonsurgical cosmetic procedure (NCP) websites to examine their use of aesthetics on the homepage and the top five procedure pages (Botox, dermal fillers, laser hair removal, laser skin resurfacing and chemical peels). Findings revealed the popularity of graphic elements (particularly a variety of logos), photographs (especially of people), cool and neutral colors and sans serif typefaces. The results also indicated that NCP websites vary their aesthetics based on the page type, with homepages displaying significantly more photos than individual procedure pages. Interestingly, differences were also found based on city ranking. NCP websites from cities ranked 1–5 used more dynamic visuals, logos, cool colors and people photographs, while websites from cities ranked 6–10 used more procedure photographs and warm colors. These findings may indicate the amount of local competition could influence NCP website aesthetics.

Lower Eyelid Synechia: A Complication of Periorbital CO2 Laser Resurfacing

Introduction: Laser resurfacing of the lower eyelids is a popular option for rejuvenation. Lower eyelid synechia (adhesions) can occur with laser skin resurfacing, but literature searches for this topic failed to show any dedicated articles addressing this complication. Materials and Methods: The author routinely performs more than 120 procedures per year involving high-fluence, high-density, multipass CO2 laser skin resurfacing to the lower eyelids (which includes full-face and periorbital treatment combined). This article discusses the author's clinical experience dealing with lower eyelid synechiae. Health Insurance Portability and accountability Act guidelines as well as the World Medical Association Declaration of Helsinki regarding ethical principles for medical research were followed. Results: Lower eyelid synechiae are an uncommon complication in the reepithelialization phase of laser resurfacing. If recognized and treated early, permanent tissue adhesion is rare; if allowed to totally reepithelialize; however, permanent deformity may occur. Conclusion: Laser resurfacing remains a popular option for rhytid effacement, skin tightening, and dyschromia improvement of the lower eyelids whether performed as an isolated procedure or as part of full-face laser resurfacing. Lower eyelid synechiae are an uncommon but potential complication that can lead to permanent disfigurement if not diagnosed and treated early in the healing period after laser treatment. All physicians and staff that perform laser resurfacing should be familiar with the early diagnosis and early treatment of lower eyelid synechiae.

Fractional laser skin resurfacing: looking at the key applications and advancements

The use of fractional laser technology can reduce the appearance of fine lines, treat photodamaged skin and minimise scarring caused by acne. Over the last decade, there have been many advancements in this area, with the most recent development being the introduction of mixed technology laser systems. Samantha Hills discusses key considerations for practitioners offering this procedure

Laser skin resurfacing: a patient-centred classification based on downtime.

Laser skin resurfacing: a patient-centred classification based on downtime.

Fractional nonablative laser resurfacing: is there a skin tightening effect?

Fractional photothermolysis, an approach to laser skin resurfacing that creates microscopic thermal wounds in skin separated by islands of spared tissue, was developed to overcome the high incidence of adverse events and prolonged healing times associated with full coverage ablative laser procedures. To examine whether fractional nonablative laser resurfacing induces skin tightening. A literature review was performed to evaluate the clinical and histologic effects of fractional nonablative laser resurfacing and full coverage ablative resurfacing procedures. Fractional nonablative lasers produce excellent outcomes with minimal risk and morbidity for a variety of clinical conditions, including photodamaged skin, atrophic scars, surgical and burn scars. Efforts to induce robust fibroplasia in histologic specimens and skin tightening in the clinical setting have yielded inconsistent results. A better understanding of the histology of fractional laser resurfacing will help to optimize clinical outcomes.

Механизмы действия различных лазеров и дифференцированные показания к их применению (обзор литературы)

To date, the methods of laser irradiation applied to the skin is much more frequent than in any other tissues, due to an exceptional variety and prevalence of skin diseases and a variety of cosmetic defects, as well as the relative simplicity of the procedures, which is associated with a surface location of objects requiring lecheniya.Lazernoe rejuvenation can be attributed to the most efficient and versatile methods of struggle with involutional changes in the skin. Target chromophores for laser radiation are almost all the chemical structures of the skin - the water, hemoglobin, melanin, collagen. The selectivity of the laser action allows you to choose individual scheme correction of involutional disorders of the skin in any type of aging skin. Wide demand for laser treatments, their high efficiency dictate the need to synthesize the available current data on the benefits and features of the application, as well as to the tactics of patients that can benefit greatly assist the individual laser medicine in the choice of the most efficient technology with the correct ratio of efficacy and safety. &#x0D; In this review article provides current data on the method of laser skin resurfacing using a CO2 laser with a description of the phase of patient management. Describes in detail the predicted side effects, adverse events, and methods for their prevention and correction.