By Paul Carniol, Neil S. Sadick
Because the quantity and diversity of lasers bring up, it truly is well timed to study which lasers are top for which scientific methods. This good illustrated textual content from revered experts offers the solutions for a few mostly encountered difficulties. Even proven laser surgeons may be to profit approximately more moderen laser types, corresponding to fractionated lasers, and on easy methods to mix extra and adjunctive techniques for a greater esthetic end result.
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Extra resources for Clinical Procedures in Laser Skin Rejuvenation
10,11 Surgeons should monitor their local communities for recommendations regarding community-acquired MRSA. There have been no published studies on the use of antifungal therapy prior to laser resurfacing, although Candida infections can develop during the postoperative period, especially when occlusive dressings are used. 9 Botulinum toxin is routinely administered to our patients prior to laser resurfacing of the face. 13 Our preference is to treat at least 2 weeks prior to laser surgery and repeat at approximately 3 months postoperatively.
5–10 mg/cm3 for very thick or indurated scars. A 30-gauge needle is used to minimize further trauma to the area, and the injection is given into the superficial dermis of the scar. Injections can be repeated every 2–4 weeks, depending on the response or progression of the scar. Treatment should be continued until the skin returns to the same texture and consistency as the surrounding tissue. Overtreatment can result in atrophy, and telangectasia can develop. Some surgeons use occlusion therapy in the early stages of scarring.
24 The CO2 laser is used to de-epithelialize the scar; total vaporization of the scar is not suggested. 5 J/cm2 with a 7 mm spot. Finally, resurfacing can be tried for scars that have not responded to the treatment modalities already described. The patient needs to be counseled extensively regarding the potential risks. The scarred area and a small amount of normal appearing skin surrounding the scar should be anesthetized with local anesthesia. The scarred area should be ablated superficially with an additional pass to blend with the surrounding skin.