Ablative laser skin resurfacing
Post on 30-Dec-2015
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Ablative laser skin resurfacing
Dr.Ali A. Maazil Plastic and reconstructive
surgeon in Alssadar medical city In Al Najaf
2012
Clinical manifestations
Roughened surface texture Variable degrees of
dyspigmenations Telangiectasia Wrinkles Skin laxity
histologically
These extrinsic aging effects are usually limited
to the epidermis and upper papillary dermis
How we can choose the most appropriate
technique
Severity of photo damage and rhytides
The expertise the laser surgeon Expectations and life style of the
patient
What is ablative laser resurfacing?
Initial vaporization of epidermis and or partial dermis
Resultant open wound with exposed dermis Normal wound healing,exudate,edema and
inflammation phases New epidermis via re epithelialization from
adnexal structures New collagen and elastin production Neo-vascularity
Where laser resurfacing excels
Periorbital region and lower eye lids
Perioral region and lips Actinic chelitis Acne scar
Patient CM : Right Eye SmartXide treated (Power) 30W Dot Mode Spacing 200 μm Scanning well Time 500 μS 2 passes under R eye with obvious reduction in rhytides and neocollagenesis
Who is the ideal patients for ablative
resurfacing
Skin photo type I and II, Cutaneous lesion amenable to
treatment with resurfacing laser . Realistic expectations of resurfacing
procedure.
Characteristics of co2 laser
Invisible ,mid infrared emission Wave length 10,600 Water is primary chromphore Collagen is secondary chromophore Effect is independent of skin colour Delivery by mirrored joints, articulated
arms
Characteristics of co2 laser
Coagulation and cutting Resurfacing is gold standard Longer healing time, redness Hypo-pigmentation
Erbium:YAG Wave length 2940 More affinity for water than co2 laser Less effective haemostasis Less thermal diffusion Less collagen contraction Can combined with co2
Pitfalls and their management
1) Proper patients selection2) Has patient ever had the areas treated
before3) What is the patients skin prototype?4) Dose the patients had history of H.L.
Pitfalls and their management
Autoimmune or other immunological deficiency
Other Dermatological conditions Any medication History of hypertrophic scar and keloid Patients prone to acne Patients expectations
Side effect and complications of ablative laser resurfacing
Expected side
effect
mild Moderate Sever
erythema Extended erythema
infections hypopigmentation
Oedema Mila ad ace hyperpigmentation
Hyper trophic scar
pruritus Contact dermatitis
Ectropin
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