Laser
treatment in aesthetic surgery.
Svetlana
Kluchareva, MD
There are different lasers using in
dermatology, aesthetic and plastic surgery. They can be divided on
tree groups:
-
– lasers for ablating of tissue
using also for skin resurfacing,
-
– lasers for destruction of dark
pigment using for hair and tattoo removing,
-
– lasers for treatment of
vascular and pigmented skin lesions.
Red and blue ectatic vessels (telangiectasia)
can occur on face, neck and legs of many people. Main factors such
as abusing the excessive sun exposure, genetic predisposition,
freezing of skin may play a role in occurrence of facial
telangiectasia. Alcohol abusing also is a factor but people avoiding
the alcohol drinking may have a “red nose”. Young women may have
ectatic vessels on legs appearing during a pregnancy. Old women and
men may suffer from leg telangiectasias due to the weakness of the
vessel walls.
Some people have continuous vascular
lesion of red or purple color. It is a port wine stain or
haemangioma. Port wine stain appears at birth but in times it
becomes bumpy and more disfiguring.
During the last ten years selective
laser coagulation become the main treatment method of cutaneous
vascular lesions. Electrocautery used in recent years for treatment
of telangiectasia has high risk of complications. There are no
effective methods except dermatological lasers for treatment of port
wine stains.
Selective laser coagulation is based
on the principle of selective photothermolysis. Pulsed lasers of
green-yellow spectra used for the treatment of vascular lesions. In
our center we use the copper vapor laser system Yachroma-Med. This
laser system has been specially designed for treatment of pigmented
and vascular lesions. Laser beam penetrates a skin and affect on
vessels under epidermis. Red pigment of blood accumulates almost all
laser energy. A temperature of the vessel increase to the
temperature of coagulation then the vessel disappears. Skin vessels
selectively warmed and coagulated by laser light without injuring
the surrounding skin.
Patients usually well tolerate the
treatment of telangiectasia. Laser feels like a hot needle being
touched against the skin. Patient’s eyes protected by special laser
goggles.
Removing a port wine stain is more
difficult. Number of vessels per square cm in port wine stain is
many times more than in case of telangiectasies. It takes one or two
treatment for removing telangiectasies but five or more treatment
for removing a port wine stain. About 70% of port wine stain
disappear after laser treatment and others notable cleared. Port
wine stains, which not can be completely treated, consist of deeper
vessels.
When port wine stain is resistant to
the treatment increasing the number of treatment isn’t reasonable
because excessive treatment can cause skin atrophy and scarring.
When telangiectasia treated skin in
the treatment area appear red and swelling immediately after
procedure Small scabs can occur on another day. All phenomena
resolve themselves in two to five days.
When telangiectasia treated healing
time lasts seven to ten days.
Special care for skin needed after
laser treatment of vascular lesions. Every day during two weeks is
necessary to use anti-bacterial ointment, which is advised by your
doctor. Excessive exercise, alcohol and aspirin must be avoided for
at least 24 hours after treatment. Accidentally scratching off the
crusts may cause scars. Skin must be protected against sun exposure
with high protector factor sunscreens.
Selective laser coagulation became a
common method for skin vascular lesion treatment and use about 20
years around the world. Every year 150 000 of patients with
telangiectasies undergoing the procedure of laser removing of
ectatic vessels. The method approved by FDA (Food and Drug
Association) USA.
Many patients worry about
reappearance of ectatic vessels. If there is genetic predisposition
and the factors continue affect telangiectasies may reappear.
According of our experience several years usually past before
occurrence of new telangiectasues. Then they can be easily removed
by selective laser coagulation. Once removed telangiectasias and
port wine stains never occur again.
Back to
the top
|
