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CC This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Lower eyelid fat bulging is a clinically evident sign of aging. Traditionally, surgical lower blepharoplasty has been used to improve this condition but the side effects and downtime have limited its use. This review summarizes the clinical manifestations, pathophysiology, and related anatomy of lower eyelid fat bulging; describes various surgical and nonsurgical alternatives to conventional open blepharoplasty; and determines the evidence-based efficacy of these procedures. The results have been favorable for the use of surgical lasers during transconjunctival lower blepharoplasty, but most non-surgical procedures lack scientific evidence despite non-invasive energy devices being safe, tolerable, and effective tools for periorbital skin rejuvenation. The data suggests that non-invasive devices should serve as an alternative, but not an equivalent substitute for surgery. CC This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Med Laser 2017;6(2):58-66 https://doi.

A 72-year-old Korean male with an atrophic surgical scar on the forehead was treated using a combination of picosecond-domain, 1,064nm neodymium-doped yttrium-aluminum-garnet laser with a fractionated beam profile and an intradermal injection of polynucleotide gel. At the follow-up 2 months after the sixth treatment, a significant improvement in the scar was observed. We suggest that the use of fractional picosecond-domain lasers in combination with injectable wound healing accelerators can be a safe and effective treatment for atrophic surgical scars.

Background and ObjectivesThe objective of this study is to determine the safety of a non-ablative fractional laser resurfacing of the face. Materials and MethodsThis is a retrospective analysis of Korean patients treated with a nonablative 1,550 nm fractional laser system for facial skin problems. Prevalence, types, and nature of side effects were identified and assessed. The safety data were analyzed according to the variables, including patient demographics, laser parameters, and adjuvant medication. ResultsA total of 286 consecutive treatment sessions in 119 patients (mean age 32.4) were included in the analysis; 159 treatments were applied for acne scars, 81 for prominent pores/wrinkles, and 46 for other facial scars. Erythema, edema, and dryness were significantly more evident and persisted longer in patients treated with higher densities. A total of 71 (24.8%) side effects were recorded. The most frequent complication was acne flaring. Other side effects included postinflammatory hyperpigmentation, herpes viral reactivation, aggravation of rosacea and melasma, and atrophic scarring. Two patients developed melasma after treatment. Side effects occurred more frequently in males than in females. Acne-prone patients were more likely to experience flaring of perioral acne, most commonly observed in the high energy treatment group. Postinflammatory hyperpigmentation and melasma were not observed in patients treated with lower densities. ConclusionNon-ablative resurfacing with a 1,550 nm fractional laser was associated with a relatively low rate of adverse effects. However, acne flaring was more common than previously reported. Both the energy and the density was the determinant of side effects. Increased density was more likely to produce pigmentary alterations in Korean patients.

Flat warts, or verrucae planae, are a common cutaneous infection, which tends to be multiple and grouped. They are more often found on sunexposed areas such as the face, neck, and extremities, and sometimes develop at the sites of skin trauma. The author reports on a case of flat warts which developed on the Q-switched laser tattoo removal site. Histologic findings confirmed the diagnosis of verruca plana. The author suggests that activation of the human papillomavirus should be included in the possible complications of the laser-assisted tattoo removal procedure.

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