1550-nm Nonablative Laser Resurfacing for Facial Surgical Scars

Pham, Annette M.; Greene, Richard M.; Woolery‐Lloyd, Heather; Kaufman, Joely; Grunebaum, Lisa D.

doi:10.1001/archfacial.2011.28

Cited by 23 publications

(17 citation statements)

References 16 publications

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“…The patient declined the other methods because of risk of infection, further scaring, hypopigmentation, hyperpigmentation, and anxiety of nose necrosis. Non-ablative fractional laser was chosen because of its safety benefit and easily controlled method compared to other methods [6,7].…”

Section: Discussionmentioning

confidence: 99%

Fractional Photothermolysis of a Replanted Nose: A Case Report

2015

Arch Aesthetic Plast Surg

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Section: Discussionmentioning

confidence: 99%

Fractional Photothermolysis of a Replanted Nose: A Case Report

2015

Arch Aesthetic Plast Surg

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“…Fraxel ® (Fraxel SR1500 RE:Store; Solta Medical, Hayward, CA, USA) is a 1550 nm erbium‐doped fiber laser that creates non‐ablative dermal microthermal injury zones. Facial surgical scars between six months and five years were treated every four weeks for four treatments at 40 mJ/cm 2 energy and treatment level 4, covering 11% of the treated area . Observers rated significant improvement in scar pigmentation, thickness, relief, and pliability but not vascularization.…”

Section: Scar Prevention and Remodelingmentioning

confidence: 98%

Scar prevention and remodeling: a review of the medical, surgical, topical and light treatment approaches

Kerwin

Tal

Stiff³

et al. 2014

Int J Dermatology

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Cosmetic, functional, and structural sequelae of scarring are innumerable, and measures exist to optimize and ultimately minimize these sequelae. To evaluate the innumerable methods available to decrease the cosmetic, functional, and structural repercussions of scarring, pubMed search of the English literature with key words scar, scar revision, scar prevention, scar treatment, scar remodeling, cicatrix, cicatrix treatment, and cicatrix remodeling was done. Original articles and reviews were examined and included. Seventy-nine manuscripts were reviewed. Techniques, comparisons, and results were reviewed and tabulated. Overall, though topical modalities are easier to use and are usually more attractive to the patient, the surgical approaches still prove to be superior and more reliable. However, advances in topical medications for scar modification are on the rise and a change towards medical treatment of scars may emerge as the next best approach. Comparison studies of the innumerable specific modalities for scar revision and prevention are impossible. Standardization of techniques is lacking. Scarring, the body's natural response to a wound, can create many adverse effects. At this point, the practice of sound, surgical fundamentals still trump the most advanced preventative methods and revision techniques. Advances in medical approaches are available, however, to assist the scarring process, which even the most advanced surgical fundamentals will ultimately lead to. Whether through newer topical therapies, light treatment, or classical surgical intervention, our treatment armamentarium of scars has expanded and will allow us to maximize scar prevention and to minimize scar morbidity.

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“…35 Pham et al also found that postsurgical scars treated with four sessions of NAFR utilizing a 1,550-nm laser resulted in subjective improvement in 13 patients' ratings of color, stiffness, thickness, and irregularity as well. 36 Burn scars, which also have been difficult to treat historically, were shown in one randomized controlled study to respond with improved skin texture after treatment with a nonablative fractional laser. Three monthly treatments were performed with a 1,540-nm instrument and blinded evaluations were performed 1 and 3 months after the final procedure.…”

Section: Clinical Data For Acne and Surgical Scarringmentioning

confidence: 99%

11 Nonablative Laser and Light Devices

Truswell¹

2016

Lasers and Light, Peels and Abrasions

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The development of laser and light therapy for skin resurfacing has revolutionized the treatment of photodamage, wrinkles, scars, and a variety of pigmented lesions. The earliest lasers used for this purpose were ablative and included carbon dioxide (CO 2 ) and erbium: yttrium aluminum garnet (Er:YAG) devices. Treatment with these ablative lasers results in coagulation and vaporization of the entire epidermal unit with the goal of improving the quality of treated skin. Downtime is in the range of 5 to 14 days, and over this period of time patients can experience edema, oozing, and discomfort. Erythema can last for months to years and dyspigmentation, including depigmentation, can appear at any time after treatment-including years later. These complications are of particular concern for patients of higher Fitzpatrick skin types, and limit the use of these lasers to Fitzpatrick types I through III. Infection and scarring can occur as well due to prolonged compromise of the epidermal barrier unit. Results are dramatic for reversal of photoaging, but the side-effect profile is a deterrent for some patients and physicians and has limited the use of fully ablative laser resurfacing. 1,2,3 Nonablative technologies were developed to allow for faster postprocedure skin recovery, targeting the deep dermis to remodel collagen. Although these lasers have the benefit of shorter downtime, more sessions are required to achieve results similar to the ablative lasers, often requiring five or six monthly treatments. These devices are also typically paired with a cooling tip that allows for cooling of the epidermis and selective treatment to the dermis. The damage induced by nonablative devices is by definition "not ablative" and does not result in disruption of the epidermis or vaporization of tissue. Characteristic histology includes coagulation of dermal components. The term nonablative is broad in nature, and can include any device that does not cause ablation. However, for true practical purposes, and for this chapter, the nonablative devices are those that are moderately absorbed by water with wavelengths ranging from 1,064 to 2,000 nm. Other devices, which deliver nonspecific thermal energy and are by definition nonablative such as radiofrequency and ultrasound technologies, are not discussed here. Nonablative Nonfractionated LasersThe 1,320-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser (CoolTouch, ICN Pharmaceuticals, Costa Mesa, California) was the first exclusively nonablative laser developed. Energy penetration occurs to a depth of 1,600 µm, a potentially effective treatment depth. Safety was optimal, yet studies showed only minimal clinical improvement in rhytids and photoaging. 4,5,6 The Smoothbeam laser (Candela Corp., Wayland, Massachusetts) emits coherent light at 1,450 nm. This device also uses water as the chromophore and results in thermal injury to the dermis and dermal components. The epidermis is protected via dynamic cryogen cooling. In 2003, Tanzi et al reported a mild to moderate clinical improvement ...

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1550-nm Nonablative Laser Resurfacing for Facial Surgical Scars

Abstract: Preliminary data suggest improved aesthetic results, demonstrating the potential use of fractional photothermolysis as a scar revision technique. Future studies with a longer follow-up period could elucidate the role of fractional photothermolysis in more permanent scar improvements.

Cited by 23 publications

References 16 publications

Fractional Photothermolysis of a Replanted Nose: A Case Report

Fractional Photothermolysis of a Replanted Nose: A Case Report

Scar prevention and remodeling: a review of the medical, surgical, topical and light treatment approaches

11 Nonablative Laser and Light Devices

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