Clinical application of intense pulsed light depilation technology in total auricular reconstruction

Abstract

Although ear reconstruction technology has been highly developed in recent years, hair growth on the reconstructed ear has plagued both surgeons and patients. In this paper, the authors introduce a clinical application of intense pulsed light depilation in total auricular reconstruction. From August 2012 to August 2013, 27 patients (28 ears) suffering from congenital microtia were treated by intense pulsed light depilation (650-950-nm filter, initial fluence of 14-16 J/cm and gradually increased, pulse width of 30-50 ms, spot size of 20 × 30 mm, intervals of 6-8 weeks, a total of four sessions) either before or after auricular reconstruction. According to the treatment situation at diagnosis, the patients were divided into two groups: the preoperative group and the postoperative group. There were no differences between the two groups in terms of age or initial fluence for hair removal; however, there were less treatments in the former than in the latter group (preoperative group 4.1 ± 0.3, postoperative group 4.7 ± 0.7, F = 9.10, P = 0.006), and the maximum fluence used for hair removal was lower in the former than in the latter group (preoperative group 18-20 J/cm, postoperative group 19-22 J/cm, F = 22.31, P < 0.001). After follow-up for ≥4-6 months, the effective rate was 100% in the preoperative group, and the effective rate was 80% in the postoperative group. Intense pulsed light depilation technology is a reasonable complementary approach to total auricular reconstruction. And preoperative depilation is recommended over postoperative depilation. The non-invasive modern photonic technology can resolve the problem of postoperative residual hair on the reconstructed auricle, improving auricular shape and increasing patient satisfaction. In addition, an adequately set preoperative hair removal area can provide surface skin that is most similar to normal auricle skin for auricular reconstruction.

Hair removal treatment using 1,064 nm long-pulsed Nd:YAG laser in auricular post reconstruction of microtia patient: two case reports

“…10 In particular, for those with congenital microtia who were diagnosed between the ages of 6 and 18 years, the pain from laser hair removal might not be tolerated. 3 In our case reports, the patients had not done the presurgical laser treatment.…”

“…The second stage is generally carried out 6 months after the first 1 and skin grafting commonly used. 3 Although the techniques and results of surgeries for microtia have improved, microtia patients with low hairlines have aesthetic problems of hair growth when scalp skin is usually used for ear reconstruction. 4 Unwanted hair may only become apparent in the later stages of a reconstruction, sometimes hair begins to grow on the rim after a second stage release, and sometimes a full thickness graft from the groin begin to grow hair when a child progresses beyond puberty.…”

“…A variety of conventional methods are available for hair removal, such as shaving, plucking, waxing, chemicals, 3,6 and electrolysis 6 which provide temporary effects 3,6 and often involve adverse reactions. 3 Lasers are now viewed as the gold standard for hair removal, 2 and considered as the most efficient method for the reduction of unwanted hair. 5 Lasers have been used both to treat hairs prior to reconstruction and to treat the ears after reconstruction.…”

“…2 In addition, the majority of patients have a low retroauricular hairline. Although ear reconstruction technology has been highly developed 3 in techniques and results of surgeries, 4 hair growth on the reconstruction ear has plagued both surgeons and patients. 3 Unwanted hair growth of the reconstructed ears of microtia patients can cause cosmetic problems, 4 physiological distress, 5 and known to be a therapeutic challenge.…”

“…Although ear reconstruction technology has been highly developed 3 in techniques and results of surgeries, 4 hair growth on the reconstruction ear has plagued both surgeons and patients. 3 Unwanted hair growth of the reconstructed ears of microtia patients can cause cosmetic problems, 4 physiological distress, 5 and known to be a therapeutic challenge. 6 There is a need for an effective, safe, and non-invasive treatment modality capable of removing hairs on a longterm basis.…”