Complications of Laser Resurfacing

Plasma Exeresis for the Treatment of Benign Eyelid Lesions: A New Surgical Approach

PURPOSE

To report the plasma therapy technique and its clinical outcomes in patients with benign eyelid lesions.

METHODS

This is a retrospective, noncomparative, interventional study. The study included 71 eyes of 66 patients who underwent plasma exeresis for benign eyelid lesions in our clinic between February 2018 and December 2022. Patient symptoms, cosmetic outcomes, and complications were evaluated.

RESULTS

The lesions were removed with a single plasma exeresis treatment in all patients. The mean size of the lesion at its largest part was 5.5 ± 1.2 mm (range, 3.0-8.8 mm). No complications were encountered during the procedure. The mean procedure time was 4.0 ± 0.7 minutes (range, 3-6 minutes). Postoperatively, only 3 cases (4.2%) with tarsal conjunctival extension had mild irritation symptoms such as pain, discomfort, and redness. The treated areas were fully improved cosmetically, and all patients were satisfied with the cosmetic outcomes.

CONCLUSIONS

The plasma therapy technique for removing benign eyelid lesions offers minimally invasive surgery, less discomfort, fast recovery, and successful anatomical and cosmetic outcomes.

Carbon Dioxide Laser Rejuvenation of the Facial Skin

This article reviews the evaluation and techniques for facial skin rejuvenation using the fractionated carbon dioxide laser. It includes a detailed overview of laser skin rejuvenation and discusses the potential complications associated with this procedure. A review of clinical outcomes in the literature is also included.

Static Crow's Feet Treated with Voltaic Arc Dermabrasion (Atmospheric Plasma): Post-Operative Pain Assessment by Thermal Infrared Imaging

BACKGROUND

In the literature, several strategies have been described for the treatment of unaesthetic marks on the face resulting from the aging processes. The atmospheric plasma procedure is a non-invasive, inexpensive technique proposed for the rejuvenation of facial tissues. The aim of this study was to evaluate the performance of voltaic arc dermabrasion (VAD) for the treatment of static crow's feet of the periorbital area.

METHODS

The crow's feet of 135 patients (127 female and 8 male) were treated using the VAD technique. The perioperative skin temperature measurement was assessed using an Infrared Temperature sensor. The pain was measured using the Visual Analogic Score (VAS) at 1 week, 1 month and 1 year. The patient's and surgeon's satisfaction were assessed using the Global Aesthetic Improvement Scale (GAIS) at 1 month and 1 year from the procedure. The severity of the crow's feet was rated using the Crow's Feet Grading Scale (CFGS).

RESULTS

A complete epidermal healing of all the subjects treated was evident at 7 days. The atmospheric plasma technique showed an efficient treatment for the removal of the crow's feet, with a good aesthetic outcome, high surgeon and patient satisfaction, without clinical complications.

CONCLUSIONS

The atmospheric plasma technique can be a useful modality in the cosmetic as well as therapeutic treatment of crow's feet.

Upper Eyelid Blepharoplasty With Voltaic Arc Dermabrasion

The aging to the upper eyelid complex includes skin laxity, resulting in rhytids, orbicularis oculi hypertrophy, and pseudohermitian of orbital fat and nowadays a high number of patients seeking cosmetic surgery. Excess and laxity of upper eyelid skin affect more than 90% of women, the impact of these problems on the patient's self-esteem can become important enough to affect quality of life in psychological and sociocultural terms.The aim of the study was to evaluate the clinical efficacy of blepharoplasty with an electrosurgical technology for treatment of skin laxity of upper eyelid, which produced a lid retraction and an elevation of the upper lid without complications.This retrospective evaluation was conducted from October 2008 to July 2015, where 80 patients (56 female and 24 male) were treated for excess and laxity of upper eyelid skin with voltaic arc dermabrasion.The outcome was that all patients displayed some aspects of tissue contraction that stretched the lax skin of the upper eyelids, resulting in cosmetic improvement.In conclusion this technique was predictable and useful to remove the laxity of upper eyelid skin minimal recurrence rates, and acceptable aesthetics.

Evaluation Effectiveness of the Voltaic Arc Dermabrasion in Perioral Rhytides Eradication

Perioral rhytides affect more than 90% of women, the impact of these problems on the patient's self-esteem can become important enough to affect quality of life in psychological and sociocultural terms. Basic science shows that skin rhytides are related to loss in quantity and function of dermal collagen fibers. An electrosurgical technology was used in this study for treatment of perioral rhytides. The authors treated 34 patients (26 women and 8 men) for perioral rhytides with voltaic arc dermabrasion technique. Patient ages ranged between 30 and 65 years and the majority (90%) of these perioral areas had class II and III wrinkle scores. Voltaic arc dermabrasion was used to remove the keratinized layer for point perioral area. Treatments are minimally painful and in the authors' experience require no anesthesia. No discomfort should be expected once the voltaic arc dermabrasion treatment is concluded. The perioral dermis appears as a pale, erythematous, dull surface. Bleeding is not seen unless excessive abrading occurs with the saline-moistened gauze. No hyperpigmentation, hypopigmentation, erythema, ecchymosis, pain, itching, outbreaks of herpes, infectious processes, and scarring were observed. All patients monitored for fine perioral rhytides showed a reduction in the treated area. Since skin-specific quality of life was significantly improved after "voltaic arc" treatment, this therapy can be recommended for patients with perioral rhytides skin wishing to improve their appearance.

Delayed infections following full-face CO2 laser resurfacing and occlusive dressing use

BACKGROUND

Carbon dioxide (CO2) laser resurfacing has become an increasingly popular procedure for the treatment of facial rhytides and solar damage. Yet despite ongoing advancements in laser technology, CO2 laser resurfacing is still a risk-laden procedure that may lead to complications such as infection. Occlusive dressings increase the healing rate and decrease pain intensity in patients who receive full face laser resurfacing. It has been said that the use of occlusive dressings in postresurfacing patients may increase the risk of infection, which typically presents 2-10 days after the procedure.

OBJECTIVE

The purpose of this article is to report the incidence of infection following full-face CO2 laser resurfacing of 354 patients who were treated with occlusive dressings. In addition, factors which may have contributed to the delayed onset in three of the four infections are discussed.

METHODS

Three hundred fifty-four patients received full-face CO2 laser resurfacing. Either a continuous wave CO2 laser with a computer-generated scanner (396 microseconds dwell time, 18 W) or a pulsed CO2 laser (500 mJ pulse energy, 90 microseconds pulse duration) were used in all cases of resurfacing. Postoperatively all patients were treated with occlusive dressings and empiric oral cephalexin. Postoperatively patients were monitored at weekly intervals during the first month and then at 3 and 6 months.

RESULTS

Of the 354 patients who received full-face laser resurfacing, there were 4 cases of culture-proven infection, which translates to an infection rate of 1.13%. Three of the four infections developed 3-5 weeks after the procedure.

CONCLUSION

This study reports an infection rate of 1.13% following full-face CO2 laser resurfacing and occlusive dressing use in 354 patients. Because infection may develop many weeks after the procedure, patients should be educated to maintain proper wound care hygiene and to avoid "double dipping" of wound care products until wounds are completely healed.