Laser Treatment of Future

DALLAS, Tex (May 16, 1999) Wavelength, waveform, and radiant exposure are more than just buzzwords—they are parameters that continue to be tweaked and balanced to perfect the technology for decreasing the lines and wrinkles of sun-damaged or aging skin. Although current laser treatments are effective, there is a downside. The epidermis (top layer of skin) takes several weeks to heal, and persistent redness and pigmentation irregularites may occur.

A new laser technology that bypasses the epidermis but reaches the dermis below to activate fibroblast cells to produce new collagen may make these side-effects of current modalities obsolete. Such "nonablative" laser treatment is in the early stage of development, and a recent study of more than 200 patients over a one-year period was presented at the annual meeting of the American Society for Aesthetic Plastic Surgery (ASAPS) in Dallas.

"At 1 year, fibroblasts were consistently stimulated, resulting in the production of new collagen in the dermal layer of the skin," says Brooke R. Seckel, MD, one of the investigators in the study. The plastic surgeon explains that the renewal of the dermis by the production of new collagen over a period of time is part of "long-term wound healing," the mechanism of action believed to be responsible for reducing wrinkles. This process occurs with laser resurfacing as well as dermabrasion and chemical peels, but studies have shown that ablation removing the epidermis as these techniques do is not necessary to provoke the dermal wound-healing response.

Clinical evaluation of the patients in this study showed that the treated lines and wrinkles around the mouth and the eyes were softened by 10% to 25%, and that the treated areas remained red for only 1 to 12 hours after the procedure. Six patients required 2 weeks to heal from epidermal burns.

The nonablative or nonexfoliating laser rejuvenation of facial wrinkles requires additional investigation to evaluate its safety and efficacy, and studies are underway to further develop the devices and the technique. Success hinges on balancing the "heating" aspects—wavelength, waveform, and radiant exposure—with the protective "cooling" of the epidermis prior to exposing it to the laser. This modality may be particularly applicable for those individuals who have been poor candidates for conventional laser resurfacing because of deeply pigmented skin, which places them at high risk for post-procedure pigmentation irregularites, or for those patients who have already undergone a laser resurfacing procedure.


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.


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