Main advantages of CO2 laser surgery:
- Instanteneous hemostasis of blood vessels smaller than 0.5mm, enables the use of this laser without danger to treat hemophiliacs and patients receiving anticoagulants.
- Sealing of lymphatic vessels theoretically reduces the risk of dissemination from potentially malignant cells. Absent or diminished post-operative pain (due to sealing of nerve endings, absence of inflammation, little swelling and little drainage).
- A sterile operative field reduces the risk of disseminating infection. Smaller chances of hypertrophic scars or keloids compared to conventional surgery.
- Fewer physical manipulations of tissues during surgery.
- Clearer view of operative field (no obstruction from instruments nor blood).
- It is often possible, in one or two operative sessions to complete a treatment that otherwise would have required several additional visits to the doctor or even hospitalization.
- Local anesthesia is usually sufficient.
- As with any surgical procedure, some complications are possible following CO2 laser therapy. These may include pigmentation changes (hypopigmentation or hyperpigmentation), hypertrophic scarring or keloids. However, most of these problems are reversible with time or treatments. Despite this, patients presenting very pigmented skin or a history of bad scarring could be excluded from CO2 laser treatments.
Main advantages of selective photothermolysis lasers:
- These lasers provide the most up to date treatment available for the removal of vascular lesions, some benign pigmented lesions, tattoos and also for hair removal. Hence they remove different types of lesions that cannot be removed through conventional surgery (on account of unacceptable scarring).
- Lesions are removed with minimal pain (no anesthesia is required for most patients) with no or minimal risk of scarring ("temporary" hypo or hyperpigmentation may occur). However, many treatment sessions may be required to obtain maximal blanching of some lesions.
Let it be said that lasers have been in medical use for over thirty-five years and that there has not been any report of long term adversed effect or development of cancer.
Eleven types of laser are now being used in our office surgery unit:
The
CO2 Laser:
has the capacity to vaporize cells. The infrared energy is absorbed
by the water contained in the cells, and this results in tissue
destruction with a loss of substance. When focused, the CO2 Laser acts as a scalpel. When defocused,
it is used to vaporize skin lesions.
The
Erbium:YAG Laser:
This new and revolutionary Erbium:YAG laser allows us to resurface
the skin of the face, neck and back of hands by removing the
damaged surface layer of dead skin cells. This laser removes
fine lines and wrinkles and minimizes acne scars.
The
CO2
SilkTouch Laser or CO2 FeatherTouch Laser:
These lasers allow us also to resurface the skin of the face.
They remove fine lines and wrinkles, improve frown creases and
minimize acne scars.
The
EpiTouch Ruby Laser, the Epitouch Alexandrite Laser with Alex
Scanner and the Altus CoolGlide Laser:
The EpiTouch Ruby Laser, the Epitouch Alexandrite Laser
with Alex Scanner and the Altus CoolGlide Laser are lasers developed
for hair removal. The light emitted by these lasers is absorbed
only by the pigment located in the hair follicle, that which
disables the follicle and prevents the transfer of excess heat
to the skin surrounding the hair follicle. Laser epilation is
most appropriate for dark hair in fair-skinned men or women.
However, the Altus CoolGlide laser is a new comer to our office.
This laser, with an integrated contact cooling device, is used
for hair removal in darker skin patients (www.altusmedical.com).
The
Dye Laser (Candela Dye ScleroPlus):
is a selective photothermolysis laser to treat cutaneous small
blood vessel disease processes (telangiectasia, port-wine malformation,
certain types of warts etc.). This highly selective destruction
of blood vessels occurs with preservation of the perivascular
area (less thermal coagulation due to its short pulse
duration) and with very little action of this yellow light on
the pigmented skin surface (no significant absorption by melanin).
This laser, to which is attached a cooling spray ("Dynamic
Cooling Device"), is also a natural complement to sclerotherapy
of lower extremities to treat effectively small vessels under
one mm in diameter.
The
Aura KTP Laser:
is a laser to treat vascular lesions (facial and leg telangiectasia).
It is used with the fiber pen for the manual treatment of linear
lesions and also with a SCANNER for the treatment of larger vascular
lesions (a CoolSpot is also used when indicated).
Two
other lasers are used to fragment pigment:
Q-Switched Ruby or Nd:YAG laser.
The indication to use one or the other varies according to the
type of pigmented lesions or the color of the tattoo. Hence it
is possible to safely, easily and effectively remove most types
of decorative, medical and traumatic tattoos without scarring.
These lasers are also used to treat superficial and deep pigmented
lesions including everything from freckles, to age (actinic)
spots, café au lait macules, junctional pigmented naevi
and some pigmented birth marks (congenital pigmented naevus).
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