Chicago — Combining laser techniques to address areas such as the décolleté and using lasers for non-facial skin tightening are up-and-coming options in cosmetic surgery.
When it comes to advances in cosmetic laser surgery there is a mix of old and new, according to Jason N. Pozner, M.D., F.A.C.S., a plastic surgeon who practices in Boca Raton, Fla. and is a voluntary assistant professor, department of surgery, University of Miami, Miami.
"Facial skin resurfacing, which started the whole laser trend in plastic surgery, hit a bit of a low about five years ago after problems with CO2 lasers became more pronounced," Dr. Pozner tells Cosmetic Surgery Times. "Since that time we have used erbium lasers for skin resurfacing with fewer complications. In the last couple of years, there has been an explosion in doing light erbium peels with short recovery periods. Instead of having the two- to three-week healing period with a deep peel, patients can opt for a lighter peel with a healing period of two to four days. Now that we have been doing these light peels for a couple of years and have gotten good results, we have gone to the next step — combining procedures."Dr. Pozner noticed that patients, especially women in South Florida, had great looking faces after facelifts and other rejuvenating procedures but the skin on their faces rarely matched the untreated skin on their necks and chests.
"We started treating the décolleté by first doing a light peel followed by a broad band light treatment," Dr. Pozner says.
Following a light erbium peel with the Sciton Contour Laser, a Sciton BBL (Broad Band Light) intense pulsed light treatment is then performed. Dr. Pozner usually treats the area in a span of about three treatments. He notes that either procedure will help to rejuvenate the area, but combining the laser treatments improves outcomes.
"Perhaps doing the light peel first, makes the absorption of the second laser easier," Dr. Pozner says.
Nonfacial skin tightening
Also at the forefront of a new era in cosmetic laser surgery is nonfacial skin tightening. Cosmetic surgeons will soon use lasers not only to treat cellulite but also to address slightly sagging abdomens after pregnancy and loose skin on thighs, Dr. Pozner says.
"I do not think there is any technology out there that is perfect for this application yet, but there are technologies that are promising," Dr. Pozner says.
"I am using Sciton's combination lasers off the face to try to tighten skin. There also is the Titan laser by Cutera and other devices," he says.
Nonablative resurfacing technology and cellulite lasers will lead this evolution, according to Dr. Pozner.
"The nonablative lasers used for facial skin tightening do not break the skin and we are starting to use them off the face. We are getting better results with these newer systems and newer protocols," he explains.
These better results, according to Dr. Pozner, have come as a result of perfecting the technique.
"With Thermage®, we are using newer tips. Cellulite lasers are combining mechanical rollers with low-level light sources to increase blood flow and break up cellulite bands. With the Sciton system we are using a combination of two different wavelengths to achieve tightening — 1064 nm and 1319 nm," Dr. Pozner explains.
Dr. Pozner also reports that the key to the success of these new cosmetic laser treatment options is patient selection. Just as nonablative resurfacing will not replace the facelift, it will not replace abdominoplasty, a lower body lift or liposuction, he notes.
Disclosure: Dr. Pozner is a consultant for Sciton, Inc.