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Current Status of Fractional Laser Resurfacing

Paul J. Carniol, MD1; Mark M. Hamilton, MD2; Eric T. Carniol, MD3
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, Rutgers New Jersey Medical School, Summit
2Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Greenwood
3Rutgers New Jersey Medical School, Newark
JAMA Facial Plast Surg. 2015;17(5):360-366. doi:10.1001/jamafacial.2015.0693.
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Fractional lasers were first developed based on observations of lasers designed for hair transplantation. In 2007, ablative fractional laser resurfacing was introduced. The fractionation allowed deeper tissue penetration, leading to greater tissue contraction, collagen production and tissue remodeling. Since then, fractional erbium:YAG resurfacing lasers have also been introduced. These lasers have yielded excellent results in treating photoaging, acne scarring, and dyschromia. With the adjustment of microspot density, pulse duration, number of passes, and fluence, the surgeon can adjust the treatment effects. These lasers have allowed surgeons to treat patients with higher Fitzpatrick skin types (types IV to VI) and greater individualize treatments to various facial subunits. Immunohistochemical analysis has demonstrated remodeling effects of the tissues for several months, producing longer lasting results. Adjuvant treatments are also under investigation, including concomitant face-lift, product deposition, and platelet-rich plasma. Finally, there is a short recovery time from treatment with these lasers, allowing patients to resume regular activities more quickly. Although there is a relatively high safety profile for ablative fractionated lasers, surgeons should be aware of the limitations of specific treatments and the associated risks and complications.

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Figure 1.
A 38-Year-Old Woman With Fitzpatrick Type IV Skin Who Underwent 5 Treatments With the Fraxel Laser
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Figure 2.
A Patient Who Underwent 5 Treatments With the Fraxel Laser
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Figure 3.
A Patient Who Underwent Full-Face Fractional Treatment With the Carbon Dioxide Laser at a Setting of 100 mJ, Density 3; 80 mJ, Density 3; Periorbital
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Figure 4.
Full-Face Fractional Carbon Dioxide Laser Treatment at a Setting of 100 mJ, Density 3, Face; 80 mJ, Density 3, Periorbital; and Transconjunctival Lower Blepharoplasty
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Figure 5.
Cheek Skin Following Face-lift and Full-Face Fractional Carbon Dioxide Laser Resurfacing at a Setting of 100 mJ, Density 3
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