Case Report
Open Access
Co2 and Erbium:Yag Lasers Improves Acne Scars
Aristides Arellano Huacuja*1, Dafne Arellano Montalvo2, Anja Arellano Montalvo3
1Department of Plastic and Reconstructive Surgery
2Department of Dermatology
3Dermatology and Aesthetic Surgery Clinic of Puebla (MEX)
2Department of Dermatology
3Dermatology and Aesthetic Surgery Clinic of Puebla (MEX)
*Corresponding author: Aristides Arellano Huacuja, Department of Plastic and ReconstructiveSurgery, 20 SUR 2539 Col. Bella VistaPuebla,
México, Tel. No: (011-52) 222 266-91-70, 243-65-05; Fax. No: (011-52) 222 237-74-94;
E-mail: @
Received: October 21, 2020; Accepted: October 24, 2020; Published: October 27, 2020;
Citation: Aristides A H, Dafne A M, Anja A M (2021). Co2 and Erbium:Yag Lasers Improves Acne Scars. Clin Res Dermatol Open Access
8(1): 1-5. DOI: 10.15226/2378-1726/8/1/001132
Abstract
The facelift and skin resurfacing techniques are carried out during
the same surgical procedure, in order to save time and improve the
patient recovery. Acne scars, photo-aging sings such as pigmentations
and changes in skin color are treated with the skin Resurfacing
technique. Many surgeons for neck and cheeks is performed as usually
have mentioned the face-lift technique. Using these two techniques,
a full-face restoration is obtained with only one surgical procedure.
The patient recovery is quicker and the result obtained is much better.
1064 cases were done with this procedure and minimal complications
have been observed.
To improve Acne scars we employ to different techniques,
in those cases that are not need to have a face-lift the CO2 10.6
MICRONS WAVELENGTH and Erbium: Yag laser 2.94 MICRONS
WAVENLENGTH is employ simultaneously. For cases were skin
laxity is important we start performing the acne scars restoration
with the face-lift procedure and SMAS plication. Then skin
resurfacing is done in one surgical stage. However, it is needed
between 4 to 6 weeks to recovery from the skin resurfacing with
CO2/Erbium laser. This procedure takes less recovery time and
edema, redness and patient discomfort are shortly. We started
in 2000 to perform both techniques with Erbium:Yag and CO2
Lasers. It is also carried out the Blepharoplasty in the upper
eyelid and the tranconjunctival approach in the lower eyelid with
the CO2 laser in the cut mode when is necessary [1-4].
Once the patient is marked in the places to be corrected, the
procedure is started making the endovenus anesthesia combined
with the local anesthesia (tumescent technique). Some patients
ask for general anesthesia, in those cases special laser endo
tracheal cannulas are used to ensure a more safety procedure.
When local anesthesia has been placed in the neck, cheeks and
the forehead in patients with skin ptosis, the incision in pre and
post-auricular zone is started with the CO2 laser in the cut mode
at 6 Watts. The skin undermining is done using scissors, from the
zygomatic arch to the nasolabial folds and the full neck. At the
end, the hemostasia and the SMAS placations are done with 3-0
Nylon. The excess skin is removed and steaches are place in the
area.
After finishing both sides of the face, the Blepharoplasty is performed if there is necessary. It is important to remember that all patients wear laser eye protectors to avoid eye damage[5-8]. If it is needed to perform and endoscopic forehead or a coronal approach, it is possible to combine those procedure and the skin resurfacing at the same time. Laser Resurfacing is done at Rate 10, Fluence 14 of Erbium:Yag and 2 Watts of CO2, no scan was used at one step. The laser removes the skin layers by vaporization; therefore, it is important to know the amount of energy that is being transmitted to the skin surface in order to control the depth penetration and to avoid skin damage. Remember that Erbium and CO2 lasers work in different ways, Erbium penetrate more skin layers in one pass than CO2 giving less heat to skin and CO2 produce more skin heat with less penetration and more collagen formation.
Skin Resurfacing carried out with the Erbium:Yag and CO2 lasers are used in the forehead, the upper and lower eyelid, the internal and external Chantal of the eyes, the nose, the cheeks, the Perioral zone and the chin. In those zones sometimes we perform one or two passes. Permitting the treatment of fine and depth acne scars, age spots and photo aging. The laser Fluence is increase or decrease depending on the acne scars deepness, sun damage, thickness, texture and skin color. In the first step, the laser is applied in the area to be treated. Once the first step is finished, we lived the burn skin in place. The second step is done decreasing or keeping the same laser energy. Sometimes on the cross-feets or the Perioral area a third step is carried out.
However, in areas where the surgical procedure was performed we employ only the CO2 laser at 5 watts in one pass. The laser is normally applied in the areas describe before during the same procedure. It is important to understand that the laser should be deeper in the central part of the face and lightly in the area were the surgical procedure was performed [9-12].
With this method the redness and changes in color pigmentation disappear at the same time in both areas, taking only 2 or 3 weeks for patients with skin type 3, 4 and 5 to get the same skin texture.
In cases where there is not necessary to realize a face-lift we only employ the CO2/Erbium laser combination. Once the anesthesia
After finishing both sides of the face, the Blepharoplasty is performed if there is necessary. It is important to remember that all patients wear laser eye protectors to avoid eye damage[5-8]. If it is needed to perform and endoscopic forehead or a coronal approach, it is possible to combine those procedure and the skin resurfacing at the same time. Laser Resurfacing is done at Rate 10, Fluence 14 of Erbium:Yag and 2 Watts of CO2, no scan was used at one step. The laser removes the skin layers by vaporization; therefore, it is important to know the amount of energy that is being transmitted to the skin surface in order to control the depth penetration and to avoid skin damage. Remember that Erbium and CO2 lasers work in different ways, Erbium penetrate more skin layers in one pass than CO2 giving less heat to skin and CO2 produce more skin heat with less penetration and more collagen formation.
Skin Resurfacing carried out with the Erbium:Yag and CO2 lasers are used in the forehead, the upper and lower eyelid, the internal and external Chantal of the eyes, the nose, the cheeks, the Perioral zone and the chin. In those zones sometimes we perform one or two passes. Permitting the treatment of fine and depth acne scars, age spots and photo aging. The laser Fluence is increase or decrease depending on the acne scars deepness, sun damage, thickness, texture and skin color. In the first step, the laser is applied in the area to be treated. Once the first step is finished, we lived the burn skin in place. The second step is done decreasing or keeping the same laser energy. Sometimes on the cross-feets or the Perioral area a third step is carried out.
However, in areas where the surgical procedure was performed we employ only the CO2 laser at 5 watts in one pass. The laser is normally applied in the areas describe before during the same procedure. It is important to understand that the laser should be deeper in the central part of the face and lightly in the area were the surgical procedure was performed [9-12].
With this method the redness and changes in color pigmentation disappear at the same time in both areas, taking only 2 or 3 weeks for patients with skin type 3, 4 and 5 to get the same skin texture.
In cases where there is not necessary to realize a face-lift we only employ the CO2/Erbium laser combination. Once the anesthesia
We have seen that performing these techniques, the patient results are much better. If face lifting is carried out at the same surgical
time with the skin resurfacing patients recovery takes less time and discomfort. In 90 days patient skin color is in the same tone.
The skin looks much younger, smooth and facial restoration is highly satisfactory. Acne scars improves with both procedures 60 to
80 percent depending on deepness. It is possible to perform different facial techniques at the same time such as fat graft, Gore-Tex
implant, chin implant, endoscopic forehead, etc.
- Arellano, Arellano O, Fernandez. CO2 laser skin resurfacing and facelift in the same surgical procedure. XXXI WORLD CONGRESS OF THE INTERNATIONAL COLEEGE OF SURGEONS. Argentina. Abstract. 1198:229-232.
- Arellano H, Arellano O, Fernandez. CO2 laser skin resurfacing and facelift in the same surgical procedure. 9th International Symposium on Cosmetic Laser Surgery. Las Vegas U.S.A. Abstract. 2000.
- Arellano H. CO2 laser skin resurfacing and facelift in the same surgical procedure. Journal Cutaneous Laser Therapy. 2000;104(2).
- Aristides Arellano-H. CO2 laser skin resurfacing and facelift: what are the issues.Journal Cutaneous Laser Therapy . 2001;201(3).
- Tessier P. The conjunctival approach to the orbital floor and maxilla in congenital malformations and trauma. G Maxilofac Surg. 1973;1(3).
- Shapahay SM, Strong MS, Anastasi GW, et al. Removal of rhinophyma with the carbon dioxide laser. A preliminary report. Arch Otolaryngol. 1980:106:257-259
- Fitzpatrick RE, Esparza J, Goldman MP. The depth of thermal necrosis using the CO2 laser: a comparison of the superpulsed mode and conventional mode. J DermatolSurgOncol. 1991;17:340-344
- Zweig AD, Meierhofer B, Muller OM. Lateral damage along pulsed laser incisions. Lasers Surg Med. 1990;262-274
- Weinstein C. Ultrapulse carbon dioxide laser removal of periocular wrinkles in association with laser Blepharoplasty. J Clin Laser Med Surg. 1994;12:205-209
- Weinstein C, Alster TS: Cutaneus laser resurfacing. In: Alster TS, Apfelberg DB, eds. Cosmetic Laser Surgery. New York: John Wiley & Sons. 1996:27
- Fitzpatrick RE, Goldman MP, Esparza J. Clinical advantage of the CO2 laser superpulsed mode. Treatment of verruca vulgaris, seborrheickeratoses, lenntigines, and actinic cheilitis. J DermatolSurgOncol. 1994;20:449-456
- Ginsbach G: Periorbital aesthetic surgery with KTP-laser presented at Laser Med 93, International Kongress Laser Medicin, Munich, Germany. 1993.
