What are the clinical applications of laser in cosmetic surgery

With the development of plastic surgery, laser has become an important part in the field of plastic surgery because it has the characteristics that ordinary light does not have. Laser has a significant effect on pigmented diseases, tattoo treatment of melanomas, vascular diseases, scars and face aging in cosmetic surgery.

1、 Tattoo therapy for melanosis

There are professional tattoos and non professional tattoos, which are caused by placing foreign pigments in the dermis for decorative, cosmetic or medical purposes, or are a consequence of trauma (explosive tattoos). The treatment is to use a Q-switched laser with high energy to make tattoo ink particles rapidly expand and crush without damaging the surrounding skin. Ink fragments are then eliminated by phagocytosis of macrophages, transport of lymphatic vessels and / or expulsion through the epidermis. After laser treatment, the skin turns white immediately without bloody exudation. After 7 ~ 10 days, the scab peeled off without pigment and scar. It takes 3 to 5 times to completely cure the darker nevus, blue, green and red tattoos, OTA nevus, etc., with an interval of about 2 months. The overall effect is still satisfactory, but there are also more laser treatments.

2、 Vascular disease

Skin vascular disease is the most common disease treated by laser at present. The selective photothermal decomposition principle makes the laser treatment no longer limited to the skin vascular disease of adults, but gradually began to be applied to infants and young children, and the scar after treatment is not obvious.

Hemangioma is the most common benign tumor in children, with a incidence rate of 1%-2%. Hydrogen ion laser, frequency doubled nd:yaq laser, pulsed dye laser, etc. can be selected. 532nm laser can be selected for the treatment of scarlet paralysis nevus, and the energy can be adjusted according to the specific situation. For cavernous hemangiomas, the second peak of light absorption by hemoglobin is 578nm, so 585nm dye laser can be used theoretically. However, cavernous hemangiomas are relatively deep, and 585nm can not reach its depth. Therefore, 1064nm infrared light is selected clinically, which can penetrate each layer, so as to distribute energy to the whole hemangioma and coagulate the rake tissue. Generally one-time treatment. But there were also 2 ~ 3 times of treatment. Those with large area should adopt the principle of small amount and multiple times of treatment. Otherwise, it will cause obvious local edema, blisters, pain, fever and other symptoms.

3、 Treating scar

Argon laser is one of the earliest laser types used in the treatment of hypertrophic scar and keloid. It is believed that it can coagulate capillaries, cause local tissue hypoxia, and with glycolysis, produce lactic acid, reduce the pH value of local tissue, resulting in the release of enzymes (including collagenase) and granulolysis. The release of collagenase leads to the dissolution of collagen and the softening and flattening of hypertrophic scar tissue. This indicates that the efficacy of laser therapy is the direct result of collagenase release in tissues, and may also be related to the reduction of D2 macroglobulin (collagenase inhibitor).

4、 Used to treat face aging

In recent years, lasers have been widely used in plastic surgery for premature facial aging and excessive skin wrinkles. Among them, carbon dioxide laser is one of the most widely used types. The new generation of carbon dioxide laser is made based on the principle of photothermal decomposition. The difference from the older generation of CW CO2 laser is that it has a fast pulse. It mainly acts on the skin epidermis and the superficial dermis, vaporizes and removes the original wrinkled skin on the face, denatures the thin collagen fiber band in the superficial dermis, regenerates a relatively flat epidermis, and replaces the denatured collagen fiber with the new collagen fiber, so as to tighten the skin, remove small wrinkles, increase the elasticity and luster of the skin, and prevent other cells unrelated to treatment from being damaged. Skin care should be given for about 3 weeks before treatment. After operation, the skin should be protected from sun exposure, and the skin care should continue to be maintained until complete healing.

Laser technology has a promising future. In clinical application, we should pay more attention to safety protection and take measures to prevent and treat complications.