FM 26–7–2000 8:45 Page i Lasers in Aesthetic Surgery FM 26–7–2000 8:45 Page ii FM 26–7–2000 8:45 Page iii Lasers in Aesthetic Surgery Edited by Gregory S. Keller, M.D. Victor G. Lacombe, M.D. Assistant Clinical Professor of Surgery Clinical Instructor of Facial Plastic Surgery University of California Los Angeles Division of Head and Neck Surgery Los Angeles, California University of California Los Angeles Private Practice Los Angeles, California Santa Barbara, California Private Practice Santa Rosa, California Patrick K. Lee, M.D. James P. Watson, M.D. Assistant Clinical Professor Assistant Professor of Plastic Surgery Departments of Medicine and Dermatology Department of Surgery University of California Los Angeles University of California Los Angeles Los Angeles, California Los Angeles, California Associate Editor: Kenneth M. Toft, M.D. Clinical Instructor of Facial Plastic Surgery Division of Head and Neck Surgery University of California Los Angeles Los Angeles, California Private Practice Carmichael, California 2001 Thieme • New York Stuttgart FM 4–8–2000 11:26 Page iv Thieme New York 333 Seventh Avenue New York, NY 10001 Lasers in Aesthetic Surgery Gregory S. Keller, M.D. Victor G. Lacombe, M.D. Patrick K. Lee, M.D. James P. Watson, M.D. Editor: Kathleen Lyons Assistant Editor: Michelle Schmitt Director, Production and Manufacturing: Anne Vinnicombe Senior Production Editor: Eric L. Gladstone Marketing Director: Phyllis Gold Sales Manager: Ross Lumpkin Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Development: Textbook Writers Associates, Inc. Cover Designer: Michael Mendelsohn Compositor: Prepare Printer: Canale Library of Congress Cataloging-in-Publication Data is available from the publisher. Copyright © 2001 by Thieme Medical Publishers, Inc. 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GSK v FM 26–7–2000 8:45 Page vi FM 26–7–2000 8:45 Page vii Contents PREFACE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi ACKNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii CONTRIBUTORS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii PART I Basic Laser Science 1. Laser Physics for Surgical Applications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Nicholas J. Razum 2. Laser Systems and Instrumentation for Aesthetic Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . 14 Michael Slatkine and Clifford E. Morrow 3. Laser Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Julene E. Cray 4. Selective Photothermolysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Paul C. Levins PART II Lasers for Skin Resurfacing and Treatment 5. Laser Resurfacing: An Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Gregory S. Keller and Victor G. Lacombe 6. Cutaneous Laser Exfoliation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 W. Gregory Chernoff 7. Sharplan SilkTouch and FeatherTouch Flashscanners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Victor G. Lacombe, Keith E. Blackwell, and Gregory S. Keller 8. Surgipulse Laser Resurfacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 William H. Beeson 9. Laser Resurfacing with Ultrapulse Carbon Dioxide Lasers. . . . . . . . . . . . . . . . . . . . . . . . . . 97 Phillipa L. Lowe and Nicholas J. Lowe 10.Single-Pass, High-Fluence, Carbon Dioxide Laser Skin Resurfacing . . . . . . . . . . . . . . . . . . 106 Maurice M. Khosh, Wayne F. Larrabee, and Bruce Smoller 11.The Luxar Laser System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 R. James Koch 12.Tru-Pulse Laser Resurfacing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Brian D. Bucalo and Ronald L. Moy vii FM 26–7–2000 8:45 Page viii viii CONTENTS 13.The Derma 20 Erbium:YAG Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 R. James Koch 14.The Erbium:YAG Laser versus the Carbon Dioxide Laser . . . . . . . . . . . . . . . . . . . . . . . . . . 131 William K. Boss, Jr., Michael A. Fiorillo, and Hakan Usal 15. Nonexfoliating Laser Rejuvenation of Facial Rhytids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 W. Gregory Chernoff PART III Lasers for the Treatment of Vascular Lesions 16.Vascular Laser Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Patrick K. Lee 17.Management of Vascular Lesions of the Head and Neck. . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Milton Waner 18.Copper Vapor and Copper Bromide Lasers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Sue E. McCoy 19.Flashlamp-Pumped Pulsed Dye Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 William Russell Ries and Patrick K. Lee 20.The VersaPulse Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 Emil A. Tanghetti 21.Noncoherent Filtered Flashlamp Intense Pulsed Light Device (PhotoDerm VL) . . . . . . . . . 195 Robert A. Weiss and Margaret A. Weiss PART IV Laser Hair Removal 22.A Comparative Study of Intense Light and Laser Sources in Photoepilation . . . . . . . . . . . . 207 Gary Lask, Shimon Eckhouse, Michael Slatkine, Michael Kreindel, and Amir Waldman 23.ESC/Sharplan Laser Hair Removal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 Victor G. Lacombe, Isabel M. Thompson, and Gregory S. Keller 24. Hair Removal with the Long-Pulsed Ruby and Alexandrite Lasers . . . . . . . . . . . . . . . . . . . 223 Tina S. Alster and Christopher A. Nanni 25.Hair Removal with the EpiLight System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 Robert A. Weiss and Margaret A. Weiss PART V Laser Treatment of Pigmented Lesions and Tattoos 26.Laser Treatment of Pigmented Lesions and Tattoos: Use of Q-Switched Ruby Lasers . . . . . 241 David Sawyer and Nicholas J. Lowe FM 26–7–2000 8:45 Page ix CONTENTS ix 27.Q-Switched Neodymium:YAG Laser Treatment of Tattoos. . . . . . . . . . . . . . . . . . . . . . . . . 252 James P. Watson 28.Alexandrite Laser Treatment of Pigmented Lesions and Tattoos . . . . . . . . . . . . . . . . . . . . . 260 Tina S. Alster 29.Treatment of Pigmented Lesions with Copper Bromide and Copper Vapor Lasers . . . . . . . 265 Sue E. McCoy PART VI Other Laser Treatments 30.Cutaneous Surgery with the Carbon Dioxide Laser. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Fred J. Stucker and Timothy Lian 31.Expanded Applications of the Carbon Dioxide Laser: Use of Magnification for the Removal of Facial Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 Louie L. Patseavouras 32.Laser Revision of Scars. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 Tina S. Alster 33.Treatment of Stretch Marks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296 W. Gregory Chernoff 34.Photodynamic Therapy of Skin Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 Brummette Dale Wilson, Thomas J. Dougherty, and Allen J. Oseroff PART VII Aesthetic Surgical Uses of Lasers 35.Lasers in Aesthetic Facial Surgery: An Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Gregory S. Keller and Victor G. Lacombe 36.Laser Rhytidectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 William H. Beeson 37.Laser Blepharoplasty with the Sharplan XJ150 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326 Maurice M. Khosh and Wayne F. Larrabee 38.Coherent UltraPulse Carbon Dioxide Laser Blepharoplasty. . . . . . . . . . . . . . . . . . . . . . . . . 333 David B. Apfelberg 39.Weekend Laser Neck Lift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340 Gregory S. Keller and Victor G. Lacombe 40.Skin Resurfacing Using Bipolar Cautery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347 Victor G. Lacombe, W. Gregory Chernoff, and Gregory S. Keller 41.Skin Rejuvenation for Sun Damage, Aging, and Rosacea Using Intense Pulsed Light . . . . . 351 Patrick H. Bitter, Sr. and Geoffery Paul Nase Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359