Laser surgery has taken gigantic steps forward
in recent years and the use of medical lasers in dermatological
surgery is a technique of great value. A laser is a device producing
an intense beam of light, visible or invisible, which can be focused
on a small area. Laser beams are different from x-rays in that
there is no ionizing radiation in the beam of light of lasers. www.class.ca
Main advantages :
| Main advantages of CO2 laser
surgery: |
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Main advantages of selective
photothermolysis lasers: |
- Instantaneous hemostasis of blood vessels smaller than
0.5mm, enables the use of this laser without danger to
treat hemophiliacs and patients receiving anticoagulants.
- Sealing of lymphatic vessels theoretically reduces the
risk of dissemination from potentially malignant cells.
Absent or diminished post-operative pain (due to sealing
of nerve endings, absence of inflammation, little swelling
and little drainage).
- A sterile operative field reduces the risk of
disseminating infection. Smaller chances of hypertrophic
scars or keloids compared to conventional surgery.
- Fewer physical manipulations of tissues during
surgery.
- Clearer view of operative field (no obstruction
from instruments nor blood).
- It is often possible, in one or two operative
sessions to complete a treatment that otherwise
would have required several additional visits to
the doctor or even hospitalization.
- Local anesthesia is usually sufficient.
- As with any surgical procedure, some complications
are possible following CO2 laser therapy.
These may include pigmentation changes (hypopigmentation
or hyperpigmentation), hypertrophic scarring or
keloids. However, most of these problems are reversible
with time or treatments. Despite this, patients
presenting very pigmented skin or a history of
bad scarring could be excluded from CO2 laser
treatments.
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- These lasers provide the most up to date treatment available
for the removal of vascular lesions, some benign pigmented
lesions, tattoos and also for hair removal. Hence they
remove different types of lesions that cannot be removed
through conventional surgery (on account of unacceptable
scarring).
- Lesions are removed with minimal pain (no anesthesia
is required for most patients) with no or minimal
risk of scarring ("temporary" hypo or
hyperpigmentation may occur). However, many treatment
sessions may be required to obtain maximal blanching
of some lesions.
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Let it be said that lasers have been in medical use for over forty five
years and that there has not been any report of long term adversed
effect or development of cancer.
16 types of laser are now being used in our office surgery unit: |
| Thermally Designed Lasers: |
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Selective Photothermolysis Lasers: |
- CO2 laser
- CO2 SilkTouch
- CO2 FeatherTouch
- Erbium:YAG 2940-nm lasers
- ConBio
- Sciton Contour ProFractional (the most recent Fraxel)
- Sciton Contour MicroLaserPeel
- Sciton Contour Resurfacing
- A thermic apparatus acquired recently
- Non-thermic apparatus acquired recently
- Accent (radiofrequency for CELLULITE)
- UltraShape (ultrasound for free surgery LIPOSUCTION)
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- CandelaVbeam Perfecta 595-nm Pulsed Dye Laser
- LaserScope Aura StarPulse 532-nm KTP laser
- Sinon Q-Switched Ruby 594-nm laser
- Palomar Q-YAG 5 laser 1064-nm and mixed 1064 / 532nm
- Lumenis ONE™
- Multi-Spot 1064-nm Nd: YAG laser
- LightSheer Diode 800-nm laser
- Sciton Profile
- ThermaScan™-1319-nm Nd:YAG laser
- ClearScan™ 1064-nm Nd:YAG laser
- Cynosure Affirm 1440-nm Nd:YAG laser
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| The CO2 Laser: |
has the capacity to vaporize cells. The infrared energy is absorbed by the water contained in the cells, and this results in tissue destruction with a loss of substance. When focused, the CO2 Laser acts as a scalpel. When defocused, it is used to vaporize skin lesions. |
| Lasers Erbium:YAG (ConBio or Profile/Contour™): |
This new and revolutionary Erbium:YAG laser allows us to resurface the skin of the face, neck and back of hands by removing the damaged surface layer of dead skin cells. This laser removes fine lines and wrinkles and minimizes acne scars. |
| Sharplan CO2 SilkTouch Laser or CO2 FeatherTouch Laser: |
These lasers allow us also to resurface the skin of the face. They remove fine lines and wrinkles, improve frown creases and minimize acne scars. |
| The Sciton Profile/ClearScan™ Nd:YAG, the LightSheer Diode lasers and the apparatus IPL(HR) Lumenis ONE™ and BBL from Sciton: |
These lasers were developed for hair removal. The light emitted by these lasers is absorbed only by the pigment located in the hair follicle, that which disables the follicle and prevents the transfer of excess heat to the skin surrounding the hair follicle. The LightSheer Diode is most appropriate for dark hair in fair-skinned men or women. The Profile/ClearScan™ Nd:YAG laser is a new comer to our office. This laser, with a contact cooling device, is used for hair removal in darker skin patients. The IPL (HR) de Lumenis ONE™ and the BBL from Sciton, both non laser, allow us to treat all types of skin, all colors from blond to black, all skin texture: fine,coarse, dense and all sizes of hair.
(www.lumenis.com)
(www.sciton.com) |
| The Dye Laser (Candela Vbeam Perfecta): |
The Dye Laser (Candela Vbeam Perfecta): is a selective photothermolysis laser to treat cutaneous small blood vessel disease processes (telangiectasia, port-wine malformation, certain types of warts etc.). This highly selective destruction of blood vessels occurs with preservation of the perivascular area (less thermal coagulation due to its short pulse duration) and with very little action of this yellow light on the pigmented skin surface (no significant absorption by melanin). This laser, to which is attached a cooling spray ("Dynamic Cooling Device"), is also a natural complement to sclerotherapy of lower extremities to treat effectively small vessels under one mm in diameter. |
| The LaserScope Aura KTP Laser: |
is a laser to treat vascular lesions (facial and leg telangiectasia). It is used with the fiber pen for the manual treatment of linear lesions and also with a SCANNER for the treatment of larger vascular lesions (a CoolSpot is also used when indicated). |
| Two other lasers are used to fragment pigment: Sinon Q-Switched-Ruby or Palomar Q-YAG 5 laser. |
The indication to use one or the other varies according to the type of pigmented lesions or the color of the tattoo. Hence it is possible to safely, easily and effectively remove most types of decorative, medical and traumatic tattoos without scarring. These lasers are also used to treat superficial and deep pigmented lesions including everything from freckles, to age (actinic) spots, café au lait macules, junctional pigmented naevi and some pigmented birth marks (congenital pigmented naevus). |
| Laser Sciton Profile/Contour™: |
The Profile/Contour™ Sciton Laser is a new generation of invasive Erbium:YAG Laser. The MicroLaserPeel is the awaited missing link between microdermabrasion and carbon dioxide laser. For the treatment of superficial wrinkles, the rejuvenation results obtained are comparable to those of a CO2 laser without the inconvenience of a long time off. It allows a uniform and control clean vaporization selecting from 10 to 50 microns. The down-time is short, 2 to 4 days, so called the week-end wrinkle laser, according to the depth of the ablation because the MicroLaserPeel does not penetrate the 110 micron epidermal barrier. This treatment may be unique or repeated at intervals of 2 months, but results are not additive.
This same laser, however, performs another function which is similar to that of carbon dioxide lasers. The results obtained are similar, but on account of the precise independent control of ablation depth and thermal zone by a high speed computer-guided scanner (LAPG Telecentric), the down-time is shorther and the post-op care is much easier. The Profile/Contour™ is used to treat deeper wrinkles, epidermal lesions and acne scars. |
| Erbium:YAG Sciton Profile/ThermaScan™-1319-nm Laser |
Is a non-ablative system of the fourth generation.
This laser at 1319-nm wavelenght has been
designed to allow a controlled heating of subepidermal layers of the skin.
The LAPG computer-guided high-speed scanner coupled with full contact
cooling technology means a short operation that treats all skin types, is
safe for tanned skin, no hyperpigmentation and a wide range of application:
Collagen remodeling: Photorejuvenation, Wrinkles, Acne scars. Heating of
sebaceous glands for acne treatment. |
| Affirm Laser: |
AFFIRM "MICRO-REJUVENATION SYSTEM" is a Nd:YAG FRACTIONAL laser from Cynosure that is used combined with a cooling device to reduce fine lines and superficial wrinkles without pain, without ablation and without downtime.
(www.cynosurelaser.com) |
| ProFractional Erbium: YAG Laser: |
PROFRACTIONAL is mainly used for acne and post-traumatic scars, aging and sun-damaged skin. A laser beam creates thousands of micro channels surrounded by normal skin to accelerate the healing process while the treated areas stimulate the production of new collagen. The face, neck, chest and back of hands may be treated. A series of 1 to 4 sessions spaced 3/6 weeks depending on your needs. Minimal inconvenience: mild redness resembling a sunburn. Down-time from one to three days depending on the depth of the treated lesion. Makeup may be applied one or two days after each session of treatment. This treatment is often combined with a MicroLaserPeel.
(www.sciton.com) |
| Accent Apparatus non-laser: |
ACCENT™ is the ONLY system on the market which provides two types of radiofrequency technology: (RF) UniPolar and BiPolar. This apparatus treats CELLULITE by reducing the dimpled appearance of the skin «orange peel» or «cottage cheese». This treatment is often combined with a bodily reshaping ultrasound device, namely UltraShape.
(www.almalasers.com) |
| UltraShape Apparatus non laser: |
ULTRASHAPE is a bodily reshaping treatment. It is an ultrasound surgery free liposuction. UltraShape breaks down unwanted fat of: Abdomen, Thighs (saddle bags) and Flanks (love handles). It is safe, effective, painless, surgery and anesthesia free, scar and dimple-wave free. Three sessions of treatment are usually required to loose an average of 4 to 10 cm in diameter of the treated area. UltraShape may be combined with an anti-cellulite treatment such as ACCENT. (www.ultrashape.com) |
| Portrait PSR Thermic Apparatus non laser |
PORTRAIT PSR³ from Rhytec is a unique and efficient procedure that promotes a non-ablative Skin Regeneration. It is an entirely new category of cosmetic treatment that reduces fine lines and middle-size wrinkles. It is a procedure to treat perioral and periorbital wrinkles and at the same time tightens, improves skin tone, skin texture and also improves dyschromia (pigmentation irregularities). However a short period of downtime of 4 to 7 days does exist, the length of which varies according to the treatment intensity. (www.rhytec.com) |
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