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Lasers and Lights--A Technological Revolution

Jeffrey Dover, MD, and Amy Kamin January 2007 issue of Skin Inc. magazine

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The effects of the world’s technological advances surround us. The result is an ability to do almost anything faster, more efficiently and very precisely. You can tackle and complete complicated tasks with the assistance of modern equipment. Major technological advances are most prevalent in medical science where patients are benefiting from this in the treatment and management of their health care needs. Technology has given patients the opportunity to have procedures performed with little or no anesthesia, less risk of infection, minimal recuperation time and better results. In cosmetic surgery, where a purely aesthetic improvement is the goal, justifying the possible risks that are associated with surgery always has been more difficult for the patient. Technological advances such as lasers, light sources, radio frequency and infrared devices have dramatically reduced procedural risks while increasing the likelihood of excellent results.

Youth: The driving force

Today’s youth-based culture, where attractiveness is defined by looking young and healthy, is certainly the driving force behind the extreme popularity of cosmetic procedures. Combined with dramatic technological breakthroughs, the options afforded interested individuals are numerous, especially in the area of facial rejuvenation. The facelift, the ultimate cosmetic surgical procedure, was first performed by Eugene Holland in Berlin in 1901, and its popularity has increased dramatically throughout the 20th century. According to the American Society for Aesthetic Plastic Surgery (ASAPS), there were 150,401 facelifts performed in the United States in 2005. Compared, however, to less invasive facial rejuvenation procedures, this is a relatively small number.

Just a few years ago facelifting was the only procedure available for the woman who wanted to rejuvenate her facial appearance. Laser and light facial rejuvenation is a relatively new procedure. There were 475,000 such procedures performed in 2005. The availability of cosmetic procedures without incisions that produce a clear complexion and skin that glows, minimizes lines and wrinkles, and tightens skin and reduces the overall look of aged skin has been revolutionary.

The facts

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Composition of Lasers

Energy sources

Electrical discharges, chemical reactions and high-powered light sources.

Active medium

Solid, liquid or gas.

Resonant cavity

Main area where the energized medium is amplified.

Common Target Areas

Category

Condition

Cutting-edge Technology

Vascular

Dilated blood vessels

Pulsed dye, Long-pulsed:Nd:YAG, KTP/532nm lasers, and intense pulsed light

Pigmented

Brown spots

Q-switched, KTP/532nm and fractional lasers, and intense pulsed light

Wrinkles

Fine and deep facial lines

Short and variable pulsed Er:YAG, Fractional Er:YAG, and CO2 lasers and plasma devices

Sagging

Loss of firmness and redistribution of fat

Devices that heat the dermis including radio frequency (RF) and infrared (IR) devices

Types of Light

Natural light: A combination of visible and nonvisible colors or wavelengths.

Laser light: A powerful beam of light that is one color and travels in one direction.

Intense pulsed light sources (nonlaser): Appears white, but actually is made up of many different colors of light.

Also called broad-spectrum or broad-band light.

Types of Age-related Vascular Defects

Telangiectasias: Enlarged facial blood vessels.

Cherry angioma: Tiny bright red collections of blood usually the size of the tip of a pencil appearing on the trunk.

Leg veins: Blue veins of various calibers that develop with age. They run in certain families and are much more common after childbirth.

Types of Pigmented Defects

Age spots/lentigines: Flat tan spots due to long-term sun exposure. These may lighten, but do not clear in the absence of sun. They also are called liver or wisdom spots.

Freckles: Flat brown, pigmented spots. These clear totally in the absence of sun.

Melasma: Facial discoloration that is tan in color and is associated with female hormones seen in pregnancy and with taking oral contraceptives.

Seborrheic keratosis: Benign skin growths unrelated to sun exposure that can be flat or raised; colors range from pink to brown.

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