Laser Resurfacing And Lipotransfer

Laser Resurfacing

It is the skin rejuvenation method that is expanding the fastest. It is possible to use both non-ablative and ablative lasers. Ablative full surface lasers and fractional laser resurfacing are two types of lasers: ablative and non-ablative.

Using heat coagulation and ablation, it eliminates the upper reticular layer of the dermis and the epidermis. Dermal remodeling and repepithelization result in resurfacing. There will be an increase in the production of new collagen and skin elastic fiber regeneration.

Collagen and elastin undergo tightening. There is a CO2 laser. It emits light with a wavelength of 10,600 nm, which water absorbs strongly. Better tightness results from the instantaneous contraction of ablated regions. The CO2 laser penetrates deeper than the Erbium Yag laser.

Indications of Laser Resurfacing

• Facial rhytids
• Sun-damaged skin
• Acne scarring

Benefits of Laser Resurfacing

• Softening/ disappearing of wrinkles
• Improved skin texture 
• Decreased pore size
• Clinical improvement in one to two treatments
• Re-surfacing occurs in 21 days.
• Treatment of scars
• It can flatten out and smoothen hypertrophic scars
• Increases collagen production beneath depressed atrophic scars- smoothening of skin topography.
• Series of surgery at intervals of 6/12 weeks. 

Related: Reconstructive Techniques – Skin Anatomy And Skin Grafts

Advantages of Laser Resurfacing

• More precise
• Less effect on melanocytes
• Less collateral damage

The CO2 laser is the first ablation laser. It emits light at a wavelength of 10,600 nm, which is strongly absorbed by water. It has a deeper penetration. Erbium yag has a longer wavelength of 2940 nm in the infra-red range, with an absorption coefficient 16 times that of CO2. It has a lower depth of penetration per pass. It is more precisely ablationed, causing less damage to surrounding skin and less thermal injury. It is less contraction and treats more superficial pathology.

Complications of Laser Resurfacing

• Prolonged edema
• Prolonged erythema and infection.
• Prophylactic- antivirals, antibiotics
• Scarring

Also Read: Skin Carcinoma – Basal And Squamous Cell  Carcinoma

Fractional Laser CO₂ Resurfacing

Alternatively known as fractional photothermolysis; skin coagulative injury devoid of confluent epidermal damage. There will be discrete heat damage lesions encircled by wider areas of intact dermal collagen coagulation in the skin.

Here, the stratum corneum is unbroken. Reepithelization may occur. Erythema subsides more quickly. Much decreased rate/risk of scarring. Compared to lasers, there is also less chance of infection.

Non-ablative Lasers

These are not as combative. The epidermis remains intact when controlled tissue damage occurs in the dermis. Aims to stimulate dermal remodeling and the production of new collagen by targeting fibroblasts in the dermis.

There are modest to moderate lines and a limited effect on wrinkles. They work better on scars from acne. ND Yag lasers at 1320 nm are employed. Diode lasers at 1450 nm are employed. Lasers with 1319 pulsed energy are employed.

Also Read: Vascular Anomalies - Hemangiomas and Malformations

Lipotransfer 

It is also referred to as autologous fat grafting. Autologous fat grafting is the process of reinjecting fat tissue that has been removed during liposuction.  It's a practical method for augmenting soft tissue. The enlargement of the glutes, face, and dorsum of the hand are used. Techniques for breast reconstruction use it. It is used to treat irregularities or malformations in the contour that result from congenital, traumatic, oncological, or iatrogenic causes. It raises volume in particular areas.

Technique used in Lipotransfer 

There is fat transfer, fat processing, and fat harvesting. The fat solution contains extra ingredients after harvesting, such as oil, dead adipocytes, blood, and local anesthetic. Use centrifugation, filtration, and sedimentation to process the fat.

Centrifugation is used to refine the fat, removing the non-viable component and producing more adipocytes and a consistent volume.

Three layers will form following centrifugation: graftable fat in the middle layer, oil and damaged adipocytes in the top layer, and water, blood, and lidocaine in the bottom layer.

Fat transfer

Within the recipient bed's vascularized tissues, blunt-tipped cannulas are used to inject tiny aliquots of fat grafts. Syringes with a lock are utilized. Often used donor locations include the back, hips, and lateral thighs.

Substitution of 1:200,000 adrenaline with lidocaine under LA-0.5%. After using the blunt cannula-mapping approach, fat is injected. Reverse liposuction technique: continuous motion of the injected cannula during fat injection.

Complications in Fat transfer

 Bruising, edema, and ecchymosis can be there. It is self-resolving. 

• Prolonged subcutaneous pigmentation 
• Lump/ swelling under the skin 
• Embolization and infection

Hope you found this blog helpful for your NEET SS Surgery Skin and Subcutaneous preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.