For years, dermatologists have treated vascular and cutaneous lesions with lasers, but only recently have cosmetic surgeons begun to realize the potential applications and advantages of lasers over convential “cold steel.” In the past lasers were inordinately expensive, complicated to maintain, and cumbersome to use. As a result of these problems and a relative lack of experience many physicians believed that lasers were “gimmicks” or “marketing tools.” Today, however, they are less costly, more compact, and easier to maintain. Handheld fiberoptics and contact tips simplify their mode of application and emulate the sensory feedback of a surgical scalpel. This article will attempt to foster a better understanding of lasers by reviewing the currently available systems, their individual functions, and their unique application.
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References
1.
EinsteinA: Zur quantenthorie der strahlung. Physiolog Z18:121–128, 1917.
2.
GordonJPZeiglerHJTownesCH: The maser new type of amplifier, frequency standard and spectrometer. Physiol Rev99:1264–1274, 1955.
3.
MaimanTH: Stimulated optical radiation in ruby rod. Nature187:493–494, 1957.
4.
CastroDJ: Atlas of Cutaneous Laser Surgery. New York: Raven Press, David B. Apfelberg, 1992, pp. 1–11.
5.
American National Standards Institute: For the Safe Use of Lasers in Health Care Facilities. ANSI No. Z136.3. New York: American National Standards Institute; sec 3.1, 1988, p. 6.
6.
VictoriaMVanderKAchauer: Lasers in plastic surgery: Applications and nursing interventions. Plast Surg Nurs10(3):107–125, 1990.
7.
Harrison-KhanwilkarE: Laser Safety. New York: Raven Press, 1992, pp. 21–22.
8.
NelsonCCPasykKA: Eye Safety During Laser Eyelid Treatment. New York: Raven Press, David B. Apfelberg, 1992:pp. 21–22.
9.
GardenGM: Papilloma virus in the vapor of carbon dioxide laser-treated Verrucae. JAMA259:1199–1202, 1988.
10.
BailinPLRatzJLWheelandRG: Laser therapy of the skin. Otolarynqol Clin N Am23:123–166, 1990.
11.
UlbrichtSMArndtKA: Surgical Lasers: A Clinical Guide. New York: TA Fuller, 1987, pp. 113–145.
12.
CarneyJMKamatBRSternRS: Cutaneous tissue repair after focused CO2 laser irradiation. Lasers Surg Med5:180–181, 1985.
13.
WheelandRG: Cosmetic Laser Surgery. Philadelphia: William P. Colman, 1991, pp. 251–266.
14.
McBurneyEL: Carbon dioxide treatment of dermatologic lesions. South Med J71:795, 1978.
15.
BohigianRKShapshaySMHybelRL: Management of rhinophyma with carbon dioxide laser. Lahey Clinic experience. Lasers Surg Med8:397–401, 1988.
16.
DavidLMSandersG: CO2 laser blepharoplasty: A comparison of cold steel and electrocautery. J Dermatol Surg Oncol13:110–114, 1987.
17.
DavidLM: Special article: The laser approach to blepharoplasty. J Dermatol Surg Oncol14:741–746, 1988.
18.
WheelandRGBailinPLKronbergE: Carbon dioxide (CO2) laser vaporization for the treatment of tricoepitheliomata. J Dermatol Surg Oncol10:470, 1984.
19.
StanleyRJRoenigkR: Actinic chelitis: Treatment with the carbon dioxide laser. Mayo Clin Proc63:230, 1988.
20.
GrottingJCVasconezLO: Lasers in plastic surgery. Alabama J Med Sci25(2): 197–199, 1988.
21.
BeckerDWBunnJC: Laser depithelialization: An adjunct to reduction mammaplasty. Plast Reconstr Surg79:754–760, 1987.
22.
BailinPLRatzJLWheelandRG: Laser therapy of the skin: A review of principles and applications. Dermatol Clin5:259–285, 1987.
23.
ReidRMullerS: Tattoo removal by CO2 laser dermabrasion. Plast Reconstr Surg65:717–728, 1980.
24.
FryTLGerbeRWBotrosSB: Effects of laser, scalpel, and electrosurgical excision on wound contraction and graft “take.”Plast Reconstr Surg65:729–731, 1980.
25.
HambleyRHebdaPAAbellE: Wound healing of incisions produced by ultrasonically vibrating knife, scalpel, electrosurgery, and carbon dioxide laser. J Dermatol Surg Oncol14:1213–1217, 1988.
26.
DixonJA: Surgical Applications of Laser. Chicago: Year Book Medical Publishers, 1983.
27.
ApfelbergDBMasterMRLashHRiversJ: The argon laser for cutaneous lesions. JAMA245:2073, 1981.
28.
GardenJMPollaIJTanOT: The treatment of port-wine stains by the pulsed-dye laser. Arch Dermatol124:889, 1988.
29.
HukkiJ: Effect of different contact laser scapels on skin and subcutaneous fat. Laser Med Surg8:276–282, 1988.
30.
WheelandRGWalkerNPJ: Lasers twenty-five years later. Int J Dermatol25:209, 1986.
31.
AbergelRPLyonsRFWhiteRA: Skin closure by Nd:YAG laser welding. J Am Acad Dermatol14:810–814, 1986.
32.
AbergelRPMeekerCALamTS: Control of connective tissue metabolism by lasers: Recent developments and future prospects. J Am Acad Dermatol11:1142–1150, 1984.
33.
ArndtKANoeJM: Lasers in dermatology. Arch Dermatol118:293, 1982.
34.
ApfelbergDBMaserMRLashH: Argon laser management of cutaneous vascular deformities: A preliminary report. West J Med124:99–101, 1976.
35.
ArndtKA: Argon laser therapy of small cutaneous vascular lesions. Arch Dermatol118:220–224, 1982.
36.
DixonJA: Argon laser treatment of port wine stains. In ArndtKARosenS, (eds): Cutaneous laser therapy: Principles and methods. New York: John Wiley and Sons, 1983, pp. 109–128.
37.
BraunerGJSchliftmanA: Laser surgery for children. J Dermatol Surg Oncol13:178–186, 1987.
38.
SchliftmanABraunerG: Evaluation of argon laser laser surgery in children under 12 years of age (abstract). Lasers Surg Med5:178, 1985.
39.
ApfelbergDBGreenRAMaserMR: Results of argon laser exposure of capillary hemangiomas of infancy—preliminary report. Plast Reconstr Surg67:188–193, 1981.
40.
AndersonRRJaenickeKFParrishJA: Mechanism of selective vascular changes caused by dye lasers. Lasers Surg Med3:211–215, 1983.
41.
GardenJMTanOTParrishJA: The pulsed-dye laser: Its use at 577 nm wavelength. J Dermatol Surg Oncol13:134, 1987.
42.
WanerMWoodsC: The treatment of facial capillary telangectasia with pulsed yellow light. Lasers Surg Med8:189, 1988.
43.
TanOTSherwoodKGilcrestBA: Treatment of children with port wine stains using the flashlamp-pulsed tunable dye laser. N Engl J Med320:416, 1989.
44.
ScheibnerAWheelandRG: Argon pumped tunable dye laser therapy for facial port wine stain hemangiomas in adults: A new technique using small spot size and minimal power. J Dermatol Surg Oncol15:277, 1989.
45.
WalkerEPButlerPHPickeringJW: Histology of port wine stains after copper vapor laser treatment. Br J Dermatol121:217–223, 1989.
46.
LancerHA: Clinical summary of copper vapor laser treatment of dermatologic disease: A private practice viewpoint. Am J Cosm Surg8:103–106, 1991.
47.
GoldmanLRockwellRJMenerR: Laser treatment of tattoos: A preliminary survey of three years' clinical experience. JAMA201:841–844, 1967.
48.
GoldmanLRockwellRJMeyerR: Investigative studies with the laser in the treatment of basal cell epitheliomas. South Med J61:735, 1968.
49.
ReidWHMcLeodPJRitchieA: Q-switched ruby laser treatment of black tattoos. Br J Plast Surg36:455–459, 1983.
50.
OhshiroTMaruyamaYNakajimaH: Treatment of pigmentation of the lips and oral mucosa in Peutz-Jegher's syndrome using Q-switched ruby and argon lasers. Br J Plast Surg33:346, 1980.
51.
PollaLLMargolisRJDoverJS: Melanosomes are a primary target of Q-switched ruby laser in guinea pig skin. J Invest Dermatol89:281, 1987.
52.
AbergelRPMeekerCALamTS: Control of connective tissue metabolism by lasers: Recent developments and future prospects. J Am Acad Dermatol11:1142–1150, 1984.
