Om. Ramirez et Jn. Pozner, LASER RESURFACING AS AN ADJUNCT TO ENDOFOREHEAD LIFT, ENDOFACELIFT, AND BIPLANAR FACELIFT, Annals of plastic surgery, 38(4), 1997, pp. 315-321
Laser resurfacing is a wonderful technological advance at improving th
e quality of aged skin. Physicians have been reluctant to perform full
facial resurfacing at the time of rhytidectomy due to risk of flap sl
ough. Newer endoscopic-assisted subperiosteal techniques allow hardy f
laps without significant blood supply interruption. Since September 19
95 we have performed 26 full facial resurfacings at the time of rhytid
ectomy or brow lift using the Coherent 5000C carbon dioxide laser. Sta
ndard settings and densities were used. Twelve patients underwent full
endoscopic facelift; 5 patients, extended endoforehead lift; 8 patien
ts, biplanar rhytidectomy; and 1 patient, standard rhytidectomy prior
to immediate laser resurfacing. An additional 2 patients underwent end
oscopic forehead lift and forehead resurfacing. There were three herpe
s infections, one in the endoscopic group, one in the biplanar group,
and one in the standard rhytidectomy patient. There were 2 patients wi
th minor skin slough in our early experience with the biplanar group.
Full facial resurfacing at the time of rhytidectomy provides a one-sta
ge rejuvenation of skin and deeper layers, and can be performed safely
. However, only experienced laser practitioners should attempt resurfa
cing over undermined flaps.