LASER RESURFACING AS AN ADJUNCT TO ENDOFOREHEAD LIFT, ENDOFACELIFT, AND BIPLANAR FACELIFT

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.