Facial rejuvenation with a nonablative 1320 nm Nd : YAG laser: A preliminary clinical and histologic evaluation

BACKGROUND. Rejuvenation of photoaged skin involves removal of the epidermi s and superficial dermis, encouraging the production of new epidermis with collagenesis and remodeling. The facial appearance during healing is unplea sant, and the complication rate is high. OBJECTIVE. We evaluate a Q-switched Nd:YAG laser operating at 1320 nm, with a cryogen delivery system and a skin temperature sensor. The system cools the target skin, followed by the laser impulse which passes through the coo led epidermis into the dermis. METHODS. Ten patients are presented. Two treatments a week were given over 4 weeks, and the patients were seen at 2 and 6 weeks after the final treatm ent. RESULTS. The histology showed improvement in the condition of the dermis in all 10 patients, but only 2 of the 10 patients expressed satisfaction with the results, despite similar histologic findings. CONCLUSIONS. Careful patient selection is required. Better patient educatio n is necessary to ensure that the patients' expectations are realistic. We should add treatments that will improve the youthful aspect of the epidermi s. The system may well help in maintaining the effects of collagen remodeli ng following traditional ablative resurfacing procedures, but studies are n ecessary to show this.