Laser resurfacing of silicone-injected skin: the "silicone flash" revisited.
OBJECTIVE
To determine whether prior silicone injection increases the risks associated with carbon dioxide laser resurfacing.


METHODS
Laboratory determination of the effect of laser energy on liquid silicone; histologic evaluation of silicone-injected skin after lasing; and histologic demonstration of silicone deposits in all layers of dermis years after injection of silicone as filler fluid.


METHODS
Tertiary care medical center. PATIENT-RELATED DATA: Histologic examination of freshly excised skin injected with microdroplets of liquid silicone and subjected to application of carbon dioxide laser energy; histologic examination of skin excised years after silicone injection.


METHODS
High-speed clinical photographic imaging of the effect of laser energy on silicone fluid; histologic examination of hematoxylin-eosin-stained sections of skin injected with liquid silicone and subsequently lased.


METHODS
Response of liquid silicone to application of laser energy; effect of this response on surrounding normal skin.


RESULTS
Exposure of microdroplets of liquid silicone to carbon dioxide laser energy produced flaring with frank flame. Flaring of dermal silicone caused collateral skin damage.


CONCLUSIONS
Prior injection with liquid silicone is a relative contraindication to cutaneous resurfacing with the carbon dioxide laser. Surgical excision of silicone-injected skin may be preferable for many patients. A strenuous needs assessment should be done, alternatives for skin rejuvenation considered, and comprehensive informed consent obtained from the patient before embarking on laser resurfacing of silicone-injected skin.
Zager
W
W
Department of Otolaryngology-Head and Neck Surgery, Jefferson Medical College, 925 Chestnut St, Philadelphia, PA 19107, USA.
Huang
J
J
McCue
P
P
Reiter
D
D
D002245:Carbon Dioxide; D000075202:Contraindications; D006801:Humans; D053685:Laser Therapy; D019651:Plastic Surgery Procedures; D012826:Silicone Elastomers; D012867:Skin / Q000473:pathology / Q000528:radiation effects
D012826:Silicone Elastomers; D002245:Carbon Dioxide