Histologic study of the structural changes in fine palpebral skin following selective photothermolysis with CO2 laser.
BACKGROUND
Resurfacing using a CO(2) laser is a modern and efficient mean to treat facial wrinkles and aging. It is based on the precise vaporization of the most superficial skin layers. This study evaluated the histologic effects of the CO(2) laser on palpebral skin.


METHODS
Twenty-six patients were selected (22 females, 4 males). Their age varied from 43 to 72 years and, of these, 19 were classified as Fitzpatrick type III and 7 as Fitzpatrick type II. The superior palpebral skin was examined before the operation and 3 months, 6 months, 1 year, and 2 years after selective photothermolysis.


RESULTS
All the postoperative evaluations showed consistent dermal and epidermal histologic modifications, with the epidermal regeneration showing a normalized anatomy, principally in the evaluations made after approximately 1 year. The dermis presents a dramatic neocollagenous transformation in the superficial and middle dermis, as well as intense modification (restructuring) of the elastic fiber system and reduction in the glycosaminoglycans. Both passes of the laser were analyzed and also the complete healing process.


CONCLUSIONS
Resurfacing of the fine palpebral skin using two passes at 300 and 200 mJ produces an accentuated collagen neoformation and correction of the dermal elastosis, in association with a rapid healing process.
Lessa
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S
Oculo-Plastic Surgery Department, 1st Infirmary of the Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil. s.lessa@alternex.com.br
Nanci
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M
Flores
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D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D053685:Laser Therapy / Q000295:instrumentation* / Q000379:methods; D054020:Lasers, Gas; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012038:Regeneration / Q000502:physiology; D015361:Rhytidoplasty / Q000295:instrumentation / Q000379:methods; D018570:Risk Assessment; D015595:Skin Aging / Q000473:pathology*; D016896:Treatment Outcome