title: Reduction of thickened flap using fractional carbon dioxide laser.
abstract: OBJECTIVE
  The paramedian forehead flap is an excellent choice when repairing a large nasal defect. However, even when carefully thinned, the flap may develop a bulky appearance, an ill-fitting contour, or trap door deformity. When on the face, these suboptimal results can be quite distressing. Surgical and non-surgical options for improvement exist. Surgical options include additional debulking and reorientation of the flap. Non-surgical options include intralesional corticosteroids or 5-flourouracil, dermabrasion, and ablative and non-ablative laser resurfacing. Each option has limited benefit as well potential side effects.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  In this report, we present dramatic improvement of a thickened paramedian forehead flap using the Fraxel Re:pair, a fractional carbon dioxide (CO(2) ) laser (Solta Medical, Inc. Hayward, CA).
  
  
  CONCLUSIONS
  To our knowledge, this is the first case in the literature demonstrating successful reduction of a bulky flap using a fractional ablative laser.
authors: Laser & Skin Surgery Center of New York, USA. lbrightman@laserskinsurgery.com
authors: Lori A
authors: LA
authors: Brightman
authors: Jeremy A
authors: JA
authors: Brauer
authors: Robert
authors: R
authors: Anolik
authors: Elliot T
authors: ET
authors: Weiss
authors: Julie
authors: J
authors: Karen
authors: Anne
authors: A
authors: Chapas
authors: Elizabeth
authors: E
authors: Hale
authors: Leonard
authors: L
authors: Bernstein
authors: Roy G
authors: RG
authors: Geronemus
mesh_terms: D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005546:Forehead / Q000601:surgery; D006801:Humans; D054020:Lasers, Gas; D008297:Male; D009669:Nose Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps