title: Efficacy and Safety of 10,600-nm Carbon Dioxide Fractional Laser on Facial Skin with Previous Volume Injections.
abstract: BACKGROUND
  Fractionated carbon dioxide (CO2) lasers are a new treatment modality for skin resurfacing. The cosmetic rejuvenation market abounds with various injectable devices (poly-L-lactic acid, polymethyl-methacrylate, collagens, hyaluronic acids, silicone). The objective of this study is to examine the efficacy and safety of 10,600-nm CO2 fractional laser on facial skin with previous volume injections.
  
  
  METHODS
  This is a retrospective study including 14 patients treated with fractional CO2 laser and who have had previous facial volume restoration. The indication for the laser therapy, the age of the patients, previous facial volume restoration, and side effects were all recorded from their medical files. Objective assessments were made through clinical physician global assessment records and improvement scores records. Patients' satisfaction rates were also recorded.
  
  
  RESULTS
  Review of medical records of the 14 patients show that five patients had polylactic acid injection prior to the laser session. Eight patients had hyaluronic acid injection prior to the laser session. Two patients had fat injection, two had silicone injection and one patient had facial thread lift. Side effects included pain during the laser treatment, post-treatment scaling, post-treatment erythema, hyperpigmentation which spontaneously resolved within a month. Concerning the previous facial volume restoration, no granulomatous reactions were noted, no facial shape deformation and no asymmetry were encountered whatever the facial volume product was.
  
  
  CONCLUSIONS
  CO2 fractional laser treatments do not seem to affect facial skin which had previous facial volume restoration with polylactic acid for more than 6 years, hyaluronic acid for more than 0.5 year, silicone for more than 6 years, or fat for more than 1.4 year. Prospective larger studies focusing on many other variables (skin phototype, injected device type) are required to achieve better conclusions.
authors.affiliation: Department of Dermatology, Hôtel-Dieu de France Hospital, Faculty of medicine, Saint Joseph University, Beirut, Lebanon.
authors.forename: Josiane
authors.initials: J
authors.lastname: Hélou
authors.forename: Ismaël
authors.initials: I
authors.lastname: Maatouk
authors.forename: Roy
authors.initials: R
authors.lastname: Moutran
authors.forename: Grace
authors.initials: G
authors.lastname: Obeid
authors.forename: Farid
authors.initials: F
authors.lastname: Stephan
keywords: Fractional CO2; safety implants; volume restoration