title: Efficacy of serial excisions of melanocytic nevi on the face using a carbon dioxide laser: a cosmetic point of view.
abstract: In cosmetic clinical practice, many patients express the desire for removal of melanocytic nevi, especially those on the face. The carbon dioxide (CO2) laser currently is the preferred for treatment of such lesions because of less scar formation, less bleeding, and simplicity of the procedure. However, if the diameter of the lesion is greater than 5 mm, many clinicians prefer surgical resection to laser resection because laser resection of relatively large nevi often results in the formation of a conspicuous dimple. The authors developed a serial laser excision method for melanocytic nevi larger than 5 mm, with division of the lesion into multiple segments, which allowed the ablated area to gain optimal granulation and reepithelialization, leading to a satisfactory cosmetic appearance. This novel procedure was performed for 25 patients with melanocytic nevi ranging from 5 to 10 mm in diameter. The lesions were divided into two segments in 21 patients, three segments in 3 patients, and four segments in 1 patient. The divided parts of the lesions were ablated by CO2 laser serially at intervals of 2-4 weeks. All the patients obtained optimal granulation and epithelialization in the treated lesions, and the final appearance was satisfactory. Although the therapeutic period was longer than for a surgical excision or a single laser treatment, the new treatment approach of serial excision by CO2 laser achieved favorable outcomes for the treatment of relatively large nevi 5-10 mm in size.
  
  
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authors.affiliation: Department of Plastic Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan, zakimin@nifty.com.
authors.forename: Mine
authors.initials: M
authors.lastname: Ozaki
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Suga
authors.forename: Hitomi
authors.initials: H
authors.lastname: Eto
authors.forename: Yoh
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Rei
authors.initials: R
authors.lastname: Watanabe
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takushima
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Harii
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D004954:Esthetics; D005145:Face / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009508:Nevus, Pigmented / Q000473:pathology / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult