Lasers and Lights: Procedures in Cosmetic Dermatology Series

157 Pages·2012·6.59 MB·English

by  George J Hruza MD

Lasers and
Lights
Procedures in Cosmetic Dermatology
Series Editor; Jeffrey S. Dover MD, FRCPC, FRCP
Associate Editor: Murad Alam MD
Chemical Peels Lasers and Lights
Second edition Third edition
Rebecca C. Tung, MD and Mark G. Rubin MD George Hruza MD and Mathew Avram MD
ISBN 978-1-4377-1924-6 ISBN 978-1-4557-2783-4
Treatment of Leg Veins Photodynamic Therapy
Second edition Second edition
Murad Alam, MD and Sirunya Silapunt, MD Mitchel P. Goldman MD
ISBN 978-1-4377-0739-7 ISBN 978-1-4160-4211-2
Body Contouring Liposuction
Bruse E Katz MD and Neil S Sadick MD FAAD FAACS C. William Hanke MD MPH FACP and Gerhard Sattler MD
FACP FACPh ISBN 978-1-4160-2208-4
ISBN 978-1-4377-0739-7
Scar Revision
Non Surgical Skin Tightening and Lifting Kenneth A Arndt MD
Murad Alam MD MSCI ISBN 978-1-4160-3131-4
and Jeffrey S Dover MD RCPC FRCP
ISBN 978-1-4160-5960-8 Hair Transplantation
Robert S. Haber MD and Dowling B Stough MD
Botulinum Toxin ISBN 978-1-4160-3104-8
Third Edition
Alastair Carruthers MA BM BCh FRCPC FRCP(Lon) and Blepharoplasty
Jean Carruthers MD FRCSC FRC(Ophth) FASOPRS Ronald L. Moy MD and Edgar F Fincher MD
ISBN 978-1-4557-2781-0 ISBN 978-1-4160-2996-0
Soft Tissue Augmentation Advanced Face Lifting
Third Edition Ronald L. Moy MD and Edgar F Fincher MD
Jean Carruthers MD FRCSC FRC(Ophth) FASOPRS and ISBN 978-1-4160-2997-7
Alastair Carruthers MA BM BCh FRCPC FRCP(Lon)
ISBN 978-1-4557-2782-7
Cosmeceuticals
Second edition
Zoe-Diana Draelos MD
ISBN 978-1-4160-5553-2
For Elsevier
Content Strategist: Belinda Kuhn
Content Development Specialist: Martin Mellor Publishing Services Ltd
Project Manager: Sruthi Viswam
Design: Miles Hitchen
Illustration Manager: Jennifer Rose
Marketing Manager: Carla Holloway
3rd PROCEDURES IN COSMETIC DERMATOLOGY
Edition
Lasers and
Lights
Edited by
George J. Hruza MD, MBA
Clinical Professor, Dermatology, Saint Louis University, Saint Louis;
Medical Director, Laser & Dermatologic Surgery Center, Chesterfeld, MO, USA
Mathew M. Avram MD, JD
Assistant Professor of Dermatology, Harvard Medical School;
Affliate Faculty, Wellman Centerfor Photomedicine;
Director, Massachusetts General Hospital Dermatology Laser & Cosmetic Center, Boston, MA, USA
Series Editor
Jeffrey S. Dover MD, FRCPC, FRCP
Associate Professor of Clinical Dermatology, Yale University School of Medicine, New Haven, CT;
Adjunct Professor of Medicine (Dermatology), Dartmouth Medical School, Hanover, NH;
Adjunct Associate Professor of Dermatology, Brown Medical School, Providence, RI;
Director, SkinCare Physicians, Chestnut Hill, MA, USA
Associate Editor
Murad Alam MD
Professor of Dermatology, Otolaryngology, and Surgery;
Chief, Section of Cutaneous and Aesthetic Surgery,
Northwestern University, Chicago, IL, USA
For additional online content visit expertconsult.com
London New York Oxford St Louis Sydney Toronto 2013
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First edition 2005
Second edition 2009
Third edition 2013
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Notices
Knowledge and best practice in this feld are constantly changing. As new research
and experience broaden our understanding, changes in research methods,
professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and
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CONTENTS
Series Preface to the Third edition vii 6 Non-ablative Fractional Laser 
Rejuvenation 59
Series Preface (First edition) ix
Chung-Yin Stanley Chan, Andrei Metelitsa,
Preface to the Third edition xi
Jeffrey S. Dover
Contributors xiii
Dedication xv
7 Laser Resurfacing 72
Jason N. Pozner, Barry E. DiBernardo,
  1  Understanding Lasers, Lights, and 
Lawrence S. Bass
Tissue Interactions 1
Fernanda H. Sakamoto, H. Ray Jalian,
8 Non-Surgical Body Contouring 86
R. Rox Anderson
Andrew A. Nelson, Mathew M. Avram
2 Laser Treatment of Vascular Lesions 10
9 Non-surgical Skin Tightening 97
Iris Kedar Rubin, Kristen M. Kelly
Melissa A. Bogle, Michael S. Kaminer
3 Laser Treatment of Pigmented Lesions 
10 Laser Treatment of Ethnic Skin 114
and Tattoos 20
Stephanie G.Y. Ho, Henry H.L. Chan
Kavita Mariwalla, George J. Hruza
11 Complications and Legal Considerations 
4 Laser Hair Removal 33
of Laser and Light Treatments 130
Omar A. Ibrahimi, Suzanne L. Kilmer
David J. Goldberg, Jeremy Man
5 Non-ablative Laser and Light Skin 
Index 137
Rejuvenation 47
Travis W. Blalock, E. Victor Ross
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SERIES PREFACE TO THE THIRD EDITION
Seven years ago we embarked on an effort to produce Our commitment has always been to ensure that the
Procedures in Cosmetic Dermatology, a series of high practical, easy to use information conveyed in the series
quality, practical, up-to-date, illustrated manuals. Our is also extremely up-to-date, incorporating all the latest
plan was to provide dermatologists, dermatologic sur- methods and materials. To that end, given the rapidly
geons, and others dedicated to the pursuit of functional changing nature of our subspecialty, the time has now
knowledge with detailed portable books accompanied by come to inaugurate the third edition. During the next
high quality “how to” DVD’s containing all the informa- few years, refned, enlarged, and improved texts will be
tion they needed to master most, if not all, of the leading released in a sequential manner. The most time-sensitive
edge cosmetic techniques. Thanks to the efforts of world books will be revised frst, and others will follow.
class volume editors, master chapter authors, and the tire- This series is an ever evolving project. So in addition
less and extraordinary publishing staff at Elsevier, the to third editions of current books, we will be introducing
series has been more successful than any of us could have entirely new books to cover novel procedures that may
imagined. Over the past seven years, 15 distinct volumes not have existed when the series began. Enjoy and keep
have been introduced, and have been purchased by thou- learning.
sands of physicians all over the world. Originally published
in English, many of the texts have been translated into Jeffrey S. Dover MD FRCPC and
different languages including Italian, French, Spanish, Murad Alam MD, MSCI
Chinese, Polish, Korean, Portuguese, and Russian.
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SERIES PREFACE FIRST EDITION
While dermatologists have been procedurally inclined book is to serve as a practical primer on a major topic area
since the beginning of the specialty, particularly rapid in procedural dermatology.
change has occurred in the past quarter century. The If you want to make sure you fnd the right book for
advent of frozen section technique and the golden age your needs, you may wish to know what this book is and
of Mohs skin cancer surgery has led to the formal incor- what it is not. It is not a comprehensive text grounded in
poration of surgery within the dermatology curriculum. theoretical underpinnings. It is not exhaustively refer-
More recently technological breakthroughs in minimally enced. It is not designed to be a completely unbiased
invasive procedural dermatology have offered an aging review of the world’s literature on the subject. At the
population new options for improving the appearance of same time, it is not an overview of cosmetic procedures
damaged skin. that describes these in generalities without providing
Procedures for rejuvenating the skin and adjacent enough specifc information to actually permit someone
regions are actively sought by our patients. Signifcantly, to perform the procedures. And importantly, it is not so
dermatologists have pioneered devices, technologies heavy that it can serve as a doorstop or a shelf fller.
and medications, which have continued to evolve at a What this book and this series offer is a step-by-step,
startling pace. Numerous major advances, including virtu- practical guide to performing cutaneous surgical proce-
ally all cutaneous lasers and light-source-based proce- dures. Each volume in the series has been edited by a
dures, botulinum exotoxin, soft tissue augmentation, known authority in that subfeld. Each editor has recruited
dilute anesthesia liposuction, leg vein treatments, chemi- other equally practical-minded, technically skilled, hands-
cal peels, and hair transplants have been invented, or on clinicians to write the constituent chapters. Most chap-
developed and enhanced by dermatologists. Dermatolo- ters have two authors to ensure that different approaches
gists understand procedures and we have special insight and a broad range of opinions are incorporated. On the
into the structure, function, and working of skin. Cos- other hand, the two authors and the editors also collec-
metic dermatologists have made rejuvenation accessible to tively provide a consistency of tone. A uniform template
risk-averse patients by emphasizing safety and reducing has been used within each chapter so that the reader will
operative trauma. No specialty is better positioned than be easily able to navigate all the books in the series. Within
dermatology to lead the feld of cutaneous surgery while every chapter, the authors succinctly tell it like they do
meeting patient needs. it. The emphasis is on therapeutic technique; treatment
As dermatology grows as a specialty, an ever-increasing methods are discussed with an eye to appropriate indica-
proportion of dermatologists will become profcient in the tions, adverse events, and unusual cases. Finally, this book
delivery of different procedures. Not all dermatologists is short and can be read in its entirety on a long plane ride.
will perform all procedures, and some will perform very We believe that brevity paradoxically results in greater
few, but even the less procedurally directed amongst us information transfer because cover-to-cover mastery is
must be well-versed in the details to be able to guide and practicable.
educate our patients. Whether you are a skilled dermato- We hope you enjoy this book and the rest of the books
logic surgeon interested in further expanding your surgical in the series and that you beneft from the many hours of
repertoire, a complete surgical novice wishing to learn a clinical wisdom that have been distilled to produce it.
few simple procedures, or somewhere in between, this Please keep it nearby, where you can reach for it when
book and this series are for you. you need it.
The volume you are holding is one of a series entitled
Procedures in Cosmetic Dermatology. The purpose of each Jeffrey S. Dover MD FRCPC and Murad Alam MD