Report Technique

■ Crow's feet in the lower-lid area can be treated well with the erbium-YAG laser. The advantage of this non-invasive procedure, which can be carried out on an outpatient basis, is the rapid healing of the treated sites. Following disinfection and anesthesia of the operation site (e.g., blocking of the infraorbital nerve), the boundaries of the section to be treated by laser are first defined. The laser is then guided evenly, section by section, over the area to be ablated. Slight overlapping will not be harmful. The use of the erbium-YAG laser as an additional resource during plastic/aesthetic procedures, e.g., facelift or blepharoplasty, is an elegant, non-invasive way of treating wrinkles and creases in aged and sun-damaged facial skin quickly, especially around the mouth and eyes and on the forehead and cheeks. When used correctly, possible risks such as abnormal pigmentation and scarring are virtually ruled out. The effect achieved is good when smoothing superficial and medium-depth skin wrinkles. When treating deeper skin wrinkles, there is definitely an improvement in the overall appearance, but the wrinkles cannot be

First Pass Effect

A 39-year-old female patient with deep lower-lid creases. Six weeks after erbium-YAG laser treatment. (First pass: fluence 5.7 J/cm2 at 8 Hz, Second pass: fluence 4.2 J/cm2 at 8 Hz)

completely removed. In this case, CO2 laser treatment is more effective. Wound discharge and crust formation are less pronounced following erbium-YAG laser treatment and do not persist for as long as with CO2 laser treatment. There is also less postoperative skin reddening and this reduces more quickly.

■ Use of the erbium-YAG laser for patients who have aesthetically disturbing skin changes in the facial area that are not yet too severe can therefore enhance the spectrum of practical work performed by surgeons with an interest in skin surgery.

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