Split face evaluation of long-pulsed non-ablative 1,064 nm Nd:YAG laser for treatment of direct browplasty scars

PURPOSE

To investigate 1,064 nm long-pulse Nd:YAG laser for postoperative treatment of direct browplasty scars.

METHODS

Nine patients who underwent direct browplasty were enrolled in this prospective study. Subjects were randomized to unilateral laser treatment at 2-week intervals for six total treatments, with the contralateral scar used as a control. Prior to each treatment, subjects rated treated and control scars on overall cosmesis. Post-treatment, subjects rated each for erythema, swelling, discomfort, and perceived hair loss. Finally, examiners masked to treatment side were asked to judge side-by-side photographs of first and final visits for improvement and side effects.

RESULTS

Subjects rated the overall appearance of the treated scar significantly higher at the time of treatment number 5 (mean score 5.13 ± 2.03, P = 0.008) and treatment number 6 (6.25 ± 1.98, P = 0.005) compared to treatment 1 (3.75 ± 2.12); by contrast, they failed to rate the control scar more highly. On masked examination of photographs, the treated scar was selected as most improved 50.0 ± 12.5% of the time. Both subjects and graders reported side effects as transient and mild to moderate (mean score 1-4), with no reports of hair loss from either subjects or observers.

CONCLUSIONS

The 1,064 nm Nd:YAG laser provided significant improvement in scar cosmesis after direct browplasty, as rated by subject self-report, but not by masked observers, and appears to be a useful tool for increasing satisfaction among those dissatisfied with direct browplasty scars. Side effects-including erythema, edema, and discomfort-were transient and universally rated as mild to moderate. Lasers Surg. Med. 48:742-747, 2016. © 2016 Wiley Periodicals, Inc.

How to correct frontal facialis palsy after radical tumour surgery: upper blepharoplasty and direct brow lift

Radical surgery of fronto-temporal non-melanoma skin cancer (NMSC) sometimes causes palsy of the frontal facialis branch. Patients may experience visual impairment due to brow and upper eyelid ptosis. Since NMSC predominantly affects elderly people, the corrective surgical procedures have to be adapted to age, comorbidities and individual needs. The direct brow lift and the upper lid blepharoplasty are two reliable and safe surgical techniques with proved efficacy. Here we present our way to deal with post-surgical brow and lid ptosis.