Outcomes of Fractional CO2 Laser Application in Aesthetic Surgery: A Retrospective Review

Background: Despite the effectiveness of ablative CO2 laser resurfacing for facial rejuvenation, its application has been limited owing to an undesirable side-effect profile, including prolonged hyperemia and potential pigmentary changes. However, newer fractional CO2 laser technology has reduced the recovery time and led to decreases in postprocedural hypo-and hyperpigmentation. Objectives: The authors investigate the application and outcomes of ablative fractional technology in a private cosmetic surgery practice. Methods: In this retrospective cohort study, the charts of patients who received fractional CO2 laser resurfacing between March 2007 and May 2008 were reviewed. Data regarding patient demographics, pretreatment regimens, detailed operative data, and posttreatment findings were obtained. The length of hyperemia (less than five weeks, five to eight weeks, and more than eight weeks), complication rates, and revision rates were analyzed. A satisfaction survey was also sent to all patients. Results: Throughout the 19-month study period, 97 patients received 101 treatments with an average follow-up of 4.5 months. Full-face laser resurfacing was performed in 81.1% of patients, with 64.3% receiving their treatment under local anesthesia without sedation. Length of hyperemia was less than five weeks in 93%, five to eight weeks in 5.9%, and more than eight weeks in 0.9% of patients. Hyperpigmentation (9.9%), milia (6.9%), acne breakout (5.9%), and transient ectropion (0.9%) were less common. Patient satisfaction surveys revealed that a majority of patients were satisfied with their results. Conclusions: New fractional CO2 laser skin resurfacing is associated with shorter periods of hyperemia, resulting in shorter recovery time in comparison with older ablative technology. The side-effect profile is minor and infrequent. This new technology provides significant clinical improvement with high patient satisfaction.