Collagen shrinkage (selective dermaplasty) with the high-energy pulsed carbon dioxide laser

BACKGROUND. The high-energy pulsed carbon dioxide (CO2) laser has proven useful for skin resurfacing. The modality can be less penetrating than chemical peels and more accurate than dermabrasion. OBJECTIVE. To demonstrate the additional benefit of dermal remodeling (selective dermaplasty) of skin lesions, scars, grafts, folds, and eyelids. METHODS. The collimated and the computerized pattern generator handpieces were used with the high-energy pulsed CO2 laser at 250-350 mJ to remodel tissue. Usually three or four passes were adequate to vaporize tissue and shrink collagen. RESULTS. A rejuvenated earlobe, eyelid, or forehead was produced in a predictable fashion. The tissue irregularities of scars, dog-ears, or trap-door deformities were reduced and remodeled. CONCLUSION. Dermal remodeling (selective dermaplasty) with the high-energy pulsed CO2 laser has proved a useful tool to remodel the skin. Areas such as the earlobe, the forehead, the eyelids, or skin lesions can be vaporized to develop a more youthful appearance. We find this a useful addition to the armamentarium of the cosmetic dermatologist. (C) 1998 by the American Society for Dermatologic Surgery, Inc.