2 Ablative Rejuvenation

Mitalee P. Christman and Roy G. Geronemus

Summary

Ablative rejuvenation is still considered the gold standard for nonsurgical treatment of photoaging. Treatment options include both traditional full-field ablative and fractional ablative carbon dioxide and erbium:yttrium aluminum garnet lasers. The ideal candidate has fine static rhytides and appropriate expectations regarding recovery and results. A thorough preoperative consult is performed and antiviral and antibacterial prophylaxis is provided to the patient. A multipronged anesthetic strategy is often necessary for optimal pain management. During the treatment, careful attention is paid to the clinical endpoint of visible wrinkle effacement and total energy delivered to the treatment area. Laser-assisted drug delivery of poly-L-lactic acid, postprocedure peptide serums, and photomodulation might enhance results and patient satisfaction. Close clinical follow-up is warranted to monitor for infectious complications. Recognition of symptoms and signs of other possible complications including erythema, dyspigmentation, and scarring is critical to allow for early intervention. With careful preoperative, intraoperative, and postoperative care, ablative rejuvenation can be a very satisfying and successful procedure.

Schlüsselwörter

ablative resurfacing - ablative rejuvenation - ablative lasers - resurfacing - carbon dioxide - erbium:YAG

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