Lasers and Lights PROCEDURES IN COSMETIC DERMATOLOGY
FOURTH EDITION
Edited by
George J.
Hruza MD, MBA
Adjunct Professor, Dermatology and Otolaryngology, Saint Louis University, Saint Louis; Medical Director, Laser & Dermatologic Surgery Center, Chesterfield, MO, USA
Elizabeth L. Tanzi, MD, FAAD
Director, Capital Laser and Skin Care, Chevy Chase, MD; Associate Professor of Dermatology, George Washington University School of Medicine, Washington, DC, USA
Series Editor
Jeffrey S. Dover MD, FRCPC, FRCP
Director, SkinCare Physicians, Chestnut Hill, MA; Associate Clinical Professor of Dermatology, Yale University School of Medicine; Adjunct Associate Professor of Dermatology, Brown Medical School, Providence, RI, USA
Associate Editor
Murad Alam MD, MSCI
Professor of Dermatology, Otolaryngology, and Surgery; Chief, Section of Cutaneous and Aesthetic Surgery; Vice-Chair, Department of Dermatology, Northwestern University, Chicago, IL, USA
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2018
Table of Contents
Cover image
Title Page
Series page
Copyright
Video contents
Series preface
Series preface first edition
Preface
List of contributors
Dedication
1 Understanding lasers, light sources, other energy-based technology
Light
Light interactions with skin
Skin optics
Selective photothermolysis
Skin cooling: limiting thermal damage to the intended targets
Fractional photothermolysis
Other energy-based technologies
Conclusion
References
Further reading
2 Laser treatment of vascular lesions
Introduction and history
Vascular anomalies classification
Port-wine stains
Infantile hemangiomas
Venous malformations
Venous lakes
Lymphangioma circumscriptum
Rosacea and telangiectasias
Approach to treatment of vascular lesions
Adverse effects and complications
Further reading
3 Laser treatment of pigmented lesions and tattoos
Introduction
Pigment removal principles
Lesion selection
Treatment techniques
Postoperative care
Further reading
4 Laser hair removal
Thermal collagen remodeling
Radiofrequency devices
Combined electrical and optical energy
Vacuum-assisted bipolar radiofrequency
Hybrid monopolar and bipolar radiofrequency
Infrared light devices
Ultrasound devices
Tips for maximizing patient satisfaction
Conclusion
Further reading
10 Laser treatment of ethnic skin
Introduction
Evaluating the patient with ethnic skin
Treatment of epidermal pigmentation
Treatment of dermal pigmentation
Treatment of dermoepidermal pigmentation
Treatment of vascular lesions
Ablative, nonablative, and fractional skin resurfacing
Conclusion
References
Further reading
11 Complications and legal considerations of laser and light treatments
Introduction
General considerations
Complications
General complications
Specific laser complications
Intense pulsed-light-specific complications
Legal aspects
Further reading
Index
Series page
Procedures in Cosmetic Dermatology
Series Editor: Jeffrey S. Dover MD, FRCPC, FRCP
Associate Editor: Murad Alam MD, MSCI
Chemical Peels
Second edition
Rebecca C Tung MD and Mark G Rubin MD
ISBN 978-1-4377-1924-6
Treatment of Leg Veins
Second edition
Murad Alam MD, MSCI and Sirunya Silapunt MD
ISBN 978-1-4377-0739-7
Body Contouring
Bruce E Katz MD and Neil S Sadick MD, FAAD, FAACS, FACP, FACPh
ISBN 978-1-4377-0739-7
Non-Surgical Skin Tightening and Lifting
Murad Alam MD, MSCI and Jeffrey S. Dover MD, FRCPC, FRCP
ISBN 978-1-4160-5960-8
Botulinum Toxin
Fourth edition
Alastair Carruthers MA, BM, BCh, FRCPC, FRCP(Lon) and Jean Carruthers MD, FRCSC, FRC(Ophth), FASOPRS
ISBN 978-0-323-47659-1
Soft Tissue Augmentation
Fourth edition
Jean Carruthers MD, FRCSC, FRC(Ophth), FASOPRS and Alastair Carruthers
MA, BM, BCh, FRCPC, FRCP(Lon)
ISBN 978-0-323-47658-4
Body Shaping: Skin Fat Cellulite
Jeffrey Orringer MD, Jeffrey S. Dover MD, FRCPC, FRCP and Murad Alam MD, MSCI
ISBN 978-0323321976
Cosmeceuticals
Third edition
Zoe Diana Draelos MD, Murad Alam MD, MSCI and Jeffrey S. Dover MD, FRCPC, FRCP
ISBN 978-0-323-29869-8
Lasers and Lights
Fourth edition
George Hruza MD and Elizabeth Tanzi MD
ISBN 978-0-323-48006-2
Photodynamic Therapy
Second edition
Mitchel P. Goldman MD
ISBN 978-1-4160-4211-2
Liposuction
C. William Hanke MD, MPH, FACP and Gerhard Sattler MD
ISBN 978-1-4160-2208-4
Scar Revision
Kenneth A. Arndt MD
ISBN 978-1-4160-3131-4
Hair Transplantation
Robert S. Haber MD and Dowling B. Stough MD
ISBN 978-1-4160-3104-8
Blepharoplasty
Ronald L Moy MD and Edgar F Fincher MD
ISBN 978-1-4160-2996-0
Content Strategist: Belinda Kuhn
Content Development Specialist: Joanne Scott
Project Manager: Srividhya Vidhyashankar
Design: Miles Hitchen
Illustration Manager: Nichole Beard
Video contents
Video 2.1 Laser Treatment of Vascular Lesions (1)
Iris Kedar Rubin, MD
Video 2.2 Laser Treatment of Vascular Lesions (2)
Thomas E. Rohrer, MD
Video 3.1 Laser Treatment of Pigmented Lesions and Tattoos
Kavita Mariwalla, MD
Video 3.2 Laser Treatment of Pigmented Lesions
Thomas E. Rohrer, MD
Video 4.1 Laser Hair Removal. Treatment Examples with Traditional Alexandrite 755nm and Diode 805nm Wavelengths
Omar A. Ibrahimi, MD, Suzanne L. Kilmer, MD
Video 4.2 Hair Reduction with an Intense Pulsed Light Device
Thomas E Rohrer, MD
Video 5.1 Non-Ablative Rejuvenation and Resurfacing using Combination 532nm/1064nm
Travis W. Blalock, MD, E. Victor Ross, MD
Video 5 2 Non-Ablative Laser Resurfacing
Thomas E. Rohrer, MD
Video 5.3 Skin Tightening with Radiofrequency: NdYAG
Thomas E Rohrer, MD
Video 5.4 Photodynamic Therapy
Thomas E. Rohrer, MD
Video 6 1 Non-Ablative Fractional Laser Rejuvenation
Jeffrey S. Dover, MD, FRCPC, FRCP
Video 7.1 Deep Erbium Laser Resurfacing
Jason N Pozner, MD
Video 7.2 Laser Skin Resurfacing: CO2 Laser
Thomas E. Rohrer, MD
Video 7.3 Fractionated Resurfacing of Scars
Thomas E. Rohrer, MD
Video 8 1 Non-Surgical Body Contouring: Cryolipolysis
Andrew A. Nelson, MD, Ray Jalian, MD, Mathew M. Avram, MD
Video 8.2 Non-Surgical Body Contouring: Cellutite
Thomas E Rohrer, MD
Video 9.1 Thermage Monopolar Radiofrequency
Michael S. Kaminer, MD, Melissa Bogle, MD
Video 9 2 Non-Surgical Skin Tightening with High Intensity Focused Ultrasound
Elizabeth L. Tanzi, MD, FAAD
Video 10.1 Laser Treatment of Ethnic Skin
Stephanie G. Y. Ho, MD, Henry H. L. Chan, MD
If you want to make sure you find the right book for your needs, you may wish to know what this book is and what it is not. It is not a comprehensive text grounded in theoretical underpinnings. It is not exhaustively referenced. It is not designed to be a completely unbiased review of the world's literature on the subject At the same time, it is not an overview of cosmetic procedures that describes these in generalities without providing enough specific information to actually permit someone to perform the procedures. Importantly, it is not so heavy that it can serve as a doorstop or a shelf filler. What this book and this series offer is a step-by-step, practical guide to performing cutaneous surgical procedures Each volume in the series has been edited by a known authority in that subfield. Each editor has recruited other equally practical-minded, technically skilled, hands-on clinicians to write the constituent chapters. Most chapters have two authors to ensure that different approaches and a broad range of opinions are incorporated. On the other hand, the two authors and the editors also collectively provide a consistency of tone A uniform template has been used within each chapter so that the reader will be easily able to navigate all the books in the series. Within every chapter, the authors succinctly tell it like they do it. The emphasis is on therapeutic technique; treatment methods are discussed with an eye to appropriate indications, adverse events, and unusual cases Finally, this book is short and can be read in its entirety on a long plane ride. We believe that brevity paradoxically results in greater information transfer because cover-to-cover mastery is practicable.
We hope you enjoy this book and the rest of the books in the series and that you benefit from the many hours of clinical wisdom that have been distilled to produce it. Please keep it nearby, where you can reach for it when you need it.
Jeffrey S. Dover MD, FRCPC, FRCP, Murad Alam MD, MSCI
List of contributors
The editor(s) acknowledge and offer grateful thanks for the input of all previous editions' contributors, without whom this new edition would not have been possible.
Macrene Alexiades MD, PhD
Associate Clinical Professor, Yale University School of Medicine; Adjunct Clinical Professor, Siggros Hospital, University of Athens; Founder and Director, Dermatology and Laser Surgery Center of New York CEO; Founder, Dr Macrene Skin Results 37 Actives, New York, NY, USA
Murad Alam MD, MSCI, Associate Professor of Dermatology, Otolaryngology, and Surgery; Chief, Section of Cutaneous and Aesthetic Surgery, Northwestern University, Chicago, IL, USA
R. Rox Anderson MD, Professor of Dermatology, Harvard Medical School; Director, Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Mathew M. Avram MD Dermatology Laser & Cosmetic Center, Massachusetts General Hospital, Boston, MA, USA
Lawrence S. Bass MD, FACS, Director, Minimally Invasive Plastic Surgery; Clinical Assistant Professor of Plastic Surgery, Department of Plastic Surgery, NYU School of Medicine, New York, NY, USA
Travis W. Blalock MD, Procedural Dermatology Fellow, Division of Dermatology and Dermatologic Surgery, Scripps Clinic, La Jolla, CA, USA
Melissa A. Bogle MD, Director, The Laser and Cosmetic Surgery Center of Houston; Associate Clinical Professor, The University of Texas Anderson Cancer Center, Houston, TX, USA
Andrew Breithaupt MD, Private Practice, Los Angeles, Clinical Instructor,
Division of Dermatology, University of California, Los Angeles, Ronald Reagan Medical Center, Los Angeles, CA, USA
Honorary Clinical Professor, Division of Dermatology, Department of Medicine, University of Hong Kong; Honorary Consultant Dermatologist, Queen Mary Hospital, Hong Kong, China; Visiting Scientist, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Chung-Yin Stanley Chan MD, Dermatologist/Mohs Surgeon, The Permanente Medical Group, Elk Grove, CA, USA
Nancy Cheng MD, Resident Physician, Department of Dermatology, University of California, Irvine, CA, USA
Barry E. DiBernardo MD, FACS
Director, New Jersey Plastic Surgery, Montclair, NJ;
Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
Catherine M. DiGiorgio MS, MD, Clinical Laser Fellow, Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, MA, USA
Jeffrey S. Dover MD, FRCPC, FRCP Director, SkinCare Physicians, Chestnut Hill, MA;
Associate Clinical Professor of Dermatology, Yale University School of Medicine
Adjunct Associate Professor of Dermatology, Brown Medical School, Providence, RI, USA
David J. Goldberg MD, JD Director, Skin Laser and Surgery Specialists of New York and New Jersey, Hackensack, NJ;
Clinical Professor of Dermatology and Director of Laser Research, Mount Sinai Medical School, New York, NY;
Clinical Professor of Dermatology and Director of Dermatologic Surgery, UMDNJ-New Jersey Medical School, NJ;
Adjunct Professor of Law, Fordham Law School, New York, NY, USA
Stephanie G.Y. Ho MB CHB, MRCP, FAMS, Director, Stephanie Ho Dermatology, Scotts Medical Center, Singapore
George J. Hruza MD, MBA
Adjunct Professor, Dermatology and Otolaryngology, Dermatology, Saint Louis
Dedication
To my “Hrilliams” family: my wife Carrie Hruza, OD and our children, Stephanie and Paul Hruza and Hope and Rose Williams for giving my life joy and fulfillment.
To my parents: Drs. Judita and Zdenek Hruza for their support and encouragement in pursuing my medical career and their unwavering love.
In memory of my mother, Judita Hruza, MD, with her Holocaust experiences of inhumanity and survival and her incredible zest for life, forgiveness, and sacrifice, she inspired many and will always be an inspiration to me to live life to the fullest with charity and grace.
George J. Hruza MD, MBA
To my parents, Joe and Lyn, who taught me through example the power of an unpretentious yet unwavering work ethic.
To my wonderful husband, Big Pete, whose love, support and attitude inspire me to always take on the next challenge.
To my children, Peter and Katie, who remind me every day what is truly important in life. Oh, how I love those smiles!
Elizabeth L Tanzi MD, FAAD
To the women in my life: my grandmothers, Bertha and Lillian, my mother, Nina, my daughters, Sophie and Isabel, and especially to my
