Laser Technique

Although beyond the primary scope of this chapter, it is worthwhile to briefly discuss our laser technique when combined with deep-plane facelifting. We classify our laser technique as moderately aggressive. Because settings vary from instrument to instrument, it is important to realize that wise surgeons will always start at low intensities until they are familiar with the effects of their unit. We use a Luxar CO2 laser. Before surgery, we mark the deepest lines of the patient. After prepping, and before surgery, we etch the deepest lines with several passes using a superpulse setting of 6 to 8 W. The char is wiped off and we then proceed with the facelift.

After the facelift is complete, using a computerized scanner, we treat the entire face with a single pass using 9 W of energy with the scanner set at maximum density. We feather into the neck to avoid a demarcated line. We do not wipe the char, but rather apply a layer of Catrix, which the patient is instructed to reapply frequently during recovery. Complete healing of the wound is expected in 8 to 10 days.

There is no question that patient satisfaction seems higher in our patients undergoing combined treatment compared with facelift alone. We expect that this practice will become much more accepted in the future.

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