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CO2 laser
or
Colorado
needle?
Blepharoplasty
a success
with
either
modality
Jun 1,
2005
By: Beth
Kapes
Cosmetic
Surgery
Times
Special
Reports
San Diego
— The
coagulation
benefits
of using
the CO2
laser over
cold Siteel
for upper
and lower
eyelid
blepharoplasty
have been
confirmed,
yet there
isn't
anything
magical
about the
CO2 laser
in this
type of
surgery
that the
Colorado
needle and
an
electrocautery
device
cannot
achieve,
according
to Cameron
K.
Rokhsar,
M.D., of
The New
York
Aesthetic
Center,
and
assistant
professor
of
dermatology,
Mount
Sinai
School of
Medicine.
Recent
literature
concludes
that most
cosmetic
surgeons
prefer the
CO2 laser
over cold
Siteel for
blepharoplasty
due to
shorter
healing
times and
less
bruising
and
swelling
as a
result of
its
ability to
seal blood
vessels
and
lymphatics.
While its
effectiveness
cannot be
disputed,
there may
be no
reason as
to why a
surgeon
cannot use
the
Colorado
needle and
electrocautery
in the CO2
laser's
place for
both upper
and lower
eyelid
blepharoplasty.
In the
first ever
head-to-head
study of
the two
modalities
comparing
their
healing
parameters,
the study
found that
there is
no
difference
in the end
result.
Speaking
here at
the
American
Academy of
Cosmetic
Surgeons
Annual
Scientific
meeting,
Dr.
Rokhsar
elaborated
on data
that
brings
into
question
why the
CO2 laser
is thought
to be the
superior
tool for
blepharoplasty.
In his
study, 12
patients
underwent
upper
eyelid
blepharoplasty
and two
had lower
eyelid
blepharoplasty
completed
for
cosmetic
reasons.
In a
randomly
designed
protocol,
the
initial
incision
was made
with a
scalpel in
each eye,
while the
CO2 laser
followed
in one eye
and the
other eye
received
the
procedure
through
the
Colorado
needle and
electrocautery.
When
assessing
patients
postoperatively
at days
one,
three,
seven, 14
and 30,
using a
scale of
one to 10
in terms
of
ecchymosis,
bruising,
edema,
erythema
and pain,
the study
found
there was
no
significant
statistical
difference
in the
healing
parameters
at each
visit
comparing
the CO2
laser's
results
and those
completed
by the
Colorado
needle and
electrocautery,
according
to the
patient
and the
blinded
evaluator.
The time
it took to
operate on
each
eyelid was
also
similar
using
either
device. At
day 30, 25
percent of
patients
noted the
eyelids to
have
healed the
same, 33
percent
reported
the CO2
side to
have
healed
better,
and 42
percent
reported
that the
Colorado
needle
side
healed
better.
"The
Colorado
needle and
electrocautery,
in
essence,
have
similar
properties
because as
you're
cutting
you're
coagulating,"
Dr.
Rokhsar
says.
"This
study
shows
there is
no
difference
between
this
approach
and the
CO2
laser's
healing
benefits."
Beyond
healing
Although
the
Colorado
needle and
electrocautery
approach
mirrors
the CO2
laser's
healing
effects on
blepharoplasty,
there are
several
other
benefits
the
surgeon
should
consider
when
considering
the
alternative.
First and
foremost,
the
Colorado
needle
offers a
cost
savings
the CO2
cannot.
"Almost
all
surgeons
have an
electrocautery
device
that is
easily
hooked to
the
Colorado
needle,
which is
far less
expensive
than the
CO2
laser,"
Dr.
Rokhsar
says. "The
Colorado
needle is
much
easier to
maneuver
than the
CO2 laser,
which is
very
bulky.
Additionally,
if you're
using a
free beam
you have
no tactile
sensation.
The
Colorado
needle
approach
allows you
to feel as
you're
performing
the
blepharoplasty."
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