白领的整容手术（英文）Office-based Cosmetic Procedures.ppt

Office-based Cosmetic Procedures Glen T. Porter, MD David C. Teller, MD University of Texas Medical Branch at Galveston Dept. of Otolaryngology January 2005 Office-based Cosmetic Procedures Laser applications Intense pulsed light Chemical peels Dermabrasion Microdermabrasion Botox injection Injectable fillers Aesthetician-provided procedures Laser—basics Light Amplification by Stimulated Emission of Radiation Coherent photons in phase temporally/spatially Collimated tight beam, parallel paths Monochromatic one wavelength Laser--basics Fluency = energy per area J/cm2 Power density = energy rate J/second Frequency = wavelength nm Light can be: Reflected (bounces off) Scattered (random dispersal) Transmitted (passes through unchanged) Refracted (change in direction) Absorbed (maximal clinical benefit) Laser – emission modes Continuous Uninterrupted beam Relatively constant power Pulsed/Superpulsed (microsec) Higher energy/shorter duration pulses Q-switched (nanosec) Extremely high energy/short pulse duration Laser – tissue interaction Each tissue differs in absorption characteristics and relaxation time (time necessary to release 50% of energy) Pulse width relaxation time = chromophore targeted with little collateral spread of energy Cutaneous chromophores: water, melanin, hemoglobin Penetration is influenced by target chromophore (more absorption = less penetration) Laser spectrum Laser spectrum Laser Wavelength (nm) Application Er:YAG 294 Skin resurfacing Argon 488/514 Vascular lesions KTP:YAG 532 Vascular lesions Copper vapor 578 Vascular lesions FLPPD 585 Vascular lesions Long pulse 595-600 Leg veins Ruby, Q-switched 694 Tattoo removal Long pulse 694 Hair removal Q-switched Alexandrite 755 Tattoo removal Nd:YAG 1064 Deep vascular Q-switched YAG 1064 Tattoo removal CO2 10600 Cut/coag/resurf Intense Pulsed Light Noncoherent Multiple wavelengths (500-1200nm) Different handles with different ranges used for vascular lesions and hair ablatio