Orlando, Florida-for years, the fully abstract renewal of laser skin in which the skin is removed using carbon dioxide lasers or Serbio-has fallen among the energy-based medicine and their patients due to long recovery times and the need for general recovery.
The fractional abstraction of laser, a less invasive procedure that makes tiny holes in the skin and leaves around the skin intact, became more popular, along with non -collagen stimulation.
But in the US Medical and Surgery Company (ASLMS) 2025, held from April 24 to 26, several presenters talked about a “resurgence” of the full removal approach.
They mentioned two reasons: First, the results of fractional treatments were not as dramatic or durable as we hoped, especially in elderly patients and, secondly, newer laser technologies allow for the execution of posting without general anesthesia and with the treatment times closer to those who are close to those who are close to those who are close to those who are close to those who are observed.
Banning many of his colleagues at the conference, Oculofacial Surgeon Brian Biesman, MDat the University of Vanderbilt, who is in a private practice in Nashville, Tennessee, said that in recent years he has returned to execute full equipment procedures after giving them a rest.
“The moment for me was when I saw a patient I knew I had seen several years ago,” Biesman said in an interview. ‘I didn’t remember what [procedure] I had done, and I thought it needed a laser renewal. I opened her graph and realized that I had made a fractional abstract renewal in the 3 years ago. Then I decided that for what we put on people, they must have a better effect than 3 years later. I decided to return to more aggressive approaches. ”
Dermatological surgeon Thomas Rohrer, mdwho is in private practice in Chestnut Hill, Massachusetts, said in an interview that in order to deal with deeper lines, especially in some parts of the face, “we come to a consensus we need this more aggressive treatment.
Abstract treatment with less pain and less recovery
While the abstract processes using technologies tested by time-leiser CO2 and Erbium-also make a return, Rohrer and other experts pointed out a newer device described as a change game: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The: The Undue 2910 Nm cold abstract fractional laser, cleared by the US Food and Drug Administration in 2022 for the treatment of photography, wrinkles and acne scars, which have since seen his Indications expanded to include certain types of colored lesions.
The device can be used in fractional abstract or fully abstract settings. It does not heat the tissue the way traditional abstract lasers do. This results in reduced pain and shorter recovery time and offers additional protection from sub-colors, a basic concern with darker skin types.
The 2910 Nm laser “has really rejuvenated our practice of reappearance in patients aged 50 to 80” Paul Friedman, MDwho is in a private practice in Houston, “because of the comfort of the patient and the fastest recovery process”, which may be as little as a week compared to a month or more for other technologies.
Laser 2910 Nm abstract procedures usually require only “local anesthesia and occasional nitrogen oxide,” Friedman told the meeting. “Before this technology, in traditional ways of renewal, we found it more effective to bring an anesthesiologist, but obviously there is hesitation from patients about it.”
Suzanne Kilmer, MDA dermatologist at the University of California, Davis, California, which is also in private practice in Sacramento, California, and a widely recognized expert in full abstraction, said he was still aware of the device. It has not yet used the 2910 Nm laser for a fully abstract process, he said, sticking to its fractional settings.
“I use it in combination with traditional Erbium and CO2 lasers,” Kilmer said in an interview, adding that he is fine with going slowly for now. “There is always a learning curve with devices,” he warned. “And you learn about dangerous procedures.”
Prevention and mitigation of complications
Complete removal “is a great process – there is nothing else like this,” Kilmer continued. But as opposed to fractional treatments, it also means that “you have removed the entire top of the skin. There is a huge open wound.
During different seminars at the conference, experts offered strategies to avoid treatment-related complications, including sub-colors, scarring and infections. They talked about choosing patients who are likely to comply with demanding protocols after care, emphasizing how to rescue cases where patients did not.
And they distributed stories of terror of patients who went 3 days after abstract treatment, accidentally remained in injuries, who developed serious erythema or scars or developed serious infections despite the use of anti -visual and antibiotic protection. With some of these complications, the professionals have recognized that there is little consensus on how to be addressed.
Jacqueline Watchmaker, MDA dermatologist in private practice in SCOTTSDALE, Arizona, reviewed the case of a patient who developed severe bacterial infection after removal due to non -compliance with post -care recommendations. It is important to know how soon the infections are likely to occur, the watchmaker said and to know the signs – especially the pain that is growing during the days. It is also important to carefully choose patients for the possibility of compliance, he added.
Other presenters discussed ways to improve compliance, such as video production.
Dermatologist Arisa ortiz, mdDirector of Laser Dermatology and Cosmetics, at UC San Diego Health, San Diego and the previous president of ASLMS warned that even with antibiotic and antique protection, patients can develop renovated infections that require emergency treatment. The right type of antibiotic prophylaxis remains controversial in fully abstract reconnection, he noted. Any apparent infections should be cultivated before treatment and systemic infections that require hospital care may occur.
Biesman, in his comments, agreed that the protection of antibiotics remains a controversial issue with the removal of renewal. “The argument from infectious disease is that you do not need antibiotic prophylaxis,” he told the conference, but in practice it is standard. And while many clinicians use cefalexin, which does not prevent infections Meticillin resistant Staphylococcus aureusor MRSA, “You really have to think about MRSA’s cover” when you prescribe an antibiotic, he said.
Friedman, Biesman and Kilmer have revealed financial relationships with Acclaro, a 2910 Nm Ultraclear Laser manufacturer, along with other devices manufacturers, pharmaceutical manufacturers and/or skin care companies. Rohrer revealed relationships with Candela and Lumenis. Watchmaker revealed relationships with Abbvie and Allergan. Ortiz revealed financial relations with several companies.
