RESUMEN
Cosmetic, functional, and structural sequelae of scarring are innumerable, and measures exist to optimize and ultimately minimize these sequelae. To evaluate the innumerable methods available to decrease the cosmetic, functional, and structural repercussions of scarring, pubMed search of the English literature with key words scar, scar revision, scar prevention, scar treatment, scar remodeling, cicatrix, cicatrix treatment, and cicatrix remodeling was done. Original articles and reviews were examined and included. Seventy-nine manuscripts were reviewed. Techniques, comparisons, and results were reviewed and tabulated. Overall, though topical modalities are easier to use and are usually more attractive to the patient, the surgical approaches still prove to be superior and more reliable. However, advances in topical medications for scar modification are on the rise and a change towards medical treatment of scars may emerge as the next best approach. Comparison studies of the innumerable specific modalities for scar revision and prevention are impossible. Standardization of techniques is lacking. Scarring, the body's natural response to a wound, can create many adverse effects. At this point, the practice of sound, surgical fundamentals still trump the most advanced preventative methods and revision techniques. Advances in medical approaches are available, however, to assist the scarring process, which even the most advanced surgical fundamentals will ultimately lead to. Whether through newer topical therapies, light treatment, or classical surgical intervention, our treatment armamentarium of scars has expanded and will allow us to maximize scar prevention and to minimize scar morbidity.
Asunto(s)
Cicatriz/terapia , Procedimientos Quirúrgicos Dermatologicos , Terapia por Láser , Administración Cutánea , Alantoína/administración & dosificación , Antimitóticos/uso terapéutico , Toxinas Botulínicas Tipo A/uso terapéutico , Cicatriz/fisiopatología , Cicatriz/prevención & control , Dermabrasión , Procedimientos Quirúrgicos Dermatologicos/métodos , Combinación de Medicamentos , Heparina/administración & dosificación , Humanos , Extractos Vegetales/administración & dosificación , Geles de Silicona/administración & dosificación , Sitoesteroles/administración & dosificación , Factor de Crecimiento Transformador beta3/uso terapéuticoRESUMEN
BACKGROUND: In the United States, liposuction is the most commonly performed cosmetic surgical procedure. Laser lipolysis is the latest adjunct to liposuction. This technique employs laser energy to induce lipolysis and hemostasis and stimulate neocollagenesis. Multiple laser systems have been studied. METHODS: PubMed literature search with the key words laser lipolysis and laser assisted liposuction. Original articles that studied the internal application of laser energy to adipose tissue were reviewed and included. RESULTS: Nineteen manuscripts were reviewed. One double-blind randomized controlled trial compared laser liposuction with tumescent liposuction. Several authors claimed that laser lipolysis offers fewer side effects than "traditional" liposuction performed under general anesthesia. A true objective comparison with tumescent liposuction is missing in the literature. LIMITATIONS: Comparison studies between laser-assisted lipolysis and conventional liposuction are limited, as are comparisons between the different laser systems and wavelengths. Standardization of laser energy settings is lacking. CONCLUSION: Laser-assisted lipolysis is a safe and efficacious procedure that may possess advantages over conventional liposuction. Lipolysis occurs in a dose-response relationship. No advantage over tumescent liposuction has been demonstrated. A specific laser wavelength may prove superior for each clinical application, but more studies are needed.