Just
How Bright is the Cosmetic Laser's Limelight?
by Corey Senn |
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Just
last October, Time Magazine ran an article touting the cosmetic
laser as "the hottest medical accoutrement since the
stethoscope." It is interesting, then, that many within
the medical community see the laser as an overrated tool for
quite a number of image enhancing procedures. These two opposing
opinions beg the question, "where exactly does the truth
about the laser lie?"
"The
medical community is starting to see the limitations of laser
procedures. Although they are very easy to control, lasers
are certainly not for everyone."
--
Paul Pin, MD
Lasers,
after all, are nothing more than light energy filtered though
a specific medium and pulsed onto a particular part of the
body. Although they are used for many procedures, lasers cannot
always accomplish the patients desired results. The field
of plastic/cosmetic surgery provides an insightful illustration
of this point.
Lasers
for Cosmetic Surgery
According
to the most recent statistics from The American Society of
Plastic Surgeons (ASPS), the most sought-after cosmetic procedures
last year were liposuction, breast augmentation/lift, eyelid
surgery, and facelifts, all invasive procedures performed
through an incision. The reason for this is that at the root
of many image-enhancing procedures lies the desire to alter
the shape of the body. Breast augmentation and liposuction
are procedures that seek to sculpt a more attractive figure.
By contrast, cosmetic lasers do not, in any significant way,
change the physical shape of the body. While lasers tighten
skin and remove blemishes, they are not the shape shifters
that create the sort of changes that many individuals desire.
Of
course, lasers are used in many specialties other than plastic/cosmetic
surgery, including dentistry, ophthalmology, dermatology,
and otolaryngology. But it is really only in the field of
ophthalmology that the laser stands out as the preeminent
tool. The most popular procedures to improve nearsightedness,
PRK and LASIK, would be nonexistent without the use of the
laser. According to Greg Fava, Director of Product Marketing
for the Iridex Corp., "Lasers have been most successful
in the field of ophthalmology, and, in the long run, will
probably remain the only way to treat certain conditions."
With regard to other specialties, the laser is certainly used,
but it is less clear whether it is always the right tool for
the job.
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The
most sought-after cosmetic procedures last year were liposuction,
breast augmentation/lift, eyelid surgery, and facelifts,
all invasive procedures performed through an incision.
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The
Drawbacks to Laser Surgery
Make no mistake about it, laser treatments have drawbacks.
Principal among them is the fact that they are, often times,
more expensive than alternative approaches. As Delwin K. McCarthy,
DDS, a former faculty member of UCLA's School of Dentistry
points out, of the many uses for a laser in cosmetic dentistry,
periodontal work is perhaps the only financially justifiable
use for the laser. Lasers are expensive, ranging anywhere
in price from $50,000 to $500,000. This is a formidable investment
for a physician. This steep price tag means a physician is
more apt to push the more expensive cosmetic laser procedures
onto their clientele. As Pin comments, "in general surgery,
sometimes the laser can be used, but there are often other
types of electronic devices that can be used that are a lot
cheaper to use and maintain." Many times, the main benefit
of the higher cost laser procedure is less time spent in the
doctor's chair.
Another
concern with laser treatments performed on the skin is the
risk of changes in skin pigmentation. This is especially true
for individuals with darker skin. Darker skin contains more
melanin, which absorbs more of the light's energy. Changes
to the skin's pigmentation can often be as frustrating as
the original problem.
As
with any procedure, success hinges on a physician's ability
to effectively utilize the equipment. Typically, a laser can
be controlled very easily. Yet, in the hands of an inexperienced
doctor, the fairly intense heat generated by the laser can
cause serious thermal damage to the skin or irreparable damage
to sensitive areas such as the eyes. Seeking out a physician
with a proven track record using the laser for cosmetic procedures
is the safest route to avoid the potential for complication.
The
Laser's Legacy
Because
of their effectiveness for specific procedures, lasers should
be here to stay. Once again, Dr. Pin: "Lasers are exceptionally
good for people with really deep wrinkling. It is probably
the one time when the laser is superior to the chemical peel.
It can erase much of the wrinkling, and the side effects (irritated
skin) are no worse than with the chemical peels." The
laser has also proved itself very effective for LASIK and
PRK surgery,for erasing skin blemishes (such as port wine
stains),and for application in the field of periodontics.
More
importantly, lasers represent an important step towards the
next phase in cosmetic skin technology --namely, the removal
of unwanted wrinkles, blemishes, and tissue, without the thermal
damage. As Pin states, "the ideal is the next mechanism
in the evolution that tightens the skin without the burning
process." If lasers can make this a reality, then they
will truly deserve a place among medical devices- such as
the stethoscope- in the annals of medicine.
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