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Published in: Aesthetic Plastic Surgery 5/2022

01-04-2022 | Silicone | Original Article

Efficacy of Early Application of 1540 nm Non-ablative Fractional Laser and Silicones to Improve Post-epicanthoplasty Scars

Authors: Bingyan Zhang, E Yang, Hengshu Zhang

Published in: Aesthetic Plastic Surgery | Issue 5/2022

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Abstract

The combination of epicanthoplasty and blepharoplasty is a popular choice in Asians to acquire a pair of charming big eyes. However, the obvious scarring in the medial canthal area may result in unsatisfactory aesthetic outcomes. Recently, various laser treatments have been used to deal with scars had achieved detectable improvement, but only a few studies investigating the efficacy of lasers used in post-epicanthoplasty scarring were developed. A total of 70 participants who underwent Z-epicanthoplasty were enrolled in this prospective clinical trial and were randomly assigned to the groups of 1540nm non-ablative fractional laser (NAFL) combined with silicones treatment and silicones alone treatment. The NAFL-exposure in the treated group was additionally applied to the medial canthal area on day 21 postoperatively, compared with the participants in the control group who had only been treated with the daily usage of silicone sheets for 12 hours and silicone gels twice for 5 months after scab had fallen from the skin. Scar evolution was performed by patient and observer scar assessment Scales (POSAS) and visual analogue scale (VAS) for 21 days, and 6 months postoperatively. 64 participants have completed the entire follow-up process. The scar recovery was statistically detected in treated group compared with the control group at 6-month postoperatively assessed by POSAS, especially in pliability of scars. Furthermore, the VAS evaluations showed superior satisfaction in treated group. The early treatment of NAFL combined with silicones has improved scar formation in medial canthal region after epicantholplasties efficiently.
Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Ni F, Luo S, Yu D, Zhu Y, Shang Y, Chen Y, Xu H, Wang Q, Hao L (2016) Scarless epicanthoplasty and concomitant double eyelidplasty in Chinese eyelids. Aesthet Plast Surg 40:840–845CrossRef Ni F, Luo S, Yu D, Zhu Y, Shang Y, Chen Y, Xu H, Wang Q, Hao L (2016) Scarless epicanthoplasty and concomitant double eyelidplasty in Chinese eyelids. Aesthet Plast Surg 40:840–845CrossRef
2.
go back to reference Wang S, Shi F, Luo X, Liu F, Zhou X, Yang J, Yang Q, Wang X (2013) Epicanthal fold correction: our experience and comparison among three kinds of epicanthoplasties. J Plast Reconstr Aesthet Surg 66:682–687CrossRef Wang S, Shi F, Luo X, Liu F, Zhou X, Yang J, Yang Q, Wang X (2013) Epicanthal fold correction: our experience and comparison among three kinds of epicanthoplasties. J Plast Reconstr Aesthet Surg 66:682–687CrossRef
3.
go back to reference Huang RL, Ho CK, Tremp M, Xie Y, Li Q, Zan T (2019) Early postoperative application of botulinum toxin type a prevents hypertrophic scarring after epicanthoplasty: a split-face, double-blind, randomized trial. Plast Reconstr Surg 144:835–844CrossRef Huang RL, Ho CK, Tremp M, Xie Y, Li Q, Zan T (2019) Early postoperative application of botulinum toxin type a prevents hypertrophic scarring after epicanthoplasty: a split-face, double-blind, randomized trial. Plast Reconstr Surg 144:835–844CrossRef
4.
go back to reference Suo L, Li J, Fu R, Xie Y, Huang RL (2020) A four-step technique for creating individual double-eyelid crease shapes: a free-style design. Plast Reconstr Surg 146:756–765CrossRef Suo L, Li J, Fu R, Xie Y, Huang RL (2020) A four-step technique for creating individual double-eyelid crease shapes: a free-style design. Plast Reconstr Surg 146:756–765CrossRef
5.
go back to reference Chung YJ, Koo MG, Lee SH (2018) Epicanthal restoration surgery with scar excision in severe epicanthal scar. Aesthet Plast Surg 42:839–846CrossRef Chung YJ, Koo MG, Lee SH (2018) Epicanthal restoration surgery with scar excision in severe epicanthal scar. Aesthet Plast Surg 42:839–846CrossRef
6.
go back to reference Lee TY, Shin YH, Choi DI (2020) Reconstruction of medial epicanthal fold using v-y advancement and turnover flap. J Plast Reconstr Aesthet Surg 73:363–368CrossRef Lee TY, Shin YH, Choi DI (2020) Reconstruction of medial epicanthal fold using v-y advancement and turnover flap. J Plast Reconstr Aesthet Surg 73:363–368CrossRef
7.
go back to reference Park DH, Park SU, Lee BK, Lee YB, Do ER, Han DG, Shim JS, Lee YJ (2014) Medial epicanthoplasty without a vertical scar. Ann Plast Surg 73:8–11CrossRef Park DH, Park SU, Lee BK, Lee YB, Do ER, Han DG, Shim JS, Lee YJ (2014) Medial epicanthoplasty without a vertical scar. Ann Plast Surg 73:8–11CrossRef
8.
go back to reference Wang Y, Li D, Du F, Zhou N, Li J (2018) Efficacy of inverted “V” release surgery in the correction of a special type of epicanthus. Aesthetic Plast Surg 42:1304–1311CrossRef Wang Y, Li D, Du F, Zhou N, Li J (2018) Efficacy of inverted “V” release surgery in the correction of a special type of epicanthus. Aesthetic Plast Surg 42:1304–1311CrossRef
9.
go back to reference Zhang S, Xue HY (2018) Adjustable V-flap epicanthoplasty based on desired eyelid morphology. Aesthetic Plast Surg 42:1571–1575CrossRef Zhang S, Xue HY (2018) Adjustable V-flap epicanthoplasty based on desired eyelid morphology. Aesthetic Plast Surg 42:1571–1575CrossRef
10.
go back to reference Kadakia S, Ducic Y, Jategaonkar A, Chan D (2017) Scar revision: surgical and nonsurgical options. Facial Plast Surg 33:621–626CrossRef Kadakia S, Ducic Y, Jategaonkar A, Chan D (2017) Scar revision: surgical and nonsurgical options. Facial Plast Surg 33:621–626CrossRef
11.
go back to reference Meaume S, Le Pillouer-Prost A, Richert B, Roseeuw D, Vadoud J (2014) Management of scars: updated practical guidelines and use of silicones. Eur J Dermatol 24:435–443CrossRef Meaume S, Le Pillouer-Prost A, Richert B, Roseeuw D, Vadoud J (2014) Management of scars: updated practical guidelines and use of silicones. Eur J Dermatol 24:435–443CrossRef
12.
go back to reference Newberry CI, Thomas JR, Cerrati EW (2018) Facial scar improvement procedures. Facial Plast Surg 34:448–457CrossRef Newberry CI, Thomas JR, Cerrati EW (2018) Facial scar improvement procedures. Facial Plast Surg 34:448–457CrossRef
13.
go back to reference Sadick NS, Cardona A (2018) Laser treatment for facial acne scars: a review. J Cosmet Laser Ther 20:424–435CrossRef Sadick NS, Cardona A (2018) Laser treatment for facial acne scars: a review. J Cosmet Laser Ther 20:424–435CrossRef
14.
go back to reference Vincent AG, Kadakia S, Barker J, Mourad M, Saman M, Ducic Y (2019) Management of facial scars. Facial Plast Surg 35:666–671CrossRef Vincent AG, Kadakia S, Barker J, Mourad M, Saman M, Ducic Y (2019) Management of facial scars. Facial Plast Surg 35:666–671CrossRef
15.
go back to reference Bui AD, Grob SR, Tao JP (2020) 5-Fluorouracil management of oculofacial scars: a systematic literature review. Ophthalmic Plast Reconstr Surg 36:222–230CrossRef Bui AD, Grob SR, Tao JP (2020) 5-Fluorouracil management of oculofacial scars: a systematic literature review. Ophthalmic Plast Reconstr Surg 36:222–230CrossRef
16.
go back to reference Karmisholt KE, Banzhaf CA, Glud M, Yeung K, Paasch U, Nast A, Haedersdal M (2018) Laser treatments in early wound healing improve scar appearance: a randomized split-wound trial with nonablative fractional laser exposures vs. untreated controls. Br J Dermatol 179:1307–1314CrossRef Karmisholt KE, Banzhaf CA, Glud M, Yeung K, Paasch U, Nast A, Haedersdal M (2018) Laser treatments in early wound healing improve scar appearance: a randomized split-wound trial with nonablative fractional laser exposures vs. untreated controls. Br J Dermatol 179:1307–1314CrossRef
17.
go back to reference Karmisholt KE, Wenande E, Thaysen-Petersen D, Philipsen PA, Paasch U, Haedersdal M (2018) Early intervention with non-ablative fractional laser to improve cutaneous scarring-A randomized controlled trial on the impact of intervention time and fluence levels. Lasers Surg Med 50:28–36CrossRef Karmisholt KE, Wenande E, Thaysen-Petersen D, Philipsen PA, Paasch U, Haedersdal M (2018) Early intervention with non-ablative fractional laser to improve cutaneous scarring-A randomized controlled trial on the impact of intervention time and fluence levels. Lasers Surg Med 50:28–36CrossRef
18.
go back to reference Tidwell WJ, Owen CE, Kulp-Shorten C, Maity A, McCall M, Brown TS (2016) Fractionated Er:YAG laser versus fully ablative er:yag laser for scar revision: results of a split scar, double blinded, prospective trial. Lasers Surg Med 48:837–843CrossRef Tidwell WJ, Owen CE, Kulp-Shorten C, Maity A, McCall M, Brown TS (2016) Fractionated Er:YAG laser versus fully ablative er:yag laser for scar revision: results of a split scar, double blinded, prospective trial. Lasers Surg Med 48:837–843CrossRef
19.
go back to reference Alberti LR, Vicari EF, VicariR, Petroianu A. DSJ (2017) Early use of CO2 lasers and silicone gel on surgical scars: Prospective study. Lasers Surg Med 49:570–576CrossRef Alberti LR, Vicari EF, VicariR, Petroianu A. DSJ (2017) Early use of CO2 lasers and silicone gel on surgical scars: Prospective study. Lasers Surg Med 49:570–576CrossRef
20.
go back to reference Du F, Yu Y, Zhou Z, Wang L, Zheng S (2018) Early treatment using fractional CO2 laser before skin suture during scar revision surgery in Asians. J Cosmet Laser Ther 20:102–105CrossRef Du F, Yu Y, Zhou Z, Wang L, Zheng S (2018) Early treatment using fractional CO2 laser before skin suture during scar revision surgery in Asians. J Cosmet Laser Ther 20:102–105CrossRef
21.
go back to reference Safra T, Shehadeh W, Koren A, Salameh F, Friedman O, Sprecher E, Artzi O (2019) Early intervention with pulse dye and CO2 ablative fractional lasers to improve cutaneous scarring post-lumpectomy: a randomized controlled trial on the impact of intervention on final cosmesis. Lasers Med Sci 34:1881–1887CrossRef Safra T, Shehadeh W, Koren A, Salameh F, Friedman O, Sprecher E, Artzi O (2019) Early intervention with pulse dye and CO2 ablative fractional lasers to improve cutaneous scarring post-lumpectomy: a randomized controlled trial on the impact of intervention on final cosmesis. Lasers Med Sci 34:1881–1887CrossRef
22.
go back to reference Tian WC (2016) Savior of post-blepharoepicanthoplasty scarring: novel use of a low-fluence 1064-nm Q-switched Nd:YAG laser. J Cosmet Laser Ther 18:69–71CrossRef Tian WC (2016) Savior of post-blepharoepicanthoplasty scarring: novel use of a low-fluence 1064-nm Q-switched Nd:YAG laser. J Cosmet Laser Ther 18:69–71CrossRef
23.
go back to reference Daoud AA, Gianatasio C, Rudnick A, Michael M, Waibel J (2019) Efficacy of combined intense pulsed light (IPL) with fractional CO2 -laser ablation in the treatment of large hypertrophic scars: a prospective, randomized control trial. Lasers Surg Med 51:678–685CrossRef Daoud AA, Gianatasio C, Rudnick A, Michael M, Waibel J (2019) Efficacy of combined intense pulsed light (IPL) with fractional CO2 -laser ablation in the treatment of large hypertrophic scars: a prospective, randomized control trial. Lasers Surg Med 51:678–685CrossRef
24.
go back to reference Jin W, Li Z, Jin Z, Jin C (2020) A novel technique for treating atrophic facial scars in Asians using ultra-pulse CO2 laser. J Cosmet Dermatol 19:1099–1104CrossRef Jin W, Li Z, Jin Z, Jin C (2020) A novel technique for treating atrophic facial scars in Asians using ultra-pulse CO2 laser. J Cosmet Dermatol 19:1099–1104CrossRef
25.
go back to reference Kacar N, Dursun R, Akbay M, Goksin S (2020) The early and late efficacy of single-pass fractional carbondioxide laser, fractional radiofrequency, and their combination in acne scars: a prospective, split-face, single-blinded, controlled clinical study. Dermatol Ther 33:e14444CrossRef Kacar N, Dursun R, Akbay M, Goksin S (2020) The early and late efficacy of single-pass fractional carbondioxide laser, fractional radiofrequency, and their combination in acne scars: a prospective, split-face, single-blinded, controlled clinical study. Dermatol Ther 33:e14444CrossRef
26.
go back to reference Lee BW, Levitt AE, Erickson BP, Ko AC, Nikpoor N, Ezuddin N, Lee WW (2018) Ablative fractional laser resurfacing with laser-assisted delivery of 5-fluorouracil for the treatment of cicatricial ectropion and periocular scarring. Ophthalmic Plast Reconstr Surg 34:274–279CrossRef Lee BW, Levitt AE, Erickson BP, Ko AC, Nikpoor N, Ezuddin N, Lee WW (2018) Ablative fractional laser resurfacing with laser-assisted delivery of 5-fluorouracil for the treatment of cicatricial ectropion and periocular scarring. Ophthalmic Plast Reconstr Surg 34:274–279CrossRef
27.
go back to reference Li K, Nicoli F, Cui C, Xi WJ, Al-Mousawi A, Zhang Z, Balzani A, Neill L, Sorge R, Tong Y, Zhang Y (2020) Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique. Sci Rep 10:21694CrossRef Li K, Nicoli F, Cui C, Xi WJ, Al-Mousawi A, Zhang Z, Balzani A, Neill L, Sorge R, Tong Y, Zhang Y (2020) Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique. Sci Rep 10:21694CrossRef
28.
go back to reference Peng L, Tang S, Li Q (2018) Intense pulsed light and laser treatment regimen improves scar evolution after cleft lip repair surgery. J Cosmet Dermatol 17:752–755CrossRef Peng L, Tang S, Li Q (2018) Intense pulsed light and laser treatment regimen improves scar evolution after cleft lip repair surgery. J Cosmet Dermatol 17:752–755CrossRef
29.
go back to reference Tenzel PA, Patel K, Erickson BP, Shriver EM, Grunebaum LD, Alabiad CR, Lee WW, Wester ST (2016) Split face evaluation of long-pulsed non-ablative 1,064 nm Nd:YAG laser for treatment of direct browplasty scars. Lasers Surg Med 48:742–747CrossRef Tenzel PA, Patel K, Erickson BP, Shriver EM, Grunebaum LD, Alabiad CR, Lee WW, Wester ST (2016) Split face evaluation of long-pulsed non-ablative 1,064 nm Nd:YAG laser for treatment of direct browplasty scars. Lasers Surg Med 48:742–747CrossRef
Metadata
Title
Efficacy of Early Application of 1540 nm Non-ablative Fractional Laser and Silicones to Improve Post-epicanthoplasty Scars
Authors
Bingyan Zhang
E Yang
Hengshu Zhang
Publication date
01-04-2022
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 5/2022
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-022-02866-y

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