Facial Moles:Laser Surgery Dr.K.O.Paulose FRCS DLO Consultant ENT SurgeonJubilee Hospital,Trivandrum,South India www.drpaulose.com, www.snorefreesleep.com
What is Laser?INTRODUCTION OFLASERLaser is an acronym thatstands for LightAmplification byStimulated Emission ofRadiation.The first concept of thelaser was initiated byAlbert Einstein in 1917.
Types of LasersCO2 LaserArgon laserThe Nd:YAG (Neodymium:Yttrium-aluminum-Garnet)The Potassium-Titanyl-Phosphate(KTP)
CO2 Laser The CO2 laser is the most versatile laser in otolaryngology. The carbon dioxide (CO2) laser emits a colorless, infrared light wavelength 10,600 nano micronsPrinciple: The radiant energy produced by the CO2 laser is strongly absorbed by pure, homogeneous water and by all biological tissues high in water content.coaxial helium neon laser as aiming beam- red in colour
How does a CO2 Laser work?Ability to coagulate, cut, vaporizeThe main constituent of cells-water,readily absorbs the wavelength of lightproduced by the CO2 surgical laser.The surgeon can control the extent bywhich the laser beam is absorbed intosurrounding tissue, resulting in anextremely precise tissue incision.
Indications of Co2 Laser in ENTOperations for snoring and sleep apneaOperations for Allergic Rhinitis,Correctingdeviated Nasal septum, Partial turbinectomy(LAPT), Choanal atresia, excision ofRhinophymaOperations for voice disorders, the addition ofthe microspot micromanipulator to the operatingmicroscope allows-arytenoidectomy, vocalnodules, early ca lesionsOperations for nose bleeds, nasal polyps,Rhinosporidiosis, HaemangiomasExcision of Facial Moles, Keloid, Scars
Indications of Co2 Laser_contdUlcers on tongue, check, multiple areas of leukoplakiacan be precisely excisedSkin lesions on head, Face and NeckTonsillectomyTympanotomy, Myringotomy,Stapedectomy(Bronchoscopic indications -management of recurrentrespiratory papillomatosis or granulation tissue within thetracheobronchial tree, excision of selected subglottic ortracheal strictures, excisions of bronchial adenomas.).
Advantages of Laser SurgeryMinimal operative bleeding due to coagulation ofblood vessels minor to 2 mm of diameter.Reduced post operative pain due to minimalthermal effect.Increased accuracy of the surgical woundPossibility of ambulatory surgeryQuick post op. healingBetter plastic result of surgical wounds due tominimal scarring (that effect is very obvious inthe post tonsillectomy preservation of thetonsillar pillars).
Disadvantages of LaserCost of equipment and maintenance .(around USD 4000=Rs 4Lakh)Special surgical skillsIncreased setup time of equipmentNeed of safety eyewearIncreased care for patient safety -explosion or fire hazard.Smoke
How Laser work?Laser surgery is the most preferred technique inremoving moles. Laser removal of moles is byfar the most simple for eliminating moles on theskin. In most cases of laser removal anesthesiamay not be necessary.The laser beam will also burn away the mole.Depending on the size of your mole, you mayneed multiple sessions to completely remove it.No scarring , no bleeding, no pain and can bedone in OPD set up with surface anesthesia.
Laser on SkinLaser effects on skin tissue depend on- the power density of the incidentbeam, absorption of tissues at theincident wavelength, time beam is heldon tissue, and the effects of bloodcirculation and heat conduction in theeffected area.
Moles:DefinitionThe medical term for a mole is a nevus(mole is Latin for “spot.”). Congenital neviare moles present at birth; acquired nevidevelop anytime later.Facial moles are common on face andneck. It can be flat, and sometimes raisedwith hairs .If there is sudden change insize, itching and ulcers, it should beremoved and sent for biopsy.
Methods used to remove facial molesLocal excision: One of the mole removal methodsthat have been around the longest is the excision ofthe mole. This process involves cutting the tissuearound the mole using a scalpel, deep enough toremove even the deep mole cells, and removing thetissue and mole completely. The remaining hole isthen stitched upElectrocautery involves the use of a specializedpiece of equipment that burns the superficial layersof skin off. Since the heating device cannotpenetrate deeper than the superficial layers, raisedmoles, or moles that reach deep into the skin,cannot be effectively removed in this manner.
Why Laser Treatment?Laser treatment of nevi (moles) is avaluable alternative to traditional surgicalexcision procedures. Lasers areparticularly valuable in treating lesions inanatomic areas which are difficult toapproach surgically such as the face,nose lips and ears.
Why Co2 laser?Laser mole removal is one of the newest mole removalmethods on the market. Laser mole removal involvesusing a highly concentrated specialized laser to vaporizethe mole tissue. Laser mole removal is only useful in the removal of flatmoles and other superficial moles such as pigmentednevis.Laser mole removal treatments usually come in series,and can take as many as three treatments before themole is fully removed.On the positive side, this treatment does not leave anyscarring because it only deals with the superficial layersof skin.
Laser Removal:The Easy WayLaser surgery is the most preferredtechnique in removing moles. Laserremoval of moles is by far the most simplefor eliminating moles on the skin. In mostcases of laser removal anesthesia maynot be necessary.
Need Biopsy ?The laser beam will also burn away themole. Depending on the size of your mole,you may need multiple sessions tocompletely remove it. No scarring , nobleeding, no pain and can be done in OPDset up with surface anesthesia.If suspect malignancy,Biopsy needed