Long-term results of facial rejuvenation by carbon dioxide laser resurfacing using a quantitative method of assessment.

Carbon dioxide laser resurfacing has been widely reported as an effective method for treating facial rhytides. Few published series, however, have assessed the long-term results of this procedure. We prospectively reviewed our long-term results of perioral CO(2) laser resurfacing using an accurate, reproducible and quantitative method of evaluation. Wrinkle depth was measured using a silicone elastomer to provide an exact negative-replica mask of the perioral region. Simple light microscopy was then used to measure the depth of rhytides. This was carried out preoperatively, 6 weeks postoperatively and 2 years postoperatively, and the results were compared for 31 patients. CO(2) laser resurfacing achieved a highly significant mean reduction in wrinkle depth at 6 weeks of 91% (paired t -test:P <0.00001), and this was well maintained at 2 years, when the mean reduction in wrinkle depth was 87% (paired t-test: P<0.00001). During the long follow-up, complications were few, with transient erythema being the most common; there were no cases of scarring. As in other series that have reported longer follow-up, we encountered three cases of minor hypopigmentation. We have used light microscopy on silicone moulds as an accurate method of assessing outcome after laser resurfacing of perioral rhytides. The early highly significant reduction in wrinkle depth was maintained at 2 years with minimal associated short-term or long-term morbidity. Copyright 2002 The British Association of Plastic Surgeons. Published by Elsevier Science Ltd. All rights reserved.