Facelift Combined with Simultaneous Fractional Laser Resurfacing: Outcomes and Complications
The combination of simultaneous surgical rhytidectomy with ablative resurfacing has been a controversial procedure due to the concern of postoperative wound healing. Traditional ablative resurfacing lasers lead to compromise of the dermal vascular perfusion, leading to delayed healing and skin flap loss when combined with face rhytidectomy surgeries. With the development of fractionated ablative laser therapy, improved skin perfusion has been showed. The objective of this study is to evaluate the clinical outcomes of patients undergoing simultaneous full-face rhytidectomy in combination with fractionated ablative skin resurfacing.
Methods/Technique:
A retrospective chart analysis was performed for all patients who had a combined procedure of facelift and ablative fractional laser resurfacing from 2008 to 2013 by the senior author (SKS). Patients actively smoking were excluded from the combined procedure. Postoperative recovery and complications were recorded. The surgical technique used for performing the facelift was an extended supraplatysmal dissection with SMAS plication. Fraxel Re:Pair 10,6000-nm fractional carbon dioxide laser was used to perform an ablative facial resurfacing including the skin flaps.
Results/Complications:
A total of 86 patients were included. Average age was 60.01 years (range of 45-78 years). Longest follow up was five years. The average skin removed per side was 13.61cm2. The average size of the elevated skin flaps was 100cm2. Average skin type was a Fitzpatrick type 2. All patients had complete re-epithelialization by one week after their procedure. Four patients (4.6%) experienced acne outbreaks. Four patients (4.6%) had facial erythema that persisted greater than two weeks. Of these four patients, all resolved by five weeks postoperatively. There was no delayed wound healing or skin flap loss observed.
Conclusion:
Our results indicate that simultaneous rhytidectomy with fractionated ablative laser resurfacing does not cause an increase in complications. No skin flap loss or delayed wound healing occured, despite having ablative skin resurfacing performed to the elevated skin flaps. Due to improved patient satisfaction and patient convinence with combining these procedures, we believe that this can be increasingly offered as a safe combination.