Introduction: The 2940-nm Erbium Laser has been used for years in photoaging treatment, with pulse duration of 0.25 ms. Currently, it has been widely used in fractionated mode.New pulse duration of 5 ms was introduced in an attempt to promote tissue coagulation,in addition to ablation, improving its treatment performance. Objective: To investigate the mechanism by which this laser rays act on cutaneous tissue, in its fractionated and dual pulse mode, clinically and histopathologically. Material and methods: Six female patients with marked photoaging (Fitzpatrick Classifi cation Scale, degrees III and IV) were designated to this technique. Biopsies were performed 1 week before and 2 months after treatment. Clinical and histological assessments were conducted using the following stains: hematoxylin-eosin, Verhoeff, and Masson’s trichrome. Results: There was signifi cant clinical improvement in all patients, and histology showed foci sizes compatible with the laser microbeam shot in areas where decreased solar elastosis occurred. In two cases with more signifi cant results, these areas were measured. Conclusions: Clinically, there was marked improvement in six patients treated. Focal changes were found and they were similar in size to the rays shot, while previous studies with fractionated 2940- nm Erbium showed areas of non-circumscribed neocollagenesis.

Keywords: REJUVENATION, PHOTOAGING, LASERS

Introduction:The treatment of cutaneous aging with fractional non-ablative lasers has been intensely studied in the last few years, yet the number of publications describing specific equipments is limited.
Objective: To describe patient and dermatologist satisfaction after treatment with the Lux 1540®laser.
Methods: Retrospective study of patients (n=16) who have undergone facial rejuvenation therapy with Lux 1540® laser. Photographic assessments were performed by a dermatologist not involved in the treatments. Patient satisfaction was analyzed before treatment and after three sessions. The study variables were spots, sagging, wrinkles, enlarged pores, telangiectasias, and general satisfaction.
Results: In the dermatologist''''''''s evaluation, good or excellent improvement was found in the majority of the patients, for all studied variables. Regarding the improvement in the patients'''''''' general appearance, 82% were rated good or excellent. Regarding patients'''''''' opinions, 63% expressed good to excellent general satisfaction.
Conclusions: Treating cutaneous aging with Lux 1540® laser yields satisfactory results and maybe a good option for patients that do not want or cannot undergo more aggressive treatments.

Keywords: LASERS, SKIN AGING, LASER THERAPY

Post-adjusted M-plasty can be used in any surgical defect that can be closed by direct approximation of the borders to avoid the formation of apical protrusions. It is performed without prior planning; the tissue is removed only if the surgeon detects a protrusion during surgery. This method offers the advantage of sparing healthy tissue by adjusting the incisions to each patient’s skin’s tension lines, wrinkles and junctions of cosmetic units, in addition to the possible use of the “M”s pedicle as a small advancement flap. This study describes the procedure step by step, highlighting the differences and advantages compared to traditional M-plasty.

Keywords: SURGICAL PROCEDURES, MINOR, AMBULATORY SURGICAL PROCEDURES, ABDOMINAL WOUND CLOSURE TECHNIQUES

Tattooing has existed in humankind's culture since the onset of civilization. Tattoo removal attempts are also very ancient. The following current methods are reported for the removal of tattoos: dermabrasion, surgical excision, and laser procedures. The most commonly used lasers for tattoo removal are: QS-Nd:YAG (1,064 and 532nm), QS-Ruby (694nm) and QS-Alexandrite (755nm). The present review is aimed at studying the action mechanism of lasers for tattoo removal and the correct indication for each type of pigment, in addition to describing complications and the best manner of preventing them.

Keywords: LASERS; LASER THERAPY; TATTOOING.

Introduction: Acne is one of the most prevalent skin conditions, representing a constant challenge to dermatologists, especially in severe cases as nodulocystic acne, which can be resistant to medicament based treatment. Traditional therapy includes topical and oral drugs that are not always effective and often lead to bacterial resistance and side effects. The use of lasers in the treatment of inflammatory acne has increased lately due to the ease, clinical efficacy, and minimal side effects of this type of therapy. Objective: To evaluate the effects of fractional laser in patients with nodulocystic acne resistant to treatment with isotretinoin. Methods: Application of laser therapy sessions with Nd:YAP in 9 patients. Assessment of the degree of patient satisfaction and comparison of photographs taken before and after treatment by dermatologists not linked to the study. Results: Average reduction of 65% in inflammatory lesions, satisfaction of all patients who underwent treatment, and approval in the assessment carried out by dermatologists. Conclusions: The fractional Nd:YAP laser was proven effective in the treatment of inflammatory acne and may represent a new therapeutic option for this pathology, especially for patients who do not respond to conventional treatment.

Keywords: ACNE VULGARIS; LASERS; LASER THERAPY.

Introduction: Obesity is a major health problem worldwide due to its high morbidity and mortality. Objective: To evaluate the reduction of abdominal fat in volunteers who underwent low-frequency diode laser therapy. Methods: A total of 60 volunteers (18 to 50 years of age, with a BMI of between 18.5 kg/m2 and 30 kg/m2, and who had abdominal fat), underwent a treatment performed twice a week for 31 days and were then evaluated. The abdominal circumference was evaluated in three locations, with photographic and ultrasound images taken of the studied area. Results: There was a reduction in the abdominal circumference measurements in the evaluated sites, with dermal compression and a significant reduction of hypodermis verified through ultrasound. Conclusion: The low-frequency diode laser therapy showed significant results in the reduction of localized fat and abdominal circumference measurements.

Keywords: LASER; ABDOMINAL FAT; LYPOLISIS.

Introduction: Hidradenitis is a chronic inflammatory disease that has a negative impact on the patient's quality of life but which has few effective therapeutic options. Currently, the use of laser technology has been standing out as a treatment. Objective: To evaluate the use of 1,340nm ND:YAP laser (Neodimiun:Ytrium Aluminum Perovskite) to treat hidradenitis. Methods: Performing 4 1,340nm ND:YAP laser sessions in 3 patients bearing hidradenitis. Results: All patients had a clinically and histologically evidenced reduction of inflammatory lesions. Conclusions: In the present study, the 1,340nm ND:YAP laser was effective in the treatment of hidradenitis, and can potentially become a new therapeutic option.

Keywords: HIDRADENITIS; LASERS; LASER THERAPY

Endometriosis is a common dermatosis that most typically affects the pelvic organs. Extra-pelvic occurrences are reported in the literature. Umbilical endometriosis is rare and can be primary (spontaneous) or secondary (after surgery). The present study describes the case of a female patient with endometriosis lesions in the umbilical region, confirmed by histology. Treatment was carried out with wide surgical excision. It is important to note that differential diagnosis should be considered in the presence of umbilical tumors in women of reproductive age.

Keywords: ENDOMETRIOSIS; SISTER MARY JOSEPH'S NODULE; ABDOMINAL NEOPLASMS; ABDOMINAL WALL; ADENOMYOSIS

Introdução: A non-invasive alternative for the treatment of localized fat is cryolipolysis that, by freezing adipocytes, reduces fat volume in the region where the procedure was performed. Objective: To statistically describe the experience of a referral center for this procedure. Methods: A cross-sectional study with 251 patients undergoing cryolipolysis was carried out with the epidemiological analysis of patient data. Results: Thirty-eight males and 213 females underwent the procedure, with a total number of 740 treated areas. The anterior abdomen (lower third) was the most popular region, with 45.30% of cases. Eighty-eight percent were satisfied or very satisfied with the result. Nearly all cases required 2 or more sessions to achieve this degree of satisfaction. Conclusions: Cryolipolysis is a noninvasive method for the selective reduction of fat that has shown efficacy in reducing the subcutaneous tissue, with minimal and reversible side effects in this study.

Keywords: LASERS; ABDOMINAL FAT; LIPOLYSIS

Introduction: Low level laser therapy has been considered a non-invasive treatment alternative to body remodeling and fat tissue reduction.
Objective: To evaluate the efficacy of low level laser therapy in reducing body circumference measures and subcutaneous adipose tissue of the abdomen and hips areas.
Methods: An open, prospective, monocentric study was performed including 25 women with localized fat on the hips and abdomen. Nine sessions of low level laser therapy were performed over 3 weeks. The participants were assessed at baseline and at 1, 4 and 12 weeks after treatment. Assessment of weight and body circumferences, lipid profile tests and MRI were performed.
Results: The abdominal circumference measurements showed a significant reduction up to 12 weeks after the treatment. Participants showed a more marked reduction in the hips region one week after the last session. Also one week after the completion of the treatment, 80% of the participants considered that the treatment improved their body contour. There was absence of reports of adverse events related to the treatment.
Conclusion: Low level laser therapy is safe and effective in reducing the circumference measurements, particularly in the abdominal region.

Keywords: LOW-LEVEL LIGHT THERAPY; SUBCUTANEOUS FAT; MAGNETIC RESONANCE IMAGING; LASER THERAPY; ABDOMINAL SUBCUTANEOUS FAT

Introduction: Introduction: Not focused ultrasound is a noninvasive alternative to improve body contour.
Methods: It's reported five cases treated with eight weekly sessions of not focused ultrasound on the abdomen.
Results: The treatment did not affect the routine of patients; it was comfortable and safe for most. There was a reduction in the thickness of the fat layer evaluated by ultrasound and in the circumferential measures in all patients, with clinical improvement evidenced in the photographic documentation especially in patients with lesser thickness of subcutaneous.
Conclusion: The device was safe, and was shown clear reduction in abdominal subcutaneous tissue.

Keywords: ADIPOSE TISSUE; ULTRASONIC THERAPY; ULTRASONOGRAPHY; ABDOMINAL SUBCUTANEOUS FAT

This study demonstrated the clinical and histologic result of the treatment of one disseminated superficial actinic porokeratosis patient with non-ablative fractional laser. The patient was treated with seven sessions of 1340-nm Nd:YAP laser, with 4 or 5 week-intervals. Biopsies and photographs were performed before and after treatment, which was well tolerated and lead to improvement in the erythema and texture of the lesions. There was a 1-year follow-up. Histopathologic examination after treatment revealed little changes in the cornoid lamella.

Keywords: Biopsy; Laser Therapy; Lasers; Porokeratosis

INTRODUCTION: The treatment of hypochromic scars is challenging, and the techniques used so far show unsatisfactory results. Bimatoprost, an analog of prostaglandin F2-alpha, has been used as a topical pigment agent, and its application as drug delivery can optimize its delivery to the dermis and potentiate pigmentation.
OBJECTIVE: To evaluate the safety and efficacy of Ablative Fractional Laser (AFL) treatment associated with bimatoprost 0.03% drug delivery in hypopigmented scars.
METHODS: The patients were submitted to the AFL, followed by the application of bimatoprost 0.03% in 4 sessions with biweekly intervals. Clinical evaluations and standardized photographs were performed. Patients’ satisfaction was assessed using a 5-question questionnaire.
RESULTS: All patients had clinical improvement in the treated areas. The degree of patient satisfaction agreed with the clinical evaluation and photographic records.
CONCLUSION: The application of AFL associated with bimatoprost 0.03% drug delivery can be a potentially effective and safe treatment for hypochromic scars.

Keywords: Lasers; Hypopigmentation; Laser Therapy

Q-switched lasers are widely used for tattoo removal. A 48-year-old-woman with a black tattoo on the left thigh was submitted to ten sessions of Q-switched Nd:YAG 1064nm laser associated with fractional CO2 laser, performed every two months. Six months after treatment end, we observed almost complete tattoo removal, besides improvement in skin texture. Q-switched lasers promote tattoo removal by a photoacoustic phenomenon. The association with fractional ablative lasers is an option for intensely pigmented tattoos or for tattoos with several colors, which are hard to remove.

Keywords: Laser Therapy; Lasers; Tattooing

Localized scleroderma (linear morphea) is a rare disease that causes facial dystrophy and asymmetry in young women. We report the case of a 20-year-old female patient who was treated with novel composite fat grafts. After extracting lipoaspirate from deep subcutaneous fat, the microfat and the unfiltered nanofat were processed separately, and amalgamated, obtaining composite fat grafts. These were meticulously transplanted layer by layer to rebuild the subcutaneous tissue of the patient's face. After one year, a good volume of fat retention was observed with successful correction of asymmetry and restoration of facial balance.

Keywords: Ambulatory surgical procedures; Abdominal subcutaneous fat; Facial asymmetry; Subcutaneous injections; Localized scleroderma