The "Hot Topic" section deals with an area of plastic surgery that is new, controversial, and noteworthy. It often deals with concepts in plastic surgery that have recently received media coverage and whose details need some extra explanation.

       Over the past two months a new laser treatment has been in the news which claims to remove or improve facial wrinkles without superficial skin damage and the inherent downtime. The new therapy is often called the N-LiteŽ (Light Initiated Tissue Enhancement) and consists of a long-duration 585nm pulsed dye laser. As explained in the Laser Surgery section of this website under Vein Therapy, the pulsed dye laser aims at blood and blood containing areas.

       The new therapy claims to heat the middle and deep layers of skin while protecting the surface. By heating the deep layers, collagen fibers can be damaged and rearranged in a new and less wrinkled pattern. This is the same theory used in standard Erbium and Carbon Dioxide laser treatments, however, in these treatments the surface is obliterated during therapy and must heal for several weeks.

       The new treatment is based on research recently performed in Europe (Selective non-ablative wrinkle reduction by laser. Bjerring P. et al. Journal of Cutaneous Laser Therapy; 2:9-15, 2000). According to this study, patients displayed improvement of wrinkles around the eyes after one treatment based on photographs of the area presented to a panel of judges. Additional biochemical data as also presented.

       It is important to weigh the possibility of cosmetic improvement against the financial cost and risks involved. In my opinion, the photos in the study displayed minimal improvement. However, the procedure does seem to be very safe and pain free. Whether or not the new laser truly achieves temperatures needed to rearrange collagen or can rearrange collagen in some other fashion is still matter of debate.

       Having worked with the pulsed dye laser for two years, I, personally, am not yet convinced that this new technology actually works, but I believe that continued research in the matter might soon show that the procedure could indeed be useful.