背景:提供非手术整容手术的具有不同经验和培训水平的医生激增。需求上升,加上众多医师专业越来越多地利用新技术和现有技术,迫使讨论适当的标准化培训和患者安全。
方法:对到我们的单中心皮肤科诊所治疗化学剥皮后并发症的患者进行回顾性分析,2013年至2024年期间由核心美容医师进行激光或能量器械治疗.核心美容医生包括整形手术,面部外科/耳鼻喉科,眼整形手术,和皮肤病学。对并发症类型的记录进行了图表审查,导致并发症的程序,和医生证书,和推荐来源。
结果:25例患者被确定为化学剥离并发症,激光治疗或基于能量的设备。涉及的设备包括CO2激光(分数或完全烧蚀),化学果皮,1064nm长脉冲Nd:YAG激光器,1320nmNd:YAG激光器,强烈的脉冲光,595nm脉冲染料激光器,调QNd:YAG激光器,有和没有微针的射频,和1550nm掺铒光纤激光器。并发症包括肥厚性瘢痕,萎缩性疤痕,炎症后红斑,炎症后色素沉着过度,和炎症后色素减退。
结论:即使在有经验的手中,可能会出现并发症。所有提供美容治疗的医生都必须具备识别临床终点的能力,识别和管理并发症,或及时转诊,以降低患者永久性和潜在破坏性美学结果的风险。
BACKGROUND: There has been a proliferation of physicians of different levels of experience and training offering nonsurgical cosmetic procedures. Rising demand, compounded by increasing utilization of new and existing technologies by numerous physician specialties, compels discussion of adequate standardized training and patient safety.
METHODS: A retrospective chart review of patients who presented to our single site dermatology clinic for managment of complications following chemical peel, laser or energy-based device treatments performed by core cosmetic physicians between the years of 2013 and 2024 was conducted. Core cosmetic physicians included plastic surgery, facial surgery/otolaryngology, oculoplastic surgery, and dermatology. Charts were reviewed for documentation of the type of complication, procedure causing the complication, and physician credentials, and referral source.
RESULTS: Twenty-five patients were identified as having complications from chemical peeling, laser treatment or energy-based devices. Devices implicated included CO2 laser (fractional or fully ablative), chemical peels, 1064 nm long-pulsed Nd:YAG laser, 1320 nm Nd:YAG laser, intense pulsed light, 595 nm pulsed dye laser, Q-switched Nd:YAG laser, radiofrequency with and without microneedling, and 1550 nm erbium-doped fiber laser. Complications included hypertrophic scarring, atrophic scarring, post-inflammatory erythema, post-inflammatory hyperpigmentation, and post-inflammatory hypopigmentation.
CONCLUSIONS: Even in experienced hands, complications can arise. It is imperative that all physicians offering cosmetic treatments are equipped to recognize clinical endpoints, identify and manage complications, or make a timely referral to decrease the risk of a permanent and potentially devastating esthetic outcome for patients.