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The article by Carniol and Greene clearly demonstrates the dilemma faced by the practicing facial plastic and head and neck surgeon who incorporates laser and nonlaser technology into the practice of facial rejuvenation and reconstruction. To assign the appropriate technology to skin and facial pathology is indeed a perplexing issue for both the novice and the experienced surgeon. The quest for perfection in today’s society, including the desire for minimal wounding and maximal results, stands as a formidable task in a market-driven environment.
Jim E. Gilmore, MD
Carniol and Greene provide an overview of the various technologies and instruments in the field and their relative values. This overview is enhanced by an excellent bibliographic database for further study and research. The authors further clarify the necessity of appropriate skill, training, and knowledge in the application of the nonlaser, laser (ablative vs nonablative), and radiofrequency devices and the need for independent study and self-assessment (other than manufacturer’s decree).
An attempt to present a vast overview of the myriad options available in an ever-changing and fluid field of study presents its own separate complexities. In this case, the authors appropriately and clearly summarize the basic matrix of knowledge for the next level of study by the reader.
In summary, this excellent article provides a thumbnail sketch of the state of known technology in real time. Subsequent additions and corollary studies would be useful in describing long-term results, overall patient satisfaction, and outcome measurement against expectations. To understand why patients who have undergone carbon dioxide super pulsing may have long-term postlaser erythema provides a platform for discussion of how intense light in combination may produce improved results. In the end, the authors give us insight into the tools at our disposal and emphasize the need for practitioners to plan carefully and to apply known, predictable science.
Correspondence: Dr Gilmore, Dallas Institute of Plastic and Cosmetic Surgery, Concorde on the Creek, 6750 Hillcrest Plaza Dr, Suite 215, Dallas, TX 75230-1400 (email@example.com).
Gilmore JE. Defining Clinical Responses in Cosmetic Laser Surgery. Arch Otolaryngol Head Neck Surg. 2004;130(11):1333–1334. doi:10.1001/archotol.130.11.1333
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