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Facial Moles:Laser Surgery




       Dr.K.O.Paulose FRCS DLO
        Consultant ENT Surgeon
Jubilee Hospital,Trivandrum,South India
  www.drpaulose.com, www.snorefreesleep.com
What is Laser?

INTRODUCTION OF
LASER

Laser is an acronym that
stands for Light
Amplification by
Stimulated Emission of
Radiation.
The first concept of the
laser was initiated by
Albert Einstein in 1917.
Types of Lasers
CO2 Laser

Argon laser

The Nd:YAG (Neodymium:Yttrium-
aluminum-Garnet)

The Potassium-Titanyl-Phosphate
(KTP)
CO2 Laser
  The CO2 laser is the most versatile laser in
  otolaryngology.

  The carbon dioxide (CO2) laser emits a colorless,
  infrared light

  wavelength 10,600 nano microns

Principle: The radiant energy produced by the CO2 laser is
   strongly absorbed by pure, homogeneous water and by
   all biological tissues high in water content.
coaxial helium neon laser as aiming beam- red in colour
How does a CO2 Laser work?

Ability to coagulate, cut, vaporize
The main constituent of cells-water,
readily absorbs the wavelength of light
produced by the CO2 surgical laser.
The surgeon can control the extent by
which the laser beam is absorbed into
surrounding tissue, resulting in an
extremely precise tissue incision.
Indications of Co2 Laser in ENT
Operations for snoring and sleep apnea
Operations for Allergic Rhinitis,Correcting
deviated Nasal septum, Partial turbinectomy
(LAPT), Choanal atresia, excision of
Rhinophyma
Operations for voice disorders, the addition of
the microspot micromanipulator to the operating
microscope allows-arytenoidectomy, vocal
nodules, early ca lesions
Operations for nose bleeds, nasal polyps,
Rhinosporidiosis, Haemangiomas
Excision of Facial Moles, Keloid, Scars
Indications of Co2 Laser_contd
Ulcers on tongue, check, multiple areas of leukoplakia
can be precisely excised

Skin lesions on head, Face and Neck

Tonsillectomy

Tympanotomy, Myringotomy,Stapedectomy

(Bronchoscopic indications -management of recurrent
respiratory papillomatosis or granulation tissue within the
tracheobronchial tree, excision of selected subglottic or
tracheal strictures, excisions of bronchial adenomas.).
Advantages of Laser Surgery
Minimal operative bleeding due to coagulation of
blood vessels minor to 2 mm of diameter.
Reduced post operative pain due to minimal
thermal effect.
Increased accuracy of the surgical wound
Possibility of ambulatory surgery
Quick post op. healing
Better plastic result of surgical wounds due to
minimal scarring (that effect is very obvious in
the post tonsillectomy preservation of the
tonsillar pillars).
Disadvantages of Laser

Cost of equipment and maintenance .
(around USD 4000=Rs 4Lakh)
Special surgical skills
Increased setup time of equipment
Need of safety eyewear
Increased care for patient safety -
explosion or fire hazard.
Smoke
How Laser work?
Laser surgery is the most preferred technique in
removing moles. Laser removal of moles is by
far the most simple for eliminating moles on the
skin. In most cases of laser removal anesthesia
may not be necessary.
The laser beam will also burn away the mole.
Depending on the size of your mole, you may
need multiple sessions to completely remove it.
No scarring , no bleeding, no pain and can be
done in OPD set up with surface anesthesia.
Laser on Skin

Laser effects on skin tissue depend on
- the power density of the incident
beam, absorption of tissues at the
incident wavelength, time beam is held
on tissue, and the effects of blood
circulation and heat conduction in the
effected area.
Moles:Definition

The medical term for a mole is a nevus
(mole is Latin for “spot.”). Congenital nevi
are moles present at birth; acquired nevi
develop anytime later.
Facial moles are common on face and
neck. It can be flat, and sometimes raised
with hairs .If there is sudden change in
size, itching and ulcers, it should be
removed and sent for biopsy.
Methods used to remove facial moles

Local excision: One of the mole removal methods
that have been around the longest is the excision of
the mole. This process involves cutting the tissue
around the mole using a scalpel, deep enough to
remove even the deep mole cells, and removing the
tissue and mole completely. The remaining hole is
then stitched up
Electrocautery involves the use of a specialized
piece of equipment that burns the superficial layers
of skin off. Since the heating device cannot
penetrate deeper than the superficial layers, raised
moles, or moles that reach deep into the skin,
cannot be effectively removed in this manner.
Why Laser Treatment?

Laser treatment of nevi (moles) is a
valuable alternative to traditional surgical
excision procedures. Lasers are
particularly valuable in treating lesions in
anatomic areas which are difficult to
approach surgically such as the face,
nose lips and ears.
Why Co2 laser?
Laser mole removal is one of the newest mole removal
methods on the market. Laser mole removal involves
using a highly concentrated specialized laser to vaporize
the mole tissue.
 Laser mole removal is only useful in the removal of flat
moles and other superficial moles such as pigmented
nevis.
Laser mole removal treatments usually come in series,
and can take as many as three treatments before the
mole is fully removed.
On the positive side, this treatment does not leave any
scarring because it only deals with the superficial layers
of skin.
Laser Removal:The Easy Way

Laser surgery is the most preferred
technique in removing moles. Laser
removal of moles is by far the most simple
for eliminating moles on the skin. In most
cases of laser removal anesthesia may
not be necessary.
Need Biopsy ?

The laser beam will also burn away the
mole. Depending on the size of your mole,
you may need multiple sessions to
completely remove it. No scarring , no
bleeding, no pain and can be done in OPD
set up with surface anesthesia.
If suspect malignancy,Biopsy needed
Co2 Laser Machine
Inside the Laser Machine
Co2:Laser Technology
Co2 Laser Beam
Testing Co2 Laser
Laser:Prescision
Co2 Lasers
Portable Co2 Laser
Parts of Co2 laser
ENT Clinic Set Up
Diode Laser
Laser Surgeon
Laser Safety
Laser Goggles
Eye protection
Laser Resistant Glass
Eye Pad
All staff should wear
ANESTHESIA

LOCAL ANESTHESIA
For local superficial
anesthesia xylocaine
spray 10 % + For
infiltration anesthesia
xylocaine 2 % + 1:
100.000 adrenaline
solution.
Laser Excision Under LA
Co2 Laser Surgery for Facial Mole
Facial Mole Removal by Laser
Facial Mole #034
Hairy Mole #029
Laser Mole : #029
Laser Facial Mole #042, #043
Laser Mole #051
Laser Mole #012
Laser Mole #013
Laser Mole #013
Laser Mole #013
Laser Mole #013
Laser Mole #013
Laser Facial Mole
Laser Facial Mole:2
Laser Facial Mole:3
Laser Facial Mole In Jubilee
Laser Mole Neck #027
Laser Facial Mole:LA
Laser Facial Mole:LA
Laser Mole Ear
Laser Mole Eye Brow
Laser Moles in The Neck
Laser Moles on the Nose
Laser Moles on Face
Laser Moles on Face-2
Laser Facial Mole #011
Laser Moles on Head and Neck
Diode Laser in ENT
Diode Laser in Nose -2
Laser Moles in the Ear
Laser Removal Moles on Face
“Scars on my Heart”
Some scars won’t fade
Scars on the Heart
Keloid on BCG Scar
Keloid Ear lobe
Laser Excision Keloid
Keloid Excision by Laser
Keloid Ear Lobe:Laser
All Healing Comes From God

All healing comes
from God whether it
is supernatural or
through a surgeon
or a physician. He is
still the source of
our healing.
I am the LORD who
heals you, says God
THANK YOU
Presented By Dr.K.O.Paulose FRCS DLO
Jubilee Hospital Trivandrum, south India




         www.drpaulose.com
        www.snorefreesleep.com

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Laser Surgery Facial Mole:By Dr.K.O.Paulose FRCS DLO

  • 1. Facial Moles:Laser Surgery Dr.K.O.Paulose FRCS DLO Consultant ENT Surgeon Jubilee Hospital,Trivandrum,South India www.drpaulose.com, www.snorefreesleep.com
  • 2. What is Laser? INTRODUCTION OF LASER Laser is an acronym that stands for Light Amplification by Stimulated Emission of Radiation. The first concept of the laser was initiated by Albert Einstein in 1917.
  • 3. Types of Lasers CO2 Laser Argon laser The Nd:YAG (Neodymium:Yttrium- aluminum-Garnet) The Potassium-Titanyl-Phosphate (KTP)
  • 4. CO2 Laser The CO2 laser is the most versatile laser in otolaryngology. The carbon dioxide (CO2) laser emits a colorless, infrared light wavelength 10,600 nano microns Principle: The radiant energy produced by the CO2 laser is strongly absorbed by pure, homogeneous water and by all biological tissues high in water content. coaxial helium neon laser as aiming beam- red in colour
  • 5. How does a CO2 Laser work? Ability to coagulate, cut, vaporize The main constituent of cells-water, readily absorbs the wavelength of light produced by the CO2 surgical laser. The surgeon can control the extent by which the laser beam is absorbed into surrounding tissue, resulting in an extremely precise tissue incision.
  • 6. Indications of Co2 Laser in ENT Operations for snoring and sleep apnea Operations for Allergic Rhinitis,Correcting deviated Nasal septum, Partial turbinectomy (LAPT), Choanal atresia, excision of Rhinophyma Operations for voice disorders, the addition of the microspot micromanipulator to the operating microscope allows-arytenoidectomy, vocal nodules, early ca lesions Operations for nose bleeds, nasal polyps, Rhinosporidiosis, Haemangiomas Excision of Facial Moles, Keloid, Scars
  • 7. Indications of Co2 Laser_contd Ulcers on tongue, check, multiple areas of leukoplakia can be precisely excised Skin lesions on head, Face and Neck Tonsillectomy Tympanotomy, Myringotomy,Stapedectomy (Bronchoscopic indications -management of recurrent respiratory papillomatosis or granulation tissue within the tracheobronchial tree, excision of selected subglottic or tracheal strictures, excisions of bronchial adenomas.).
  • 8. Advantages of Laser Surgery Minimal operative bleeding due to coagulation of blood vessels minor to 2 mm of diameter. Reduced post operative pain due to minimal thermal effect. Increased accuracy of the surgical wound Possibility of ambulatory surgery Quick post op. healing Better plastic result of surgical wounds due to minimal scarring (that effect is very obvious in the post tonsillectomy preservation of the tonsillar pillars).
  • 9. Disadvantages of Laser Cost of equipment and maintenance . (around USD 4000=Rs 4Lakh) Special surgical skills Increased setup time of equipment Need of safety eyewear Increased care for patient safety - explosion or fire hazard. Smoke
  • 10. How Laser work? Laser surgery is the most preferred technique in removing moles. Laser removal of moles is by far the most simple for eliminating moles on the skin. In most cases of laser removal anesthesia may not be necessary. The laser beam will also burn away the mole. Depending on the size of your mole, you may need multiple sessions to completely remove it. No scarring , no bleeding, no pain and can be done in OPD set up with surface anesthesia.
  • 11. Laser on Skin Laser effects on skin tissue depend on - the power density of the incident beam, absorption of tissues at the incident wavelength, time beam is held on tissue, and the effects of blood circulation and heat conduction in the effected area.
  • 12. Moles:Definition The medical term for a mole is a nevus (mole is Latin for “spot.”). Congenital nevi are moles present at birth; acquired nevi develop anytime later. Facial moles are common on face and neck. It can be flat, and sometimes raised with hairs .If there is sudden change in size, itching and ulcers, it should be removed and sent for biopsy.
  • 13. Methods used to remove facial moles Local excision: One of the mole removal methods that have been around the longest is the excision of the mole. This process involves cutting the tissue around the mole using a scalpel, deep enough to remove even the deep mole cells, and removing the tissue and mole completely. The remaining hole is then stitched up Electrocautery involves the use of a specialized piece of equipment that burns the superficial layers of skin off. Since the heating device cannot penetrate deeper than the superficial layers, raised moles, or moles that reach deep into the skin, cannot be effectively removed in this manner.
  • 14. Why Laser Treatment? Laser treatment of nevi (moles) is a valuable alternative to traditional surgical excision procedures. Lasers are particularly valuable in treating lesions in anatomic areas which are difficult to approach surgically such as the face, nose lips and ears.
  • 15. Why Co2 laser? Laser mole removal is one of the newest mole removal methods on the market. Laser mole removal involves using a highly concentrated specialized laser to vaporize the mole tissue. Laser mole removal is only useful in the removal of flat moles and other superficial moles such as pigmented nevis. Laser mole removal treatments usually come in series, and can take as many as three treatments before the mole is fully removed. On the positive side, this treatment does not leave any scarring because it only deals with the superficial layers of skin.
  • 16. Laser Removal:The Easy Way Laser surgery is the most preferred technique in removing moles. Laser removal of moles is by far the most simple for eliminating moles on the skin. In most cases of laser removal anesthesia may not be necessary.
  • 17. Need Biopsy ? The laser beam will also burn away the mole. Depending on the size of your mole, you may need multiple sessions to completely remove it. No scarring , no bleeding, no pain and can be done in OPD set up with surface anesthesia. If suspect malignancy,Biopsy needed
  • 19. Inside the Laser Machine
  • 26. Parts of Co2 laser
  • 31. Laser Goggles Eye protection Laser Resistant Glass Eye Pad All staff should wear
  • 32. ANESTHESIA LOCAL ANESTHESIA For local superficial anesthesia xylocaine spray 10 % + For infiltration anesthesia xylocaine 2 % + 1: 100.000 adrenaline solution.
  • 34. Co2 Laser Surgery for Facial Mole
  • 38. Laser Mole : #029
  • 39. Laser Facial Mole #042, #043
  • 50. Laser Facial Mole In Jubilee
  • 56. Laser Moles in The Neck
  • 57. Laser Moles on the Nose
  • 59. Laser Moles on Face-2
  • 61. Laser Moles on Head and Neck
  • 63. Diode Laser in Nose -2
  • 64. Laser Moles in the Ear
  • 66. “Scars on my Heart”
  • 68. Scars on the Heart
  • 74. All Healing Comes From God All healing comes from God whether it is supernatural or through a surgeon or a physician. He is still the source of our healing. I am the LORD who heals you, says God
  • 75. THANK YOU Presented By Dr.K.O.Paulose FRCS DLO Jubilee Hospital Trivandrum, south India www.drpaulose.com www.snorefreesleep.com