Laser applications in plastic and reconstructive surgery.

Very shortly after the laser's first successful firing in 1960, applications were found in the medical field in the specialities of ophthalmology and dermatology and have since expanded to include indications in plastic and reconstructive surgery. In the photodestructive mode, laser energy is used selectively to vaporize, incise, excise, ablade and coagulate target tissue; the surgical laser can also degrade or denature protein in the target tissue, and the latter photoreaction now forms the basis for laser tissue welding in a variety of tissue types. The author refers to these photodestructive applications as high reactive-level laser treatment, or HLLT. In laser therapeutic applications, the temperature of the cells may rise only very slightly or not at all, and there is no immediate irreversible change in the target tissue architecture. The level of reaction is thus lower than the cell survival threshold, giving a direct photoactivative effect. The author refers to this as low reactive-level laser therapy, or LLLT: LLLT applications include pain attenuation, wound healing acceleration; enhanced remodeling in accelerated bone and tendon repair; restoration of normal neural function; normalization of abnormal hormonal function; modulation of the autoimmune system; control of hyper- and hypotension and so on. HLLT and LLLT are contrasted and compared, and applications of both HLLT and LLLT in PRS are discussed in brief.