Aesthetic Plastic Surgery

, Volume 43, Issue 1, pp 213–220 | Cite as

Comparison of the Scar Prevention Effect Between a Carbon Dioxide Fractional Laser and a Continuous Ablative Carbon Dioxide Laser with a 595-nm Nd:YAG Laser

  • Seong Joo Lee
  • Jun Won Lee
  • Seong Hwan Kim
  • In Suck Suh
  • Hii Sun JeongEmail author
Original Article Non-Surgical Aesthetic



A linear surgical scar, when located in the head and neck region, can be a significant cosmetic concern. Laser skin resurfacing with a fractional laser and a pulsed dye laser has been proven to be useful for treating such scars. As alternatives, we used a classic ablative CO2 laser in continuous mode with a 1-mm spot size and a 595-nm Nd:YAG laser. We investigated the effect of the combination of the continuous CO2 laser and 595-nm Nd:YAG laser and compared it to the effect of fractional CO2 laser monotherapy on linear scars.


This was a retrospective, case-controlled study designed to compare the efficacy between fractional CO2 laser therapy and combination therapy with a conventional CO2 laser in continuous mode and a 595-nm Nd:YAG laser. Treatment efficacy was evaluated by two different scar scales: the Stony Brook Scar Evaluation Scale (SBSES) and the modified Vancouver Scar Scale (mVSS). Laser treatments were performed every month until the 6th month after surgery.


The SBSES and mVSS scores improved over time in both the monotherapy and the combination therapy (P < 0.001). No significant differences were found between the therapies for all the subcategories of the SBSES. However, among all the subcategories of the mVSS, pigmentation showed a better prognosis with combination therapy (P = 0.04).


Monotherapy and combination therapy can provide similar positive effects on linear scar improvement after repeated treatment, whereas combination therapy exerts more favorable anti-pigmentation effects than monotherapy. The combination of a continuous ablative CO2 laser with a 595-nm Nd:YAG laser can be used as a favorable alternative to a fractional CO2 laser. The 1-mm spot size of the CO2 laser beam may mimic the fractional laser form and offer more effective results for linear incision scars.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Facial injuries Scar Carbon dioxide Pigmentation Lasers 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Seong Joo Lee
    • 1
  • Jun Won Lee
    • 1
  • Seong Hwan Kim
    • 1
  • In Suck Suh
    • 1
  • Hii Sun Jeong
    • 1
    Email author
  1. 1.Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, College of MedicineHallym UniversitySeoulRepublic of Korea

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