Nonsurgical Lip and Eye Rejuvenation Techniques by Gabriella Fabbrocini Maria Pia Padova & Antonella Tosti

Author:Gabriella Fabbrocini, Maria Pia Padova & Antonella Tosti
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Fig. 9.6Infantile hemangiomas of the periorbital area before and after treatment with the 595 nm pulsed dye laser

Vascular malformations are localized defects of vascular morphogenesis, which is in contrast to the neoplastic nature of hemangiomas. They are categorized by their anomalous vessels (e.g., capillary, venous, arterial, lymphatic) and by whether they have a fast (arterial) or slow flow.

Capillary vascular malformations (CVMs), often referred to as port-wine stains, are observed in 0.03 % of the population [42]. Facial CVMs classically course along the distribution of trigeminal nerve sensory branches, namely, V1 (ophthalmic), V2 (maxillary), and V3 (mandibular) branches. When present, especially around the eye, risks of coincident glaucoma and choroidal vascular malformations exist, as do concerns for syndromic capillary venous malformations such as Sturge-Weber syndrome, von Hippel-Lindau syndrome, and Bonnet-Dechaume syndrome [43]. Over years and without treatment, CVMs typically develop vessel ectasia, which corresponds to the thickening, darkening, and cobblestoning appearance in aged lesions [44, 45]. Exuberant overgrowth can potentially lead to visual field obstruction of the eye or airway depending on location. The PDL is an important therapy in the treatment of periorbital CVMs and should be considered a treatment of choice for flat or mildly hypertrophic lesions [43, 46]. Other technologies are helpful, however, as intense pulsed light and the alexandrite lasers, among others, have demonstrated efficacy and even advantage in some situations [47, 48]. Early treatment has been shown to be safe and more effective [46]. Although anatomic differences do exist in terms of response to laser and light treatments, periorbital CVMs tend to respond well [49]. Efficacy from treatment with the 595 nm PDL can be appreciated in Fig. 9.7.

Fig. 9.7Port-wine stain of the periorbital area before and after completed treatment with the 595 nm pulsed dye laser

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