Is Prophylactic Pulsed-Dye Laser (PDL) irradiation effective in improving the quality and cosmetic appearance of post reduction mammoplasty incisional lines?

Pulsed-dye laser (PDL) has been used with variable degrees of success in the treatment of hypertrophic scars and keloids. Some studies show that the newer scars respond better to treatment than the elder ones. Recently few studies have shown the benefits of the 585-nm PDL in improving the quality of surgical scars starting on the day of suture removal. This randomized controlled clinical trial (RCT) was designed to evaluate the effects of 585nm PDL to improve the post reduction mammoplasty surgical scars when used three weeks after surgery. Six patients with 24 linear post mammoplasty scars completed the trial. In any patient 3cm of the terminal part of the medial and lateral incisional lines were randomly allocated to be treated with PDL and the symmetrical site as control. The laser sites were treated three times on monthly intervals with 585-nm PDL which started 3 weeks after mammoplasty. The scars were evaluated by blinded examiner using the Vancouver Scar Scale (VSS) before laser sessions and 2 months after the last treatment. Two months after the last PDL session, there was significant improvement of vascularity, pliability and height of the scars in laser group (p value< 0.001), in contrast to the lesions in control group in which the improvement of vascularity (p value= 0.14), pliability (p value = 0.13) and height of the scars were not significant. The results of this RCT suggest that prophylactic 585-nm PDL irradiation is effective and safe in improving the quality and cosmetic appearance of post reduction mammoplasty incisional lines when used shortly (three weeks) after surgery.