Barbie vs. Star Wars: Part I -The Advent of Laser Cosmetic Medicine in Plastic Surgery

Park Avenue Plastic Surgery Class

Episode 2

Barbie vs. Star Wars: Part I -The Advent of Laser Cosmetic Medicine in Plastic Surgery


There are two major factors that transformed  plastic surgery from the classic limited number of aesthetic surgeries to the current modern approach:

  • Adaptation of Laser technologies for cosmetic medical applications
  • A broader vision of beauty
    1. This produced treatments that were more customized
    2. Later, the treatments became more ethnically diverse


Historically, the Barbie doll was a very monolithic concept of beauty,  not very much like real humans.  Plastic surgery historically relied on classic Greco-Roman concepts about facial harmony and proportion.  As we entered the 90’s and beyond, more customization and nuance in results were introduced into plastic surgery procedures.  This will be discussed more extensively in Episode 3.

Lasers have been used in skin surgery since the 1960’s, mostly for vaporizing skin lesions or to cut tissue instead of using a scalpel.  This took place at research and academic centers but was not a day to day part of dermatology or plastic surgery.

In the 1980’s a number of technological changes took place resulting in a flood of innovations in medical devices .  One factor fueling this in an unintended way was the strategic defense initiative which was launched by the Reagan administration to develop lasers which could shoot down ballistic missile.  Extensive funding was provided to national defense laboratories like Los Alamos and Lawrence Livermore for this purpose.  The Strategic Defense Initiative was nicknamed the star wars program.  After SDI was cancelled, national defense labs needed civilian uses for these technologies.  Few of these actually ended up in clinical medicine but this accelerated transfer of innovative technologies from use in defense to civilian applications primed researchers in many fields to find worthwhile applications in other fields.  Laboratory research data that had previously been of interest only to academic scientists was being re-examined for potential solutions to real world problems.

In the 1990’s the term translational research was coined but this activity was really taking place in the 1980’s in a big way.  Lasers became faster and easier to make.  The technologies transitioned from gas discharge tubes to sturdier, more compact solid state devices.  Substantial advanced in our understanding of laser –tissue interaction spawned an explosion of clinical applications for lasers in dermatology and plastic surgery in the 1980’s and early 1990’s.  Further advances in the 1990’s expanded these treatments to all skin types, not just light Caucasian skin.

Currently lasers are used for all manner of skin conditions.  Other energy based devices have played an increasing role using energy sources such as radiofrequency, ultrasound, microwave and broadband light (not a single wavelength like lasers).

  • Skin on the face, neck chest and hands are treated for redness, broken blood vessels, pigment changes like sun spots and dyschromia and wrinkles. Laser hair removal has revolutionized the treatment of large areas like the back and legs.  Laser and energy based devices are used for skin lifting, laxity reduction and smoothing.
  • Body skin smoothing and non-invasive treatment of fat are newer applications of lasers and energy based devices.
  • Surgical procedures have been enhanced by advanced laser and energy based tools providing enhanced outcomes or more precision.Safety –medical treatments –supervised by medical personnel –risks are minimized. Still some risk but reasonable.


Important Takeaways:

  • Many transformations have taken place in plastic surgery over the last few decades substantially improving care for patients.
  • There is a better understanding of individual beauty features, creating customized, not cookie cutter treatments and procedures.
  • Doctors and patients are considering a much broader concept of beauty and more ethnically diverse.
  • New technologies allow more complete rejuvenation than before.
  • Treatments are less invasive with less recovery time.
  • Laser and energy based treatments are medical treatments that must be properly supervised by licensed medical personnel. With proper patient selection and parameter selection for treatment goals and skin type, risks are minimal.



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