Best Laser Treatment for a Deeper Vascular/Venous Malformation Inside Upper Lip?

Long Pulse Nd:Yag 1064 nm works, but Destroyed Hair Follices and left some scarring on the outside of upper lip.

Doctor Answers 4

Best laser for vascular lip malformation

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You have a few options for your vascular malformation, and it really depends on the size of this lesion. A laser such as a Vbeam is a great option, but surgical excision may also be a good option. Sclerotherapy in the right hands is also a reasonable option. Best to speak with your dermatologist and/or plastic surgeon to see the best option for you.

Toronto Dermatologic Surgeon

Laser Surgery

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The VBEAM by Candela is another consideration or you can sacrifice the hair and treat with a NdYag at a little lower setting. Thank you for your question and good luck.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Best treatment for deeper venous malformation is NOT laser.

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You have already demonstrated that laser treatment directed at deeper structures unfortunately damages those structures closer to the surface as well; in this case, your hair follicles and skin (causing scar formation).

I have treated true venous malformations for over 2 decades with sclerotherapy (utilizing sotradecol), and use lasers only for those vascular lesions close enough to the surface of the skin for effective laser energy absorption. I have taught laser surgery since 1988, and received my undergraduate degree in Math and Physics, so laser use is something I have always taught on the basis of energy interaction with tissue. Wavelength of laser energy, absorption characteristics at specific wavelengths and by specific tissue chromophores, depth of penetration (dependent upon the previous two items, as well as other factors), and actual efficacy is much more important than the idea that "Laser is high-tech, so it must be the best" for whatever application or medical situation that is at hand. This is a marketer's approach to laser surgery, not a (proper) physician's.

Consider consultation with someone versed in other options before asking "What is the best hammer?" This is not a nail, and a hammer is not the best tool for this situation. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Best laser treatment depends on the type of malformation

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I am sorry to hear about the hair follicle destruction.  This is unfortunately an adverse outcome of laser treatment for vascular malformation on hairy areas.

The anwer to your question depends on whether it is a true port-wine stain which is a capillary malformation or a a true venous malformation.  The former may do well with a long-pulsed alexandrite laser and applied from the inside of the lip and not from the outside.  Thus, you would be able to avoid the risk for hair loss. 

If it a venous malformation you may benefit form a long-pulsed diode laser (810nm). 

Hope this help.

Daniel I. Wasserman, MD
Naples Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.