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A patient came to Dr. David Stall because she wanted to have a sizable lesion on her lower left lip removed. She had seen an oral surgeon that discussed using a scalpel and making a football-shaped incision that would possibly pull on her lip when sutured. She wanted to avoid this. The patient’s lesion seems firm but was raised, moveable, not painful, and she would often accidentally bite it. It was sized 10 x 10 mm as seen in Figures 1a and 1b. Dr. Stall discussed the use of the laser to release a flap and then the mass underneath.
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- Figure 1a: Large lesion on the lower left part of the patient’s lip.
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- Figure 1b: The lesion measured 10 by 10 millimeters.
The patient was given local anesthesia and Dr. Stall using his LightScalpel CO2 laser (set at 3 Watts, 20 Hz, 1500 MW, in SuperPulse mode), made a bloodless incision through the lip to access the lesion. The lesion was then excised (See Figures 2-4). He thought it was a lipoma and sent it to the lab for a pathology report. Four sutures (chromic gut 5-0) were placed to minimally approximate the margins of the large lesion without affecting the contours of the outer lip. Due to the hemostatic ability of the CO2 laser, the center of the surgical wound was left to heal by secondary intention.
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- Figure 2: After a bloodless incision using the LightScalpel CO2 laser.
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- Figure 3: The mass was then removed.
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- Figure 4: The surgical site showed immediately before placing sutures.
Compared to a conventional scalpel, the use of the LightScalpel CO2 laser in this lipoma removal offered several benefits. Some of these benefits include cutting in a non-contact mode (to avoid mechanical trauma to the tissue) and without bleeding and minimized postoperative pain, edema, and inflammation.[1]
The pathology report confirmed it was a non-cancerous lipoma. Recovery was uneventful and the patient was very happy with the results.
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- Figure 5: 2-weeks post-surgery. Healing well; some granulated tissue is visible.
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- Figure 6: 1-month post-surgery. With very minimal scarring, the surgical site is now almost invisible.
About Dr. David Stall
David E. Stall, DMD, is a general dentist and owner of David Stall Dental in West Chester, PA. Dr. Stall graduated from SUNY at Buffalo in 1977 with his B.A. in Geography. After receiving his Masters’s degree in Public Health at Tulane University, he moved to Philadelphia in 1979 to attend one of the top 5 dental schools in the nation, the University of Pennsylvania School of Dental Medicine. Following graduation in 1983, he spent the next year as a resident at the Mount Sinai Medical Center in New York City, where he received additional training in General and Hospital Dentistry. In 1985 he opened his dental practice in West Chester, Pennsylvania.
In 1989, Dr. Stall received the prestigious Academy of General Dentistry Fellowship Award, given to those dentists who have shown dedication to patient care through continuing education. Dr. Stall has taken over 1800 hours of continuing dental education courses since 1983 and is a past clinical instructor in restorative and cosmetic dentistry at the University of Pennsylvania. In addition, he mentors other dentists in areas relating to implant and restorative dentistry.
To learn more about Dr. Stall please visit his website at westtowndentalarts.com.
References
- Levine R, Vitruk P. “Enhanced hemostasis and improved healing in CO2 laser-assisted soft tissue oral surgeries.” Implant Practice US. 2015;8(3):34-37.
