Laser Therapy

Access procedures for initial visits and consultations for patients with cutaneous lesions (non-melanoma) and angiomatous and angiodysplastic conditions
Initial visits and consultations take place at the Laser Surgery Outpatient Clinic by prior telephone booking (02-23901).
At the time of booking, it is necessary to provide the patient’s full name, date of birth, and contact telephone number.
These visits take place every Thursday afternoon from 14:00 to 16:00 in room A of the Institute’s general outpatient clinic.

Access procedures for diagnostic and follow-up visits for patients undergoing laser therapy
Visits take place at the Laser Surgery Outpatient Clinic by prior telephone booking (02-23901).
At the time of booking, it is necessary to provide the patient’s full name, date of birth, and contact telephone number.
These visits take place every Tuesday morning from 9:00 to 13:00 in room D of the Institute’s general outpatient clinic, located on floor -1.

Access procedures for dressings related to patients undergoing laser therapy
Appointments take place at the Laser Surgery Outpatient Clinic by prior telephone booking (02-23901).
At the time of booking, it is necessary to provide the patient’s full name, date of birth, and contact telephone number.
These visits take place on Tuesday mornings from 9:00 to 13:00 in room D of the Institute’s general outpatient clinic, located on floor -1.

Diagnostic-Therapeutic Pathway
After being examined at the Laser Therapy outpatient clinic, the patient is admitted to the facility to continue the diagnostic-therapeutic pathway. Upon arrival, the secretary registers the patient’s presence, and an admitting nurse reviews the clinical documentation and any tests, carrying out a brief medical history. An admission form is completed, and the patient’s time of entry into the ward is recorded; the patient is then accompanied to the operating room and prepared for the procedure. At the end of the procedure, the surgeon writes the operative report and provides instructions for appropriate therapy, scheduling subsequent follow-up visits. The patient then leaves the operating room and goes to the facility’s administrative office, where the secretary provides the discharge report, schedules the first dressing appointment, and arranges the collection of any histological examination results according to the surgeon’s instructions.

CUTANEOUS NEOPLASMS
The activity of the Simple Structure of Laser Therapy is organized in the fields of elective reconstructive, post-oncological, and post-traumatic care, providing procedures aimed at restoring the morpho-functional integrity of the body area affected by disease.

Diagnosis
Diagnosis is carried out using clinical and instrumental methods (clinical dermatoscopy, dermatoscopy, incisional and excisional biopsy).

Therapy
At the laser therapy facility, treatment with CO2 laser is the first-line therapy and is performed on a Day Hospital basis.

TREATMENT OF VASCULAR LESIONS
Cavernous angioma, tuberous angioma, venous angioma, arteriovenous angioma, fibroangioma, and flat angioma are all descriptive terms belonging to older classifications and, as such, do not allow for precise diagnostic orientation or a consequent modern therapeutic approach.
“Angioma” is a very general term, usually used to refer to both infantile hemangioma and vascular malformations in pediatric age.
At the Laser Therapy facility, these malformations are managed through an interdisciplinary diagnostic-therapeutic pathway.

VON RECKLINGHAUSEN DISEASE
This condition is included in the national classification of rare diseases.
Treatment of the cutaneous manifestations of this pathology is performed using laser therapy, which allows either complete removal of the lesions or their significant reduction with minimal scarring and faster return to normal work or social activities.

Diagnosis
Clinical diagnosis is multidisciplinary, in collaboration with geneticists.

Therapy
Laser therapy is the first-line treatment.

SCAR OUTCOMES
Patients with hypertrophic or keloid scars are treated, resulting from major surgical procedures or following radiotherapy.

Diagnosis
Diagnosis is essentially clinical, with biopsy performed only in selected cases.

Therapy
Laser treatment, possibly combined with corticosteroids, is indicated in cases of hypertrophic or keloid scars.
For contractile scars, the first-line treatment is surgical.
For hypertrophic or keloid scars, the first-line treatment is laser therapy.
For scarred and dystrophic areas resulting from radiotherapy, the treatment of choice is surgical laser therapy.

STURGE-WEBER SYNDROME
Sturge-Weber syndrome is a rare congenital neurological and dermatological disorder.

Diagnosis
Diagnosis is essentially clinical, with biopsy performed only in selected cases.
Among the symptoms and clinical signs are venous malformations, glaucoma, and abnormal facial growth. Angioma is often present, while other manifestations include epilepsy, intellectual disability, hemiparesis, and, to a lesser extent, urogenital dysfunctions and obesity. Meningeal involvement is often observed; any brain lesions may become apparent only during childhood.

Therapy
Treatment of the angiomatous component involves the use of Nd:YAG laser, pulsed light, and, in selected cases, CO2 laser.

The facility collaborates with:
NEUROLOGICAL INSTITUTE C. BESTA
POLICLINICO DI MILANO (MEDICAL GENETICS)

The Structure is involved in clinical and experimental research activities in the following areas:

• treatment of rare conditions such as Nevus of Ota, Nevus of Ito, Von Recklinghausen disease, Sturge-Weber syndrome
• treatment of hypertrichosis in congenital nevi
• use of lipofilling associated with laser therapy
• intralesional laser treatment of cavernous angiomas
• evaluation of advanced dressings in postoperative treatment

Innovative therapies

• intralesional laser treatment of cavernous angiomas
• adipose cell transplantation associated with laser therapy

We have been and are engaged in the following activities:

• International Congresses;
• National institutional refresher seminars, including those held at external partner hospital sites, aimed at general and plastic surgeons;
• Institutional refresher seminars aimed at radiologists and radiotherapists;
• Monothematic training courses organized at institutional level;
• Production of CDs for the dissemination of oncoplastic techniques (Piccin);
• Drafting of specific informed consent documents;
• Intradivisional refresher days.

CONGRESS ACTIVITY TO DATE

1. Aesthetic surgery of the breast. Safe surgical approach – non invasive and minimally invasive surgical treatments. Fifth European Symposium. Milan, 28 November – 1 December 2012.
2. Oncoplastic breast surgery. 19–20 October 2012 – Stresa. Coordinators: Maurizio Nava – Vittorio Zanini
3. Oncoplastic and reconstructive surgery of the breast: Sixth European Conference. Milan, 14–17 December 2011.
4. Aesthetic surgery of the breast. Safe surgical approach – non invasive and minimally invasive surgical treatments. Fourth European Symposium. Milan, 9–11 December 2010.
5. “Oncoplastic surgery applied to breast surgery.” Piacenza, 4–5 June 2010
6. Oncoplastic and reconstructive surgery of the breast: Fifth European Conference. Milan, 9–12 December 2009
7. “Tissue regeneration in reconstructive and aesthetic surgery: platelet growth factors and adipose cell transplantation.” Santa Margherita Ligure, Genoa, 23–24 October 2009
8. “DCE-MRI: Principles and clinical applications.” Milan, 27 May 2009
9. Aesthetic surgery of the breast. Safe surgical approach – non invasive surgical treatments. Third European Symposium. Milan, 10–12 December 2008
10. “Imaging diagnosis in patients undergoing plastic surgery.” Milan, 21 November 2008
11. “Breast oncoplastic surgery.” Bormio, 5–6 September 2008
12. Plastic and reconstructive surgery of the breast: Fourth European Conference. Milan, 12–15 December 2007
13. “Breast reconstruction and radiotherapy: state of the art and new perspectives.” Milan, 28 May 2007
14. Aesthetic surgery of the breast. Safe surgical approach – pre-op and post-op breast detection. Second European Symposium. Milan, 14–16 December 2006
15. “Update on breast reconstruction techniques with prosthetic implants. Criteria for expander and final implant selection.” Forlì, 6–7 October 2006
16. “How to improve cosmetic outcomes after breast conservative surgery for cancer.” Milan, 3 July 2006
17. Plastic and reconstructive surgery of the breast: Third European Conference. Milan, 14–17 December 2005
18. “Imaging diagnostics in breast prosthetic implants.” Milan, 7 October 2005
19. “Conservative mastectomy.” Milan, 25 May 2005
20. “Breast reconstruction with prosthetic implants. Criteria for expander and final implant selection.” Brescia, 29–30 April 2005
21. “Workshop on biosystemic indicators for breast reconstruction.” Milan, 18 April 2005
22. Aesthetic surgery of the breast. Safe surgical approach – pre-op and post-op breast detection. First European Symposium. Milan, 9–11 December 2004
23. Plastic and reconstructive surgery of the breast: Second South American Conference. Buenos Aires, Argentina, 4–7 November 2004
24. “Update on breast plastic surgery topics.” Milan, 6 May 2004
25. Plastic and reconstructive surgery of the breast: Second European Conference. Milan, 9–14 November 2003
26. “How to optimize cosmetic outcomes after breast conservative surgery for cancer. Choice of surgical techniques.” Milan, 22–23 June 2003
27. “Immediate and delayed breast reconstruction. Criteria for expander and final implant selection.” 16 December 2002
28. Plastic and reconstructive surgery of the breast: First South American Conference. Rio de Janeiro, Brazil, 16–18 November 2002
29. “Back to Beauty” in collaboration with Elizabeth Arden. Milan, 19 October 2002
30. “First course on photodynamic therapy and technological evolution of laser sources.” Milan, 13–14 September 2002
31. “Back to Beauty” in collaboration with Elizabeth Arden
    Sessions:
    19 June 2002 – Milan
    26 September 2002 – Milan
    14 March 2003 – Milan
    9 December 2003 – Modena
    26 April 2004 – Milan
32. Plastic and reconstructive surgery of the breast: First European Conference. Milan, 11–14 November 2001
33. “Breast reconstruction: prostheses versus autologous flaps; indications and limits.” Milan, 20–21 November 2000
34. “Breast conservative surgery: how to improve aesthetic outcomes.” Milan, 15–16 November 1999