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Better wound healing and less postoperative pain with laser procedures compared with the same procedure performed with the cold scalpel or with electrothermy were reported by those who first used the surgical laser in the late 1960’s and early 1970’s, which was an added beneficial component associated only with laser surgery compared with conventional methodology. This was obviously a photo-mediated effect rather than purely thermal or electrothermal and was first termed the ‘ -effect’ in the early 1990’s, was then classified by the author as simultaneous laser therapy in the mid 1990’s, but is now more accurately classified by the author in his latest classification of laser treatment as part of the auto-simultaneous aspect of laser treatment, whereby a number of different reactions can be obtained at the one time with a single laser. Laser/tissue reactions fall into three broad groups. Irreversible and destructive photoreactions in the tissue is classified as high-reactive-level laser treatment (HLLT), as in laser surgery for incision, excision, vaporization and tissue coagulation. If some irreversible damage occurs together with reversible photodamage, as in tissue welding, the author refers to this as mid reactive-level laser treatment (MLLT). If the level of reaction in the target tissue does not cross the survival threshold of the cells making up the tissue, then this is called low reactive-level laser therapy (LLLT). All three of these classifications can occur simultaneously in the one target, and fall under the umbrella of laser treatment (LT). Auto-simultaneous laser treatment (ASi-LT) is used to describe a treatment situation whereby 2 or more tissue reaction types are achieved simultaneously in tissue with the one laser, and accounts for the successful surgical application of the laser in many fields compared with conventional modalities, such as in laser full face resurfacing, nonablative skin regeneration and tissue welding, due to the beneficial actions on the wound healing process of the zone of photobiomodulated cells at the periphery of any such surgical beam.

AUTO-SIMULTANEOUS LASER TREATMENT: A NEW EFFECT-BASED CLASSIFICATION