Microwaves Versus Combined Microwaves and Fractional Carbon Dioxide Laser in the Treatment of Postpartum Abdominal Laxity Among Filipino Patients in a Tertiary Hospital: A Randomized, Prospective, Assessor-Blinded, Simultaneous Split-Abdomen Trial

Background

Postpartum abdominal laxity is a growing concern for women. Noninvasive options like microwave technology and fractional carbon dioxide (CO₂) laser show promise, but their combined efficacy and safety require further investigation.

Aim

To compare the efficacy and safety of microwaves versus combined microwaves and fractional CO₂ laser in the treatment of postpartum abdominal laxity among Filipino patients.

Patients/Methods

Thirty-two patients with Fitzpatrick skin types III–V and postpartum abdominal laxity received three microwave sessions, with one side randomly assigned an additional fractional carbon dioxide laser session (designated as Side B, while the other as Side A). Global aesthetic improvement scale (GAIS) scores and patient satisfaction (PS) scores were determined at every follow-up. Baseline and completion anthropometric measurements were taken, and adverse effects were recorded.

Results

Significant improvements in GAIS and PS scores were noted for both sides across all sessions (p < 0.001), with side B showing superior scores post-CO₂ laser (p < 0.001). A moderate correlation between metabolic equivalent (METs) scores and GAIS scores (p = 0.413, p = 0.019) indicated that higher levels of physical activity were associated with higher GAIS scores. These improvements were attributed to epidermal thickening and dermal collagen and elastin remodeling, the latter seen histologically in a representative patient. Adverse effects were mild and noted only with CO₂ laser.

Conclusions

The combined use of the microwave system and fractional CO₂ laser is safe and well tolerated and is superior to microwaves alone in the treatment of postpartum abdominal laxity.