Current Issue | Vol.2 Issue 3: Apr/May 2012

Laser-assisted facial contouring

Javier Moreno-Moraga, Josefina Royo de la Torre, Gema Pérez Sevilla

Objective: Facial ageing correlates with a gradual redistribution of soft tissue and an inversion of the ‘triangle of youth’. The shift in subcutaneous fat exacerbates the signs of bone ageing, with ptosis of the nasolabial fold. The labiomental fold and jowl appear on the lower third as a consequence of sagging fat. Laser-assisted facial contouring can be applied to directly treat sagging fat. This technique can be performed with local anaesthetic on an outpatient basis and with a short downtime.

Patients and methods: The authors used a dual-emission diode laser (924 and 975 nm) for facial rejuvenation in 124 women who completed a 3-month follow–up. Improvement was assessed double–blind using the Wrinkle Severity Rating Scale and the Global Aesthetic Improvement Scale. Data were analysed using SAS 9.2.

Results: Patients improved 1–2 degrees on both scales, with no difference as a result of the double-blind approach. Patient satisfaction was 7.3 out of a maximum of 10 points. The most significant side-effects were prolonged induration and burns, which can be avoided by perfecting the technique. All side-effects had resolved after 3 months of follow-up.

Discussion: Laser-assisted facial contouring was moderately to markedly effective, with high patient satisfaction. It improved skin tightening and reduced the incidence of injury. The flexible tip allows for ease of use. The technique provided better results than traditional liposuction approaches, was less invasive, and also prevented the facial disproportion that is sometimes caused by facial fillers used to correct the defects examined in the present study.

Conclusions: The outcome of laser-assisted facial contouring for the rejuvenation of the lower third of the face is satisfactory. However, it does not remove the need for rhytidectomy, dermal fillers, or autologous fat transfer.

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Hyaluronidase to treat HA excesses, fibrosis and granuloma

Philippe Deprez and Evgeniya Ranneva

Hyaluronidase is an enzyme that specifically dissolves hyaluronic acid polymers. In the past it has been largely used for undoing cellulitis fibrosis and more recently, for dissolving hyaluronic acid filler excesses of granulomas.

The use of hyaluronidase is very simple and comprises the injection of a sterile dissolution of the hyaluronidase powder directly inside the problem area to be treated. An allergy test is absolutely essential before every injection session, since hyaluronidase is an enzyme, an exogenous protein.

Results can be seen very quickly and are definitive.

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Skin boosting using NASHA-specific products

Marina Landau

Skin ageing is accompanied by a significant change in the dermal content of collagen and hyaluronic acid. It has been shown that enrichment of the dermis by injectable stabilised hyaluronic acid creates a long-lasting improvement in skin quality.

Following this clinical observation, a novel concept of skin boosting has been developed. Specifically designed skin boosters are effective and safe for this indication.

This article presents the theoretical basis and the clinical application of skin boosting using stabilised hyaluronic acid.

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Otoplasty today: maximal benefit with state-of-the-art surgery

Alexander Berghaus and Thomas Braun

The variety of otoplasty techniques can be grouped into three basic concepts: cutting, scoring, and pure suture techniques. Not only can suture techniques effectively create the antihelical fold, correct the concha cavum and a protruding lobule, but they also have the lowest risk of undesired creases, edges, defects, or deformities that are difficult to correct. By using biocompatible suture material, complications are rare.

Studies using validated tools show that successful otoplasty using suture techniques leads to a significant and long-lasting increase in the health-related quality of life of children and adults suffering from protruding ears.

The authors have therefore relinquished any aggressive cutting and scoring techniques and avoid skin resections. If a revision is needed, the prospect for success is excellent owing to the preserved cartilage and skin.

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Cosmeceutical dispensing in the aesthetic clinic

Wendy Lewis

There has been a worldwide explosion in skincare dispensing by physicians interested in supplementing their income in a tight economy. The growing market for cosmeceuticals, or cosmetic actives, is also driven by increasing consumer demand and confusion.

Cosmetic patients are seeking the expertise of professionals to help them make decisions on which skincare products and regimens are right for them.

These consumers want more than just a cleanser and a moisturiser. They want products that work quickly and reliably, make visible changes to their skin, and look and feel good. Along with function and performance, the products' sensory and emotional benefits must complete the package to entice customers to buy them.

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