Clinical evaluation of non-ablative radiofrequency facial rejuvenation.

OBJECTIVE: To evaluate the clinical efficacy of non-ablative cutaneous radiofrequency (RF) facial rejuvenation. DESIGN: Prospective study with longitudinal follow-up of a validation cohort set in an urban, private practice of an ambulatory facial plastic surgery center in southern California. METHODS: A consecutive sample was enrolled of 35 healthy adults with moderate facial aging, manifested by skin laxity, rhytids, and ptosis (brow, midface, jowls). Following intravenous sedation anesthesia, the study area was treated with 115-144 J/cm2 using the non-ablative RF device (ThermaCool TC). The main outcome measures were the objective measurement of brow height, investigator evaluation of skin parameters, a patient satisfaction questionnaire, and standardized photography, at fixed time intervals. RESULTS: At 12 weeks, a statistically significant increase in mean vertical brow height of 1.6-2.4 mm was observed in patients treated exclusively with the RF device (p<0.0001). All skin parameters (laxity, wrinkles, clarity, pore size) were improved. Complications and side effects were minimal. Patients were uniformly satisfied. CONCLUSIONS: The ThermaCool TC RF system represents a promising non-invasive method of obtaining moderate facial rejuvenation in the appropriately selected patient. Long-term results are pending.     

Laser peel: facial rejuvenation with a superficial erbium:YAG laser treatment

BACKGROUND : Facial rejuvenation is a popular procedure to temporarily mask the effects of aging. Most patients desiring this treatment are younger and want improvement without any down time. This study was conducted to evaluate the use of Er:YAG laser as a facial rejuvenation tool. METHODS : The full faces of 18 volunteers were treated with an Er:YAG laser using a fluence of either 5 or 10 J/cm 2 . All volunteers applied EMLA ® cream (lidocaine 2.5% and prilocaine 2.5%) two hours before the procedure and were treated with a single pass using a pulse duration of about 300µs. Follow-up visits were made in order to evaluate the degree of discomfort, erythema, swelling and improvement in skin aging. Skin biopsy was performed in one volunteer before and two hours after EMLA ® application, although preceding laser treatment. RESULTS : Most volunteers experienced moderate discomfort during the treatment. There was mild to moderate erythema and mild swelling. The improvement in general skin appearance, actinic bronzing and photo-damage was mild to moderate. The microscopic evaluation of pre-laser treated skin two hours after EMLA ® application was suggestive of increased water content in the dermis. CONCLUSION : The Er:YAG laser is an effective and safe tool for facial rejuvenation. With a superficial treatment, resolution of intense erythema is fairly rapid, averaging two to three days. The improvement, however, is mild compared to full laser skin resurfacing (LSR).     

Outcome of facial rejuvenation with polydioxanone thread for Asians

Background: Techniques in rejuvenating the aging face have evolved, involving various types of threads. Facial rejuvenation with absorbable polydioxanone is popular in aesthetic clinics in Korea. Aim: The purpose of this study was to describe our polydioxanone thread method and to evaluate the outcomes of facial rejuvenation. Patients/Methods: A retrospective chart review was performed over a 12-month period. Thirty-five Asian patients were included. All participants underwent thread-lifting using polydioxanone. On each side, five 360° spiral cog threads were used in the procedure. The results were evaluated using photography and patient satisfaction. Results: Thirty-three patients (94.3%) were satisfied with the outcomes. Objective outcomes using photography were categorized as very much improved (68.6%), much improved (25.7%), and improved (5.7%). Subjective outcomes using patients’ satisfaction were categorized as excellent, very good, good, fair, and poor. The incidence of complications was low, and the complications resolved spontaneously without any surgical interventions. Asymmetry, however, was noted. Conclusions: Using our technique, we could achieve the desired facial rejuvenation. Our method demonstrated an excellent success rate in patients with moderate degree laxity. We believe that facial rejuvenation with polydioxanone thread for Asians is a safe and effective treatment method.     

光电协同技术治疗面部敏感性皮肤疗效观察及定量评价

目的观察光电协同技术对面部敏感性皮肤的治疗效果及客观定量评价对皮肤屏障功能的影响。方法Goffin评分及乳酸试验确诊22例面部敏感性皮肤患者,并进行低能量强脉冲光联合射频治疗,3~4周治疗1次,5次为1个疗程。用VISIA皮肤检测仪及CK无创皮肤测试仪分别检测患者治疗前及治疗5次后皮肤主观特征及生理指标的变化,对比观察并计算统计学差异。结果强脉冲光联合射频治疗5次后,患者诉主观症状较前明显改善。VISIA皮肤检测仪结果显示,5次治疗后患者面部炎症反应较前明显改善,患者满意度较高。CK无创皮肤测试仪结果显示,与治疗前相比皮肤红斑值、经皮水丢失量(TEWL)、pH值减少,差异有统计学意义(P<0.01);皮肤含水量增加,差异亦有统计学意义(P<0.01);黑素值、皮脂含量有所减少,但差异无统计学意义(P>0.01)。所有患者无明显不良反应。结论光电协同技术治疗面部敏感性皮肤安全性高,对主观症状及炎症反应等效果显著,同时患者皮肤屏障功能明显改善,可作为治疗面部敏感性皮肤的新方法。     

A Randomized,Prospective, Split-Face Pilot Study to Evaluate the Safety and Efficacy of 532-nm and 1,064-nm Picosecond-Domain Neodymium:Yttrium-Aluminum-Garnet Lasers Using a Diffractive Optical Element for Non-Ablative Skin Rejuvenation: Clinical and Histological Evaluation

BackgroundThe advent of fractionated picosecond (ps) lasers has provided an opportunity to explore new ways of creating microinjuries in the skin to induce skin rejuvenation.ObjectiveTo compare the efficacy and safety of diffractive optical element (DOE)-assisted ps neodymium: yttrium-aluminum-garnet (Nd:YAG) lasers with 532-nm and 1,064-nm wavelengths (532-nm and 1,064-nm Nd:YAG P-DOE) using a novel fractional handpiece for the treatment of photoaged skin.MethodsAn ex vivo guinea pig skin experiment was performed by evaluating the histology of the skin after 532-nm Nd:YAG P-DOE irradiation. A randomized, prospective, split-face study was performed on eight subjects with 532-nm and 1,064-nm Nd:YAG P-DOE.ResultsBased on the histological evaluation using ex vivo guinea pig skin, a reasonable safety profile and the potential to generate effective skin rejuvenation was observed using the 532-nm Nd:YAG P-DOE. Results demonstrated that both 532- and 1,064-nm Nd:YAG P-DOE were similarly effective in improving skin texture and skin pores; however, 532-nm Nd:YAG P-DOE was more effective in treating dyspigmentation.ConclusionAt a preliminary level, this study revealed that 532-nm and 1,064-nm ps Nd:YAG lasers using DOE fractional technology may improve photoaged skin. In conclusion, 532-nm Nd:YAG P-DOE may be especially beneficial for skin with epidermal pigmentary lesions.     

Combination of microneedle radiofrequency (RF), fractional RF skin resurfacing and multi-source non-ablative skin tightening for minimal-downtime,full-face skin rejuvenation

Background: In the recent years, there is a growth in demand for radiofrequency (RF)-based procedures to improve skin texture, laxity and contour. The new generation of systems allow non-invasive and fractional resurfacing treatments on one platform. Objective: The aim of this study was to evaluate the safety and efficacy of a new treatment protocol using a multisource RF, combining 3 different modalities in each patient: [1] non-ablative RF skin tightening, [2] fractional skin resurfacing, and [3] microneedling RF for non-ablative coagulation and collagen remodelling. Methods: 14 subjects were enrolled in this study using EndyMed PRO^? platform. Each patient had 8 non-ablative treatments and 4 fractional treatments (fractional skin resurfacing and Intensif). Results: The global aesthetic score was used to evaluate improvement. All patients had improvement in skin appearance. About 43% had excellent or very good improvement above 50%, 18% had good improvement between 25 and 50%, and the rest 39% had a mild improvement of < 25%. Downtime was minimal and no adverse effect was reported. Conclusions: Our data show significant improvement of skin texture, skin laxity and wrinkle reduction achieved using RF treatment platform.     

Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation

Background Mesotherapy, commonly known as “biorejuvenation” or “biorevitalization”, is a technique used to rejuvenate the skin by means of a transdermal injection of a multivitamin solution and natural plant extracts that are thought to improve the signs of skin aging. Objectives This prospective study aimed to evaluate the clinical effect of mesotherapy applied to periorbital wrinkles and to quantitatively evaluate histological changes in the skin occurring in response to the same treatment. Methods Six volunteers with Fitzpatrick skin types III or IV and Glogau class I–III wrinkles were subjected to a three‐month course of mesotherapy injections in the periocular area (six sessions administered at two‐week intervals). Standard photographs and skin biopsies were obtained from the treatment area at baseline, at the end of treatment, and at three months post‐treatment. Quantitative evaluation of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin was performed using a computerized morphometric analysis. Results The clinical evaluation of volunteers at baseline, end of treatment, and three months post‐treatment revealed no significant differences. Histological and immunostaining analysis of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin showed no statistically significant changes (P > 0.05) after mesotherapy injection. Conclusions The present study indicates that mesotherapy for skin rejuvenation does not result in statistically significant histological changes or clinical improvement.     

寻常痤疮患者面部皮肤特征的定量评价

目的了解寻常痤疮患者面部皮肤特征表现,并进行定量评价。方法随机选取2011年1月～2012年6月在北京军区总医院激光美容中心进行痤疮治疗的180例痤疮患者和同一时期进行美容咨询的50名健康者,应用VISIA皮肤图像分析仪和SOFT5.5皮肤性质测试仪对患者和健康者皮肤性质进行定量分析和评价。结果 VISIA数据显示与男性健康者相比,男性痤疮患者在纹理、毛孔和紫质均有明显差异性（P〈0.05）,与女性健康者相比,女性痤疮患者在皱纹、毛孔、紫质和红色区均有明显差异性（P〈0.05）;与女性痤疮患者相比,男性痤疮患者在色素斑、毛孔和紫质均有明显差异性（P〈0.05）,与女性健康者相比,男性健康者在色素斑、皱纹、纹理、毛孔和紫质均有明显差异性（P〈0.05）,而红色区未见明显差异性（P〉0.05）;不同严重程度的痤疮患者差别主要在紫质和红色区;SOFT数据显示与男性健康者相比,男性痤疮患者在油脂有明显差异性（P〈0.05）,与女性健康者相比,女性痤疮患者水分和油脂均有明显差异性（P〈0.05）;与女性痤疮患者相比,男性痤疮患者在pH和油脂均有明显差异性（P〈0.05）,与女性健康者相比,男性健康者在水分和油脂均有明显差异性（P〈0.05）,而pH和弹性未见明显差异性（P〉0.05）;不同严重程度的痤疮患者差别主要在水分和油脂。结论寻常痤疮患者面部皮肤特征较健康皮肤表现为皮肤pH、水分和油脂等肤质的差异性且具有明显的性别差异性。     

脂肪蒂皮瓣在修复皮肤肿瘤切除术后面部缺损中的临床疗效观察

【摘要】 目的 探讨脂肪蒂皮瓣在修复皮肤肿瘤切除术后面部缺损中的临床疗效。方法 回顾分析了杭州市第三人民医院皮肤科收治的39例面部肿瘤患者的临床资料,男20例,女19例,年龄55 ± 7.3岁（范围42 ~ 80岁）,包括基底细胞癌15例,鳞状细胞癌10例,角化棘皮瘤5例和日光角化病9例。术后缺损面积1.5 cm × 3.0 cm ~ 8.0 cm × 4.5 cm。所有患者均接受肿瘤切除术后缺损脂肪蒂皮瓣修复治疗,术后24 h观察皮瓣存活情况,术后1、3个月及之后每3个月进行随访,观察皮瓣的外形、质地及与周围组织的匹配度等。结果 39例患者术后24 h,切口均无感染,皮瓣存活良好;2例皮瓣远端部分坏死,其皮瓣长与蒂宽比大于3∶1,为下睑部缺损,经处理后创面愈合。术后1个月,3例出现外观臃肿,其皮瓣长与蒂宽比分别小于2∶1、2∶1 ~ 3∶1、大于3∶1,其中2例为上唇部缺损,1例位于面颊部。所有患者随访1 ~ 12个月,平均7个月,皮瓣色泽和质地较好,供皮区和受皮区在功能和外形上均达到良好效果。结论 采用脂肪蒂皮瓣治疗面部皮肤缺损,临床疗效显著,皮瓣组织成活率高,安全可靠,同时对供区损伤较小。     

Split-face histological and biochemical evaluation of tightening efficacy using temperature- and impedance-controlled continuous non-invasive radiofrequency energy

Background: Bipolar radiofrequency (RF) is capable of heating dermal collagen fibers and inducing skin tightening by collagen remodeling. Objective: To substantiate safety and improvement of skin laxity following skin heating with a novel temperature- and impedance-controlled non-invasive radiofrequency (RF) device by histological and biochemical evaluations. Methods: A split-face study was performed on 4 subjects who underwent 8 weekly RF sessions on one side of their face, leaving the other side an untreated control and then underwent facelift procedure. Clinical evaluation by photographs was done prior to the surgical procedure. Ex vivo fragments were harvested from both sides and compared. Morphometric analysis of dermal collagen fibers, collagen synthesis, and elastin synthesis evaluations were compared in triplicates. Results: Facial skin tightening was apparent in split-face photographs. A significant increase of 7.9% in dermal collagen content, and a significant increase of 34.7% in collagen synthesis were demonstrated in the treated samples. No statistically significant effect on elastin synthesis was detected. Conclusions: Skin tightening following treatment with non-invasive RF has proven histologically and biochemically to derive from increase in dermal collagen synthesis and content.     

A Clinical and Biochemical Evaluation of a Temperature-Controlled Continuous Non-Invasive Radiofrequency Device for the Treatment of Melasma

BackgroundMelasma shows characteristic histological features of photoaged skin.ObjectiveWe evaluated the effect of dermal rejuvenation using a temperature-controlled continuous non-invasive radiofrequency (RF) device on melasma.MethodsContinuous skin heating at the temperature of 43°C for 20 minutes was performed in ten subjects with melasma who underwent 3 tri-weekly RF sessions. Pigmentation was evaluated with Mexameter® and investigator’s global assessment (IGA). Immunohistochemical staining and image analysis was performed to evaluate biopsies from melasma skin before and after the treatment.ResultsThe lesional melanin index was decreased by 13.7% at week 9. IGA score was improved from 3.50 at baseline to 2.95 at week 9. No significant adverse event was reported. Histologic analysis revealed reduced melanin and increased collagen density and thickness. The expression of procollagen-1 and type IV collagen was increased after the treatment. The number of p16^INK4A-positive senescent fibroblasts was reduced after the treatment, while the expression of heat shock protein 70 and 90 was increased. Stromal derived factor-1, a senescence-associated anti-melanogenic factor secreted from the fibroblasts, was up-regulated after the treatment, while the level of c-kit was not changed.ConclusionThermal skin stimulation by the temperature-controlled continuous RF device improved melasma through dermal rejuvenation.     

Clinical and histological evaluation of microneedle fractional radiofrequency treatment on facial fine lines and skin laxity in Koreans

Background

Facial wrinkles and sagging are the most visible signs of aging and can cause profound distress. Microneedle fractional radiofrequency (MFR) is a minimally invasive procedure, which utilizes both microneedling and radiofrequency energy to rejuvenate the skin.

Objective

To describe the safety and efficacy of a temperature-controlled MFR device on facial fine lines and laxity.

Patients and Methods

A retrospective chart & histology review was performed on individuals who received bipolar MFR for facial rejuvenation. A total of 15 Koreans with a median age of 46 years were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the participants' satisfaction scores. Histologic changes before, immediately after MFR and at 4 months follow-up was examined. Complications were also recorded.

Results

Partially denatured collagen fibers and dermal shrinkage was observed immediately after MFR whereas an increase in elastin and collagen was noted at 4 months follow-up. 86.7% of recipients considered the results satisfactory. Consensus ratings by two independent dermatologists on the objective outcomes at 4-month follow-up were very much improved (53.3%), much improved (26.7%) and improved (20%). Treatment was well tolerated and did not cause any significant long-lasting discomfort.

Conclusion

Temperature-controlled bipolar MFR is a minimally invasive treatment option to consider for facial fine lines and laxity via neo-collagenesis and neo-elastogenesis. The procedure was safe and clinically effective.     

低能量强脉冲光治疗104例面部敏感性皮肤病的疗效观察

双波长低能量强脉冲光能有效、安全治疗面部敏感皮肤.     

宫腔镜联合自凝刀射频消融子宫内膜治疗围绝经期功能性子宫异常出血的临床疗效分析

目的探讨宫腔镜联合自凝刀射频消融子宫内膜治疗围绝经期子宫功能性异常出血的临床疗效。方法选取2015年2月至2017年2月广东药科大学附属第三医院妇科诊治的81例围绝经期子宫功能性异常出血患者作为研究对象。随机分为观察组与对照组,其中观察组41例,对照组40例。观察组采用宫腔镜联合自凝刀射频消融子宫内膜治疗,对照组在超声引导下采用自凝刀射频消融子宫内膜治疗。观察比较两组患者的有效率、子宫内膜厚度以及Kupperman评分、血清卵泡生成激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平变化情况等。结果观察组平均手术时间、术中出血量同对照组比较,差异无统计学意义(P>0.05);观察组闭经率(65.85%)高于对照组闭经率(42.50%),差异具有统计学意义(χ~2=13.252,P=0.018),观察组总有效率(95.12%)与对照组总有效率(95.00%)比较,差异无统计学意义(χ~2=4.386,P=0.221),但秩和检验,差异无统计学意义(χ~2=4.386,P=0.221);观察组子宫内膜厚度及Kupperman评分与对照组相比,差异具有统计学意义(P<0.05);观察组血清FSH、E2、LH水平较对照组降低更为显著,差异具有统计学意义(P<0.05)。结论采用宫腔镜联合自凝刀消融子宫内膜手术,治疗围绝经期功能性子宫异常出血具有安全有效,可保留患者子宫,能显著提升患者疗效,更为彻底地消融子宫内膜,改善患者更年期综合征,降低血清激素水平,改善患者血清激素紊乱。     

Clinical evaluation of a novel fractional radiofrequency device for hair growth: Fractional radiofrequency for hair growth stimulation

AGA is a common disorder. Different treatments are available to prevent hair loss and achieve hair growth with variable results. The purpose of the present study was to evaluate the efficacy and safety of a novel fractional radiofrequency (RF) device (HairLux, Innogen Technologies Ltd., Yokneam, Israel), to prevent hair loss and induce hair growth. Twenty‐five patients received 10 fractional RF treatments every 2 weeks, and were followed up 2 months after the last treatment. All patients were evaluated by global photography. In 10 patients, blinded manual hair counts were performed. Patients demonstrated less hair shedding, fuller hair, and faster hair growth. There was an average increase of 31.6% in hair density (based on hair counts) and 18% increase in hair shaft thickness. All subjects tolerated the treatments well. The HairLux device is effective and safe for hair growth stimulation in AGA. Ten treatment sessions are recommended to maximize results.