ARTICLE | OPHTHALMOLOGY | The theoretical basis of
rejuvenation with light is based on the theory of selective photothermolysis combined with the phenomenon of stimulating the production of new
collagen, which occurs in response to mild thermal injury in the reticular and papillary dermis.
lid, which were treated over a few weeks using
Biafine. Using phototherapy, one woman experienced a pigmented spot, but this saw a spontaneous improvement in a few weeks, without any adverse sequelae. Such complications are generally rare.
Discussion The signs of facial ageing appear differently depending on the location. On the d•c olletage and neck, a gradual change begins to appear from the age of 20 years; in the mid-facial region (including the periorbital area) changes generally occur at around 40 years of age, and stabilising at 60 years. The work of Hester2
and Hamra3–9 shows that the lower
lid, releasing the orbitomalar ligament, is responsible for the pseudo-extension deformation to a ÔVÕ shape. If this analysis is not taken into account, and the deformation is not treated, the result of blepharoplasty will be insufficient. It is therefore important to consider the mid-face in the treatment protocol, with a concurrent malar lift or lipo-filling. The dynamic of a personÕs smile can give the appearance of youth by shortening the lower lid and malar area. To improve the texture and appearance of the eye,
treatments may include non-ablative RF and pulsed light, or ablative lasers. The use of the Ellipse delivers a beam of light with wavelengths between 350 and 1100 nm. The technology is based on a selective photothermolysis beyond traditional phototherapy by introducing heat to the equation ® the authors use the
Figure 4 52-year-old female before (A), (B), (C) and after (D), (E), (F) lifting blepharoplasty with fat graft
heat generated by the flash of light rather than eliminating it. With the addition of heat, a smaller amount of light is enough to reach the temperature of coagulation. By reducing the light energy to levels below 10 J/cm2
, there is no need to cool the skin and the risk of
dangerous side-effects is minimal. The rejuvenation of the skin can be divided into a
number of categories: ■ The removal of pigmented lesions (e.g. sun/age lentigines)
Figure 5 48-year-old female before (A), (B), (C) and after (D), (E), (F) lifting blepharoplasty, fat grafting and phototherapy
■ The removal of vascular lesions (e.g. rosacea) ■ Improving the texture and mitigation of fine lines and wrinkles.
Although the same type of treatment is used for all
underlying processes, the results produced are somewhat different.
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