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ARTICLE | FACIAL REJUVENATION | Table 1 Study population WSRS


Absent Mild


Moderate Severe


Extreme Total


Total n


0


17 71 33 3


124 % 0 13.7


57.25 26.61 2.42 100


WSRS = Wrinkle Severity Rating Scale Mean age = 54.2 years Gender = 100% female


Table 2 Results of laser-assisted facial contouring on the middle and lower thirds of the face


Middle third ■ Reduction in thickness of the nasolabial fold


■ Reduction/elimination of nasolabial ptosis associated with a sagging appearance


■ Reduction of the anterior projection of submalar fat


■ Reduction of the malar crease, with increased luminosity of the cheekbone


■ Smoothing of the union of the eyelid with the cheek ■ Improved appearance of the submalar triangle ■ Reduced appearance of loss of volume ■ Reduced need for complementary filling ■ Overall contraction of the skin and surrounding tissue


Lower third


■ Reduction of the herniation of perioral fat that leads to bulges


■ Improved mandibular line, leaving a more youthful profile


■ Reduced presence of the fold anterior to the cheek ■ Reduced need for complementary filling


■ Improved roundness of the lower third and the facial triangles, which in turn reduces the classic ‘squaring’ brought on by ageing


■ Marked retraction of the skin and surrounding tissue


Figure 2 48-year-old female patient before (A) and after (B) treatment


forced. Consequently, skin surface irregularity and


lymphatic vessel rupture are common, explaining the persistence of oedema in this area. The most abundant bleeding produces hyperpigmentation10–14 Levi et alÕs15


. study in G˜ ttingen minipigs revealed


damage to the epidermal surface at temperatures above 46 C. Histologically, discreet bleeding, coagulation of collagen fibres, and adipocyte injury are observed on the first day after surgery. Adipocytes remain surrounded by histiocytes (a marker of lipolysis) 1 month after surgery. Collagen deposits can be observed in subdermal fat 1 week after surgery and are more intense at 1 month. Gentile16


showed more severe coagulation in a


laser-treated flap than a surgical flap. The objective of the authorsÕ study


The objective of the


authorsÕ study was to assess the degree of


rejuvenation obtained on


the lower and middle thirds of the face by applying laser-assisted


facial contouring in areas affected by the


displacement of fat pads.


was to assess the degree of rejuvenation obtained on the lower and middle thirds of the face by applying


laser-assisted


facial contouring in areas affected by the displacement of fat pads.


Material and methods Study design The authors performed a randomised double-blind study at Instituto M• dico L‰ ser, Madrid. The study population comprised 124 patients (Table 1), all of whom were women aged over 18 years (mean age 54.2 years). Patients were


instructed not to undergo any other treatment on the same area for the duration of this study. Written informed consent was obtained from all patients, and follow-up was scheduled to last 3 months. The study protocol complied with the guidelines of the


Declaration of Helsinki (1975) and was approved by the local Ethics Committee of Instituto M• dico L‰ ser. The exclusion criteria were as follows:


■ Active or chronic skin disease ■ Inflammation or other symptoms (cancerous or precancerous lesions) in the treatment area or neighbouring areas


■ Presence of non-reabsorbable fillers in the treatment area


24





April/May 2012 | prime-journal.com


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