| FACIAL REJUVENATION | ARTICLE References


1. Holcomb JD, Turk J, Baek SJ, Rousso ED. Laser-assisted facial contouring using a thermally confined 1444-nm Nd-YAG laser: a new paradigm for facial sculpting and rejuvenation. Facial Plast Surg 2001; 27(4): 315–30


2. Coleman S, Saboeiro A, Sengelmann R. A comparison of lipoatrophy and aging: volume deficits in the face. Aesthetic Plast Surg 2009; 33(1): 14–21


3. McKinney P, Cook JQ. Liposuction and the treatment of nasolabial folds. Aesthetic Plast Surg 1989; 13(3): 167–71


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5. Weiss RA, Beasley K. Laser-assisted liposuction using a novel blend of lipid- and water-selective wavelengths. Lasers Surg Med 2009; 41(10): 760–6


Discussion The results indicate that laser-assisted facial contouring is effective. The assessments applied show an improvement in the opinion of both the investigator and the blinded observer. This degree of improvement can be classed as moderate to marked. No negative results were observed. Patient satisfaction was more than 7 points out of 10. Of note, the authors observed no unnatural deformities or overcorrections, both of which are relatively common when treating with dermal fillers20, 21


or invasive surgery22–24 . Laser technology as a coadjuvant of liposuction


proved safe and effective for skin retraction, although opinions are divided as to the ideal device. The authors chose a cannula-free, continuous-emission device with a flexible tip, which many authors believe is safe and more manageable5, 6, 25–28


. The procedure was comfortable,


and the safety of continuous emission removed the stress involved in maintaining continuous movement to prevent burning. Any injuries caused did not lead to delays in recovery. The authors were unable to


find other studies concerning the necessary laser doses for treatment using the same device in the present study. While the authors have vast experience treating double chin cases with this methodology, the face is a different matter entirely and therefore burns sometimes occurred when the laser fibre was introduced. To more accurately assess this treatment modality,


6. Moreno-Moraga J, Royo de la Torre J. Our experience treating 500 lipodystrophic areas with a 924/975 nm Laser, a new device that induces lipolysis and heating of the dermis and fibrous septa of fatty tissue. J Clin Dermatol 2010; 1(2): 1–10


7. Apfelberg DB, Rosenthal S, Hunstad JP, Achauer B, Fodor PB. Progress report on multicenter study of laser-assisted liposuction. Aesthetic Plast Surg 1994; 18(3): 259–64


8. Anderson RR, Farinelli W, Laubach H et al. Selective photothermolysis of lipid-rich tissues: a free electron laser study. Lasers Surg Med 2006; 38(10): 913–9


9. Mordon SR, Wassmer B, Reynaud JP, Zemmouri J. Mathematical modeling of laser lipolysis. Biomed Eng Online 2008; 7: 10


10. O’Dey D, Prescher A, Poprawe R, Gaus S, Stanzel S, Pallua N. Ablative targeting of fatty-tissue using a


high-powered diode laser. Lasers Surg Med 2008, 40(2): 100–5


11. Khoury JG, Saluja R, Keel D, Detwiler S, Goldman MP. Histologic evaluation of interstitial lipolysis comparing a 1064, 1320 and 2100 nm laser in an ex vivo model. Lasers Surg Med 2008; 40(6): 402–6


12. Weiss R, Seckel B, Doherty S, Weiss M, Beasley K. Enhanced Tissue Retraction with a Novel Lipid-and-Water-Selective Device for Laser-Assisted Liposuction. Lasers Surg Med 2009; 41: 760–6


13. Childs JJ, Smirnov M, Zelenchuk A, Yaroslovsky I, Altshuler G. Selective Laser Induced “Melting”. http://tinyurl.com/7lv3yc7 (accessed 8 March 2012)


14. Ichikawa K, Miyasaka M, Tanaka R, Tanino R, Mizukami K, Wakaki M. Histologic evaluation of the pulsed Nd:YAG laser for laser lipolysis. Lasers Surg Med 2005; 36(1): 43–6


15. Levi JR, Veerappan A, Chen B, Mirkov M, Sierra R, Spiegel JH. Histologic evaluation of laser lipolysis comparing continuous wave vs pulsed lasers in an in vivo pig model. Arch Facial Plast Surg 2011; 13(1): 41–50


16. Gentile RD. Laser-assisted neck-lift: high-tech contouring and tightening. Facial Plast Surg 2011; 27(4): 331–45


17. Dover JS, Rubin MG, Bhatia AC. Review of the efficacy, durability, and safety data of two nonanimal stabilized hyaluronic acid fillers from a prospective, randomized, comparative, multicenter study. Dermatol Surg 2009; 35(Suppl 1): 322–30


18. Nast A, Reytan N, Hartmann V, et al. Efficacy and durability of two hyaluronic acid-based fillers in the correction of nasolabial folds: results of a prospective, randomized, double-blind, actively controlled clinical pilot study. Dermatol Surg 2011; 37(6): 768–75


19. Turlier V, Rouquier A, Black D et al. Assessment of the clinical efficacy of a hyaluronic acid-based


deep wrinkle filler using new instrumental methods. J Cosmet Laser Ther 2010; 12(4): 195–202


20. Mittelman H, Spencer JR, Chrzanowski DS. Chin region: management of grooves and mandibular hypoplasia with alloplastic implants. Facial Plast Surg Clin North Am 2007; 15(4): 445–60


21. Meier JD, Glasgold RA, Glasgold MJ. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg 2009; 11(1): 24–8


22. Holcomb JD. Facelift adjunctive techniques: skin resurfacing and volumetric contouring. Facial Plast Surg Clin North Am 2009; 17(4): 505–14


23. Calderon W, Andrades PR, Israel G, Cabello R, Leniz P. SMAS graft of the nasolabial area during deep plane rhytidectomy. Plast Reconstr Surg 2004; 114(2): 559–64


24. Rudkin G, Miller TA. Aging nasolabial fold and treatment by direct excision. Plast Reconstr Surg 1999; 104(5): 1502–5


25. Badin AZ, Gondek LB, Garcia MJ, Valle LC, Flizikowski FB, de Noronha L. Analysis of laser lipolysis effects on human tissue samples obtained from liposuction. Aesthetic Plast Surg 2005; 29(4): 281–6


26. Mordon S, Eymard-Maurin AF, Wassmer B, Ringot J. Histologic evaluation of laser lipolysis: pulsed 1064-nm Nd:YAG laser versus cw 980-nm diode laser. Aesthet Surg J 2007; 27(3): 263–8


27. Goldman A. Submental Nd:Yag laser-assisted liposuction. Lasers Surg Med 2006; 38(3): 181–4


28. Seckel BR, Doherty ST, Childs JJ, Smirnov MZ, Cohen RH, Altshuler GB. The role of laser tunnels in laser-assisted lipolysis. Lasers Surg Med 2009; 41(10): 728–37


As few complications


were observed, the safety margin of the technique can be considered high. Nevertheless, complications should be monitored carefully.


the authors propose a number of follow-up studies for the future: ■ A 2-year follow-up study ■ Laser-assisted facial contouring combined with fat grafts in areas of lost volume


■ An assessment of whether fat grafting with stem cells can improve the duration of the fat grafts.


prime-journal.com | April/May 2012


Conclusions The experience of the authors shows that the outcome of laser-assisted facial contouring is satisfactory for the rejuvenation of the lower third of the face; however, it does not remove the need for rhytidectomy, fillers, or autologous fat grafts. Laser-assisted facial contouring provides a better outcome than conventional liposuction approaches, reduces the need for an invasive approach (even if surgery is necessary), and prevents the disproportion sometimes observed with conventional fillers used to correct these defects.


 Declaration of interest The authors declare that they have no relationship with the manufacturers of the laser and that they have received no financial support for this study.


 Figure images 1–6 ç J. Moreno-Moraga, J. Royo de la Torre, and G. Perez Sevilla


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