PEER-REVIEW | FACIAL AESTHETICS | COMBINING THERAPIES FOR THE AGEING FACE:


THE DUBLiN LIFT


Patrick Treacy presents a novel method for full facial rejuvenation, which combines a number


of treatments to obtain the most optimum results ABSTRACT


Objective The DUBLiN Lift: To establish the clinical effectiveness of combining five treatments in the rejuvenation of the ageing face in an effort to increase aesthetic effect, patient safety, and reduce laser downtime.


The face is the area for which the majority of patients seek cosmetic rejuvenation as the convex lines of a youthful appearance tend to flatten and droop as one grows older. The younger face is characterised by a balance captured in the classic shape of the inverted triangle. The reversal of this


‘triangle of beauty’ as ageing proceeds is considered generally less aesthetically appealing1


. At present, a variety of different


dermatologic and volumising treatments are available for facial rejuvenation. These include chemical peels, dermal fillers, intense pulsed light and radiofrequency lasers, platelet-rich plasmas (PRP) microneedling, microdermabrasion, botulinum toxin injections, and laser resurfacing. Each treatment has its own relative benefit, as well as risks2, 3


.


In recent years, facial rejuvenation has been revolutionised with the development of CO2


T


DR PATRICK TREACY is Medical Director of Ailesbury Clinics Ltd and Ailesbury Hair Clinics Ltd; Chairman of the Irish Association of Cosmetic Doctors and Irish Regional Representative of the British Association of Cosmetic Doctors; European Medical Advisor to Network Lipolysis and the UK’s largest cosmetic website Consulting Rooms. He practices cosmetic medicine in his clinics in Dublin, Cork, London and the Middle East


email: ptreacy@gmail.com 18 ❚ fractional laser skin


he face, and particularly the eyes, is very important for contact between humans, as this area provides a window to the rest of society with regard


to a patientÕs level of health, tiredness and emotional status, as well as interest in others4


. Many health professionals


consider the periorbital area of the face as the most important area of rejuvenation as eye-to-eye communication occurs in approximately 80% of all human interactions6


. Both


areas present a barometer of a patientÕs chronological and environmental age, and mastering the proper evaluation and execution of their aesthetic rejuvenation is paramount for all cosmetic doctors. More recently, patients are seeking


effective facial rejuvenation procedures with less downtime and low risks7


. This


change in attitude has been prompted by a realisation of both doctors and patients


January/February 2013 | prime-journal.com


resurfacing. This procedure benefits from faster recovery time, more precise control of ablation depth, and reduced risk of post-procedural problems. However, there have been cases of hypopigmentation, hypertrophic scars and skin mottling, most often seen on the face, neck and chest when the laser parameters are used more aggressively4


.


Furthermore, the technique does not attend to chronological ageing problems, such as volume deficits resulting from the loss and repositioning of facial fat. This article examines the possibility of combining five established therapies


in an attempt to address these deficits. The facial rejuvenating therapies include microneedling, low-dose UltraPulse laser, PRP growth factors, Omnilux 633 nm light, and neurotoxins. The technique is called the DUBLiN facelift as an acronym of the procedures involved: Dermaroller, UltraPulse laser, Blood growth factors, Light (near-red 633 nm), and Neurotoxin. The author compared this method


to fractional laser skin resurfacing with regard to the reduction of photoageing and overall aesthetic effect. Neurotoxin was used in both arms of the study.


For many years, CO2


that the much hyped non-ablative methods were often subject to extravagant claims in terms of efficacy2–4 laser resurfacing was


laser resurfacing with a fractional (CO2 Patients are .


considered the Ôgold standardÕ in treating photodamaged facial skin6–11


. Cutaneous )


laser involves the vapourisation of the entire epidermis, as well as a variable thickness of the dermis. Many physicians stated that the ultrapulsed CO2


laser was


the most effective method of laser resurfacing12–13


. Photodamaged skin is the


result of years of exposure to harmful ultraviolet light and is clinically demonstrated as a gradual deterioration of cutaneous structure and function. This results in the epidermis and upper papillary dermis having a roughened surface texture, as well as laxity, telangiectasias, wrinkles and variable degrees of skin pigmentation14–15


. Although ultrapulsed CO2 resurfacing lasers were considered the best


seeking effective facial rejuvenation procedures with less downtime and low risks.


KEYWORDS fractionalised laser resurfacing, platelet-rich plasma, microneedling, Omnilux 633 nm light, neurotoxin


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