ARTICLE | FACIAL AESTHETICS |
was superior in 62% and 55.2% of patients respectively, while fractional laser skin resurfacing was superior in 33.3% and 34.4% of patients. (P < 0.0004). An ÔoptimalÕ cosmetic result was achieved in a higher percentage of patients in Group 2 compared with Group 1. Investigator-based and patient-based ratings using both
the WSRS and GAIS indicated that the DUBLiN lift was more effective than conventional ablative laser resurfacing in creating cosmetic correction to the lower face. This resulted from the volumising effect of adding PRP to the larger folds in this area. At 3 months post-treatment, a higher proportion of patients showed a greater than or equal to 1-grade improvement in WSRS with the DUBLiN Lift compared with fractional laser skin resurfacing. The author suspects the PRP may have a longer aesthetic effect when used in association with microneedling and 633 nm light than previously noted27, 29
. However, the results
were almost reversed whenever periorbital rejuvenation was assessed alone, with almost every patient (93%) favouring conventional fractional laser skin resurfacing. Investigator-based GAIS assessment of this region at 3 months after baseline indicated that fractional resurfacing was superior in 93% of patients, while the DUBLiN Lift was superior in 6.8% of patients (P = 0.0025).
Facial ageing is a consequence of many interacting
intrinsic and extrinsic factors. The most important of these include sun exposure or photoageing, and the intrinsic changes associated with chronological ageing.
Histological results were obtained from both groups
showing the depth of laser penetration and consequential formation of new collagen. All skin biopsies showed thermal coagulation of the epidermis and superficial dermis in a depth ranging from 85 to 113 m . The zone of residual thermal (coagulative) damage was less in the Group 2 patients, in whom less laser energy was used. The best neocollagenesis results ® at 3 months ® were evident in Group 1, in which one patient had evidence of effect at 700 m . This was reflected in the patientÕs skin, which continued to improve over the period. Owing to the variance in energy of the CO2
laser in Group 1 and
Group 2, it was expected that the documented depth of histological ablation and thermal effects would vary between them. Responses of aesthetic effect were evaluated at 6 and 12 weeks after baseline. The two methods appeared to produce different
clinical improvement of lesions and rhytides. The GAIS for photoageing for the DUBLiN lift improved from 13.2 to 10.2 at day 30. This compared to 13.8 at baseline and 9.6 at day 30 for conventional fractional laser skin resurfacing alone. The score for fine lines was the most significant reduction, dropping from 3.6 at baseline to 1.4 at day 30. The score for reduction of coarse wrinkles (3.2 at baseline to 2.2 at 6 weeks) was more difficult to interpret in this heterogeneous age grouping, with older patients requiring the conventional ActiveFX settings rather than the ÔsofterÕ settings. According to investigator-based WSRS and GAIS assessments at 3 months after baseline, the DUBLiN lift
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Objective results Re-epithelialisation occurred in all laser-treated areas of both groups by day 7, and this appeared to be clinically similar for both procedures. Mean duration of erythema was 6.9 days after resurfacing (range 4–10 days) in Group 1 and 4.2 days in Group 2 (range 3–7 days). This appeared to be in keeping with previous studies37
. All patients reported
having no ÔcrustingÕ effect remaining on their face after 6 days. Residual erythema remained in one patient in Group 1 for a period of 14 days, but this was minimal. Post-operative erythema was most intense in the areas treated with the ActiveFX at an energy level above 125 mJ. The mean pain sensation (Table 2) felt during the
DUBLiN lift was 2.2 compared to conventional fractional resurfacing treatment, which was 3.4. The author noted that most patients did not feel much pain at all with the ActiveFX until the energy level crosses 100 mJ. No patient
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