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PEER-REVIEW | DERMAL REJUVENATION |


Figure 4 61-year-old female. (A) before treatment and (B) after three treatment


sessions. A significant wrinkle reduction can be seen in the perioral and chin area


40–42 C. Treated areas were visually assessed for skin


responses, including oedema, erythema, and textural changes following the treatment. Dedicated questionnaires were used for both doctor and


patients in order to grade different parameters, such as efficacy, safety, and comfort of treatment, in addition to subjective satisfaction of the patients. The patient answered the questionnaires at the end of the six sessions, at 1-month and 3-month follow-up. In addition, the physician answered a dedicated questionnaire for each patient. Clinical improvement in skin laxity and texture was


evaluated by the physician. Evaluation of the clinical improvement was based on a scale of improvement (Table 1).


Results All patients completed six treatment sessions, except for two patients: one who had only five sessions, and one who had eight sessions. The patient who had only five sessions did not attend the sixth appointment owing to personal reasons. The patient who received eight treatments had two shorter than usual sessions (of the standard six), so the physician decided to administer two further treatments for this patient. Fitzpatrick Wrinkle and elastosis Scale (FWS) scores before the treatment sessions ranged between 3 and 8, while FWS after six treatment sessions ranged between 2 and 7. Three months after the end of treatment, the average Fitzpatrick scale decreased by more than one level. All patients except for two had a decrease in Fitzpatrick scale of at least one level (Figure 3). Before and after images can be seen in Figures 4 and 5.


All subjects


experienced mild to moderate oedema and erythema as an immediate response to the treatment. Both oedema and erythema were resolved after one hour post- treatment.


Patient experience The patient experience was evaluated using multiple choice questionnaires. All subjects experienced mild to moderate oedema


and erythema as an immediate response to the treatment. Both oedema and erythema were resolved after one hour post-treatment. No unexpected adverse events were detected or reported. Eighty percent of patients reported the treatment as comfortable (no discomfort at all) and 17% reported minimal discomfort during the treatment. None of the patients experienced burns, skin breakdown, or scarring. No patients reported any pain during the study (Figure 6). When asked at the end of the last session whether treatment met expectations, 67% of patients responded


ÔyesÕ, and 27% responded Ôyes to some extentÕ (Figure 7). When asked at the end of the last session their subjective


opinion of the cosmetic change they experienced, 54% reported an improvement greater than 50% (NB. two patients did not answer this question) (Figure 8). When asked whether they would recommend the skin


tightening treatment to their colleagues and friends, 67% of patients answered Ôdefinitely yesÕ and 20% answered


ÔyesÕ (Figure 9). All but one patient believed that the treatment had a


Figure 5 62-year-old female (A) before treatment and (B) after six treatment sessions. A significant improvement in skin laxity in the lower face and a reduction of wrinkles can be seen


noticeable tightening effect (one patient did not answer this question as she could not evaluate), with 55% of patients experiencing a noticeable wrinkle reduction (three patients did not answer this question). All but one patient believed the treatment had a noticeable improvement in skin texture (one patient did not answer this question), and that the treatment improved the contour of their face and neck (one patient did not answer this question).


Physician evaluation No complications were recorded during the treatment sessions. Eighteen patients had undergone a skin tightening


treatment with a different technology in the past; 82% of these patients reported the same or better result with the EndyMed Pro system (this question was not answered by one of the patients). The author was satisfied with the safety of the


84 ❚


EndyMed Pro system, both with the ease of performing the skin tightening treatment procedure and with the duration of the treatment procedure while using the EndyMed Pro system.


March 2013 | prime-journal.com


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