PEER-REVIEW | FACIAL AESTHETICS |
Parameter Global score
Fine lines Pigmentary
problems Touch
problems Facial veins Coarse lines Complexion
Table 1 Patient treatment (positive) scoring chart 0
1 Area of
None None
Even None
None Pink
roughness roughness roughness roughness roughness x 0
Area of x 1
Rare
Area of x2
Area of x3
Patchy Moderate Heavy Rare
Mild
Rare Rare Pale
Area of x4
Several Moderate Many Marked
Moderate Several Moderate Slightly
Severe Severe
Several Moderate Many Grey
Distinct yellow-grey yellow-grey Parameter
Table 2 Patient treatment (negative) scoring chart 0
1
(herpes/acne) Crusting Pain of
procedure Improvement
Erythema severity None Infective outbreak
None None None
Rare Rare Rare Mild
None Minimal 2 3
Several Moderate Several Moderate Several Moderate Tolerable Moderate Fair
Good and dermis can be targeted by microneedling and
near-red light, resulting in fibroblast stimulation. Omnilux Revive (633 nm) therapy stimulates fibroblast activity, leading to faster and more efficient collagen synthesis and extracellular matrix (ECM) proteins. It also increases cell vitality by increasing the production of cellular adenosine triphosphate (ATP) and stimulates the contractile phase of the remodelling process producing better lineated collagen30–33
. Collagen induction therapy is
an aesthetic medical procedure that involves repeatedly puncturing the skin with tiny, sterile needles. Typically,
4
Severe Severe Severe Severe
Excellent 2 3 4
this is done with a specialised instrument called a microneedling device. Controlled studies have suggested that the application
of PRP can enhance wound healing in both animals and humans29
. Five major growth factors such as transforming
growth factor (TGF), insulin-like growth factor (IGF), platelet-derived growth factor (PDGF), epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF) are known to be related to the wound-healing processes28
.
These growth factors are released from platelets, and the production of collagen and fibroblasts is stimulated by IGF, EGF, Interleukin-1 (IL-1) and tumour necrosis factor (TNF)-α34, 35
. In vivo studies report TGF-β to be the most
stimulative growth factor. PRP may be used for dermal augmentation and Sclafani observed aesthetic improvements of the nasolabial fold in less than 2 weeks, and the results lasted for up to 3 months28, 29
.
Research design and methods This multi-centre randomised study included 44 patients of skin types 1 and 2 aged between 39 and 68 years, presenting with photoageing of the skin, 37 of whom were women and seven were men. The subjects presented with the typical hallmarks of chronological and photoageing, such as expression lines, rhytides, wrinkles, eyelid skin laxity, dermatochalasis, lowered brows, lateral hooding, and prominent fat pads. All patients were subjected to a programme of skin tightening and neocollagenesis by one of two methods: conventional fractional laser skin resurfacing (Group 1) or the DUBLiN Lift (Group 2). The mean patient age in Group 1 was 49 years (range 37–71 years) and in Group 2 was 55 years (range 41–76 years). Fifteen patients underwent Lumenis ActiveFX with
settings as (energy) 125 mJ and (rate) 19 w CPG 3/5/4. Twenty-nine patients received the DUBLiN Lift, a three-phase combination of established treatments with microneedling, platelet growth hormones, near-red
633 nm light, and low-energy UltraPulse fractional CO2 laser skin tightening. All patients received Dysport– in
Patient histology Carbon dioxide laser ablative fractionalisation
All skin biopsies show the effect of thermal treatment with thermal coagulation of the epidermis and superficial dermis
Depth range 113 microns 22 ❚
Group 1 patient showing ablative CO2
laser penetration to 118 nm.
Group 2 patient at Phase 3. Depth range 85 microns
Group 1 patient showing collagen formation at 3 months. Depth range 700 microns
Group 2 patient showing collagen formation at 3 months, representing a skin biopsy from a Group 2 patient 3 months post-treatment. Depth range 118 microns
January/February 2013 |
prime-journal.com
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