| FACIAL AESTHETICS | PEER-REVIEW
ENCORE, Lumenis Ltd). Technical differences between this non-sequential fractional device and the older ultrapulsed CO2
include tissue bridges left between spots,
resulting in faster healing time, and less thermal damage to the basal cell membrane. The device has a smaller spot size (1300 mm rather than 2500 mm), resulting in less post-procedure erythema. The computer pattern generator lays down a random
series of spots rather than a sequential sequence resulting in less overheating of the treated tissue. This application is termed ÔCool ScanÕ, and was used with every patient in the study. The Traylife Kit (PRP) (Promoitalia Wellness Research)
provides blood plasma enriched with a concentrated source of autologous platelets that releases a number of growth factors and other cytokines that stimulate the healing of soft tissue. Omnilux Revive (633 nm) (Photo Therapeutics, Inc.,
UK) stimulates fibroblast activity, leading to faster and more efficient collagen synthesis and extracellular matrix proteins. Dermaroller Collagen Induction Therapy (CIT) is a minimally-invasive cosmetic procedure that involves the use of a micro-needling device. Scoring charts are presented in Tables 1–4.
Group 1: fractional laser skin resurfacing Phase 1 Dysport– treatment to three areas: glabellar, frontalis and periorbital.
Phase 2 (Week 2) Lumenis ActiveFX with settings (energy) 125 mJ (rate) 1 9w CPG 3/9/4. In the pre-laser procedure, the author typically
prescribes Valium (diazepam 5–10 mg orally) for anxiety, administered 45 minutes before the procedure. For infection prophylaxis, Famvir (famciclovir) 750 mg
daily or Valtrex (valcyclovir hydrochloride) 500 mg twice per day for 7 days, was prescribed for every patient starting 3 days before procedure. If the patient had a strong history of acne, doxycycline (100 mg daily) or Keflex (cephalexin 500 mg twice per day) was prescribed for 7 days, beginning on the day of surgery. Diflucan (fluconazole 150 mg) was not routinely prescribed in any patient. The patients were treated under topical and regional
anaesthesia. Topical anaesthesia comprised benzocaine 20%, lidocaine base 6%, and tetracaine 4%. Regional anaesthesia was three-fold: ■ Supraorbital and supratrochlear nerve block. The supraorbital foramen was located and 1 cc of 1Ð 2% lidocaine injected just above the bone laterally, with the needle directed medially, parallel to the brow and toward the nose
■ Infraorbital nerve block. 1 cc of 1Ð 2% lidocaine injected into the buccal cavity with the needle directed towards the infraorbital foramen
■ Mental nerve block. 1 cc of 1Ð 2% lidocaine injected into the mental foramen just above the bone level.
prime-journal.com | January/February 2013 ❚
Figure 5 Patient in differing phases of DUBLiN Lift
Group 2: DUBLiN lift Phase 1 Dysport– treatment to three areas: glabellar, frontalis and periorbital.
Phase 2 (Week 2) Microneedling Topical anaesthesia: benzocaine 20%, lidocaine base 6%, and tetracaine 4%. Each patient received an oxygenating skin cream
post-procedure to reduce erythema and inflammation. Tepid water was used to cleanse the face for the following 48 hours, and dried gently. It was recommended that make-up was not applied for 12 hours after the procedure. After the procedure, a broad-spectrum UVA/UVB sunscreen with SPF 50 was recommended for use.
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