FACIAL REJUVENATION
News From the ‘Cutting Edge’
Dr. Larry Bishop
I RECENTLY returned from the American Society of Dermatologic Surgeons annual meeting, which gives an insight into the always-changing trends in dermatologic surgery. This meeting, along with the American Academy of Dermatology, is one of the premier events which vendors of lasers, cosmetic medical devices and instruments showcase their new products.
As always, the meeting is as much about what’s new in cosmetic and dermatologic surgery, as well as how well those new devices work. It’s a great way to get insight into the research labs, and see what real world results those devices bring.
The vendors display their products in a mammoth exhibit hall we fondly call “the carnival,” but since each salesperson is trained to put his or her product in the best possible light, it is nearly impossible to sift through claims and counterclaims of the competing technologies. That’s where the seminars come in handy.
Every major medical device goes through an exhaustive process where it is tested for safety and effectiveness. However, all devices are not equal in safety and effectiveness, and we rely on the physicians who tested those products and high tech devices to tell us the ins and outs of how they really work. And the results are sometimes very illuminating.
Fractional Lasers
The biggest buzz at this meeting was generated by a group of relatively new devices called fractional CO2 lasers. Derived from the technology that drove the wildly popular fractional Erbium lasers into the stratosphere, these new lasers split the beam as did the original fractional lasers, but have a much more potent wavelength resulting in very dramatic results without the pigment loss that plagued the old CO2 lasers.
Dramatic Results
By using this fractional technology, laser surgeons can achieve more dramatic results in one or two sessions than could be accomplished with the Erbium laser. Both the facial and off-facial results with the fractional laser rival the old ablative laser results, but without the nearly two weeks of downtime. Make no mistake, though. The new lasers have at a minimum three to five days of down time, which is far more than the Erbium lasers, but with more dramatic results.
The distinct advantage of the new fractional CO2 lasers is that for the first time, we are seeing significant tissue tightening, as well as very dramatic reduction in facial lines, marked reduction in the color changes of more mature skin, and significant improvement of skin texture with old scars such as acne scars. The Erbium lasers provide the same changes other than skin tightening, but with less dramatic results. Both the Erbium and the CO2 fractionals have their niche, and you should listen to your doctor for advice as to which way to go.
EVOLENCE, derived from pig collagen, shows promise in the correction of mild to moderate lines of the face. Since Evolence is relatively new, it is unclear as to whether or not it has any significant advantages over hyaluronic acid fillers such as Juvederm and Restylane.
Pig Collagen Derived Fillers
There continues to be more movement in the fillers used to correct smile lines and add fullness to the face. There is a new product out, derived from pig collagen, which shows promise in the correction of mild to moderate lines of the face. The product is called Evolence, and it is used exactly the same as the other fillers. Since it is relatively new, it is unclear as to whether or not it has any significant advantages over the hyaluronic acid fillers such as Juvederm and Restylane. Time will tell whether this new product will meet the high standards of its predecessors.
Treatment for Cellulite
At the Society meeting, there were some very illuminating talks by researchers about what works, and what doesn’t. The general consensus is that there is no good treatment at present for cellulite that provides reproducible, long term results. Additionally, on the same subject, there has been an intense marketing blitz by manufacturers of laser-assisted lipolysis (breaking down of fat by using a laser) devices, but they seem not to provide any benefit that would not be derived from the gold standard, tumescent liposuction.
Skin tightening devices are showing some modest gains, and the general consensus is that the patients achieve results for 12 to 18 months. Thermage seems to be the industry leader in this regard, with other devices showing more modest gains.
Acne Treatment
Finally, in the realm of acne treatment, there was an interesting series of discussions on the uses of devices to treat the active lesions of acne as well as the post-acne complications of pigmentation and scarring. The newest wrinkle in acne treatment seems to be the use of what is known as photodynamic therapy, often with the use of a device that combines suction with intense pulsed light.
The patients are first treated with a topical solution of a light-sensitizing agent known as Levulan, and then treated with the suction/intense pulsed light device known as the Aesthera Isolaze, which leads to destruction of the acne-causing bacteria, and additionally shrinkage of the oil glands and removal of the debris that obstructs the pores.
Getting Better and Better
Well, there you have it! A short overview of the hot topics from the American Society of Dermatologic Surgeons. As you can tell, the technology just keeps getting better and better, but not all that glitters is gold. The manufacturers will continue to make new machines and products they promise will make us good looking and we, the doctors, will continue to make sure they are telling the truth.
Dr. Bishop graduated with honors from Wright State University School of Medicine, and served in the Air Force for nine years. He is an affiliate of MIMA and specializes in cosmetic and surgical dermatology, including Mohs Micrographic Surgery, as well as non-surgical rejuvenation of the face. He has lectured on dermatologic surgery techniques both in the U.S. and in Europe. For more information CLICK HERE, or you may call Dr. Bishop at 321-751-9097.
Related posts:
Recent COmments