Intense Pulsed Light: A Methodical Approach to Understanding Clinical Endpoints.

BACKGROUND: Intense Pulsed Light (IPL) is a non-coherent polychromatic broadband filtered flashlamp that emits light in the spectrum of approximately 400–1200 nm. Its effects on photorejuvenation are well documented. The goal of this study is to help practitioners better conceptualize and fine tune IPL device settings in order to produce the most effective and safest clinical outcome. MATERIALS/METHODS: This was a prospective study testing several filters (515 nm; 560 nm; 590 nm and 530–650; 900–1200 nm vascular filter), fluences, pulse durations, and pulse numbers (ie, multiple sequence pulsing or MSP) with a new IPL system. RESULTS: Post-procedure erythema response was more pronounced with increasing fluence, decreasing wavelength, fewer pulses and shorter pulse duration. The exception was the 515 nm filter with regard to pulse duration, which was observed to have a more pronounced response with longer pulse durations. The overall clinical outcome at the 4-week follow-up visit demonstrated greatest improvement in erythema and pigmentation using the 515 nm filter on a Fitzpatrick Skin Type III individual. CONCLUSION: Greatest clinical endpoint response at 4-week follow-up was observed with more robust initial responses. This was most apparent at higher fluence levels and fewer pulse counts. However, when the IPL is pushed to aggressive parameters, there is risk of hypopigmentation and hair loss as seen in this case study. Skin type is an important consideration when using IPL and MSP adds to its safety profile. J Drugs Dermatol. 2021;20(2):203-207. doi:10.36849/JDD.5638.

Safety and Efficacy of a Novel 730 nm Picosecond Titanium Sapphire Laser for the Treatment of Benign Pigmented Lesions.

BACKGROUND AND OBJECTIVES: Picosecond lasers in dermatology were originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have expanded its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this retrospective review, we evaluate a novel 730 nm picosecond titanium sapphire laser in treating benign pigmented lesions. STUDY DESIGN/MATERIALS AND METHODS: This is a retrospective review of all patients who presented to our institution between December 2019 and March 2020 for treatment of their benign pigmented lesions with a 730 nm picosecond titanium sapphire laser. All Fitzpatrick skin types (I-VI) were included. Absolute and relative evaluations were conducted by two blinded board-certified dermatologists using high-resolution photographic images. RESULTS: Twenty-two of 64 patients satisfied inclusion and exclusion criteria. Patients received 1.1 ± 0.3 treatment sessions. The absolute average pigmentation score prior to treatment was 2.04 ± 0.7 versus 1.39 ± 0.6 after treatment (P < 0.05). Improvement in pigmentation was observed in 86% of the patients, while 3% had no improvement and 11% had worsening of pigmentation. No other adverse events were observed. Downtime consisted of 1-2 days of mild edema and erythema followed by 3-5 days of mild pigment darkening and superficial crust. CONCLUSION: The novel 730 nm picosecond titanium sapphire laser is a safe and effective treatment for benign pigmented lesions. Future prospective randomized control studies would be beneficial to further clarify its role in the treatment of benign pigmentation. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Evaluation of Long-Term Outcome and Patient Satisfaction Results After Tumescent Liposuction.

BACKGROUND: Liposuction is one of the most common cosmetic surgery procedures around the world. Tumescent liposuction using local anesthesia has been shown to be the safest technique. Few long-term studies of results and satisfaction have been published on tumescent liposuction. OBJECTIVE: To evaluate long-term results and patient satisfaction of tumescent liposuction in a single-center institution. METHODS: Patients (n = 600) who had tumescent liposuction performed in our practice from 2002 to 2014 were contacted through letter, email, or phone to complete a questionnaire survey and in-office follow-up visit regarding their past liposuction procedures. RESULTS: Thirty-two patients (n = 32) completed the patient questionnaire survey and followed up in the office. Surgeon and blinded evaluators saw significant differences in both the neck volume (surgeon evaluator: 2.42 vs. 0.71, p < .01; blinded evaluator: 2.8-1, p = .02) and Investigator Assessment Skin Laxity scales (blinded evaluator: 1.14 vs. 0.77, p < .01 for laxity and 1.33 vs. 0.75, p < .01 for firmness; surgeon evaluator: 1.17 vs. 0.83, p = .01 for laxity and 1.31 vs. 0.83; p < .01 for firmness). The mean follow-up period was 8.9 years overall and 9.9 years for the neck. Overall, 85.7% of the patients would recommend liposuction to their friends and family members. CONCLUSION: Tumescent liposuction is a safe procedure with long-lasting results and high patient satisfaction.