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J Cosmet Dermatol ; 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34535947


BACKGROUND: The aging face is characterized by skin laxity and volume loss. Attenuation of facial retaining ligaments significantly contributes to skin sagginess and soft tissue volume loss. AIMS: We designed a prospective cohort study to quantitatively assess the efficacy of hyaluronic acid (HA) with adjunct poly-L-lactic acid (PLLA) injections in strengthening the retaining ligaments. PATIENTS/METHODS: A total of 12 Asian women were treated with HA injections to the orbital, zygomatic, buccal-maxillary, and mandibular retaining ligaments with adjunct supraperiosteal and subdermal PLLA injections to the temporal region, midface, and lower face. Cephalometric measurements were done before treatment and 2, 4, 12, and 24 weeks post-procedurally. RESULTS: Eyebrow peak and tail angles increased 20.0° ± 3.8° to 21.0° ± 3.8° (p < 0.05) and -2.9° ± 4.2° to -1.3° ± 3.3° (p < 0.001) at week 12. Eyebrow-to-orbital-rim distance increased 1.9 ± 2.0 mm to 3.9 ± 1.5 mm (p < 0.001) at week 12. Eyebrow-to-upper-eyelid distance increased 11.6 ± 3.0 mm to 12.7 ± 3.2 mm (p < 0.001) at week 24. Eyebrow-peak-to-lateral-limbus distance decreased 6.1 ± 3.1 mm to 5.3 ± 2.4 mm (p < 0.05) at week 4. Tragus-oral-commissure length and lower-facial-contouring length decreased 281 ± 11 mm to 275 ± 10 mm (p < 0.01) and 297 ± 14 to 292 ± 11 mm (p < 0.05) at week 12, respectively. CONCLUSION: Hyaluronic acid injection for strengthening of facial retaining ligaments with adjunct PLLA is viable, safe, and effective in facial rejuvenation as supported by quantitative data.

Dermatol Surg ; 47(1): e10-e14, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32271179


BACKGROUND: Picosecond lasers appear to be effective and safe in treating pigmentation and photoaging disorders through laser-induced optical breakdown. OBJECTIVE: To analyze the feasibility of photorejuvenation using picosecond lasers with diffractive lens array (DLA) in patients with melasma. METHODS: Ten Asian (N = 10) women with melasma and Fitzpatrick skin Type IV were enrolled and treated using 755-nm picosecond alexandrite lasers with DLA. All individuals were assessed before treatment, and at 12, 20 weeks, and 1 year by post-hoc test on melasma area and severity index (MASI) and with VISIA Complexion Analysis System using percentile rank for measurement. RESULTS: The median participant age was 46.5 years. The average MASI continually and significantly (p < .05) decreased until the 1-year follow-up, with the photoaging characteristics, such as wrinkles and red areas improving simultaneously (p < .05). Spots, texture, pores, ultraviolet (UV) spots, brown spots, and porphyrins exhibited alleviation, but this improvement relapsed by the 1-year follow-up. No postinflammatory hyperpigmentation or hypopigmentation occurred. CONCLUSION: In patients with melasma, picosecond laser treatment with DLA may alleviate pigmentation disorder and the related photoaging characteristics (e.g., wrinkled skin and increased vascularity), and the effects may be maintained for a long time. Nevertheless, post-treatment clinical visits every 3 to 6 months are recommended.

Grupo com Ancestrais do Continente Asiático , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade , Melanose/radioterapia , Envelhecimento da Pele , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos
Photobiomodul Photomed Laser Surg ; 37(9): 559-566, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31411549


Objective: To evaluate the efficacy and safety of picosecond (ps) 755-nm alexandrite laser with a diffractive lens array (DLA) generating laser-induced optical breakdown, which may be beneficial for melasma treatment. Background: Melasma is notorious for difficult to treat with any modality setting. Recently, picosecond alexandrite laser with DLA seems promising for dealing with it without intolerable complications. Methods: Twenty (N = 20) Asian female melasma patients with Fitzpatrick skin type IV were recruited for 3 treatment sessions of picosecond 755-nm alexandrite laser with DLA at a 4- to 6-week interval. The pulse duration was 750 ps. An 8-mm spot size and the fluence of 0.4 J/cm2 was used over the target area with 2 passes per treatment area and around 2000-2500 passes in total. The repetition rate was 10 Hz. Melasma Area and Severity Index (MASI) score and VISIA® imaging system analysis were utilized for evaluation before treatment and 4 weeks after the completion of the third treatment session. The clinical improvement and adverse events were assessed by the physicians and patients, respectively. Results: The median age of the patients was 45 years (from 27 to 55 years). In the physicians' evaluation, 40% (n = 8) of patients showed good improvement and 40% (n = 8) of patients showed moderate improvement. The mean MASI score before and after laser therapy showed significant improvement from 9.0 ± 4.8 to 6.5 ± 3.7 (p < 0.001). VISIA analysis of the forehead presented significant improvement in spots (p = 0.007) and porphyrins (p = 0.032). Some patients experienced erythema (25%), pruritus (20%), and scaling (20%) but subsided within few days of using emollients and sunscreen. Only 5% (n = 1) of patients developed mild postinflammatory hyperpigmentation, which also subsided in 3 weeks. Conclusions: Three sessions of picosecond 755-nm alexandrite laser with a DLA were effective for melasma treatment in Asian patients with minimal side effects.

Dermatoses Faciais/radioterapia , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Melanose/radioterapia , Adulto , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Pessoa de Meia-Idade