2017-18 HSC Section 4 Green Book

FACIAL REJUVENATION USING MULTIPLE LASER MODALITIES

a high density and high fluence deep fractional CO 2 ablation, and a fully ablative non-fractionated Er:YAG in the same treatment session; considerable pigment- and vascular-specific work; and fractional CO 2 ablation of the neck. The results achieved are therefore superior to that which can be achieved with any combination of pulsed light or non-ablative laser. Importantly, safety and acceptable healing times were still maintained. For those patients who present with advanced photodamage and desire the most striking result, the aggressive combination approach described in this study is ideal. With excellent results and the requirement for only one treatment session, patients are well-served with a simul- taneous multi-modal approach to facial rejuvenation. REFERENCES 1. Fitzpatrick RE, Goldman MP, Satur NM, Tope WD. Pulsed carbon dioxide laser resurfacing of photo-aged facial skin. Arch Dermatol 1996;132:395–402. 2. Manuskiatti W, Fitzpatrick RE, Goldman MP. Long-term effectiveness and side effects of carbon dioxide laser resurfac- ing for photoaged facial skin. J Am Acad Dermatol 1999;40: 401–411. 3. Nanni CA, Alster TS. Complications of carbon dioxide laser resurfacing. An evaluation of 500 patients. Dermatol Surg 1998;24:315–320. 4. Tajirian AL, Goldberg DJ. Fractional ablative laser skin resurfacing: A review. J Cosmet Laser Ther 2011;13:262–264. 5. Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: A new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004;34:426–438. 6. Shamsaldeen O, Peterson JD, Goldman MP. The adverse events of deep fractional CO(2): A retrospective study of 490 treatments in 374 patients. Lasers SurgMed 2011;43:453–456. 7. Chan CS, Saedi N, Mickle C, Dover JS. Combined treatment for facial rejuvenation using an optimized pulsed light source followed by a fractional non-ablative laser. Lasers Surg Med 2013;45:405–409.

8. Gold MH, Biron JA, Sensing W. Facial skin rejuvenation by combination treatment of IPL followed by continuous and fractional radiofrequency. J Cosmet Laser Ther 2016;18(1): 2–6. 9. Kearney C, Brew D. Single-session combination treatment with intense pulsed light and nonablative fractional photo- thermolysis: A split-face study. Dermatol Surg 2012;38:1002– 1009. 10. Kim JE, Chang S, Won CH, Kim CH, Park KH, Choi JH, Lee MW. Combination treatment using bipolar radiofrequency- based intense pulsed light, infrared light and diode laser enhanced clinical effectiveness and histological dermal remodeling in Asian photoaged skin. Dermatol Surg 2012; 38:68–76. 11. Tao L, Wu J, Qian H, Lu Z, Wang W, Zhao X, Tu P, Yin R, Xiang L. Intense pulsed light, near infrared pulsed light, and fractional laser combination therapy for skin rejuvenation in Asian subjects: A prospective multi-center study in China. Lasers Med Sci 2015;30:1977–1983. 12. Yun WJ, Moon HR, Lee MW, Choi JH, Chang SE. Combina- tion treatment of low-fluence 1,064-nm Q-switched Nd: YAG laser with novel intense pulse light in Korean melasma patients: A prospective, randomized, controlled trial. Derma- tol Surg 2014;40:842–850. 13. Anayb Baleg SM, Bidin N, Suan LP, Sidi Ahmad MF, Krishnan G, Johari AR, Hamid A. Combination of Er: YAG laser and CO 2 laser treatment on skin tissue. Photochem Photobiol 2015;91:134–138. 14. Gold MH, Biron JA. Combined superficial & deep fractional skin treatment for photodamaged skin—A prospective clinical trial. J Cosmet Laser Ther 2012;14:124–132. 15. Cohen JL, Ross EV. Combined fractional ablative and nonablative laser resurfacing treatment: A split-face compar- ative study. J Drugs Dermatol 2013;12:175–178. 16. Manuskiatti W, Fitzpatrick RE, Goldman MP. Treatment of facial skin using combinations of CO 2 , Q-switched alexan- drite, flashlamp-pumped pulsed dye, and Er:YAG lasers in the same treatment session. Dermatol Surg 2000;26:114– 120. 17. Wang B, Wu Y, Luo YJ, Xu XG, Xu TH, Chen JZ, Gao XH, Chen HD, Li YH. Combination of intense pulsed light and fractional CO(2) laser treatments for patients with acne with inflammatory and scarring lesions. Clin Exp Dermatol 2013; 38:344–351.

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