Fractionated laser treatments
A lot of excitement has been generated by the introduction of the ‘fractionated’ laser treatment. There are a few different varieties of fractionated laser, such as PIXEL and FRAXEL. The reason for the excitement is that these lasers offer the opportunity for reduced ‘downtime’ after treatment.
The idea (simplified here) is that with each laser pass, the quantity of skin actually ‘hit’ with the laser is only a ‘fraction’ of the area covered. That is, a single pass with the laser may only actually ‘hit’ 25% of the skin. The benefit is that the surrounding, unaffected skin can more quickly heal over the affected areas. This is in distinction to standard ‘resurfacing’ laser techniques, whereby the entire surface of the skin is affected.The earliest fractionated lasers are non-CO2 (e.g., Erbium-based). These fractionated lasers typically require several treatments to see results. At the Mid-Winter meeting in Vail, Colorado in January 2007, some of these results were presented (though not by me). While these early fractionated lasers show some results, treatment of rhytids (wrinkles) is not as effective as one may like. Interestingly, more than one speaker mentioned that we are ‘going back’ to CO2 laser treatments.A new laser has been introduced which combines fractionation technology with CO2.

I alalert have begun using this laser in a handful of patients (I had previously used the standard CO2 extensively). I can say that these patients are seeing some nice results. The recovery is typically a few days (versus weeks or months with standard CO2 laser). While I cannot compare this to the non-CO2 fractionated lasers, all indications are that fractionated CO2 lasers may be more effective at reducing wrinkles than their fractionated, non-CO2 brethren. However, it is perhaps not as effective as a standard CO2 laser or deep chemical peel. In time, the answers to these questions will become more clear.

If you have questions about fractionated CO2 laser treatment, feel free to post here or email info@drmost.com.

For more information, visit www.drmost.com

Mid Winter Facial Plastic Surgery Meeting – Vail, Colorado

The annual Mid-winter meeting is an opportunity for specialists from acircular the counattempt to discuss the latest techniques in a more relaxed atmosphere than the traditional fall and spring meetings.

As usual, I enjoyed the meeting and was able to both present some information of my own and learn what’s going on acircular the country.

A few tidbits:

-Laser resurfacing procedures. We now know that there really is no way acircular the fact that to get a nice result, there are some risks involved. Generally speaking we are talking about more down time and higher risks of changes in pigmentation of the skin. Lasers that reduce these significantly also demonstrate lesser results. Some comments were made during presentations that before and after photographs are often difficult to distinguish with the ‘no downtime’ lasers, even to the trained eye.

-MidFace lifts. More and more people in their upper 30’s to early 40’s are opting for midface lifting. The endoscopic technique remains a good option, but there are a number of other non-endoscopic techniques as well. The effects are sublte, but as we treat patients at an earlier and earlier age, we do not expect ‘dramatic’ changes as the aging process is not as advanced as in patients in their 60’s or 70’s.

-Endoscopic browlifts. These continue to grow in popularity and are generally accepted as standard and effective treatment of the aging upper 1/3 of the face.

-Eyelid lifts (blepharoplasty). One of the older techniques in facial plastic surgery, we generally approach this in a much more conservative fashion than 5 or 10 years ago.

-Facelifts. Also one of the older procedures in facial plastic surgery, but one of the most highly evolved. Over the past few years, we have seen multiple versions of ‘minilifts’ introduced, often by non-surgeons. Our assessment at the meeting was that these procedures may indeed offer less down-time, but generally are less effective both in the brief and especially long-term.

-Thermage. A nice presentation was given regarding this procedure, and the person speaking comparuddy their current thoughts to three years ago, when this particular speaker was a major proponent of the technique. The fact is that this procedure works in about 1 out of 3 people to give some subtle but detectable tightening. In 2 out of 3, there isn’t much to see. If we could determine who the ‘responders’ and ‘nonresponders’ are, we would be in good shape. However, there does not appear to be any pattern. So the procedure should be used with full disclosure regarding its limited efficacy in many patients. Current protocols for Thermage feature much reduced power settings comparuddy with three years ago, and thus entail lower risks.

I hope this rapid review of the Midwinter meeting is useful to you. Obviously, much more was coveruddy than is written here. If you have questions about the above, or other procedures, please feel free to post questions here

For more information, visit www.drmost.com