Subject Global Aesthetic Improvement Scale Research Articles

Long-term duration and safety of Radiesse (+) for the treatment of jawline.

Calcium hydroxyapatite (CaHA)-carboxymethylcellulose (CMC)+ has unique properties that make it optimal for lifting, contouring, and defining the jawline. This long-term follow-up of a randomized, multicenter, rater-blinded trial reports efficacy and safety of CaHA-CMC(+) through 48 and up to 60 weeks post-treatment. Eligible patients were randomized (2:1) to the treatment or the control/delayed treatment group to receive CaHA-CMC(+) injections in both jawlines. While touch-ups were permitted 4 weeks post-treatment for both groups, only the treatment group was eligible for optional retreatment after 48 weeks. The primary outcome was ≥1-point improvement on both jawlines on the Merz Jawline Assessment Scale (MJAS); secondary endpoints included the Subject Global Aesthetic Improvement Scale (SGAIS) among others. Post hoc analysis included pooling up to 48-week data from the combined treatment and control/delayed groups and 60-week data for the treatment group. Overall, 175 received treatment. MJAS responder rates were 77.9%, 78.7%, and 62.9% at 12, 24, and 48 weeks post-treatment, respectively. Responder rate on the MJAS at 60 weeks was 74.6% for those who received retreatment and 43.5% for those patients who received only the initial and touchup treatments. SGAIS scores demonstrated 93.4%, 85.6%, and 68.5% of patients rated themselves very much improved after 12, 24, and 48 weeks, respectively. Adverse events consisted of procedure or CaHA-CMC(+)-related events that were mostly resolved and overwhelmingly mild. CaHA-CMC(+) produced clinically meaningful and long-lasting improvements in jawline contour and was well tolerated in patients through 60 weeks. ClinicalTrials.gov Identifier: NCT03583359.

Intradermal Platelet-Rich Plasma for the Treatment of Melasma: A Clinical and Dermoscopic Evaluation in Dark Skin.

Melasma is a common dermatosis in both men and women showing varying degrees of success with treatment. Relapse of melasma is high in dark skin types, which necessitates the need for finding a modality of treatment, which not only treats but also prevents relapse. To study the effectiveness of platelet-rich plasma (PRP) in patients of melasma both clinically and dermoscopically in dark skin types. A prospective study of 20 female patients of Fitzpatrick skin type IV-V with mixed type of melasma and bilateral involvement of the face were enrolled for the study. PRP was injected intradermally at 4 weeks interval for three sittings, and the results were assessed clinically (by modified melasma area and severity score) and dermoscopically. Patients were counselled to ensure strict sun protection measures. Patient satisfaction was noted at baseline, 4 weeks, 8 weeks, and 12 weeks. Patients were followed up for 3 months to see for any relapse of the pigmentation. The follow-up showed no relapse of melasma in these patients. Analysis of variance was used with Bonferroni correction for modified melasma area and severity score at various time interval. Subject global aesthetic improvement scale (SGAIS) and physician global esthetic improvement scale (PGAIS) were expressed in counts. P-value ≤ 0.05 was considered significant. Modified melasma area and severity score and dermoscopic changes showed statistically significant improvement compared at the end of study in mild to severe cases. The subjective assessment was made by PGAIS. Patient satisfaction levels (assessed by SGAIS) also showed significant improvement in successive weeks of treatment. Few patients had mild redness and burning post procedure, which resolved spontaneously after few hours. From this study we concluded that PRP shows a significant improvement in melasma after 12 weeks of treatment with no relapse even after 3 months. Hence, PRP may be used not only as an adjuvant but also as a first line treatment in the view of longer sustained results when combined with strict sun protection. There is a paucity of studies showing results of PRP treatment in dark skin types, which is more resistant to treatment than lighter skin. Moreover, clinical improvement should not be the only parameter to decide on stopping treatment as chances of relapse can be higher. Dermoscopic evaluation helps in determining the changes in vasculature (telangiectasias) and pigmentation (dots and globules), which are better indicators of success of treatment.

Efficacy and tolerability of a microneedling device for treating wrinkles on the face.

A microneedling pen has been cleared by the US Food and Drug Administration, indicated for improving the appearance of adult facial acne scars. The objective of this study was to assess the device's effectiveness for treating wrinkles of the face area. Healthy adults seeking to improve the appearance of face wrinkles were enrolled (N=35), receiving four monthly microneedling procedures by a trained aesthetician who treated the face skin per manufacturer instructions. Wrinkle assessments were performed by two trained blinded raters by comparing baseline images of each subject with images obtained at 90days post-procedure. Subsequently, the two raters were unblinded for the Clinician's Global Aesthetic Improvement Scale (CGAIS) assessment. Subjects completed the Subject's Global Aesthetic Improvement Scale (SGAIS) and a Satisfaction Questionnaire at 30 and 90days post-treatment. The study was completed by 32subjects with a mean (SD) age of 56.3 (5.0) years. Wrinkle assessments demonstrated significant improvement in the face areas (p<0.001). The SGAIS scores showed significant improvements after 30 and 90days post-treatment (for each, p<0.001). The CGAIS scores also showed significant improvements at 90days post-treatment (p<0.001). Most subjects reported some level of improvement in their appearance at 30days (73.3%) and 90days (68.8%) post-treatment. The satisfaction questionnaire showed high levels of improvement in wrinkles (93.8%), satisfaction with the treatment procedure (87.5%) and would recommend microneedling to friends and family members (80.6%) on the face and neck. Microneedling is a viable, minimally invasive option for treating wrinkles of the face. gov Identifier: NCT03803059.

The Efficacy of Intense Pulsed Light as a Treatment for Benign Pigmented Lesions on the Dorsal Hand.

Intense pulsed light (IPL) is a noninvasive therapeutic option to treat benign pigmented lesions by targeting melanin. The purpose of this study was to assess IPL as a treatment for benign pigmented dorsal hand lesions. A total of fifteen subjects, 40 to 73 years old, received 3 monthly IPL treatments over the dorsal hands. Subjects followed up 1 and 3 months after treatment. At every visit, photographs were taken using the VISIA Complexion Analysis System (Canfield Scientific, Fairfield, NJ) and analyzed using the RBX Brown Spots Analysis algorithm. The Clinician Global Aesthetic Improvement Scale and Subject Global Aesthetic Improvement Scale were completed at both follow-up visits. A total of fifteen subjects completed all six visits. The number of brown spots decreased 9.26% ( p = .0004) and 7.52% ( p = .0132) at each follow-up visit. The mean brown intensity decreased 6.15% ( p = .0183) and 7.67% ( p = .0178), whereas the mean contrast intensity decreased 8.88% ( p < .0001) and 6.60% ( p = .0007) 1 and 3 months after treatment, respectively. The mean Clinician Global Aesthetic Improvement Scale was 2.03 and 2.23, whereas the mean Subject Global Aesthetic Improvement Scale 1 and 3 months after treatment was 1.6 and 1.8, respectively. Objective analysis, along with clinician and subject assessments, showed an improvement in the appearance of benign pigmented lesions in the treated area after 3 IPL treatments.

A Prospective Multicenter Study to Evaluate the Safety and Efficacy of the Topical Application of MYOWNN™, an Autologous Growth Factor Concentrate (AGFC) Serum, in Anti-Aging.

BackgroundGrowth factors from platelets have been emerging as a revolutionary treatment with the ability to induce cell growth in the skin, which results in retarding and reversing the aging process. Platelet-rich plasma (PRP) allows for greater release of growth factors and biologically active proteins, which in turn activates the cascade of stimulation of neoangiogenesis and collagen production. PRP is used in anti-aging and facial skin rejuvenation in the form of dermal injections and topical application during micro-needling. This study was conducted to assess the safety and efficacy of a topically applied face serum, MYOWNN™ (Wockhardt Ltd., Mumbai, India). MYOWNN™ is an autologous growth factor concentrate that has been made into a topical face serum.MethodsMale and female subjects in the age group between 30 and 55 years (both inclusive) with Fitzpatrick skin type III-V who had not taken any oral or topical treatments for at least four weeks before and any platelet-rich plasma (PRP) based facial treatment (injections) at least six months before the study entry were included. MYOWNN™ serum was applied on the face once daily at night, approximately 30 minutes before sleeping preferably, for a total duration of five months. Six parameters, i.e. spots, pores, wrinkles, texture, moisture, and pigmentation, were evaluated at regular intervals with Visage-LS (dermaindia®, Tamil Nadu, India), a face analysis system that gives the live status of these six parameters and is an advanced live status skin detection equipment together with shooting, analyzing, and displaying functions, as well as the subjective analysis, was performed by subjects and physicians using different globally accepted scales like physician’s global aesthetic improvement scale (PGAIS), subject’s global aesthetic improvement scale (SGAIS), subject satisfaction score (SSS), and wrinkle severity rating scale (WSRS). For analysis, a mixed model for repeated measures was used. The model had change from baseline as the dependent variable visit as a factor and baseline assessment result as a covariate. All primary and secondary efficacy endpoints were analyzed using Modified Intent-to-Treat (mITT) populations.ResultsImprovement in an average of six anti-aging parameters was observed as early as three months while statistically significant improvement was observed by the end of five months of application. A statistically significant improvement in wrinkles was observed by the end of three months of the application itself. There were no product-related adverse events reported.ConclusionsFive months of application of MYOWNN™ serum showed a statistically significant improvement in an average of six parameters of anti-aging and face rejuvenation with a p-value of 0.0150 (<5% level of significance (i.e. 0.05) and was also well-tolerated.

A Prospective, Randomized, Double-Blind, Vehicle-Controlled Study Evaluating the Efficacy, Safety, and Patient Satisfaction of Tretinoin 0.05% Lotion for Chest Rejuvenation.

There is increasing interest in non-invasive options for chest rejuvenation with minimal to no downtime. Topical retinoids have long been used to correct photoaging due to their ability to promote epidermal hyperplasia, matrix metalloproteinase inhibition, collagen synthesis, and dispersion of melanin granules. Topical retinoid use is often limited by the ensuing irritation that occurs with initial use and resolves after about one month. Vehicle of delivery is a key factor to consider in order to minimize irritation and increase patient satisfaction. Micronized tretinoin 0.05% suspended in a polymer emulsion of hydrating ingredients (sodium hyaluronate, soluble collagen, and glycerin) is designed to aid in reducing irritation while ensuring uniform drug delivery. The primary objective of our study is to evaluate the safety, efficacy, and patient satisfaction of tretinoin 0.05% lotion for nonprocedural photorejuvenation of the chest. A total of 29 patients completed the trial, average age of 54.42 years (37-66 years old), Fitzpatrick II-IV skin types. Both the active and vehicle groups showed 30-40% improvement at day 180 according to the blinded evaluator mean percent improvement. Investigator global aesthetic improvement scale also trended towards improvement in both groups, with most patients exhibiting "improvement." Both the active and vehicle groups showed a significant change over time according to the nine-point photodamage and wrinkling scale, P&lt;0.001 and P=0.007 (single factor ANOVA), respectively. The Fabi Bolton Wrinkle Scale also demonstrated improvement from screening to day 180; however, there was no statistical significance at any time point. At day 90, the active group had statistically significantly more erythema than the vehicle group (P&lt;0.001), although both groups were only mild. At day 180, erythema decreased in both groups with the active group being similar to the vehicle group, 0.50&plusmn;0.73 versus 0.09&plusmn;0.30, respectively. Subjects in both the active and vehicle groups were equally satisfied at day 180, (2.38&plusmn;1.15 in the active group versus 2.30&plusmn;1.16 in the treatment group), with most subjects feeling "satisfied" with their results by day 180. This was also reflected in the subject global aesthetic improvement scale with most subjects noting noticeable improvement in the appearance of their chest from day 30 to day 180. Tretinoin 0.05% lotion delivered in a proprietary blend of hydrating ingredients offers a safe and efficacious option that has minimal downtime for patients seeking non-procedural photo-rejuvenation of the chest. The proprietary vehicle, containing hyaluronic acid, glycerin, and collagen, was crucial in minimizing irritation and producing at least a one-point improvement according to the 9 point photodamage scale and 30-40% improvement in photodamage as noted by the blinded evaluator percent improvement score in both the vehicle and active groups. J Drugs Dermatol. 2022;21(6):645-652. doi:10.36849/JDD.6658.

Evaluation of an SPF50 Sunscreen Containing Photolyase and Antioxidants for its Anti-Photoaging Properties and Photoprotection.

Background: Skin exposure to ultraviolet radiation (UVR) causes DNA damage, which can lead to mutagenesis, carcinogenesis, cellular death, and photoaging. Signs of photoaging include wrinkling, erythema, skin laxity, uneven skin texture, and hyperpigmentation. Photolyase is an exogenous DNA repair enzyme that can restore DNA integrity when applied topically to human skin. Antioxidants also play a key role in reducing UVR-associated molecular damage. To assess the efficacy and safety of a tinted mineral-based sunscreen containing 10.7% zinc oxide (SPF50) with the active ingredients photolyase, antioxidants (Peptide Q10), and peptides in both protecting and repairing signs of photoaging. In an open-label, single-center, 12-week study, patients aged 35&ndash;55 years and Fitzpatrick skin phototypes II&ndash;IV applied the sunscreen daily for 84 days. VISIA photography was performed at baseline as well as 6- and 12-week follow-ups. At each visit, the investigator and subject evaluated clinical photoaging parameters including overall photodamage, fine lines/wrinkles, coarse lines/wrinkles, skin tone evenness, tactile roughness, and radiance. The Investigator Global Aesthetic Improvement Scale (IGAIS) found that 63% of patients showed improvement at week 6 and 81% at week 12. The Subject Global Aesthetic Improvement Scale (SGAIS) showed 58% and 62.5% of patients reported the appearance of their skin was improved at week 6 and 12, respectively. Overall, there was a statistically significant improvement in skin radiance as well as improvement in overall facial aesthetics reported by both investigators and subjects. This tinted mineral based SPF50 sunscreen containing photolyase, antioxidants, and peptides is effective at repairing some clinical signs of photoaging and is well-tolerated for daily use. J Drugs Dermatol. 2022;21(5):517-520. doi:10.36849/JDD.6503.

Efficacy of a combined chemical peel and topical salicylic acid-based gel combination in the treatment of active acne.

Acne vulgaris is a common skin condition affecting the pilosebaceous unit of the skin characterized by the presence of comedones, papules, pustules, nodules, and cysts, which might result in permanent scars. It commonly affects adolescents, but it can occur in any age-group with the second group of incidence in young women in their 30s. Acne vulgaris can highly affect a person's quality of life. Therefore, it is necessary to act against it to prevent emotional impact and long-term complications. This study aimed to demonstrate the efficacy of a chemical peel in combination with a home care-exfoliating and purifying product in improving mild and moderate acne. The study included 45 patients with mild-to-moderate acne. Patients were treated with a chemical peel containing a mix of salicylic acid, pyruvic acid, and retinoic acid once every 3weeks for 4 times, plus a home care treatment after the healing process. Michaelson's acne severity score, Subject Global Aesthetic Improvement Scale, and Face Skin Q questionnaire were used to evaluate patients' skin improvement and patients' satisfaction. All patients have shown improvement in skin lesions after 4sessions of chemical peel according to Michaelson's acne severity score and Subject Global Aesthetic Improvement Score. Face Skin Q questionnaire demonstrated an improved quality of life in all treated patients. The combination of salicylic acid-based chemical peel plus exfoliating home care treatment appears to be a very good strategy against acne. Therefore, the physician may use this combination as an effective treatment for patients dealing with acne vulgaris.

Forehead Contouring as an Adjunct to Rhinoplasty: Evaluation of the Effect on Facial Appearance, Personal Traits and Patient Satisfaction.

The nose has a great impact on facial beauty and appearance. Therefore rhinoplasty is one of the most performed procedures worldwide. However, considering the varying degrees of cosmetic operations holistic approach to face is essential to achieve more successful results. In order to this, the forehead is noteworthy with its gender-related features and important relation to the nose. The purpose of this study is to assess the effect of forehead contouring with fat grafting adjunct to rhinoplasty on personal traits, facial appearance and patient satisfaction. A total of 15 patients who underwent rhinoplasty and forehead contouring with fat grafting were enrolled in this retrospective study. Facial appearance and personal traits were evaluated via subject Global Aesthetic Improvement Scale (S-GAIS), and patient satisfaction was assessed with custom design Forehead Rhinoplasty Outcome Evaluation Questionnaire (F/ROE-Q). Forehead inclination was calculated as an objective indicator of fat graft survival and contour improvement. Pre- and postoperative photographs were taken and used for evaluation. According to the F/ROE-Q score, mean total preoperative score was 9,13 and the mean total postoperative score was 24,86 (p < 0,01). High postoperative satisfaction scores were observed in all patients. Statistically significant improvement was observed in attractiveness, femininity, youthfulness, facial harmony, forehead contour, facial profile view parameters based on S-GAIS assessment. The mean forehead inclination angle was 19,04o preoperatively and 16,74° postoperatively. With the important benefits such as higher patient satisfaction and improvement on facial appearance and personal traits, forehead contouring with fat grafting was an efficient and applicable procedure adjunct to rhinoplasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A 12-Month Study to Evaluate Safety and Efficacy of Polymethylmethacrylate-Collagen Gel for Correction of Midface Volume Loss Using a Blunt Cannula as Measured by 3-D Imaging

BACKGROUND Although polymethylmethacrylate (PMMA)-collagen gel is approved for correction of nasolabial folds, there are no reports characterizing safety and efficacy in the midface, an area where fillers are often used in clinical practice. OBJECTIVE To determine the safety and efficacy of PMMA-collagen gel for long-term volume restoration in the midface. METHODS In this prospective, single-center, 12-month study, 23 subjects with a pretreatment Midface Volume Deficit Scale (MFVDS) grade of 3, 4, or 5 were treated with PMMA-collagen gel. Efficacy was measured by the investigator and blinded reviewers using the MFVDS at 3, 6, and 12 months. Subject Global Aesthetic Improvement Scale (SGAIS) and physician GAIS (PGAIS) ratings were collected at 3, 6, and 12 months. RESULTS Improvement in the MFVDS score from baseline was significant at all post-treatment time points (p &lt; .0001). All subjects with baseline MFVDS grades of 5 (severe) or 4 (significant) had a grade of 0 (none) or 1 (minimal) at 12 months. Subject GAIS (SGAIS) and PGAIS ratings of improved or much improved were 100% at Month 3 and were maintained at 12 months (PGAIS = 100%, SGAIS = 91.3%). All adverse events were minor. CONCLUSION Polymethylmethacrylate-collagen gel is safe and effective for long-lasting correction of midface volume deficit.

Development and Validation Clinician and Patient Reported Photonumeric Scales to Assess Buttocks Cellulite Severity.

The Clinician Reported Photonumeric Cellulite Severity Scale (CR-PCSS) and Patient Reported PCSS (PR-PCSS) are newly developed tools for assessing cellulite severity. To report on the reliability, validity, and ability to detect a change in cellulite severity on the buttocks of adult women with the CR-PCSS and PR-PCSS. Content validity of both scales was established through concept elicitation and cognitive interviews. Test-retest reliability was evaluated, and intra-rater (both scales) and inter-rater (CR-PCSS only) reliability were estimated using intraclass correlation coefficients (ICCs) for agreement and consistency. Ability to detect a change was determined using the Subject-Global Aesthetic Improvement Scale (GAIS) or Investigator-GAIS as anchors. For the CR-PCSS (n = 6) at baseline and Day 2, the mean interrater ICCs were ≥0.70 and mean intrarater ICCs (95% confidence interval [CI]) were ≥0.81 (0.72-0.90) for both buttocks. For the PR-PCSS (n = 99) at baseline and Day 14, the mean test-retest reliability ICCs (95% CI) were ≥0.86 (0.79-0.91) for both buttocks. A clinically meaningful change was 1.0 point on the PR-PCSS and 1.0 on the CR-PCSS. The CR-PCSS and PR-PCSS reliably assess cellulite severity of the buttocks and can detect a clinically meaningful change after treatment for cellulite.

Customized lip enhancement for clinical different lip features: An observational study.

The request for lip improvement treatments with injectable hyaluronic acid (HA) is increasing. However, as the patient's needs can be extremely different, it is unconceivable to use the same technique/product for clinical different lips to grant customized results. To provide a specific treatment approach for clinically different lips based on the Author's clinical experience. Patients belonged to four clinical groups: young lips requiring volume enhancement or a reshaping intervention, and senescent lips requiring rejuvenation or a rebuild intervention. At first visit T0, subjects underwent a pretreatment evaluation and the investigator performed an individual treatment based upon patient's esthetic goals and lip's baseline features. Lip fullness was assessed by the investigator using a Medicis Lip Fullness Scale (MLFS) at first visit (T0) and at 2weeks (T1). Subjects and investigator answered to the Global Aesthetic Improvement Scale (GAIS) at 2weeks T1 and at 12weeks (T2). A photographic evaluation was undertaken at T0 and T2. Only, in the two groups requiring volumization there was 1 grade of improvement in the MLFS (young lips-volume and senescent lips-rebuild). Nonetheless, the performed combination of techniques/products was overall very satisfactory: 80% of the subjects reported a much improved/very much improved outcome in the GAIS, and the same was reported by the investigator in 90% of the subjects. A weak positive correlation was found between MLFS responses and subject's GAIS at T1 in all groups. This customized treatment approach, consisting in choosing the right gel technology injected in minimum quantities with the right technique, ensures a harmonic result avoiding aberrations and standardizations.

Dynamics of hyaluronic acid fillers formulated to maintain natural facial expression.

BackgroundSubjects seeking facial rejuvenation want the results to appear natural. Currently, however, there is no consensus definition of, or assessment scale for, “naturalness.”AimsThis open‐label pilot study explored evaluation techniques and criteria to assess naturalness of facial movement and expression following optimal bilateral correction of moderate‐to‐severe nasolabial folds and marionette lines with soft‐tissue hyaluronic acid fillers formulated with XpresHAn Technology™.MethodsPrimary efficacy was investigator assessed naturalness of dynamic expressions using baseline and Day 42 posttreatment 2D video. Other evaluations included investigator assessed naturalness using static images, wrinkle severity, investigator and subject Global Aesthetic Improvement Scale assessments, and subject satisfaction.ResultsThirty Caucasian females (41‐65 years) received either Restylane ® Refyne, Restylane ® Defyne or both. Naturalness of dynamic expressions was at least maintained in all subjects. Naturalness of static expressions was not negatively affected in most subjects (96.7%). For dynamic expressions, 83.3% of subjects showed enhanced attractiveness, younger appearance and maintained naturalness.ConclusionsOverall, nasolabial folds and marionette lines improved significantly based on severity and Global Aesthetic Improvement Scale scores, with high subject satisfaction and favorable safety profile. Based on subject satisfaction and investigator assessments, using highly flexible hyaluronic acid dermal fillers did not compromise naturalness of lower facial expressions while achieving the desired improvements in attractiveness and youthfulness. The preliminary results obtained in this pilot study suggest that dynamic and static assessments of facial animation may aid the evaluation of natural outcomes in facial rejuvenation procedures.

Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the décolletage

Laxity and rhytides are manifestations of photodamage on the chest. We sought to evaluate efficacy and safety of microfocused ultrasound with visualization treatment of décolletage laxity and rhytides. In all, 24 subjects with moderate to severe rhytides, as measured by a validated 5-point photonumeric scale (Fabi/Bolton Chest Wrinkle Scale), received microfocused ultrasound with visualization treatment. Efficacy was measured at 90 and 180 days by the Fabi/Bolton Chest Wrinkle Scale, mid-clavicular to nipple distance, masked assessment, Physician and Subject Global Aesthetic Improvement Scales, and patient satisfaction. Adverse events were recorded. Rhytides improved over time (P < .0001), with 46% and 62% of subjects showing a 1- to 2-point improvement at days 90 and 180, respectively. Mean (SD) mid-clavicular to nipple distance decreased (P < .0001), from 20.9 (1.57) cm to 19.8 (1.50) cm and 19.5 (1.59) cm, at days 90 and 180, respectively. At day 90, 100% were improved by Subject Global Aesthetic Improvement Scale score (P < .0001) and 96% were improved by Physician Global Aesthetic Improvement Scale score (P < .0001), with similar findings at day 180. All subjects were satisfied or very satisfied at day 90, with similar results at day 180. Improvement by masked assessment at day 90 was 71%. Single-center study, small sample size, and only Fitzpatrick skin types I and II enrolled were limitations. There was appreciable efficacy and patient satisfaction after a single microfocused ultrasound with visualization treatment in wrinkle reduction and lifting of the décolletage.

Microfocused Ultrasound for Nonablative Skin and Subdermal Tightening to the Periorbitum and Body Sites: Preliminary Report on Eighty-Two Patients

Lax crepey skin is a major unsightly finding throughout the face and body that occurs from chronological aging and environmental photodamage. Surgical lifting procedures are unable to induce sufficient neocollagenesis and also associated with visible scars, risks and recovery time. In this preliminary report, non-invasive delivery of microfocused ultrasonic thermal coagulation points at two levels of the dermis outside the orbital rims was effective in reduction of crepey, wrinkled and sagging skin for about 1 ? years in nineteen treated patients. Matched Orientation Mirror Imaging produced an average brow height elevation of 1 - 2 mm. Microfocused thermal coagulation points at multiple tissue levels also induced tissue tightening and reduction of crepey wrinkled skin in the décolletage, brachium, periumbilicus, inner thigh and knees. Investigator and Subject Global Aesthetic Improvement Scale graded responses that correlated to the severity of the degree of crepiness and laxity. Pain management during the procedure included the use of infiltration of local anesthesia. No permanent adverse events were observed. Further innovations in the current technology are needed for more effective and safer delivery of energy to improve the appearance of crepey and lax tissue in the head, neck and body.