Multimodality Aesthetic Skin Rejuvenation

ABSTRACT

Patients requesting skin correction and rejuvenation are motivated by a number of clinical problems. Photo damage, abnormal pigmentation or vascularity, textural problems, rhytides, and laxity due to chronological aging are the primary complaints of the majority of patients. Advances in new technology in the past decade have provided the skin correction specialist with new options for treatment. Specialists with multiple technology options then face a new dilemma. What is the best treatment plan for individual patients when many options exist? Over the past five years we have developed an approach to our patients based on an individualized treatment plan consisting of a prescribed series of skin correction treatments utilizing the most specific rejuvenation techniques for each clinical problem. Multimodality aesthetic skin rejuvenation (MMASR) emphasizes the corrective process and utilization of the most appropriate technology for the patient's clinical skin problem as evidenced by the clinical examination. MMASR also takes into consideration patient bias, cost concerns, expectations of treatment, and feasibility of combining different technologies in the same treatment session. Combining skin rejuvenation techniques with surgical rejuvenation is also reviewed as an option for patients with both facial laxity and clinical skin problems.

Skin rejuvenation - laser rejuvenation - laser resurfacing - chemical peel - dormabrasion - photodynamic therapy

REFERENCES

• 1 Wood-Smith D, Rees T D. Chemabrasion and dermabrasion. In: Wood-Smith D, Rees TD Cosmetic Facial Surgery. Philadelphia; WB Saunders 1973: 213-220
• 2 McCollough E G, Langsdon P R. Dermabrasion and Chemical Peel. New York; Thieme Medical Publishers 1988
• 3 Gentile R D. Multi-modality aesthetic skin rejuvenation. Presented at: the 17th Annual Symposium on the Latest Advances in Cosmetic Surgery of the Face August 9, 2003 Newport Beach, CA;
• 4 Chiarello S E. Multi-modality skin resurfacing. Available at: http://www.totalskincarecenter.com/whatsnew/htm Last accessed: July 10, 2005
• 5 Carniol P J, Farley S, Friedman A. Long pulse 532 nm diode laser for non-ablative facial skin rejuvenation.  Arch Facial Plast Surg. 2003;  5 511-513
• 6 Shpall R, Beddingfield III F C, Watson D, Lask G P. Microdermabrasion: a review.  Facial Plast Surg. 2004;  20 47-50
• 7 Weinstein C, Scheflan M. Combined erbium:YAG laser resurfacing and face lifting.  Plast Reconstr Surg. 2001;  107 586-594
• 8 Gentile R D. Concurrent full facial resurfacing with rhytidectomy. Presented at: American Academy of Facial Plastic and Reconstructive Surgery, Spring Meeting April, 29 1999 Palm Desert, CA;
• 9 Hetter G P. An examination of the phenol-croton oil peel: Part I. Dissecting the formula.  Plast Reconstr Surg. 2000;  105 227-239 discussion 249-251
• 10 Perkins S, Mangat D. Skin rejuventaion. Presented at: American Academy of Facial Plastic and Reconstructive Surgery, Annual Meeting September 17, 2004 New York, NY;
• 11 Grema H, Greve B, Raulin C. Facial rhytides-subsurfacing or resurfacing? A review.  Lasers Surg Med. 2003;  32 405-412
• 12 Kim K H, Geronemus R G. Nonablative laser and light therapies for skin rejuvenation.  Arch Facial Plast Surg. 2004;  6 398-409
• 13 Lee M W. Combination of 532 nm and 1064 nm lasers for noninvasive skin rejuvenation and toning.  Arch Dermatol. 2003;  139 1265-1276
• 14 Bhatia A C, Dover J S, Stewart B, Arndt K. Adjunctive use of topical aminolevulinic acid with intense pulse light in the treatment of photoaging. Presented at: American Society of Dermatologic Surgery, Annual Meeting October 3, 2004 San Diego, CA;
• 15 Hongcharu W, Taylor C R, Chang Y, Aghassi D, Suthamjariya K, Anderson R R. Topical ALA-photodynamic therapy for the treatment of acne vulgaris.  J Invest Dermatol. 2000;  115 183-192
• 16 Touma D J, Gilchrest B A. Topical photodynamic therapy: a new tool in cosmetic dermatology.  Semin Cutan Med Surg. 2003;  22 124-130
• 17 Goldman M P, Boyce S M. A single-center study of aminolevulinic acid and 417 nm photodynamic therapy in the treatment of moderate to severe acne vulgaris.  J Drugs Dermatol. 2003;  2 393-396
• 18 Koch B B, Perkins S W. Simultaneous rhytidectomy and full-face carbon dioxide laser resurfacing: a case series and meta-analysis.  Arch Facial Plast Surg. 2002;  4 227-233
• 19 Alster T S, Doshi S N, Hopping S B. Combination surgical lifting with ablative laser skin resurfacing of facial skin: a retrospective analysis.  Dermatol Surg. 2004;  30 1191-1195