Periorbital Rejuvenation with Fractional 1,550-nm Ytterbium/Erbium Fiber Laser and Variable Square Pulse 2,940-nm Erbium:YAG laser in Asians: A Comparison Study

Wattanakrai, Penpun; Pootongkam, Suwimon; Rojhirunsakool, Salinee

doi:10.1111/j.1524-4725.2011.02298.x

Cited by 26 publications

(20 citation statements)

References 29 publications

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“…In 2012, Wattanakrai, Pootongkam and Rojhirunsakool compared the methods in periorbital wrinkles of 22 patients, and suggested that they were equivalent. 21 Parameters were similar to those we proposed in our study but no histologic observation was performed. Again in 2012, Bas and colleagues published the first histological comparison between these methods.…”

Section: Introductionsupporting

confidence: 85%

Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months

Borges

Cuzzi

Mandarim-de-Lacerda

et al. 2014

An. Bras. Dermatol.

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BACKGROUNDFractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective.OBJECTIVESTo evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium.METHODSEighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out.RESULTSAll patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001).CONCLUSIONSThree 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.

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Section: Introductionsupporting

confidence: 85%

Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months

Borges

Cuzzi

Mandarim-de-Lacerda

et al. 2014

An. Bras. Dermatol.

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“…30 In another study, 55% of patients displayed moderate to excellent improvement after three serial treatments. 40 Because eyelid skin is very thin, high energies are not required to achieve effective skin tightening in this area, even with a nonablative device. A series of treatments is recommended for optimal results.…”

Section: Clinical Data On Periorbital Resurfacing or Tighteningmentioning

confidence: 99%

11 Nonablative Laser and Light Devices

Truswell¹

2016

Lasers and Light, Peels and Abrasions

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The development of laser and light therapy for skin resurfacing has revolutionized the treatment of photodamage, wrinkles, scars, and a variety of pigmented lesions. The earliest lasers used for this purpose were ablative and included carbon dioxide (CO 2 ) and erbium: yttrium aluminum garnet (Er:YAG) devices. Treatment with these ablative lasers results in coagulation and vaporization of the entire epidermal unit with the goal of improving the quality of treated skin. Downtime is in the range of 5 to 14 days, and over this period of time patients can experience edema, oozing, and discomfort. Erythema can last for months to years and dyspigmentation, including depigmentation, can appear at any time after treatment-including years later. These complications are of particular concern for patients of higher Fitzpatrick skin types, and limit the use of these lasers to Fitzpatrick types I through III. Infection and scarring can occur as well due to prolonged compromise of the epidermal barrier unit. Results are dramatic for reversal of photoaging, but the side-effect profile is a deterrent for some patients and physicians and has limited the use of fully ablative laser resurfacing. 1,2,3 Nonablative technologies were developed to allow for faster postprocedure skin recovery, targeting the deep dermis to remodel collagen. Although these lasers have the benefit of shorter downtime, more sessions are required to achieve results similar to the ablative lasers, often requiring five or six monthly treatments. These devices are also typically paired with a cooling tip that allows for cooling of the epidermis and selective treatment to the dermis. The damage induced by nonablative devices is by definition "not ablative" and does not result in disruption of the epidermis or vaporization of tissue. Characteristic histology includes coagulation of dermal components. The term nonablative is broad in nature, and can include any device that does not cause ablation. However, for true practical purposes, and for this chapter, the nonablative devices are those that are moderately absorbed by water with wavelengths ranging from 1,064 to 2,000 nm. Other devices, which deliver nonspecific thermal energy and are by definition nonablative such as radiofrequency and ultrasound technologies, are not discussed here. Nonablative Nonfractionated LasersThe 1,320-nm neodymium:yttrium aluminum garnet (Nd:YAG) laser (CoolTouch, ICN Pharmaceuticals, Costa Mesa, California) was the first exclusively nonablative laser developed. Energy penetration occurs to a depth of 1,600 µm, a potentially effective treatment depth. Safety was optimal, yet studies showed only minimal clinical improvement in rhytids and photoaging. 4,5,6 The Smoothbeam laser (Candela Corp., Wayland, Massachusetts) emits coherent light at 1,450 nm. This device also uses water as the chromophore and results in thermal injury to the dermis and dermal components. The epidermis is protected via dynamic cryogen cooling. In 2003, Tanzi et al reported a mild to moderate clinical improvement ...

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“…Eyelid skin is the thinnest in the body . Presently, there are many optional procedures for treating periorbital wrinkles, such as applying topical drugs with retinoids, chemical peeling with glycolic or trichloroacetic acid, microdermabrasion, botulinum toxin, filler injection, laser, nonlaser method, and surgery . Nevertheless, there is currently no standard treatment.…”

Section: Introductionmentioning

confidence: 99%

Nitrogen plasma skin regeneration for the treatment of mild‐to‐moderate periorbital wrinkles: A prospective, randomized, controlled evaluator‐blinded trial

Theppornpitak

Udompataikul

Chalermchai

et al. 2018

J of Cosmetic Dermatology

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Periorbital Rejuvenation with Fractional 1,550-nm Ytterbium/Erbium Fiber Laser and Variable Square Pulse 2,940-nm Erbium:YAG laser in Asians: A Comparison Study

Abstract: Fractional Yb/Er fiber and VSP Er:YAG lasers are effective in improving periorbital wrinkles in Asians, with minimal side effects.

Cited by 26 publications

References 29 publications

Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months

Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months

11 Nonablative Laser and Light Devices

Nitrogen plasma skin regeneration for the treatment of mild‐to‐moderate periorbital wrinkles: A prospective, randomized, controlled evaluator‐blinded trial

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