A novel bioabsorbable device for facial suspension and rejuvenation.

To evaluate the safety and efficacy of a novel bioabsorbable suspension device made of a polymer of polylactic acid and polyglycolic acid (Endotine Ribbon), we performed a retrospective multi-institutional case study of 21 patients who underwent minimally invasive or open rhytidectomy with the use of the device in an ambulatory surgery center setting. Twelve patients had an excellent result, 7 a good result, and 2 a fair result. Early complications were corrected with technical modifications.

Preliminary evaluation of a fast-absorbing multipoint fixation device.

Background: Since the Endotine forehead fixation device (Coapt Systems, Palo Alto, CA) was introduced in 2003, a small percentage of surgeons and patients have complained of persistent palpability and sensitivity related to its 12- to 15-month absorption time. Therefore, a refinement of the original design, the Ultratine (Coapt Systems), consisting of a polymer blend altered for faster absorption and biodegradability, was introduced in 2006.

Objective: The authors report early results of fixation using the Ultratine with respect to permanence of elevation and the duration of visibility, palpability, and sensitivity of the implant.

Midface lift technique with use of a biodegradable device for tissue elevation and fixation.

Background: Aesthetic surgeons have become increasingly aware that elevation of the midface is a significant component of facial rejuvenation. However, adequate fixation remains a problem in midface lift procedures, regardless of the approach.

Objective: The purpose of this study was to evaluate the efficacy and ease of application of the Endotine midface device (Coapt Systems, Palo Alto, CA), as well as patient and surgeon satisfaction with the results of treatment.

Effects of varying density patterns and passes on depth of penetration in facial skin utilizing the carbon dioxide laser with automated scanner.

Histologic data describing the depth of penetration that occurs with the CO2 laser using variations in delivered energy, number of passes, and density settings have been limited. Most of the initial studies used a 3-mm collimated handpiece; few studies used the computerized pattern generator, which is now standard in treatment. This study examined histologic depth of thermal damage with varying density settings and number of passes using the computerized pattern generator.

Side effects, sequelae, and complications of carbon dioxide laser resurfacing.

The reader is presumed to have a broad understanding of plastic surgery procedures and concepts. After studying this article, the participant should be able to: Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination based on material covered in this article. The examination begins on page 373.

UltraPulse carbon dioxide laser with CPG scanner for deepithelialization: clinical and histologic study.

The UltraPulse carbon dioxide laser with CPG scanner was utilized to deepithelialize dermal pedicles in breast reduction inferior pedicle flaps. Clinical advantages include lack of bleeding, markedly shortened time of dissection, and excellent wound healing. Histologic studies confirm that the laser removes epidermis and papillary dermis but leaves undamaged the superficial vascular plexus and reticular dermis.

Ultrapulse carbon dioxide laser with CPG scanner for full-face resurfacing for rhytids, photoaging, and acne scars.

Eleven female patients are reported who underwent full-face resurfacing. Three patients were treated for cosmetic rhytids, five for residual acne scarring, and three for photoaging. There were no complications or side effects in this group of patients.

A critical appraisal of high-energy pulsed carbon dioxide laser facial resurfacing for acne scars.

Thirteen patients with mild and severe acne scarring have been treated with the Ultra Pulse carbon dioxide laser over a 24-month period. Nine patients had full-face and 4 patients had regional reurfacing. All patients were pretreated with a Retin-A preparation.

Results of multicenter study of laser-assisted liposuction.

Fifty-one patients underwent a study approved by the Food and Drug Administration for laser-assisted liposuction in five plastic surgery centers. The YAG laser fiber is contained within the cannula, shears off the fat cleanly, and coagulates blood vessels as the fat is drawn into the cannula. Hemoglobin decrease was relatively modest after surgery, and patients were able to return to work at 6 days and light exercise at 7 days.

The ultrapulse carbon dioxide laser with computer pattern generator automatic scanner for facial cosmetic surgery and resurfacing.

The ultrapulse carbon dioxide laser has been used in 110 patients for resurfacing and 50 patients for facelift, eyelid, and forehead surgery. Skin resurfacing is able to remove layers of skin of 100 microns without bleeding. Use of the computer pattern generator automatic scanning device allows a very rapid, uniform treatment in a variety of geometric patterns, sizes, and densities.

Argon and YAG laser photocoagulation and excision of hemangiomas and vascular malformations of the nose.

A total of 22 patients--19 children, 3 adults--with a variety of hemangiomas and vascular malformations of the nose were treated over a 5-year period. Various laser modalities were used. Some lesions could be photocoagulated by the argon or the yttrium-aluminum-garnet (YAG) laser.

Argon and Q-switched yttrium-aluminum-garnet laser treatment of nevus of Ota.

Twenty patients with nevus of Ota have been treated with the argon laser, Q-switched yttrium-aluminum-garnet (YAG) laser, or a combination of both lasers. The argon laser was originally used from 1975 to 1993 and has now been replaced by the Q-switched YAG laser. The Q-switched YAG laser mechanism of action is selective photothermolysis in which the pulse width of the laser beam is very short, thus allowing the melanocyte chromophore target to dissipate its heat without burning adjacent normal tissue.

Intralesional laser photocoagulation-steroids as an adjunct to surgery for massive hemangiomas and vascular malformations.

Massive hemangiomas and vascular malformations have been treated with lasers and adjunctive measures. Intralesional laser photocoagulation involves the direct penetration of a tumor by a yttrium-aluminum-garnet laser fiber with photocoagulation at various depths and levels to produce thromboses and controlled coagulation necrosis, thus shrinking and blanching the malformation. Seven children have benefited from intralesional laser photocoagulation as well as steroids, embolization, and excisional surgery.

YAG laser meloplasty and blepharoplasty.

Twenty-eight patients have undergone facelift and blepharoplasty in which the YAG laser scalpel was used. The laser is able to produce an incision with excellent hemostasis. The patients in this series demonstrated markedly diminished blood loss during surgery and reduced bruising, swelling, pain, and discomfort postoperatively.

Argon-pumped tunable dye laser.

The argon-pumped tunable dye laser (APTDL) is useful in the treatment of a wide variety of superficial vascular and melanocytic lesions. Safety is enhanced by the use of a computerized scanning device--the Hexascan. Over a 1-year period, 140 patients (33 patients under the age of 21, and 21 patients from 0 to 10 years of age) were treated.

Progress report on multicenter study of laser-assisted liposuction.

Fifty-one patients underwent an FDA-approved study of laser-assisted liposuction in five plastic surgery centers. The YAG laser fiber is contained within the cannula and shears off the fat cleanly and coagulates blood vessels as the fat is drawn into the cannula. The drop in hemoglobin was relatively modest after surgery.