Improvement in the appearance of cellulite and skin laxity resulting from a single treatment with acoustic subcision: Findings from a multicenter pivotal clinical trial.

Introduction And Objectives: Surface depressions and skin laxity together play a role in the appearance of cellulite. Cellulite depressions can be improved through disruption of the subcutaneous fibrous structures. Some currently utilized approaches accomplish this through invasive techniques requiring local anesthesia and potential down time.

Noninvasive approach to treatment of submental fullness.

A recent survey done by the American Society for Dermatologic Surgery indicated that 67% of respondents were bothered by "excess fat under the chin/neck." Accumulation of fat in the preplatysmal compartment of the neck is a common cause for fullness in the submental area. In the past, surgical liposuction was the only option to remove fat in the submental area.

Multicenter prospective cohort study of the incidence of adverse events associated with cosmetic dermatologic procedures: lasers, energy devices, and injectable neurotoxins and fillers.

Importance: Common noninvasive to minimally invasive cosmetic dermatologic procedures are widely believed to be safe given the low incidence of reported adverse events, but reliable incidence data regarding adverse event rates are unavailable to date.

Objective: To assess the incidence of adverse events associated with noninvasive to minimally invasive cosmetic dermatologic procedures, including those involving laser and energy devices, as well as injectable neurotoxins and fillers.

Design, Setting, And Participants: A multicenter prospective cohort study (March 28, 2011, to December 30, 2011) of procedures performed using laser and energy devices, as well as injectable neurotoxins and soft-tissue augmentation materials, among 8 geographically dispersed US private and institutional dermatology outpatient clinical practices focused on cosmetic dermatology, with a total of 23 dermatologists.

Microfocused ultrasound for skin tightening.

The demand for noninvasive skin tightening procedures is increasing as patients seek safe and effective alternatives to aesthetic surgical procedures of the face, neck, and body. Over the past decade, radiofrequency and infrared laser devices have been popularized owing to their ability to deliver controlled heat to the dermis, stimulate neocollagenesis, and effect modest tissue tightening with minimal recovery. However, these less invasive approaches are historically associated with inferior efficacy so that surgery still remains the treatment of choice to address moderate to severe tissue laxity.

Noninvasive lifting of arm, thigh, and knee skin with transcutaneous intense focused ultrasound.

Background: Transcutaneous intense focused ultrasound is a novel Food and Drug Administration-approved technology for noninvasive skin tightening of the face and neck. No studies have reported on its safety and effectiveness on nonfacial areas.

Materials And Methods: Eighteen paired areas (6 each) on the upper arms, medial thighs, and extensor knees were randomly treated with two different transducers (4.

Combined 595-nm and 1,064-nm laser irradiation of recalcitrant and hypertrophic port-wine stains in children and adults.

Purpose: Although pulsed dye laser (PDL) treatment of port-wine stain (PWS) has long been proven safe and effective, incomplete clearance of these vascular malformations can be problematic. In addition, advanced PWS with deeper coloration and tissue hypertrophy can be particularly difficult to treat because of the superficial dermal penetration of 585- to 595-nm light. The purpose of this study was to evaluate the safety and efficacy of a novel device that delivers sequential pulses of 595- and 1,064-nm wavelengths in the treatment of recalcitrant and hypertrophic PWS.

Effect of a novel low-energy pulsed-light device for home-use hair removal.

Background: Removal of unwanted hair is the most popular skin treatment worldwide. Over the past decade, various lasers and light sources for epilation have been advocated for use in an office setting, although most people continue to treat unwanted hair with a variety of temporary physical methods (e.g.

Photopneumatic therapy for the treatment of acne.

Background: A wide variety of laser and light-based therapies have been utilized for acne vulgaris; however, current techniques have been limited by photosensitivity issues or inconsistent results.

Objective: To determine the clinical efficacy and side-effect profile of photopneumatic therapy for the treatment of facial acne vulgaris.

Methods: Twenty adults with mild to severe facial acne vulgaris received 4 successive treatments at 2-week intervals with a combined photopneumatic device (intense pulsed light [IPL]: fluences = 3.

Fraxel laser indications and long-term follow-up.

Fractional photothermolysis, based on creating spatially precise microscopic thermal wounds, is performed using a 1550-nm erbium fiber laser that targets water-containing tissue to effect the photocoagulation of narrow, sharply defined columns of skin known as microscopic thermal zones. According to the authors, Fraxel resurfacing has been shown to be both safe and effective for facial and nonfacial photodamage, atrophic acne scars, hypopigmented scars, and dyspigmentation. Because only a fraction of the skin is treated during a single session, a series (typically 3 to 6 treatments) of fractional resurfacing at 2- to 4-week intervals is required for the best clinical improvement.

Side effects and complications of fractional laser photothermolysis: experience with 961 treatments.

Background: A novel 1,550-nm erbium-doped laser (Fraxel, Reliant Technologies Inc.) has been shown to be effective in the treatment of photodamaged skin and scars with minimal postoperative recovery; however, studies evaluating its side effects and complication rates have been limited.

Purpose: The purpose was to determine the frequency and range of side effects and complications associated with fractional photothermolysis treatment.

The use of fractional laser photothermolysis for the treatment of atrophic scars.

Background: Patients with atrophic scars commonly seek treatment for their removal but are often concerned about the prolonged recovery, short-lived results, and/or ineffectiveness of available therapies. A novel treatment using a 1,550-nm erbium-doped fiber laser to induce fractional photothermolysis of treated skin has been used to resurface photodamaged skin but has not been studied previously in patients with atrophic scars to determine its effectiveness for this condition.

Purpose: To determine the effectiveness and safety of 1,550-nm erbium-doped fiber laser treatment on atrophic scars.

Fractional photothermolysis: treatment of facial and nonfacial cutaneous photodamage with a 1,550-nm erbium-doped fiber laser.

Purpose: To evaluate the safety and effectiveness of a novel nonablative 1,550 nm erbium-doped fiber laser in the treatment of facial and non-facial photodamaged skin.

Methods: 50 patients with mild to moderate cutaneous photodamage, rhytides, and dyspigmentation received 3 successive treatments at 3-4 week intervals with a 1,550 nm erbium-doped fiber laser (Fraxel, Reliant Technologies Inc., San Diego, CA).

Cellulite treatment using a novel combination radiofrequency, infrared light, and mechanical tissue manipulation device.

Background: Most post-pubertal women exhibit cellulite, particularly in the thigh and buttock regions. The prevalence of cellulite has led to many attempts at treatment, including a variety of topical solutions, massage-based therapies, and surgical techniques--most with suboptimal clinical effects. The purpose of this controlled study was to evaluate a novel combination device involving radiofrequency, infrared light, and mechanical tissue manipulation for the treatment of cellulite.

Improving patient retention after botulinum toxin type A treatment.

Background: Botulinum toxin treatments have been associated with consistently high patient satisfaction rates, but calculation of patient retention rates is not routinely performed. Retention measurements serve as critical indicators of clinical performance and can be optimized by evaluation of current office policies and implementation of strategies to improve patient retention.

Purpose: To investigate the reasons patients discontinue botulinum toxin treatments and to evaluate the effect of a single intervention intended to improve patient retention.

Photorejuvenation of facial skin with topical 20% 5-aminolevulinic acid and intense pulsed light treatment: a split-face comparison study.

Background: Photorejuvenation of facial skin has been reported after intense pulsed light (IPL) therapy alone and in conjunction with topical 5-aminolevulinic acid (5-ALA), but no comparative studies between these regimens have been performed.

Objective: To evaluate the safety and effectiveness of combination topical 5-ALA and IPL compared to IPL treatment alone.

Methods: Ten patients with mild to moderate photodamage were randomly assigned treatment with 5-ALA + IPL on one facial half and IPL alone on the contralateral side.

Cutaneous laser surgery in darker skin phototypes.

Effective laser surgery in patients with darker skin phototypes can be achieved despite a greater inherent risk of side effects. Although the incidence of undesirable postoperative sequelae has decreased with the development of advanced laser technology and individualized treatment parameters, the risks may never be eliminated completely. Therefore, thorough patient preoperative preparation and education regarding the risks of cutaneous laser surgery will remain an essential aspect of treatment in patients with darker skin tones.

Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study.

Background: Atrophic scar revision techniques, although numerous, have been hampered by inadequate clinical responses and prolonged postoperative recovery periods. Nonablative laser treatment has been shown to effect significant dermal collagen remodeling with minimal posttreatment sequelae. Although many studies have been published regarding the effectiveness of these nonablative lasers on rhytides, there are limited data demonstrating their specific effects on atrophic scars.

Long-pulsed 1064-nm Nd:YAG laser-assisted hair removal in all skin types.

Background: Although there are several different laser systems available for the reduction of unwanted hair, no single system has been shown to be superior in providing safe and effective hair removal in every skin type. The purpose of this study was to evaluate the safety and efficacy of a high-energy, long-pulsed, 1064-nm Nd:YAG laser with a contact cooling device for hair removal in skin phototypes I-VI.

Methods: Thirty-six adult patients (skin phototypes I-VI) with dark terminal facial or nonfacial hair were treated with a long-pulsed Nd:YAG laser (1064 nm, 10-mm spot size, fluence of 30 to 60 J/cm2).

Laser surgery in dark skin.

Although challenging, effective laser surgery in patients with darker skin tones can be achieved despite a higher inherent risk of untoward side effects. While the incidence of undesirable postoperative sequelae has decreased with the development of advanced laser technology and individualized treatment parameters, these risks may never be eliminated completely. Consequently, thorough patient preoperative preparation and education regarding the risks of cutaneous laser therapy will remain an essential component of treatment in darkly pigmented patients.

Photodynamic therapy with topical aminolevulinic acid and pulsed dye laser irradiation for sebaceous hyperplasia.

Successful and long-standing eradication of sebaceous hyperplasia has remained difficult due to the propensity of these lesions to be extensive. Current treatments include excision, electrodesiccation, laser vaporization, and oral isotretinoin, each often associated with unacceptable side effects or lesional recurrence. The purpose of this study was to evaluate the safety and effectiveness of laser-assisted photodynamic therapy using topical 5-aminolevulinic acid (5-ALA) and 595 nm pulsed dye laser (PDL) irradiation for the treatment of sebaceous hyperplasia.

Lasers in dermatology: four decades of progress.

Advances in laser technology have progressed so rapidly during the past decade that successful treatment of many cutaneous concerns and congenital defects, including vascular and pigmented lesions, tattoos, scars, and unwanted hair-can be achieved. The demand for laser surgery has increased substantially by patients and dermatologists alike as a result of the relative ease with which many of these lesions can be removed, combined with a low incidence of adverse postoperative sequelae. Refinements in laser technology and technique have provided patients and practitioners with more therapeutic choices and improved clinical results.

Hypertrophic scars and keloids: etiology and management.

Keloid and hypertrophic scars have affected patients and frustrated physicians for centuries. Keloid and hypertrophic scars result from excessive collagen deposition, the cause of which remains elusive. Clinically, these scars can be disfiguring functionally, aesthetically, or both.

Treatment of facial rhytides with a nonablative 1,450-nm diode laser: a controlled clinical and histologic study.

Objective: To evaluate the safety and effectiveness of a nonablative 1,450-nm midinfrared diode laser in the treatment of facial rhytides.

Methods: Twenty-five patients (skin phototypes I-III) with mild-to-moderate perioral or periorbital rhytides received four successive treatments at 3- to 4-week intervals with a 1,450-nm diode laser (SmoothBeam; Candela Corp., Wayland, MA).