Facial Skin Rejuvenation Technology, FACIAL PLASTIC SURGERY CLINICS OF NORTH AMERICA

Preface Having beautiful skin has been a constant desire through the ages, and the history of skin improvement, including cosmetics, dates to ancient Egypt nearly 6000 years ago.1 My interest in skin care started with my residency training at Baylor College of Medicine. At that time, most commercial skin-care improvement products existed in cosmetics, and not much was available for prescription skin-care and medical practice. The laser era was in its infancy. Retin A was introduced for acne treatment in 1962 but became popular as a wrinkle therapy and has remained highly prescribed along with retinol, its milder cousin.

Update on Facial Skin Rejuvenation Technology Recent years have provided multiple modalities being promoted for improvement of facial appearance, including facial rhytid removal or smoothing, facial lesion correction, scar improvement, and general tightening and skin rejuvenation. Evaluation of the effectiveness of these techniques in addition to insightful selection of the appropriate equipment and treatment technology can be challenging to the contemporary facial plastic surgeon. This issue of Facial Plastic Surgery Clinics of North America is organized to address these questions and help educate the reader regarding the types of treatment results that can be expected from a variety of technologies and techniques.

Broad Band Light and Skin Rejuvenation Pulsed light has proven its usefulness, effectiveness, and versatility in treating a multitude of skin problems, delaying skin aging, maintaining healthy skin, and as an adjunct to a cosmetic surgical practice in the treatment of postsurgical scars. Practitioners contemplating adding a pulsed light device to their practice should choose a device that has at least 4 important features: a large spot size, variable-sized smaller spot adaptors, pulse rates of at least 1 pulse per second, a wide range of cutoff filters, including 515 nm, 560 nm, 590 nm, 640 nm, and 695 nm, to treat most skin types.

Microneedle Radiofrequency Microneedle radiofrequency (RF) is a breakthrough in targeting skin laxity and rhytids that provides direct in situ delivery, impedance measurements, temperature measurements, energy delivery controls, and targeting of various skin depths to achieve desired clinical outcomes. Microneedle RF controls penetration depth and delivery to specified temperatures and impedance measurements, ensuring significantly improved efficacy in the treatment of mild-to-moderate rhytids and skin laxity of the face and neck, and cellulite and laxity on other body sites. Combining microneedle RF with dermal fillers and neuromodulators may be used to further improve clinical outcomes and achieve high patient satisfaction.

Photodynamic Therapy for Photodamage, Actinic Keratosis, and Acne in the Cosmetic Practice Photodynamic therapy is the combination of the initial application of a photosensitive chemical on the skin and then using typically a blue filter light of varying spectrums. This treatment protocol has been more useful and functional than other chemical peels and lasers for a variety of conditions. There has been efficacy in antiviral treatments, such as herpetic lesions; malignant cancers of the head and neck; and lung, bladder, and skin cancers. It has been tested for prostate cancers, cervical cancer, colorectal cancer, lung cancer, breast cancer, esophageal cancer, stomach cancer, pancreatic cancer, vaginal cancer, gliomas, and erythroplasia of Queyrat.