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Fractional Resurfacing (fractional + resurfacing)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Fractional Resurfacing

  • nonablative fractional resurfacing
    		•

    Selected Abstracts

    Commentary: Fractional Resurfacing: A Step in Progress

    DERMATOLOGIC SURGERY, Issue 10 2010
    MARY CHRISTIAN-REED MD
    Mary Christian-Reed, MD, is a luminary for the Palomar Corporation. [source]

    Letter: Re: Eyelid Tightening and Improved Eyelid Aperture Through Nonablative Fractional Resurfacing

    DERMATOLOGIC SURGERY, Issue 7 2009
    BRETT S. KOTLUS MD
    No abstract is available for this article. [source]

    Eyelid Tightening and Improved Eyelid Aperture through Nonablative Fractional Resurfacing

    DERMATOLOGIC SURGERY, Issue 11 2008
    SEAN A. SUKAL MD
    BACKGROUND AND OBJECTIVE The effects of fractional resurfacing on eyelid tightening and aperture are unknown. Our purpose was to retrospectively examine the potential for eyelid tightening and eye-aperture opening in patients treated with nonablative fractional resurfacing for facial photorejuvenation. STUDY DESIGN/MATERIALS AND METHODS Fractional laser treatments using a 1,550-nm erbium-doped fiber laser system on the upper and lower eyelids were given at a pulse energy of 17 to 20 mJ at 125 micro-thermal zones (MTZ)/cm2 to a final density of 500 to 750 MTZ/cm2. Each patient had 3 to 7 treatments. Standard pre- and post-treatment photographs were taken at each visit. Physicians who graded 31 preselected patient photographs using a 4-point scale evaluated eyelid tightening. Increase in eyelid aperture was also evaluated. RESULTS All patients had some degree of eyelid tightening; 19% achieved 1% to 25% tightening, 26% achieved 25% to 50%, 26% achieved 50% to 75%, and 29% achieved 75% to 100%. Increase in eyelid aperture was seen in 55.9% of patients. Postoperative wounding, hypopigmentation, hyperpigmentation, persistent erythema, and scarring were not observed. All patients experienced mild or no edema for a few days after treatment. CONCLUSION Fractional resurfacing tightens and increases eyelid aperture without wounding, downtime, or long-term complications. [source]

    Fractional Photothermolysis for Photoaging of Hands

    DERMATOLOGIC SURGERY, Issue 1 2008
    MING H. JIH MD
    BACKGROUND Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional resurfacing has been previously shown to effectively treat facial rhytids and dyschromia. OBJECTIVE We examined the effect of fractional resurfacing for photoaging of the hands. METHODS AND MATERIALS Ten patients (skin phototypes II to IV) with hand photodamage were randomized to receive five treatments with a 1,550-nm diode-pumped erbium fiber laser (Fraxel SR, Reliant Technologies) laser on either the right or left hand. Treatments were performed at settings of 8 to 9 mJ/microscopic treatment zone and density of 2,500 microscopic treatment zones/cm2. Subjective assessments by the patients and investigator were performed for skin roughness, wrinkling, and pigmentation using a 5-point scale. Skin biopsies were taken at baseline and at 1 and 3 months. RESULTS Patient subjective assessment and physician clinical assessment at 1 and 3 months revealed a mean 51% to 75% improvement in skin pigmentation and 25% to 50% improvement in skin roughness and wrinkling. Biopsies of the skin showed increased density of dermal collagen. Patients experienced transient erythema and edema and none had scarring or other adverse effects. LIMITATIONS This was a small study. CONCLUSION Fractional resurfacing appears to be an effective and safe treatment modality for correcting both the pigmentary and the textural aspects of photoaging of the hand. [source]

    The Treatment of Melasma with Fractional Photothermolysis: A Pilot Study

    DERMATOLOGIC SURGERY, Issue 12 2005
    Cameron K. Rokhsar MD
    Background. Melasma is a common pigmentary disorder that remains resistant to available therapies. Facial resurfacing with the pulsed CO2 laser has been reported successful but requires significant downtime, and there is a risk of adverse sequelae. Objective. To determine if melasma will respond to a new treatment paradigm, fractional resurfacing. Methods. Ten female patients (Fitzpatrick skin types III,V) who were unresponsive to previous treatment were treated at 1- to 2-week intervals with the Fraxel laser (Reliant Technologies, Palo Alto, CA, USA). Wavelengths of 1,535 and 1,550 nm were both used, and 6 to 12 mJ per microthermal zone with 2,000 to 3,500 mtz/cm2 were the treatment parameters. Four to six treatment sessions were performed. Responses were evaluated according to the percentage of lightening of original pigmentation. Two physicians evaluated the photographs, and each patient evaluated her own response. Results. The physician evaluation was that 60% of patients achieved 75 to 100% clearing and 30% had less than 25% improvement. The patients' evaluations agreed, except for one patient, who graded herself as 50 to 75% improved as opposed to the physician grading of over 75%. There was one patient with postinflammatory hyperpigmentation and no patient with hypopigmentation. No downtime was necessary for wound healing. Conclusions. Fractional resurfacing affords a new treatment algorithm for the treatment of melasma that combines decreased risk and downtime with significant efficacy. This treatment modality deserves further exploration to maximize benefits. RELIANT technologies LOANED THE FRAXEL LASER FOR THE STUDY. RICHARD E. FITZPATRICK, MD, IS A PAID CONSULTANT FOR RELIANT AND A STOCKHOLDER. [source]

    Skin rejuvenation with microthermal fractional photothermolysis

    DERMATOLOGIC THERAPY, Issue 2007
    Vic A. Narurkar
    ABSTRACT:, Fractional resurfacing is gaining acceptance as a preferred method for skin resurfacing. Experience in treating photoaging, acne scars, and melasma is reviewed. [source]

    Eyelid Tightening and Improved Eyelid Aperture through Nonablative Fractional Resurfacing

    DERMATOLOGIC SURGERY, Issue 11 2008
    SEAN A. SUKAL MD
    BACKGROUND AND OBJECTIVE The effects of fractional resurfacing on eyelid tightening and aperture are unknown. Our purpose was to retrospectively examine the potential for eyelid tightening and eye-aperture opening in patients treated with nonablative fractional resurfacing for facial photorejuvenation. STUDY DESIGN/MATERIALS AND METHODS Fractional laser treatments using a 1,550-nm erbium-doped fiber laser system on the upper and lower eyelids were given at a pulse energy of 17 to 20 mJ at 125 micro-thermal zones (MTZ)/cm2 to a final density of 500 to 750 MTZ/cm2. Each patient had 3 to 7 treatments. Standard pre- and post-treatment photographs were taken at each visit. Physicians who graded 31 preselected patient photographs using a 4-point scale evaluated eyelid tightening. Increase in eyelid aperture was also evaluated. RESULTS All patients had some degree of eyelid tightening; 19% achieved 1% to 25% tightening, 26% achieved 25% to 50%, 26% achieved 50% to 75%, and 29% achieved 75% to 100%. Increase in eyelid aperture was seen in 55.9% of patients. Postoperative wounding, hypopigmentation, hyperpigmentation, persistent erythema, and scarring were not observed. All patients experienced mild or no edema for a few days after treatment. CONCLUSION Fractional resurfacing tightens and increases eyelid aperture without wounding, downtime, or long-term complications. [source]

    Fractional Photothermolysis for Photoaging of Hands

    DERMATOLOGIC SURGERY, Issue 1 2008
    MING H. JIH MD
    BACKGROUND Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional resurfacing has been previously shown to effectively treat facial rhytids and dyschromia. OBJECTIVE We examined the effect of fractional resurfacing for photoaging of the hands. METHODS AND MATERIALS Ten patients (skin phototypes II to IV) with hand photodamage were randomized to receive five treatments with a 1,550-nm diode-pumped erbium fiber laser (Fraxel SR, Reliant Technologies) laser on either the right or left hand. Treatments were performed at settings of 8 to 9 mJ/microscopic treatment zone and density of 2,500 microscopic treatment zones/cm2. Subjective assessments by the patients and investigator were performed for skin roughness, wrinkling, and pigmentation using a 5-point scale. Skin biopsies were taken at baseline and at 1 and 3 months. RESULTS Patient subjective assessment and physician clinical assessment at 1 and 3 months revealed a mean 51% to 75% improvement in skin pigmentation and 25% to 50% improvement in skin roughness and wrinkling. Biopsies of the skin showed increased density of dermal collagen. Patients experienced transient erythema and edema and none had scarring or other adverse effects. LIMITATIONS This was a small study. CONCLUSION Fractional resurfacing appears to be an effective and safe treatment modality for correcting both the pigmentary and the textural aspects of photoaging of the hand. [source]

    The Treatment of Melasma with Fractional Photothermolysis: A Pilot Study

    DERMATOLOGIC SURGERY, Issue 12 2005
    Cameron K. Rokhsar MD
    Background. Melasma is a common pigmentary disorder that remains resistant to available therapies. Facial resurfacing with the pulsed CO2 laser has been reported successful but requires significant downtime, and there is a risk of adverse sequelae. Objective. To determine if melasma will respond to a new treatment paradigm, fractional resurfacing. Methods. Ten female patients (Fitzpatrick skin types III,V) who were unresponsive to previous treatment were treated at 1- to 2-week intervals with the Fraxel laser (Reliant Technologies, Palo Alto, CA, USA). Wavelengths of 1,535 and 1,550 nm were both used, and 6 to 12 mJ per microthermal zone with 2,000 to 3,500 mtz/cm2 were the treatment parameters. Four to six treatment sessions were performed. Responses were evaluated according to the percentage of lightening of original pigmentation. Two physicians evaluated the photographs, and each patient evaluated her own response. Results. The physician evaluation was that 60% of patients achieved 75 to 100% clearing and 30% had less than 25% improvement. The patients' evaluations agreed, except for one patient, who graded herself as 50 to 75% improved as opposed to the physician grading of over 75%. There was one patient with postinflammatory hyperpigmentation and no patient with hypopigmentation. No downtime was necessary for wound healing. Conclusions. Fractional resurfacing affords a new treatment algorithm for the treatment of melasma that combines decreased risk and downtime with significant efficacy. This treatment modality deserves further exploration to maximize benefits. RELIANT technologies LOANED THE FRAXEL LASER FOR THE STUDY. RICHARD E. FITZPATRICK, MD, IS A PAID CONSULTANT FOR RELIANT AND A STOCKHOLDER. [source]

    Long-term efficacy of a fractional resurfacing device,,§

    LASERS IN SURGERY AND MEDICINE, Issue 2 2010
    Arisa E. Ortiz MD
    Abstract Background and Objective Recently, there has been much debate regarding the long-term efficacy of fractional resurfacing devices. While pulsed CO2 laser resurfacing is considered a highly effective treatment, fractionated resurfacing is a newer modality and its long-term efficacy has yet to be assessed. We report the long-term outcomes of subjects previously treated with fractional CO2 resurfacing for photodamaged skin and acne scars. Study Design/Materials and Methods Ten subjects from our previous studies who received fractional resurfacing for the treatment of acne scarring and photodamage returned for long-term follow-up visits at 1 and 2 years, respectively. Investigators graded maintenance of improvement on a quartile scale based on clinical photography. Results Subjects maintained 74% of their overall improvement at their long-term visits compared to 3-month follow-up visits. While clinical improvement was maintained long-term, the results were not as remarkable as those seen at 3-month visits. The authors speculate that results seen at 3 months may be enhanced by persistent inflammatory changes, as evidenced by heat shock protein 47 activity and ongoing collagen remodeling seen in previous histologic studies. Relaxation of tightening is to be expected with any procedure along with the natural progression of aging. However, patient satisfaction was upheld long-term. Conclusion Fractional CO2 laser resurfacing does have long-term efficacy and persistence of improvement of acne scarring and photodamage compared to baseline. However, additional treatments may be necessary to enhance long-term results. Lasers Surg. Med. 42:168,170, 2010. © 2010 Wiley-Liss, Inc. [source]

    Hypertrophic scarring of the neck following ablative fractional carbon dioxide laser resurfacing

    LASERS IN SURGERY AND MEDICINE, Issue 3 2009
    Mathew M. Avram MD
    Abstract Background Ablative fractional carbon dioxide (CO2) laser treatments have gained popularity due to their efficacy, shortened downtime, and decreased potential for scarring in comparison to traditional ablative CO2 resurfacing. To date, scarring with fractional CO2 lasers has not been reported. Objective Five patients treated with the same fractional CO2 laser technology for photodamage of the neck were referred to our practices 1,3 months after treatment. Each patient developed scarring. Of the five cases, two are discussed in detail. The first was treated under general anesthesia on the face and anterior neck at a pulse energy of 30 mJ (859 µm depth) with 25% coverage. Eleven days after treatment, three non-healing areas along the horizontal skin folds of the anterior neck were noted. At 2 weeks after CO2 ablative fractional resurfacing, these areas had become thickened. These raised areas were treated with a non-ablative fractionated 1,550 nm laser to modify the wound healing milieu. One week later, distinct firm pale papules in linear arrays with mild hypopigmentation had developed along involved neck skin folds. Skin biopsy was performed. For the second patient, the neck was treated at a pulse energy of 20 mJ (630 µm depth) with 30% coverage of the exposed skin, with a total treatment energy of 5.0 kJ. Minimal crusting was noted on the neck throughout the initial healing phase of 2 weeks. She then experienced tightness on her neck. Approximately 3 weeks after treatment, she developed multiple vertical and horizontal hypertrophic scars (HS). Results Histopathology for the first case confirmed the presence of a hypertrophic scar. The papules in this case completely resolved with mild residual hypopigmentation after treatment with topical corticosteroids. HS failed to resolve in the second case to date after 1 month. Conclusion As with traditional ablative CO2 laser resurfacing, HS is a potential complication of ablative fractional CO2 laser resurfacing, particularly on the neck. With early diagnosis and appropriate treatment HS of neck skin may be reversible. We urge caution when treating the neck with this device and close attention to wound care in the post-operative period. Lasers Surg. Med. 41:185,188, 2009. © 2009 Wiley-Liss, Inc. [source]

    The effects of multiple passes on the epidermal thermal damage pattern in nonablative fractional resurfacing,

    LASERS IN SURGERY AND MEDICINE, Issue 2 2009
    Dieter Manstein MD
    Background and Objective Nonablative fractional resurfacing is a concept of cutaneous re-modeling whereby laser-induced microscopic treatment zones (MTZs) are surrounded by normal viable tissue. Such thermal damage pattern with a small diameter of individual lesions allows fast re-epithelialization with minimal side effects. The purpose of this in vitro study was to determine the fraction of thermal injury per unit surface area (fill factor) and lesion size in relation to pulse energy and number of passes. Methods Full thickness abdominal skin samples were exposed ex vivo to the Fraxel SR 750 laser (Reliant Technologies, Mountain View, CA). One set of exposures was performed for pulse energies in the range of 8 to 40 mJ for a single pass at 250 MTZ/cm2. A second set of exposures was performed at 10 mJ with number of passes from 1 to 30. The thermal damage pattern was assessed by incubation of epidermal sheets with NitroBlueTetrazoliumChloride (NBTC) stain. Size of individual MTZ and fill factor were determined by image analysis (ImageJ, NIH, Bethesda, MD) of digital micrographs. Results Width of the thermal injury zone was directly related to the pulse energy used. The fill factor did not have a uniform relationship with the number of passes. Due to the stochastic placement of individual MTZs, even for greater number of passes, some residual undamaged tissue was found. Due to formation of thermal damage clusters, defined as overlapping individual MTZs, the size of the resulting clustering lesions which we defined as microscopic treatment cluster (MTC) increased linearly as a function of the number of passes. Conclusion We have described the fill factor as it relates to the number of passes and have demonstrated that the average size of individual lesions depends on the number of passes. Clustering of MTZs lead to the development of MTC, the average size of which increased with the number of passes. The clinical implications of these findings are contingent on further studies. Lasers Surg. Med. 41:149,153, 2009. © 2009 Wiley-Liss, Inc. [source]

    Ex vivo histological characterization of a novel ablative fractional resurfacing device,

    LASERS IN SURGERY AND MEDICINE, Issue 2 2007
    Basil M. Hantash MD
    Abstract Background and Objectives We introduce a novel CO2 laser device that utilizes ablative fractional resurfacing for deep dermal tissue removal and characterize the resultant thermal effects in skin. Study Design/Materials and Methods A prototype 30 W, 10.6 µm CO2 laser was focused to a 1/e2 spot size of 120 µm and pulse duration up to 0.7 milliseconds to achieve a microarray pattern in ex vivo human skin. Lesion depth and width were assessed histologically using either hematoxylin & eosin (H&E) or lactate dehyrdogenase (LDH) stain. Pulse energies were varied to determine their effect on lesion dimensions. Results Microarrays of ablative and thermal injury were created in fresh ex vivo human skin irradiated with the prototype CO2 laser device. Zones of tissue ablation were surrounded by areas of tissue coagulation spanning the epidermis and part of the dermis. A thin condensed lining on the interior wall of the lesion cavity was observed consistent with eschar formation. At 23.3 mJ, the lesion width was approximately 350 µm and depth 1 mm. In this configuration, the cavities were spaced approximately 500 µm apart and interlesional epidermis and dermis demonstrated viable tissue by LDH staining. Conclusion A novel prototype ablative CO2 laser device operating in a fractional mode was developed and its resultant thermal effects in human abdominal tissue were characterized. We discovered that controlled microarray patterns could be deposited in skin with variable depths of dermal tissue ablation depending on the treatment pulse energy. This is the first report to characterize the successful use of ablative fractional resurfacing as a potential approach to dermatological treatment. Lasers Surg. Med. 39:87,95, 2007. © 2007 Wiley-Liss, Inc. [source]