Microfocused Ultrasound for Nonablative Skin and Subdermal Tightening to the Periorbitum and Body Sites: Preliminary Report on Eighty-Two Patients

Gordon H.  Sasaki; Ana  Tevez

doi:10.4236/jcdsa.2012.222022

Gordon H. Sasaki^*, Ana Tevez

Abstract: Lax crepey skin is a major unsightly finding throughout the face and body that occurs from chronological aging and environmental photodamage. Surgical lifting procedures are unable to induce sufficient neocollagenesis and also associated with visible scars, risks and recovery time. In this preliminary report, non-invasive delivery of microfocused ultrasonic thermal coagulation points at two levels of the dermis outside the orbital rims was effective in reduction of crepey, wrinkled and sagging skin for about 1 ? years in nineteen treated patients. Matched Orientation Mirror Imaging produced an average brow height elevation of 1 - 2 mm. Microfocused thermal coagulation points at multiple tissue levels also induced tissue tightening and reduction of crepey wrinkled skin in the décolletage, brachium, periumbilicus, inner thigh and knees. Investigator and Subject Global Aesthetic Improvement Scale graded responses that correlated to the severity of the degree of crepiness and laxity. Pain management during the procedure included the use of infiltration of local anesthesia. No permanent adverse events were observed. Further innovations in the current technology are needed for more effective and safer delivery of energy to improve the appearance of crepey and lax tissue in the head, neck and body.

Keywords: Crepey; Focused; Imaged; Ultrasound; Noninvasive; Lifting; Tightening

Cite this paper: G. Sasaki and A. Tevez, "Microfocused Ultrasound for Nonablative Skin and Subdermal Tightening to the Periorbitum and Body Sites: Preliminary Report on Eighty-Two Patients," Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 2 No. 2, 2012, pp. 108-116. doi: 10.4236/jcdsa.2012.222022.

References

[1] M. Alam, L. E. White, N. Martin, et al., “Ultrasound Tightening of Facial and Neck Skin: A Rater-Blinded Prospective Cohort Study,” Journal of the American Aca- demy of Dermatology, Vol. 62, No. 2, 2009, pp. 262-269. doi:10.1016/j.jaad.2009.06.039

[2] G. H. Sasaki and Tevez, “Focused Imaged Ultrasound: Clinical Efficacy and Safety (2 Year Experience),” Aesthetic Surgery Journal, Vol. 32, No. 5, 2012.

[3] W. M. White, I. R. S. Makin, P. G. Barthe, et al., “Selective Creation of Thermal Injury Zones in the Superficial Musculoaponeurotic System Using Intense Ultrasound Therapy,” Archives of Facial Plastic Surgery, Vol. 9, No. 1, 2007, pp. 922-929.

[4] W. M. White, I. R. S. Makin, M. H. Slayton, et al., “Selective Transcutaneous Delivery of Energy to Porcine Soft Tissues Using Intense Ultrasound (IUS),” Lasers in Surgery and Medicine, Vol. 40, No. 2, 2008, pp. 67-75. doi:10.1002/lsm.20613

[5] R. E. Gliklich, W. M. White, M. H. Slayton, et al., “Clinical Pilot Study of Intense Ultrasound Therapy to Deep Dermal Facial Skin and Subcutaneous Tissues,” Archives of Facial Plastic Surgery, Vol. 9, No. 2, 2007, pp. 88-95. doi:10.1001/archfaci.9.2.88

[6] D. Manstein, G. S. Herron and R. K. Sink, “Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury,” Lasers in Surgery and Medicine, Vol. 34, 2004, pp. 426- 438. doi:10.1002/lsm.20048

[7] G. H. Sasaki, H. M. Travis and B. Tucker, “Fractional CO2 Laser Resurfacing of Photoaged Facial and Non-Facial Skin: Histologic and Clinical Results and Side Effects,” Journal of Cosmetic and Laser Therapy, Vol. 11, No. 4, 2009, pp. 190-201. doi:10.3109/14764170903356465

[8] T. S. Alster and J. R. Lupton, “Nonablative Cutaneous Remodeling Using Radiofrequency Devices,” Clinics in Dermatology, Vol. 25, 2007, pp. 487-491. doi:10.1016/j.clindermatol.2007.05.005

[9] C. C. Dierickx, “The Role of Deep Heating for Noninvasive Skin Rejuvenation,” Lasers in Surgery and Medicine, Vol. 38, No. 9, 2006, pp. 799-807. doi:10.1002/lsm.20446

[10] N. Sadick, “Tissue Tightening Technologies: Fact or Fiction,” Aesthetic Surgery Journal, Vol. 28, 2008, pp. 180-188.

[11] M. L. Elsaie, “Cutaneous Remodeling and Photorejuvenation Using Radiofrequency Devices,” Indian Journal of Dermatology, Vol. 54, No. 3, 2009, pp. 201-205. doi:10.4103/0019-5154.55625

[12] D. J. Maitland and J. T. Walsh, “Quantitative Measurements of Linear Birefringence during the Heating of Native Collagen,” Lasers in Surgery and Medicine, Vol. 20, No. 3, 1997, pp. 310-318. doi:10.1002/(SICI)1096-9101(1997)20:3<310::AID-LSM10>3.0.CO;2-H

[13] S. P. Arnoczky and A. Aksan, “Thermal Modification of Connective Tissues: Basic Science Considerations and Clinical Applications,” Journal of the American Academy of Orthopaedic Surgeons, Vol. 8, No. 5, 2000, pp. 305- 313.

[14] B. M. Hantash, A. A. Ubeid, H. Chang, et al., “Bipolar Fractional Radiofrequency Treatment Induces Neoelastogenesis and Neocollagenesis,” Lasers in Surgery and Medicine, Vol. 41, No. 1, 2009, pp. 1-9. doi:10.1002/lsm.20731

[15] D. Shoshani, E. Markovitz, S. J. Monstrey, et al., “The Modified Fitzpatrick Wrinkle Scale: A Clinical Validated Measurement Tool for Nasolabial Wrinkle Severity Assessment,” Dermatologic Surgery, Vol. 34, No. S1, 2008, pp. S85-S91. doi:10.1111/j.1524-4725.2008.34248.x