Presidential Greeting - American Society for Laser Medicine and ...

Background: Recently a specially designed point-array
compression tip (XD Optics, Palomar Medical Technologies, Inc.)
for fractional non-ablative laser was been investigated. The
objective of this study is to compare the efficacy and complications
of fractional non-ablative laser with compression versus without
compression.
Study: Twelve Asian patients were enrolled in the study. Half of
the face was treated with 1,540 nm fractional non-ablative laser
(45 mJ, 15 milliseconds, 50% overlap, 2 passes, single treatment)
with compression and the other half of the face was treated with
same laser without compression. A Canfied Visia CR system was
used to objectively evaluate the patient.
Results: There is no significant difference of efficacy. However,
pain score is significantly lower and dowmtime is significantly
shorter in fractional non-ablative laser with compression side. All
patient selected fractional non-ablative laser with compression in
the next treatment.
Conclusion: 1,540 nm fractional non-ablative laser with
compression has a possibility to reduce the epidermal damage and
pain. Further study is warranted to compare the efficacy with
multiple treatment sessions.
#83
American Society for Laser Medicine and Surgery Abstracts 27
#85
DEEP HEATING OF DERMIS USING NON-
ABLATIVE FRACTIONAL TECHNIQUE WITH
MICRO-COMPRESSION OPTICS
Christine Dierickx, Sean Doherty
Laser Clinic Boom, Boom, Belgium; Boston Plastic Surgery
Associates, Concord, MA
Background: Non-ablative fractional treatment (NAFT) has
been proven as safe and effective technique for skin resurfacing.
Up to recently, however, the depth of NAFT was limited to 1 mm,
restricted by acceptable level of surface damage. In this study, we
investigated feasibility of creating fractional coagulative damage
in the reticular dermis and subcutis without skin cooling by using
advanced micro-compression optics and pulse stacking. The
principal hypothesis was that point-like tissue compression
allowed accumulation of the absorbed optical energy in the deep
dermis resulting in incremental increase of the size of the zones of
coagulation.
Study: A 1,540 nm fractional system with point-array
compression tip (Lux1540, XD Optics, Palomar Medical) was used.
The study comprised three parts: (1) computer modeling of optothermal
dynamics to optimize treatment regime; (2) histological
ex vivo evaluation of columns of microdamage (CMD); and (3) pilot
clinical tests with emphasis on facial skin tightening. Up to five
pulses were stacked, with total cumulative fluence up to 65 J/cm 2
in three passes.
Results: Both computer simulations and ex vivo histology data
suggested feasibility of creating CMDs protruding deep into
dermis. Pilot clinical tests have been initiated in parallel
at two centers. Total of seven subjects have been treated on the
face up to date. The treatment was well tolerated and did not
require any anesthesia. Side effects included pronounced
erythema and edema and resolved completely in 2 weeks.
Follow-ups conducted up to 2 months post-treatment
demonstrated significant improvement in skin laxity and
appearance.
Conclusion: Micro-compression-enhanced NAFT may provide
means for efficient yet safe treatment of deep dermis and subcutis,
with the potential benefit of skin tightening.
HISTOLOGICAL EVALUATION OF A
NON-ABLATIVE 1,940 NM FRACTIONAL LASER
E. Victor Ross, Chad Tingey, Yacov Domankevitz,
Kevin Schomacker, James Hsia
Scripps Clinic, San Diego, CA; Candela, Wayland, MA
Background: The standard CO2 and Er:YAG laser nonfractional
systems for skin resurfacing produce predictable
cosmetic enhancement, however, because of the prolonged
recovery period, they have decreased in popularity. Non-ablative
fractional lasers cause little down time, however, some patients
want more noticeable results with fewer treatments. The
1,940 nm wavelength matches one of the water absorption peaks
in the mid infrared band of electromagnetic energy. The skin
absorption is much stronger than other non-ablative wavelengths
(1,440–1,550 nm) and weaker than ablative wavelengths. The
objective was to characterize laser tissue interactions
histologically in an ex vivo model. A human study is approved and
initial treatments are planned.
Study: Ex vivo porcine samples were irradiated with a fractional
1,940 nm laser. The thulium laser rod was pumped by a
3 milliseconds pulsed alexandrite laser. The fractional patterns
included dot and grid geometries. The ‘‘dot’’ beamlet size was
230 mm and the fixed pitch between lenslets was 480 mm. There
were 481 beamlets per macrospot. The macro-spot size was 12 mm
and a total energy was about 5 J (about 10 mJ per beamlet) and
fluence of 40 J/cm 2 . The grid pattern included 700 mm wide lines.
Results: Histological analysis has shown that with the
appropriate laser settings, damage extended about 200 mm deep to
the surface.
Conclusion: The study demonstrated that the 1,940 nm diode
laser, at appropriate settings, achieves injury patterns capable of
skin rejuvenation.
#86
CLINICAL RESULTS OF NON-ABLATIVE
FRACTIONAL PHOTOTHERMOLYSIS FOR
HOME-USE TREATMENT OF PHOTODAMAGED
SKIN
Christopher Zachary, Marieke van Grootel,
Tom Nuijs, Kerrie Jiang, Steven Struck
University of California, Irvine, CA; Philips Research, Eindhoven,
The Netherlands; Solta Medical, Hayward, CA; The Struck Clinic,
Palo Alto, CA
Background: Fractional photothermolysis (FP) has been proven
to be effective in the hands of professionals for the treatment of a
broad range of skin conditions, including pigmented lesions, fine
wrinkling and textural changes. In this study, we have
investigated the safety, efficacy and acceptability of repeated, lowdensity
in-home treatments for photodamaged skin.
Study: Multiple sequential clinical studies were conducted
employing a twice weekly treatment regimen for a period of 8–16
weeks. Studies involved both investigator-conducted and selfadministered
full-facial treatments and treatment of off-face, sunexposed
areas. Improvement was assessed by study subjects and
investigators. Objective improvement was assessed by
independent blinded evaluators based on clinical photographs.
Histological analysis was performed on both ex vivo skin and
on biopsies taken from treated areas according to the study
regimen.