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

76 American Society for Laser Medicine and Surgery Abstracts
Study: The devices illustrated will be both red and infra-red
lasers and LEDs.
#255
IS SKIN TIGHTENING AN ADDED ADVANTAGE TO
LASER LIPOLYSIS AS COMPARED TO
CONVENTIONAL SUCTION ASSISTED
LIPOSUCTION? A CONTROLLED STUDY
Kenneth Rothaus
New York Presbyterian Hospital Weill Cornell, New York, NY
Background: The purpose of this study is to determine in a
prospective controlled fashion using an IRB approved protocol if in
fact there are any additional skin tightening benefits during laser
lipolysis compared to conventional liposuction.
Study: A 24 W 924/975 nm laser (Palomar Medical Technologies)
was used to perform laser lipolysis on the posterior aspect of the
upper extremity for correction of the ‘‘bat wing’’ deformity on nine
patients. The contralateral extremity served as the control and
underwent conventional liposuction. Treatments were performed
in an accredited office based surgical facility using local tumescent
anesthesia. Laser energies were delivered until an internal
temperature of 45 and 508C measured using an internal probe was
achieved. Following the laser lipolysis, the patients underwent
traditional liposuction using 2.5-mm cobra cannulae. The controls
sides underwent traditional liposuction alone. All patients were
followed for up to 24 weeks. Skin tightening was measured as
change in diameter of the abducted upper extremity measured
using a commercial web-based program (ImageStore, Portola
Valley, California). Patient questionnaires were concurrently
taken at 72 hours, 4 and 12 weeks to assess pain, morbidity, skin
contour changes and overall satisfaction.
Results: The lasered extremities experienced greater skin
tightening (3.77%) than the controls (0.28%). This was significant
using a paired T-test (P < 0.04). There were no complications.
Patients had minimal bruising that was resolved within 7–10
days. Patient discomfort was also minimal. Patient questionnaires
demonstrated increased satisfaction and skin contour changes as
well as decreased pain and morbidity on the lasered side as
compared with the controls. These findings were consistent with
investigator assessment.
Conclusion: Upper extremities treated with laser-assisted
liposuction using a 924/975 nm laser device demonstrated
statistically greater skin tightening than those treated with
traditional liposuction alone with no increase in complications or
patient morbidity and increased patient satisfaction.
#256
POLARIZED PHOTOGRAPHY OF THE SKIN
Claudia Sá Guimarães
Rio de Janeiro, Brazil
Background: It is proposed that clinical examination is
accompanied by photographs with circular polarizing filter that
enhances skin pigmentation and vascularization as a way to
improve the assessment of these patients. Through the use the
circular polarizing filter it is possible to register the presence of
hemoglobin and melanin in the skin, which are not observable to
the naked eye. The development of photographic equipment with
more powerful CCD (15 MP) for the prosumer machines, enabled
the recording of details of the skin independent of its natural color.
The luminance increased with the use of torches flash provides
illumination similar to daylight (55,000 K), as well as the use of
technical lighting with light sources applied to 458, improves the
quality of the pictures with the representation of colors faithfully,
and permitted the use of circular polarizing filter attached to
digital camera and exposure compensation with increasing
aperture.
Study: A group of 30 volunteers selected at random were
photographed with digital camera Canon T1i, with 60 mm and
100 mm macro lens, and circular polarizing filter (Hoya Pro1) and
lighting of torches flash applied at an angle of 458. The light was
measured with a digital photometer for calculating the aperture
(f) and shutter speed.
Results: Digital photography with polarized filter has proved to
be a biased method of clinical evaluation improved more than
the examination with naked eye, as it enables the observation of
the colors red and brown skin, allowing the observation of
cutaneous vascular and variations of the melanin pigment in all
patients.
Conclusion: The use of polarized light in the dermatological
examination and photographs is not new. However, with the
improvement of photographic equipment and photographic
technique (respecting focal length, proper lighting, good focus on
the object photographed and the use of circular polarizing filter) it
is possible a faithful record of the moment of the dermatological
examination and aid in the detection of skin pigments. The
method is simple, fast and low cost.
#257
AN ANATOMICALLY-BASED ALGORITHM FOR
CELLULITE TREATMENT WITH A 1,440 NM
PULSED LASER FOR LIPOLYSIS, SUBCISION OF
FIBROUS SEPTAE AND DERMAL THICKENING
AND ELASTICITY
Gordon Sasaki, Barry DiBernardo
Cynosure, Pasadena, CA; Cynosure Montclair, NJ
Background: Cellulite, characterized by alterations to the
cutaneous surface, pseudo-herniations of fat and septal dimpling,
especially to the buttocks and thighs, represents a common
unsightly condition. Cellulite’s definition, etiology, and anatomy
are subjects of continued debate and, currently, challenges
consistent effective treatment. (1) Evaluate the safety, efficacy
and duration of a pulsed 1,440 nm laser for subdermal lipolysis,
release of septal bands, and thermal salutary effects on dermal
structures. (2) Evaluate improvements in skin elasticity and
thickness. (3) Evaluate physicians and subjects satisfaction by
questionnaires.
Study: Healthy female subjects (n ¼ 50; average age 41
7.3 years; average BMI 27.5 6.2) with Grade II–III (Modified
Muller Nuremberger Scale) cellulite on their thighs were
enrolled in a prospective, IDE-approved study conducted in two
plastic surgery offices, each treating 25 subjects. Subjects were
treated in a single session with a 1,440 nm pulsed Nd:YAG laser.
A measured amount of energy was delivered through a 1,000 mm
side-firing fiber to create localized damage in order to disrupt
fat cells, subcise septae, and heat the dermal/fat junction to
damage fat and stimulate collagen production within the
tumesced mapped areas. At baseline, 2, 3 and 6 months,
treatment efficacy was assessed by (1) high-resolution
standardized digital photography graded by evaluators, (2) skin
elasticity by DermaLab Elasticity module, and (3) skin
thickness with a 20-MHz high frequency ultrasound DermaScan
probe.