Faculty Bibliography

BACKGROUND:Patients commonly complain about the appearance of acne scars. While various lasers and energy-based devices can offer clinical improvement, many of them are limited in treating patients with skin of color. Concerns exist regarding efficacy and safety, including risks of scarring, prolonged dyspigmentation, necrosis, and burns. OBJECTIVE:To examine the utility of a 755-nm picosecond laser with fractionated lens array in improving the clinical appearance of acne scars in patients with Fitzpatrick skin types V and VI. MATERIALS AND METHODS:A prospective clinical study investigated this laser using up to 5 monthly treatments. RESULTS:Twenty-four subjects were enrolled, while 17 subjects completed a 3-month follow-up. The mean age was 33.9 years, and 95.8% of the subjects were women. Fitzpatrick skin types V and VI were represented. Assessments compared baseline to 3-month follow-up. Two of the 3 blinded reviewers agreed on identifying pretreatment and post-treatment photographs for 82.4% of the cases. For physician Global Aesthetic Improvement Scale, 100% of the subjects had clinical improvement. Overall, 94.1% of subjects were satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION:A 755-nm picosecond laser with fractionated lens array can safely and effectively improve acne scars in patients with Fitzpatrick skin types V and VI.

BACKGROUND:Ultrasound-based devices have been developed to improve various cosmetic indications, including fines lines, wrinkles, eyebrow laxity, and submental laxity. Ultrasound waves of high intensity targeting the dermis can induce neocollagenesis, neoelastogenesis, and subsequent remodeling to improve the clinical appearance of these indications. OBJECTIVE:To examine the utility of a novel ultrasound device that utilizes high-intensity, high-frequency, parallel ultrasound beams to improve the clinical appearance of skin laxity on the upper arms. MATERIALS AND METHODS/METHODS:A prospective, multicenter, clinical study investigated this novel ultrasound device using two treatments. RESULTS:Forty-six subjects were enrolled and underwent treatment. Mean age was 59 years, and 100% were women. Fitzpatrick skin types I-IV were represented. Assessments compared baseline to 3-month follow-up. Two out of 3 blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 88.9% of subjects (p < .0001), who were considered responders. Blinded reviewers rated significant improvements in skin crepiness and laxity scale (1.97 vs 2.95; p < .0001) and also in Global Aesthetic Improvement Scale in 93.3% of photographs. No device-related adverse events occurred. CONCLUSION/CONCLUSIONS:A novel ultrasound device that utilizes high-intensity, high-frequency, parallel ultrasound beams can safely and effectively improve skin laxity of the upper arms.

BACKGROUND:Neck rejuvenation has consistently become a popular cosmetic procedure. While various treatment modalities have been used, a novel fractional thermomechanical skin rejuvenation system was recently developed to create dermal coagulation through direct heat transfer with subsequent neocollagenesis. OBJECTIVE:A prospective clinical trial evaluated the efficacy and safety of a thermomechanical fractional injury device (Tixel 2, Novoxel, Netanya, Israel) for neck rhytides. MATERIALS AND METHODS/METHODS:Subjects with moderate to severe neck rhytides were enrolled for 4 monthly treatments. RESULTS:Twenty-six subjects were enrolled and completed all study visits. The mean age was 58.4 years, and 100.0% were women. Fitzpatrick skin types I to IV were included. For Fitzpatrick Wrinkle Classification System (FWCS), the mean baseline score was 6.3. As per investigator, there was a mean 1.5-grade improvement in FWCS at 1-month follow-up (p < .00001) and 1.4-grade improvement in FWCS at 3-month follow-up (p < .00001). For physician Global Aesthetic Improvement Scale, all subjects (100%) had improvement at both 1- and 3-month follow-up visits. There were no severe adverse events, and subjects experienced minimal pain. CONCLUSION/CONCLUSIONS:A novel thermomechanical fractional injury device is effective and safe for the treatment of neck rhytides.

BACKGROUND:Patients frequently complain about fine lines, wrinkles, dyschromia, and photoaging, for which lasers and energy-based devices can treat each of these. Pairing various devices in a single treatment session can be safe and effective, but different technologies, mechanisms, histologies, parameters, and techniques must be considered. OBJECTIVE:To examine the utility of a paired treatment regimen using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array to improve the clinical appearance of facial wrinkles and photoaging. MATERIALS AND METHODS:A prospective clinical study investigated this paired treatment regimen using 4 monthly sessions. RESULTS:Twenty-five subjects were enrolled, while 18 subjects completed 3-month follow-up. The mean age was 54 years, and 92% were women. Fitzpatrick Skin Types I to IV were represented. Assessments compared baseline with the 3-month follow-up. Two of 3 blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 94.4% of cases. For physician Global Aesthetic Improvement Scale, 100% of subjects had clinical improvement. Overall, 88.9% of subjects were considered to be satisfied with their treatment. No serious or unanticipated adverse events occurred. CONCLUSION:Paired treatment using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array can safely and effectively improve facial wrinkles and photoaging.

BACKGROUND:Ultrasound energy can successfully treat fine lines and wrinkles, as well as lift the eyebrow and submentum. Ultrasound waves of high intensity induce thermal injury in the dermis with subsequent tissue remodeling. OBJECTIVE:To examine the utility of a novel ultrasound device that utilizes high-intensity, high-frequency, parallel ultrasound beams to improve the clinical appearance of cellulite on the thighs and buttocks. MATERIALS AND METHODS/METHODS:A prospective, multicenter, clinical study investigated this novel ultrasound device using 2 treatments. RESULTS:Sixty-five subjects completed both treatments. The mean age was 46 years, and 100% were women. Fitzpatrick skin types I to VI were represented. Assessments compared 3-month follow-up with baseline. Two blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 89.2%. For Cellulite Severity Scale rating, there was significant improvement of 1.61 units ( p < .001). For cellulite Global Aesthetic Improvement Scale (GAIS), 89.2% had improvement, with a mean of 0.87 units ( p < .001). For Laxity Scale rating, there was significant improvement of 0.70 units ( p < .001). For skin laxity GAIS, 89.2% had improvement, with a mean of 0.76 units ( p < .001). No device-related adverse events occurred. CONCLUSION/CONCLUSIONS:A novel ultrasound device that utilizes high-intensity, high-frequency, parallel ultrasound beams can safely and effectively improve the clinical appearance of cellulite on the thighs and buttocks.

IMPORTANCE/UNASSIGNED:Early treatment of port-wine birthmark (PWB) can be life-altering and is often associated with improved outcomes and quality of life. There is growing evidence that shorter treatment intervals may play a role in more rapid PWB clearance; however, the optimal treatment interval has not been established. OBJECTIVE/UNASSIGNED:To describe the outcomes of once-weekly pulsed dye laser (PDL) treatments for PWB in infants. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This case series analyzed the medical records of patients with PWB who received once-weekly PDL treatments between January 1, 2022, and December 31, 2023, at the Laser & Skin Surgery Center of New York. These patients were younger than 6 months. Before-and-after treatment photographs were independently assessed and graded 2 months after initiation of treatment. INTERVENTION/UNASSIGNED:Once-weekly PDL treatments. MAIN OUTCOMES AND MEASURES/UNASSIGNED:The primary outcome was the percentage improvement of PWB, which was graded using the following scale: 0% (no improvement), 1% to 25% (mild improvement), 26% to 50% (moderate improvement), 51% to 75% (marked improvement), 76% to 95% (near-total clearance), and 96% to 100% (total clearance). RESULTS/UNASSIGNED:Of the 10 patients (6 males [60%]; median [range] age at first treatment, 4 [<1 to 20] weeks) included, 7 (70%) had experienced either near-total clearance (76%-95%) or total clearance (96%-100%) of their PWB with once-weekly PDL treatments after 2 months. The other 3 patients all saw marked improvement (51%-75%) and subsequently went on to achieve near-total clearance with additional treatments. The median (range) duration of treatment and number of treatments to achieve near-total or total clearance in all patients were 2 (0.2-5.1) months and 8 (2-20) treatments, respectively. No adverse events were noted. CONCLUSION AND RELEVANCE/UNASSIGNED:This case series found that once-weekly PDL treatments for PWB in the first few months of life was associated with near-total or total clearance of PWB with no reported adverse events, suggesting improved outcomes can be achieved with shorter overall treatment duration. Further investigation into this novel decreased treatment interval of 1 week is warranted.

Traumatic tattoos can occur when foreign pigment particles are embedded within the dermis, sometimes resulting as traumatic events. Traditional treatment modalities, including surgical excision, cryosurgery, electrosurgery, dermabrasion, CO₂ lasers, and argon lasers, have limitations such as nonselectivity for pigment and risks of scarring and discoloration. We present the case of a patient who developed a postoperative tattoo after a minimal access cranial suspension facelift procedure that subsequently completely resolved after treatment with the high-powered 1064-nm picosecond laser. The patient achieved complete resolution of the postoperative tattoo after five laser treatments without adverse events or recurrence of pigmentation on follow-up. High-powered 1064-nm picosecond laser can serve as a fast, safe, and effective modality that in our clinic has become the first-line treatment for traumatic tattoos, and in our patient led to high satisfaction.