Faculty Bibliography

Combining laser treatments with cosmetic injectables can offer synergistic benefit, increased convenience for both patients and physicians, and lessened overall patient downtime. Although paired treatments can be effective, there remain theoretical concerns that this may add new risks. Theoretical risks of combining laser treatment with neurotoxin injections include unintentional spread of the neurotoxin, which may result in eyelid ptosis and muscle weakness. Potential risks with soft-tissue fillers include unexpected loss of filler volume, necrosis, burn, and product migration. This retrospective chart review of single-session, same-day facial treatments using a low-energy, low-density 1927 nm fractional thulium fiber laser and cosmetic injectables found no adverse events related to this combination approach. This is important safety information that can offer reassurance to physicians using this clinical approach.

BACKGROUND AND OBJECTIVES/OBJECTIVE:Melasma may be related to aberrant blood vessels, but there has been no report on the utility of dynamic optical coherence tomography (D-OCT) in studying vessel characteristics in melasma. We studied the characteristics of cutaneous blood vessels in melasma and the effects of oral tranexamic acid (TXA) with D-OCT. STUDY DESIGN/MATERIALS AND METHODS/METHODS:Six patients with moderate to severe melasma had a D-OCT scanning of the areas on the face affected by melasma and not affected by it. Three of them had scans within 3 months after starting oral TXA and at a follow-up visit. Blood flow at different depths of the skin and vessel diameter were compared between the melasma and normal skin. For those taking oral TXA, we compared the percent change of blood flow and diameter between the melasma and normal skin. RESULTS:Dermal blood flow and vessel diameter were greater in the melasma skin than in the normal skin. Oral TXA reduced dermal blood flow in both the melasma and normal skin, but the reduction was more dramatic in the lesional melasma skin. CONCLUSIONS:D-OCT findings that (i) dermal blood vessels in melasma are increased in size and flow and (ii) oral TXA reduced the vessel size and flow, providing evidence supporting the relationship between melasma and cutaneous blood vessels. D-OCT may be utilized in measuring response to treatments targeting melasma. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

This commentary examines the growing popularity of cosmetic procedures in men. With the recent increase in aesthetic procedures across the nation, it is important for physicians to understand trends as they evolve, which can help to optimize clinical training, business operations, and practice management. Although the popularity of cosmetic procedures in men has increased, available data on consumer behavior is limited. Our data fills this gap by examining the patterns of cosmetic procedures in men. Due to hormonal and anatomic differences, the pathophysiology of cutaneous aging differs between sexes, which can have significant implications for treatment. Our data demonstrates a positive trend in recent years and also breaks it down by individual procedures.

In recent years, the popularity of fillers has risen significantly. Traditionally, women have undergone the vast majority of cosmetic procedures, but men have steadily shown increasing interest. Recently, significant research has been dedicated to understanding the anatomic differences between male and female facial structures and their clinical aesthetic implications, especially for filler placement. In order to compare actual treatment data to evidence these discussions, we randomly selected 100 cases each of men and women, who were matched for age, and documented their filler placement locations. Facial heat maps were constructed to provide readers with visual evidence. Male cheeks were more inferiomedial, while female cheeks were more superolateral. Men had more jawline fillers, while women had more lip and perioral fillers. Our study builds upon gender-specific considerations. It is important for physicians to be knowledgeable regarding the unique approaches to fillers in men and women in order to deliver more effective, tailored, and high-quality care.