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AAD Looks Into New Minimally Invasive Rejuvenating Treatments

Posted: August 11, 2008

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While nonablative lasers are designed for patients with superficial skin damage who are not expecting dramatic results, fractional nonablative lasers can deliver better results for patients with more extensive signs of aging. Fractional nonablative lasers heat pixilated columns of skin to depths three to four times deeper than traditional nonablative heating, creating increased collagen production that provides improved results in skin texture, fine wrinkles and acne scars. The primary side effect of fractional nonablative lasers is redness that lasts slightly longer than their nonablative counterparts—in most cases, overnight as compared to a few hours.

For patients with even deeper wrinkles and scars, fractional ablative lasers are considered comparable to the traditional ablative lasers, such as the CO2 laser that is considered the gold standard in laser skin resurfacing. With fractional ablative lasers, microscopic plugs of tissue are removed and heated at the same time. Because only 10–40% of the surface area of the skin is treated, Kauvar noted that the procedure requires much less downtime and the risks are lower than with other ablative lasers. "Fractional ablative lasers are a dramatic advance over traditional laser resurfacing," she said.

Even with laser resurfacing, wrinkles that are a result of constant muscle movement—frown lines and crow's feet, for example—can be hard to treat. Kauvar added the popular injectible botulinum toxin, which works by relaxing the muscles that cause wrinkles, works well for these hard-to-treat wrinkles when used in combination with skin resurfacing. For deeper folds and creases, such as vertical lip lines or smile lines, Kauvar suggests hyaluronic acid fillers.

Skin looseness and loss of volume

With the further loss of collagen, the skin loses elasticity and becomes lax. These deeper folds result in jowl formation or what is commonly referred to as chicken neck. Fortunately, there are a variety of options to tighten loose skin.