Hersant Barbara, SidAhmed-Mezi Mounia, Chossat Adrien, Meningaud Jean Paul
Department of Plastic and Cosmetic Reconstructive Surgery and Maxillo Facial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France.
Lasers Surg Med. 2017 Jan;49(1):78-83. doi: 10.1002/lsm.22561. Epub 2016 Jul 18.
Due to the increasing demand for aesthetic procedures, especially facial aesthetic surgery, a new laser technology has been developed for facial skin rejuvenation and wrinkle treatment. The aim of this study was to objectively and subjectively assess the clinical efficacy and safety of Erbium:YAG laser combined with Spatially Modulated Ablation (Er:YAG + SMA) on facial skin rejuvenation.
STUDY DESIGN/MATERIALS AND METHODS: Patients with Fitzpatrick skin type's I-IV were prospectively included. Inclusion criteria consisted of having wrinkles and irregular skin texture. All patients underwent two Er:YAG + SMA sessions (1 month apart) to stimulate tissue regeneration. Er:YAG laser emits wavelength at 2,940 nm and when combined with SMA, a resonance effect is produced in the dermis to promote tissue regeneration. Facial skin elasticity and firmness were objectively assessed by Cutometer at baseline and month 6 (M6). Aesthetic improvement was qualitatively assessed using digital photographs. Patient satisfaction with regard to their facial appearance was self-assessed using the validated FACE-Q scale and the patient-perceived age VAS scale at baseline, M1, and M6. Side effects were investigated after each session.
Thirty-four patients were included, 50% (18 patients) had Fitzpatrick skin type III and 41% (14 patients) were smokers. Skin elasticity indices were significantly improved: from 0.335 ± 0.015 at baseline to 0.387 ± 0.021 at M6 (P = 0.05*) for R5 (net elasticity). Skin firmness was assessed through R7 (biological elasticity) and R6 (viscoelastic ratio) at baseline and M6: a significant increase from 0.235 ± 0.01 to 0.2709 ± 0.009 (P < 0.03**) and decrease from 0.486 ± 0.022 to 0.3918 ± 0.023 (P < 0.006***) were respectively observed. A negative value for R6 corresponded to an improved skin condition. The FACE-Q scores were significantly increased from 39.4 ± 6.7 at baseline to 45.4 ± 9.1 at M1 (P < 0.006***) and 50.4 ± 9.8 at M6 (P < 0.0001***), reflecting wrinkle reduction and enhanced rejuvenation. According to the age appraisal VAS scale, results showed that patients felt younger by -2.92 years at M1 (P < 0.0001***) and -4.13 years (P < 0.0001***) at M6. No adverse reaction was reported.
The Er:YAG + SMA technology offers an effective and safe treatment alternative for facial skin rejuvenation. It reduces the recovery time compared to conventional lasers such as carbon dioxide laser. Lasers Surg. Med. 49:78-83, 2017. © 2016 Wiley Periodicals, Inc.
由于对面部美容手术等美容程序的需求不断增加，已开发出一种用于面部皮肤年轻化和皱纹治疗的新型激光技术。本研究的目的是客观和主观地评估铒：钇铝石榴石激光联合空间调制消融（Er:YAG + SMA）对面部皮肤年轻化的临床疗效和安全性。
研究设计/材料与方法：前瞻性纳入了Fitzpatrick皮肤分型为I-IV型的患者。纳入标准包括有皱纹和皮肤质地不匀。所有患者均接受了两次Er:YAG + SMA治疗（间隔1个月）以刺激组织再生。Er:YAG激光发射波长为2940nm，与SMA联合使用时，在真皮层产生共振效应以促进组织再生。在基线和第6个月（M6）使用皮肤弹性测定仪对面部皮肤弹性和紧致度进行客观评估。使用数码照片对面部美学改善进行定性评估。在基线、M1和M6时，使用经过验证的FACE-Q量表和患者感知年龄视觉模拟量表对患者对面部外观的满意度进行自我评估。每次治疗后调查副作用。
纳入了34例患者，50%（18例患者）为Fitzpatrick III型皮肤，41%（14例患者）为吸烟者。皮肤弹性指数显著改善：R5（净弹性）从基线时的0.335±0.015提高到M6时的0.387±0.021（P = 0.05*）。在基线和M6时通过R7（生物弹性）和R6（粘弹性比）评估皮肤紧致度：分别从0.235±0.01显著增加到0.2709±0.009（P < 0.03**），以及从0.486±0.022降低到0.3918±0.023（P < 0.006***）。R6的负值对应于皮肤状况改善。FACE-Q评分从基线时的39.4±6.7显著提高到M1时的45.4±9.1（P < 0.006***）和M6时的50.4±9.8（P < 0.0001***），反映出皱纹减少和年轻化增强。根据年龄评估视觉模拟量表，结果显示患者在M1时感觉年轻了-2.92岁（P < 0.0001***），在M6时感觉年轻了-4.13岁（P < 0.0001***）。未报告不良反应。
Er:YAG + SMA技术为面部皮肤年轻化提供了一种有效且安全的治疗选择。与二氧化碳激光等传统激光相比，它缩短了恢复时间。《激光外科与医学》49:78 - 83，2017年。©2016威利期刊公司
