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. 2018 Oct;36(10):541-547.
doi: 10.1089/pho.2018.4479. Epub 2018 Sep 20.

Resurfacing with Ablation of Periorbital Skin Technique: Indications, Efficacy, Safety, and 3D Assessment from a Pilot Study

Stefania Guida  1 , Steven Paul Nisticò  2 , Francesca Farnetani  1 , Ester Del Duca  3 , Nathalie De Carvalho  1 , Flavia Persechino  1 , Tommaso Verdina  4 , Luca Giannetti  5 , Martina D'Alessandro  6 , Giacomo Giovanni Urtis  7 , Giovanni Pellacani  1 , Giovanni D'Alessandro  8
Affiliations

Resurfacing with Ablation of Periorbital Skin Technique: Indications, Efficacy, Safety, and 3D Assessment from a Pilot Study

Stefania Guida et al. Photomed Laser Surg. 2018 Oct.

Abstract

Objectives and background: Nowadays, several approaches for skin rejuvenation of the lower eyelid are available. We present a new technique of resurfacing with ablation of periorbital skin (RAP) performed in a single session.

Methods: This is a retrospective study involving 20 patients showing skin elastosis with or without evidence of the nasojugal fold and atrophic and dyschromic skin or needing a combined approach of transconjuntival lower blepharoplasty for fat bag removal. RAP technique is assessed in terms of efficacy, safety, and 3D evaluation of results at 6 months' follow-up.

Results: Global Assessment Improvement Scale results highlighted an improvement in all cases, for both physicians (blinded to treatment) and individual subjects. Only minor adverse events (edema, erythema, and discoloration) were reported in almost all patients, lasting 2-3 weeks after treatment, and were resolved without intervention. A 3D imaging tool revealed the reduction of medium protrusions and depressions and an improved texture at 2 months. Skin recovery was inversely correlated with hemoglobin reduction.

Conclusions: RAP seems to offer expert dermatologists a safe and clinically effective technique for skin rejuvenation of lower eyelids, without significant adverse events. Further studies will be performed to confirm our results.

Keywords: CO2 laser; lower eyelid; resurfacing.

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Conflict of interest statement

Dr. Giovanni D'Alessandro received honoraria from Deka M.E.L.A. for speaker activities. Disclosure for all other authors: none reported. Declaration of funding interests: Deka M.E.L.A. provided support for publication fees.

Figures

<b>FIG. 1.</b>
FIG. 1.
Indications for treatment: (A) skin elastosis and (B) atrophic skin with heterogeneous color skin.
<b>FIG. 2.</b>
FIG. 2.
Intraoperative pictures: (A) removal of topical anesthesia, (B) epidermis vaporization (maximum vertical diameter in blue) corresponding to opalescent skin associated with microvesicles, and (C) dermal retraction (maximum vertical diameter in red) obtained after defocused irradiation of the dermis. (D) Schematic representation of how a dermal retraction can be performed. Following traction lines, a centripetal retraction is obtained with single or linear pulses. The sum of each pulse will determine the total amount of retraction.
<b>FIG. 3.</b>
FIG. 3.
Clinical picture of a 45-year-old woman (A) pretreatment and (B) 6 months post-treatment; clinical picture of a 52-year-old woman (C) pretreatment and (D) 6 months post-treatment.
<b>FIG. 4.</b>
FIG. 4.
Antera 3D pictures: (A) pretreatment and two months post-treatment of a 45-year-old woman. (B) Medium surface depressions at different time intervals: pretreatment, 7 days, 1 month, and 2 months post-treatment. (C) Medium texture at different time intervals: pretreatment, 7 days, 1 month, and 2 months post-treatment. (D) Medium protrusions at different time intervals: pretreatment, 7 days, 1 month, and 2 months post-treatment. (E) Hemoglobin at different time intervals: pretreatment, 7 days, 1 month, and 2 months post-treatment.
<b>FIG. 5.</b>
FIG. 5.
Antera 3D plots of a 52-year-old woman (A) pretreatment, (B) 7 days, (C) 1 month, and (D) 3 months post-treatment.
<b>FIG. 6.</b>
FIG. 6.
Clinical picture of a 54-year-old patient (A) pretreatment and (B) 9 months post-treatment.
See this image and copyright information in PMC

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