Abstract

Objectives: To evaluate the efficacy and safety of combining fractional carbon dioxide laser and polydioxanone threads in treating skin laxity and brow ptosis in Asian patients Introduction: For much of the Asian population, skin laxity around the eye and brow ptosis are the first to be observed with aging. Descending of the upper lid due to skin laxity over the entire eyes and less arching of the brows translates as “tired or sad look” which prompts patient to seek consult. Blepharoplasty although considered as the gold standard in upper lid ptosis treatment is a surgical procedure that may inevitably lead to surgical complications such as under/over correction, scarring and infection. Due to this possibility, minimally invasive non-surgical procedures are now the treatment of Materials / method: Study of 15 patients male and female was selected, aged 35-50 years old with Fitzpatrick skin type IV. All subjects had 1 session of Fractional carbon dioxide laser around the eye area over the orbital rim at 5% concentration at 10 J/cm2 followed by PDO thread insertion over the brow area using 10 pieces , mono, 29G, 25mm/30mm,6.0 and lower lid 15 pieces, mono, 31G, 12mm/10mm threads. Topical antibiotics were applied twice a day for 5 days. Inflammation and bruising were managed by ice packs and Vitamin K cream and oral analgesics . Results: RESULTS A single combined treatment of fractional carbon dioxide laser and PDO thread insertion increased brow height of an average of 4 mm, widened the upper lid crease by 1-3 mm and improved skin laxity scores by minimum of 1-2 Grades. All patients observed significant degrees of skin tightening, brow elevation, texture improvement and wrinkle reduction in the eye area. Statistical data analysis was significant. Conclusion: This study proved that by combining fractional carbon dioxide laser and polydioxanone threads showed significant improvement in upper lid ptosis and brow ptosis based on measurement of the 1) Midline brow height with reference to the mid pupillary line and 2) Margin crease distance on all patients. This also showed improvement in scores of patient’s lid distraction test. Safety of the treatment is also established