Resumo

Objectives: 1.To satisfy our patient's demands ,one has to keep into consideration, their idea of self-image & their actual aesthetic needs. 2.We have a lot of responsibility to come up with the best approach. When combination treatments are to be offered, one has to map out the complete plan keeping in mind their budget and life style. 3.Combination therapy challenges physician to have a detailed understanding of patient's needs at cellular level to anatomic reversal of age related changes in each layer of face & neck.Your treatment plan will affect the over all aesthetic outcome & patient satisfaction. Introduction: We had 2 groups of females, 15 in each group that had different treatment needs. Group A with more photo-damaged skin was offered peels, ablative lasers, non ablative laser and skin boosters later followed by subtle fillers and toxins. Group B with more sagging & bony changes were first given skin structural support by EBD as Hifu & RF, followed by threads, that was later followed by high G' fillers with bony placement and toxins. The different treatment approach gave a great patient satisfaction. Materials / method: Females within age 30-55 years were included with Photo-damage and skin sagging. Group A included those with texture changes, pore visibiltiy, rhytides & pigmentary changes. Group B had faces with ageing signs and assessed as upper, mid and lower 1/3rd for wrinkles score and appearance of jowls. Group A with less sagging & more photodamage were offered peels, cosmaceutical ,microneedling , and ablative/non ablative lasers with less fillers and toxins. For Group B with more heavier faces and sagging, Hifu &RF was offered followed by Threads and High G' fillers. Results: group A & B both had high aesthetic outcome and satisfaction level. There were no major side effects of combining various modalities. with Threads there were few complaints of pain at the treatment site , swelling and in 2 patients there was a palpable thread that settled in 2-3 weeks. HIfu ,RF and EBD were generally well tolerated. No untoward effect was seen with Fillers or toxins. Conclusion: Combination therapy gives a great deal of synergy and an over all better aesthetic outcome to patient. There is not a single treatment modality that can address all aesthetic aspects for any one individual case. Educating patient before starting a treatment plan will gain confidence for your patient and enable the patient to stay with you for long term.