Objectives: Demostrar que el tratamiento combinado (de varias técnicas) tiene mejores resultados que el tratamiento individual (con una sola técnica) y cada día este tipo de procedimientos hacen parte de una nueva tendencia en nuestra área.

Introduction: El concepto de rejuvenecimiento facial total debe incluir las capas no solo superficiales sino las profundas de la piel.

Materials / method: Procedimientos quirúrgicos y no quirúrgicos para rejuvenecimiento facial.

Results: Óptimos resultados.

Conclusion: Mediante la combinación de procedimientos quirúrgicos y no quirúrgicos se optimizan los resultados.

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Objectives: To know the possible treatment methods that would affect the appearance of the periorbital area in patients avoiding surgical intervention.

Introduction: Periorbital rejuvenation is quite challenging. Ageing in the periorbital zone is affected by three factors. 1- loss of collagen, hence the inelastic skin. 2- underlying bone resorption, and 3- dislocation/absorption of fat pads.
This study is about targeting these three factors for rejuvenating the periorbital area.

Materials / method: TCA is carefully applied to the eyelids to induce collagen into the inelastic skin. Fractional CO2 with or without PRP also helps improve the wrinkles and the loose skin by stimulating collagen. Bone resorption can be replaced with High G prime dermal fillers whereas soft fillers can be placed with a 25G cannula to cover the dark circles in younger patients as well as replacing volume loss with high G prime in older patients.

Results: Tightening of the inelastic eyelids skin, as well as improvement of the undereye wrinkles, were noted with TCA peels. Undereye wrinkles were also improved with fractional resurfacing. Careful placement of High G prime fillers provide a good architectural base and improve complexion. I prefer using a 25G cannula as it can easily glide along the curved orbital rim of the maxilla. A brow lift can also be achieved with a gunshot technique with a needle.

Conclusion: From topical treatments like chemical peeling to injectable like mesotherapy, fillers to energy-based devices like fractional co2 for under eye wrinkles, multiple procedures can be tried for targeting tough areas of the periorbital zone.

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Objectives: Currently there is a growing demand for non-invasive therapies aimed at treating facial aging.
We present clinical results in facial rejuvenation with the combination of two technologies: facial non-ablative fractional laser 1340nm Nd:YAP and Intraoral 2940nm Er:YAG SMOOTH mode.

Introduction: The advent of high potency pulsed ablative CO2 laser for the treatment of photoaging in the mid-1990s, laser resurfacing became the standard treatment for facial rejuvenation. The results are impressive but the discomfort, the prolonged recovery and the high risk for complications lead to patient dissatisfaction.
With the advances in laser technology, multiple non-ablative lasers for facial rejuvenation became available.
Non-ablative laser improves mild to moderate aged skin, with a minimal risk of complications and without the downtime associated to ablative laser techniques

Materials / method: The treatment platform used was ETHEREA-MX® (VYDENCE Medical®, São Carlos, SP, Brazil). 1- handpiece ProoDeep – non-ablative fractional laser Nd:YAP (Neodimiun:Ytrium Aluminum Peroviskita) of 1340nm and 2- handpiece DualMode - Intraoral 2940nm Er:YAG SMOOTH mode.
The skin cooling was performed with the device SIBERIAN (VYDENCE Medical®, São Carlos, SP, Brazil) for comfort during and after the procedure.

Results: Clinical results will be presented and illustrated in photos and videos.

Conclusion: The combination of these two technologies (facial non-ablative fractional laser 1340nm Nd:YAP and Intraoral 2940nm Er:YAG SMOOTH mode) has proven to be a modern, safe and effective alternative for the treatment of facial rejuvenation, especially in the challenging perioral region.

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