IMCAS

Introduction

Different approaches to overcome recalcitrant port wine stains (PWS)

Objectives: This presentation will address the factors thought to contribute to treatment resistance of cases with port wine stain, as well as review currently available treatment options to overcome PDL resistance in the treatment of port wine stain

Introduction: Port-wine stains (PWS) are capillary malformations of the skin that are typically present at birth. PWS progressively darken and may become hypertrophic or nodular without treatment.
There are several treatment options available for PWS, like pulsed dye laser (PDL) which is the treatment of choice. In most of the cases complete clearance cannot be achieved even after multiple PDL treatments, some lesions are resistant to PDL (20 %) even at the higher doses.

Materials / method: review of literature related to recalcitrant cases of port wine stain

Results: Recalcitrant PWS cases to PDL may require a combination of treatment methods, different wavelengths, and topical antiangiogenic agents to overcome treatment resistance

Conclusion: While much is known about the possible mechanisms of resistance of PWS to PDL treatment, alternative approaches should be developed and subsequently validated in order then to demonstrate more efficacy to overcome resistant cases of PWS.

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Combined plasma and RF energy for tissue tightening

Objectives: Learn the science behind RF technology

Understand the improvement of combining RF with plasma energy

Introduction: Though a fairly recent technology, radio frequency energy used subcutaneously has become a highly trusted and effective means for tightening skin and subcutaneous tissue over the last few years. The latest application of RF energy includes a combination with Plasma energy. This new application is more efficient and more effective.

Materials / method: A discussion of Helium based plasma combined with RF energy is presented. Technology using RF energy alone is contrasted with combination plasma and RF energy treatments. Clinical application is also demonstrated.

Results: Results from treatments of face, breast and body using combined plasma and RF technology is shown. Results are also compared to treatments using RF energy alone.

Conclusion: The combination of plasma energy with RF energy has elevated the quality, efficiency and effectiveness of these types of energy based treatments.

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Radiofrequency microneedling for skin tightening of the lower face - A prospective analysis of the efficacy, tolerability and patient satisfaction

Objectives: 1: Learn benefits and limitations of radiofrequency microneedling treatment
2: Evaluate radiofrequency microneedling as a non-invasive alternative to surgical facelift

Introduction: Skin aging of the face and neck region manifests by the formation of fine lines, wrinkles and skin laxity along the jawline. Currently, minimally invasive rejuvenation treatments are gaining importance due to increasing interest of patients and physicians. Radiofrequency (RF) microneedling is one of the latest generations of fractional skin rejuvenation methods. The present study analysis the efficacy, tolerability, and patient satisfaction of RF microneedling treatment of the lower third of the face and the neck area.

Materials / method: A prospective, intraindividual controlled study with 1 to 3 treatments with a fractional RF microneedling system at intervals of 11 weeks was performed. Control visits were performed 12 and 24 weeks after the last session. Efficacy was assessed by standardized 3D photo documentation, multiphoton tomographic measurements and subjective assessments of clinical benefits (Physician and Subject Global Aesthetic Improvement Scale). Furthermore, pain intensity on the Visual Analog Scale (VAS), tolerability and satisfaction (5-point scale) were evaluated.

Results: 30 patients (mean age 55.5 years, Fitzpatrick skin type I - IV) were included. Preliminary evaluation of 3D visual documentation showed significant improvement of wrinkles, refinement of skin texture and volume reduction of the submental and jawline region. Multiphoton tomographic measurements demonstrated an increase in dermal thickness. Patients, the practitioner and an independent examiner rated the appearance as significantly improved. Overall, the treatment was well tolerated with a mean pain intensity of 6.3/10 on VAS and a downtime of a few days. All subjects reported high satisfaction.

Conclusion: Fractional RF microneedling treatment is a safe and effective method for skin rejuvenation of the lower face and neck region. By conducting focused thermal energy into the dermis, collagen and elastin regeneration is stimulated, resulting in a significant improvement of skin texture, wrinkles and skin laxity.

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New study comparing the efficacy between the use of isolated Er:YAG laser, with the association of intense pulsed light in photodamage

Objectives: The main objective is to compare the response to photodamage treatment with the use of isolated laser or combined to photothermolysis technology.
The secondary objective is observing if there is a reduction in skin recovery time and in the amount of sessions necessary for the combined treatment.

Introduction: Cutaneous aging ,has in chronic solar light exposure ,an important intrinsic inductor, responsible for almost 90% of the alterations related to environment influence.
Many procedures are performed with the objective to prevent or revert this damage.The ablative laser is considered a golden standard .IPL devices, however, emit difuse light, which influences the remodeling of the extracelular matrix of aging skin.

Materials / method: The methodology purposes the assortment of 40 patients ,with phototypes from I to III, according to the Fitzpatrick classification, in the 40 to 60 age range.
Patients will be submitted to face skin biopsy ,1 week before and 30 days after the session .Half of the sample will be treated with isolated fractional erbium yag laser and the other half will combine this laser with intense pulsed light .

Results: When the isolated Erbium Yag Laser and the combination of Erbium Yag Laser + Pulsed Light treatments are compared to each other, we can observe that there is no statistical difference between them on a 5% improvement significance level of the combination, which means that both treatments offer statistically equivalent results.

Conclusion: We then conclude that the treatment with the proposed technology is efficient in the treatment of photodamage. No difference with statistical significance was observed between the two groups. Nonetheless, the slight superiority of the combined treatment can indicate higher efficacy of this method and motivates us to produce more studies ,with a greater sample size ,in order to confirm such affirmation.

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The antiaging treatment of the periocular area using coablative radiofrequency

Objectives: A combined treatment with fractional resurfacing and microneedles remodeling is generally performed in 4 alternating sessions every 3 weeks.
The objective of this study was to evaluate a new protocol of coablation at the same session for the periocular region.Treatments were repeated every month for 3 times.

Introduction: Radiofrequency tightens and firms the skin by stimulating the body’s collagen renewal processes. The ablative one creates a fractional skin resurfacing and remodeling combining a vaporization of the epidermis with heat delivery to the dermis to achieve collagen contraction

Materials / method: Twenty female patients, 55 to 70 yo,who had indicated with periocular skin ageing were enrolled in the study. 25 spots followed by additional 25 for each side of microneedles (1,5mm depth,11W power and 80m/sec width) and fractional radiofrequency (2w power 20m/sec width)were administrated in a row using a device with 6 independent phase-controlled RF generators.

Results: No significant adverse events have been reported. Only mild clinical effects as painful skin,edema lasting up to 24 hours and small scabs that appear after using ablative radiofrequency that fell off within 2 days were observed. After 3 months patients showed a good improvement in skin quality, 25 to 75% in skin texture, according to the Global Aesthetic Improvement Scale.

Conclusion: Double ablation performed in the same session instead of delayed, allows to achieve a synergic effect due to skin resurfacing and collagen remodeling of the periocular region. Side effects are not more relevant than in the alternate sessions protocol. Concerning the level of energy to be released we noticed that patients with deeper marks of ageing could be treated using high power strating from the first session

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Progressive and accumulative rejuvenation effect of 1 yearly treatment with broad band light and long pulsed Nd:Yag: a 12 year experience and follow up

Objectives: Present our 12 years experience achieving long term and accumulative improvement on pigmentation, redness, skin tone, pore size and overall skin quality with a protocol based in one yearly treatment combining an advanced Intense Pulsed Light technology and a submilisecond long pulsed Nd:YAG Laser.

Introduction: Different studies have shown the long-term rejuvenation effect of periodic Broad Band Light treatments at different levels (clinical, histological and genetical). Our observation of skin quality improvement when using sub millisecond Long Pulsed Nd:YAG to control redness and flushing in rosacea patients led us to design a rejuvenation program combining these two technologies.

Materials / method: Retrospective analysis of the clinical outcomes of patients treated with a combination of Broad Band Light and a sub millisecond long pulsed Nd:YAG laser. Patients were treated once a year with cut off filters 515nm, 560nm or 590nm, pulse width 8-15 msec and fluences from 10 to 18J/cm2 according to skin type. After two passes with this technology a third pass with a long pulsed Nd:YAG laser (5mm, 0.3msec, 16J/cm2, 9Hz or 7mm, 0.3msec, 7J/cm2, 11Hz).
Pictures of 450 patients taken before and 1 month after every treatment were analyzed to establish clinical improvement and its evolution with eve

Results: A progressive and sustained improvement of all signs of aging (pigmentation, redness, tone, pore size, texture and superficial wrinkles) was observed in almost all the cases. This improvement was accumulative and persistent even up to 4 years after the last treatment in those patients that discontinued the treatment.
Moderate and transient secondary effects were referred in 15% of the patients (swelling, crusting and transient hyper or hypopigmentation). Satisfaction rate was of 98%.

Conclusion: The absorption of the 500-600nm range wavelengths by hemoglobin and 400-800nm by melanin makes Broad Band Light a very efficient technology to treat redness and pigmentation. The emission of a part of the energy in the infrared spectrum helps induce a non-selective tissue heating through targeting water as a chromophore and thus stimulates the synthesis of new collagen which translates in a skin quality improvement (texture, pore sizes, superficial wrinkles). The addition of a sub millisecond long pulse Nd:YAG laser permits to boost the vascular effect of Broad Band Light, targeting the deeper

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请注明名称（个人，公司，学会等等）: sction

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Post-acne scar split face: a comparative study between long pulsed and Q-switched Nd:YAG laser

Objectives: This study was aiming to asses and to compare the efficacy and safety of between Long Pulsed and Q-switched Nd : YAG Laser in post-acne scar split face.

Introduction: Laser is a more promising option for post-acne scar treatment than other modalities. The process involved stimulating fibroblasts to fill and finish the scar defect, replacing the lost collagen and elastin dermal components.

Materials / method: A total of 25 patients with different skin types suffering from mild, moderate and severe facial acne scars, were split face group: ( Rt side with Long pulsed 1064nm Nd-YAG laser and Lt side with Q-switched 1064nm Nd-YAG laser).

Results: There was statistical significance differences in number of sessions among Rt side compared to Lt side. Also there was decrease in frequency of inflammation among Lt side compared to other side, and decrease in frequency of bleeding and edema among Rt side compared to other side and finally increase in frequency of hyperpigmentation Lt side compared to Rt side.

Conclusion: Q-switched and long-pulsed 1064 nm Nd-YAG lasers are considered an efficient and safe modality for the treatment of mild to moderate post-acne facial scars, particularly in elderly patients (30-40 years of age) with type 4 skin without the need for downtime, and in this study their daily activity was not disturbed, but we found that Q-switched is more effective and satisfied.

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A new approach to lip enhancement with 1064 nm Q-switched Nd:YAG fractional laser

Objectives: Determine the efficacy of a 1064nm Q-switched Nd:YAG fractional laser on improving lip definition, color, and volume.

Introduction: Lips undergo several changes with age, including a decrease in volume, the upper vermilion border becomes thicker, more pallid, and less pronounced, the Cupid’s bow area and the philtrum columns become flattered and less defined, and perioral wrinkles appear. Furthermore, there is a decrease in elasticity, turgor, and collagen content. Q-switched Nd:YAG laser can increase the production of procollagen and elastin and can promote the generation of collagen.

Materials / method: 32 female patients were treated with Q-switched 1064 nm every 2-3 weeks for a total of 3-5 treatments. The entire lip area was treated by lasing continuously in-motion, accumulating up to 1kJ (5-10 passes). Initial treatment was at a fluence of 800-1200mJ/P and increased to 1200-1600 mJ/P for the second session, 1600-2000 mJ/P for the third 1800-2200mJ/P for the fourth session. Improvement was measured at a 3-month follow up visit after the final treatment by patients and physicians. Scoring using the Likert scale assessed improvement in lip color, volume, texture, and overall improvement.

Results: Patients (n=32) achieved meaningful aesthetic recognition improvement in all parameters. 94% of patients reported improvement in lip color (Likert=4 or 5 out of 5), 72% saw an increase in lip volume, 91% improved lip texture, and 82% improved overall lip appearance. Furthermore, 91% were satisfied with treatment results and 100% from the overall experience. There were no associated side effects, and the associated pain level was rated as 0 (on a 0-10 scale) in 84% of individuals and 16% as 1.

Conclusion: The results demonstrate that laser treatment using a 1064 nm Q-switched Nd:YAG fractional laser on lips is safe, well tolerated and effective in restoring definition, color and volume to the lips.

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The orbitary frame: a real improvement with an energy device

Objectives: Objective of this work is to update knowledge of RF energy on periocular area

Introduction: The treatment of the orbital frame with an energy device has been discussed for some time depending of the energy device chosen.
The aim of this study in our experience was to evaluate the use of a RF fractional device and evaluate its effectiveness to reduce periocular wrinkles, reduce lower lids bags ,malar bags, and how to avoid complications with this device.

Materials / method: thods: 40 patients from February 2020 to December 2020 underwent treatment of the orbitary frame with fractional needle RF.
The criteria for admission to treatment were: a slight palpebral skin laxity,lower lids bags malar bags or periocular wrinkles. The patients were 100% females with age ranging from 28 to 67 y.
Evaluation of the photos and the self-assessment of the patient through the compilation of a questionnaire were the evaluation criteria. Fractional RF was performed with different parameters following guide lines (power, depth of treatment, number of passages.)

Results: Results: The percentage of patients satisfied with the result was 85%. The complications involved 30% of patients treated with edema of the lower palpebral region for more than a week and in 20% a persistent erythema up to 3 weeks.

Conclusion: Conclusions: The use of Fractional rf in the lower orbital frame is a procedure that in selected appropriate patients can be an ideal procedure with good results.

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Q-Switched laser: going off the beaten tracks

Objectives: Identify through consistent review of the literature and before and after cases underused but also non promising indications of QSwitched ndyag laser in both Dermatological and aesthetic fields.

Introduction: QSWITCHED ndyag Laser is a treatment of choice in tattoo removal and lentigos. It’s use in those indications is standardized and while in other Dermatological indications it’s use is non codified due to lack of data.

Materials / method: We discuss through before and after cases the adden value of QSwitched ndyag laser in misused and/or less documented indications. These indications include, depigmentation of residual universal vitiligo, lip melanosis (different aetiologies), post inflammatory hyperpigmentation, lichen planus pigmentosus, scars, recalcitrant and resistant melasma and other Dermatological indications.

Results: The aim of the lecture is to identify, based on a targeted review of the literature and our documented cases with established protocoles, additional interesting indications where QSwitched might be more than a simple therapeutic option.

Conclusion: QSwitched ndyag laser is a promising tool for laser therapists with an interesting modality of emission. This laser is probably underused and might be extended to other Dermatological and aesthetic applications.

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Combination Treatment of 755nm Alexandrite Picosecond Laser and Microneedle Pulsed Radiofrequency in Treating Recalcitrant Melasma

Objectives: 1. Understanding pathogenesis of Melasma
2. Understanding involvement of abnormal blood vessels and basement membrane in Melasma
3. Exploring the efficacy and safety of combining Picosecond lasers and Microneedle Pulsed Radiofrequency in treating recalcitrant melasma

Introduction: Melasma is one of the major skin concerns in the Asian population. Majority of aesthetic and dermatology centres of this region manage melasma on a daily basis. Managing melasma has always been challenging. There are various treatments available with inconsistent outcomes. Histologically, melasma lesions show higher degrees of ultraviolet induced damage, basal membrane disruptions as well as increase vascularity. Recent studies have highlighted the importance of reducing the vascular endothelial growth factor (VEGF) and strengthening of the basement membrane to improve treatments outcome.

Materials / method: All melasma patients undergone 6 sessions of Picosecond lasers and 6 sessions of Microneedle Pulsed Radiofrequency alternatively in 2 weeks interval.

Results: Melasma greatly improved and the result is longer lasting. Skin tightening seen adjunct with the combination treatment

Conclusion: Pathogenesis of Melasma: Heterogenous Dermal ECM abnormalityBasement membrane disruptionIncreased vascularization in melasma lesionIncreased mast cell
Combination of treatments is needed to fully tackle every aspects of Melasma

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Clinical evaluation of a 1940 non-ablative fractional diode laser for skin resurfacing and treatment of benign pigmented lesions

Objectives: The attendee will learn about a novel 1940nm non-ablative fractional diode device to treat texture and pigment. An overview of non-ablative near and mid IR wavelengths will be presented along with histology that show the superficial impact of the 1940 wavelength. A discussion of treatment parameter selection based upon indication and skin type will also be discussed based on study results.

Introduction: The 1940 nm wavelength is very close to one of the water-absorption peaks in the mid-IR band and can achieve controlled superficial depths of focal damage extending about 200 μm deep to the skin surface, without ablating it. Treatment with non-ablative fractional 1940-nm thulium laser results in skin rejuvenation and treatment of pigmentation, rhytids and elastosis with a high safety profile. In this clinical study a novel fractional non-ablative 1940 nm diode laser applicator with adjustable scan widths was evaluated for the treatment of pigmented lesions and skin texture.

Materials / method: Subjects (39) underwent up to three monthly skin resurfacing treatments to the face or body with 5-20 mj of energy, 20-70% density coverage and 4-12mm scan widths. Standardized digital photography was performed at all study visits. Subjects reported on satisfaction and graded their overall cosmetic improvement at 1-month and 3-month follow-ups using a 5-point Likert scale and Global Aesthetic Improvement Score. Blinded evaluation of randomized pre-treatment versus 1- and 3-month post final treatment photos and GAIS assessments were conducted by three independent dermatologists.

Results: A total of 172 treatments were administered with no treatment complications. Mean overall pigment improvement score was 2.0. Improvement was most notable for the face with 75% of treated areas showing improvement at the 1-month follow-up and 83% at the 3-month follow-up. Subjects reported that 91% and 84% of the treated areas had ‘improved’ to ‘very much improved’ at the 1- and 3-month follow-ups, respectively. Subject satisfaction with treatment outcome was high, with 93% and 84% of the assessments reported as ‘somewhat satisfied’ to ‘very satisfied’, at the 1- and 3-month follow-ups.

Conclusion: In this study, this 1940 non-ablative fractional diode laser was used to resurface the skin and to treat various benign pigmented lesions. Blinded evaluator assessments demonstrated significant improvement following two to three treatments. Subjects reported high satisfaction and improvement with treatment outcome. Superficial resurfacing is with 1940nm diode laser with adjustable scan widths is well tolerated and efficacious.

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请注明名称（个人，公司，学会等等）: Candela Medical

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请注明名称（个人，公司，学会等等）: Candela Medical Honoraria

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小时	讲者	演讲标题	讲稿摘要	数字
13:30		Introduction		112453
13:32	Shady Mohmoud Attia IBRAHIM 医师	Different approaches to overcome recalcitrant port wine stains (PWS)	查看	113710
13:41	Adam RUBINSTEIN 医师	Combined plasma and RF energy for tissue tightening	查看	113387
13:50	Lynhda NGUYEN 医师	Radiofrequency microneedling for skin tightening of the lower face - A prospective analysis of the efficacy, tolerability and patient satisfaction	查看	113500
13:59	Adriana CAIRO MELLO PAIVA 医师	New study comparing the efficacy between the use of isolated Er:YAG laser, with the association of intense pulsed light in photodamage	查看	113636
14:08	Stefano TOSCHI 医师	The antiaging treatment of the periocular area using coablative radiofrequency	查看	114369
14:17	Antonio CAMPO VOEGELI 医师	Progressive and accumulative rejuvenation effect of 1 yearly treatment with broad band light and long pulsed Nd:Yag: a 12 year experience and follow up	查看	114342
14:26	Khaled GHARIB 医师	Post-acne scar split face: a comparative study between long pulsed and Q-switched Nd:YAG laser	查看	114403
14:35	Hen IFRACH 医师	A new approach to lip enhancement with 1064 nm Q-switched Nd:YAG fractional laser	查看	115120
14:44	Pier Paolo ROVATTI 医师	The orbitary frame: a real improvement with an energy device	查看	115121
14:53	Achraf ELLOUADGHIRI EL IDRISSI 医师	Q-Switched laser: going off the beaten tracks	查看	115954
15:02	Christie MOEY 医师	Combination Treatment of 755nm Alexandrite Picosecond Laser and Microneedle Pulsed Radiofrequency in Treating Recalcitrant Melasma	查看	116094
15:11	Konika SCHALLEN 医师	Clinical evaluation of a 1940 non-ablative fractional diode laser for skin resurfacing and treatment of benign pigmented lesions	查看	116776
15:20		Q&A		114353

IMCAS World Congress 2022
大会日程

S083

Contributing lectures - Lasers & EBD

主席

本场演讲内容

推荐会议

IMCAS World Congress 2022 大会日程

S083

Contributing lectures - Lasers & EBD

主席

本场演讲内容

推荐会议

IMCAS World Congress 2022
大会日程

本场演讲内容