-
Aesthetic Surgery Journal. Open Forum 2023The facelift remains the gold standard for rejuvenating the aging face. Many surgical techniques exist in the surgeon's armamentarium that vary based on scar burden,... (Review)
Review
The facelift remains the gold standard for rejuvenating the aging face. Many surgical techniques exist in the surgeon's armamentarium that vary based on scar burden, extent of skin undermining, and manipulation of the superficial musculoaponeurotic system. Yet, existing strategies predominantly address the mobile face and have limited effect on fixed zones such as perioral, periorbita, and forehead. Multiple ancillary techniques have therefore been developed to address this therapeutic gap in facial rejuvenation. The most popular techniques today include dermabrasion, lasers, chemical peels, and radiofrequency devices. All have demonstrable safety and efficacy and are chosen based on the patient's unique anatomical presentation, comfort level, and tolerability of recovery time. Surgeons are ideally equipped with the tools and skills to offer all modalities and then tailor their treatment to the specific patient's anatomy. Herein, we review the most effective ancillary procedures of the facelift and describe an evolution of their use in our practice.
PubMed: 38828090
DOI: 10.1093/asjof/ojad063 -
Frontiers in Oncology 2021The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is... (Review)
Review
The occurrence of non-melanoma skin cancer (NMSC) is closely linked with advanced age and ultraviolet-B (UVB) exposure. More specifically, the development of NMSC is linked to diminished insulin-like growth factor-1 (IGF-1) signaling from senescent dermal fibroblasts in geriatric skin. Consequently, keratinocyte IGF-1 receptor (IGF-1R) remains inactive, resulting in failure to induce appropriate protective responses including DNA repair and cell cycle checkpoint signaling. This allows UVB-induced DNA damage to proliferate unchecked, which increases the likelihood of malignant transformation. NMSC is estimated to occur in 3.3 million individuals annually. The rising incidence results in increased morbidity and significant healthcare costs, which necessitate identification of effective treatment modalities. In this review, we highlight the pathogenesis of NMSC and discuss the potential of novel preventative therapies. In particular, wounding therapies such as dermabrasion, microneedling, chemical peeling, and fractionated laser resurfacing have been shown to restore IGF-1/IGF-1R signaling in geriatric skin and suppress the propagation of UVB-damaged keratinocytes. This wounding response effectively rejuvenates geriatric skin and decreases the incidence of age-associated NMSC.
PubMed: 35071017
DOI: 10.3389/fonc.2021.813132 -
The Australasian Journal of Dermatology May 2021Congenital melanocytic naevi are hamartomas of the neuroectoderm caused by genetic mosaicism. Congenital melanocytic naevi are seen in 1-6% of all live births and... (Review)
Review
Congenital melanocytic naevi are hamartomas of the neuroectoderm caused by genetic mosaicism. Congenital melanocytic naevi are seen in 1-6% of all live births and commonly classified based on the projected size in adults. Congenital melanocytic naevi appear in different colours, shapes, and sizes, and occasionally present with complications. In this review, we sought to evaluate congenital melanocytic naevi, their clinical, dermatoscopic, and reflectance confocal microscopic features, behavioural pattern over time, new trends in classification, underlying genetic factors and their influence on clinical manifestations and management, associated risks, complications, magnetic resonance imaging findings and their management in the light of recent literature.
Topics: Dermabrasion; Dermoscopy; Humans; Laser Therapy; Melanoma; Melanosis; Microscopy, Confocal; Mutation; Neurocutaneous Syndromes; Nevus, Pigmented; Proto-Oncogene Proteins B-raf; Risk; Skin Neoplasms
PubMed: 33591589
DOI: 10.1111/ajd.13535 -
Seminars in Plastic Surgery Nov 2020The process of scar formation is a sequela of the healing following soft tissue injury extending to, or through, the reticular dermis. Scars, within the head and neck in... (Review)
Review
The process of scar formation is a sequela of the healing following soft tissue injury extending to, or through, the reticular dermis. Scars, within the head and neck in particular, may be physically disfiguring with resultant psychosocial implications. Mitigation of excessive scar formation during the healing process following surgery, or in the setting of trauma, begins with meticulous soft tissue handling and reconstructive technique. The reconstructive surgeon's armamentarium must therefore include techniques that minimize initial scar formation and revision techniques that address unfavorable outcomes. With this in mind, this article reviews both conservative nonsurgical and surgical treatment modalities that mitigate scar formation or address mature scar formation.
PubMed: 33380918
DOI: 10.1055/s-0040-1721768 -
Dermatologic Clinics Jul 2019Scar revision is of premier importance to the dermatologic surgeon. Some of the least invasive modalities include use of silicone gel sheets, resurfacing with... (Review)
Review
Scar revision is of premier importance to the dermatologic surgeon. Some of the least invasive modalities include use of silicone gel sheets, resurfacing with electrosurgical instruments, dermabrasion, chemical peels, and subcision. Laser technology also has been implemented to selectively target and ablate fibrous scar tissue via selective thermolysis. Other lasers have been used to target dyschromia associated with scar formation. Lastly, invasive modalities of scar revision include excisional modalities and/or rearrangement of skin to enhance cosmesis of unsightly or morbid scars. Herein is a discussion of the multiple modalities of scar revision as well as advantages and disadvantages of each.
Topics: Ablation Techniques; Adrenal Cortex Hormones; Chemexfoliation; Cicatrix; Dermabrasion; Gels; Humans; Injections, Intralesional; Laser Therapy; Massage; Silicones
PubMed: 31084731
DOI: 10.1016/j.det.2019.03.007 -
Plastic and Reconstructive Surgery Jul 2021Striae distensae, or stretch marks, are common linear lesions of atrophic skin characterized histologically by epidermal atrophy, absent rete ridges, and alterations in... (Review)
Review
Striae distensae, or stretch marks, are common linear lesions of atrophic skin characterized histologically by epidermal atrophy, absent rete ridges, and alterations in connective tissue architecture. Hormonal excess, mechanical stress, and genetic predisposition are all associated with striae distensae, but their exact pathogenesis remains unknown. Despite a multitude of options, no single treatment has yet proven effective. In this article, the authors describe an up-to-date overview of striae distensae in terms of their etiology, pathophysiology, and therapeutic options. Further research is required to better elucidate their pathophysiology and to develop targeted effective treatments.
Topics: Administration, Cutaneous; Atrophy; Combined Modality Therapy; Dermabrasion; Dermatologic Agents; Esthetics; Humans; Laser Therapy; Prevalence; Quality of Life; Skin; Striae Distensae; Treatment Outcome
PubMed: 34181606
DOI: 10.1097/PRS.0000000000008065 -
Facial Plastic Surgery Clinics of North... Nov 2020Skin resurfacing techniques allow improvement of skin texture and color. This includes the effacement of wrinkles, signs of photoaging, and the softening of scars. Laser... (Review)
Review
Skin resurfacing techniques allow improvement of skin texture and color. This includes the effacement of wrinkles, signs of photoaging, and the softening of scars. Laser resurfacing, chemical peels, and dermabrasion are associated with overlapping risks of complications. The most common of these include infection, hypopigmentation, hyperpigmentation, and scarring. Patient evaluation helps provide treatment that gives the maximal benefit with a minimization of risks. This includes understanding the extent of each patient's issues (Glogau scale) and Fitzpatrick type. A thorough knowledge of potential risks will reduce their incidence and optimize early recognition and treatment of these complications when they do occur.
Topics: Chemexfoliation; Cicatrix, Hypertrophic; Dermabrasion; Erythema; Eye Injuries; Face; Humans; Hyperpigmentation; Hypopigmentation; Infections; Laser Therapy; Risk Factors; Skin Pigmentation
PubMed: 33010868
DOI: 10.1016/j.fsc.2020.06.008 -
Dermatologic Clinics Jan 2024Chemical peeling is a procedure used for cosmetic improvement of the skin or treatment of some medical skin disorders, by the application of chemical exfoliant. In spite... (Review)
Review
Chemical peeling is a procedure used for cosmetic improvement of the skin or treatment of some medical skin disorders, by the application of chemical exfoliant. In spite of a long history of clinical use of chemical peels, understanding of the science behind the procedure is still evolving. In this article, we review new concepts, understandings, and publications in the field of chemical peels.
Topics: Humans; Skin Diseases; Chemexfoliation; Skin; Skin Aging; Dermabrasion
PubMed: 37977680
DOI: 10.1016/j.det.2023.06.005 -
Dermatologic Clinics Jan 2024Cosmetic procedures involve the maintenance, restoration, or enhancement of one's physical appearance through surgical or medical techniques. Restorative or... (Review)
Review
Cosmetic procedures involve the maintenance, restoration, or enhancement of one's physical appearance through surgical or medical techniques. Restorative or reconstructive procedures, on the other hand, are essential procedures that restore normal function or appearance to abnormal structures caused by trauma or infection. Cosmetic procedures are generally elective and may either be surgical or nonsurgical. Nonsurgical or minimally invasive cosmetic procedures include laser hair or tattoo removal, chemical peeling, micro-dermabrasion, and soft tissue augmentation with injectables. These procedures are fast-growing with more than a 50% increase globally over the last 5 years.
Topics: Humans; Adolescent; Cosmetic Techniques; Dermabrasion; Chemexfoliation; Rejuvenation; Skin Aging
PubMed: 37977675
DOI: 10.1016/j.det.2023.06.009