Facial Rejuventation

Facial Rejuventation

Ross J. VanAntwerp, DOLaser Center of MarylandRoss J. VanAntwerp, DOLaser Center of Maryland

Trends in Facial Rejuvenation

• Trends towards minimally invasive procedures

• Moving away from old fashion coronal facelifts

• More options on market

• Lasers

• Dermal fillers

• Neurotoxins

• Patients want less downtime (still want same results!)

Tell us about your goals

• Laxity?

• Vascularity and Redness?

• Sun Damage?

• Fine Lines and wrinkles?

• Scarring and Textural changes?

• No downtime

• 24 hours downtime

• 3-5 days

• 1 week or more

What do you wantto achieve?

Maximal Results Minimal Downtime

The Aging Face

• Facial shape changes over time. The triangle become inverted with increasing age

Layers of the Skinmicroscopic viewLayers of the Skinmicroscopic view

Epidermis: 5 layers

60-100 microns thick

Epidermis: 5 layers

60-100 microns thick

Papillary Dermisthin layer of collagen

100 microns thick

Papillary Dermisthin layer of collagen

100 microns thick

Reticular DermisDense Collagen

1000 microns

Reticular DermisDense Collagen

1000 microns

Stratum Corneum: 10 microns dead skin cells

Stratum Corneum: 10 microns dead skin cells

Model courtesy of Jared Mallalieu, DO.Model courtesy of Jared Mallalieu, DO.

What’s a wrinkle?

Lines and wrinkles are caused by collagen loss and sun damage and are improved with laser, neurotoxins, and

skin care

Folds are caused by volume loss and respond best to filler

Tell us about your goals

• Can treat variety of conditions

• Rhytids

• Dyschromia

• Rosacea

• Laxity

• Scarring - Acne and surgical

Lasers

The ArticPeel(Series of 5)The ArticPeel(Series of 5)

Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

The ArticPeel(Series of 5)The ArticPeel(Series of 5)

Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

The ArticPeel(Series of 5)The ArticPeel(Series of 5)

Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Microlaser Peel(Single Tx 60microns)Microlaser Peel

(Single Tx 60microns)Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Microlaser Peel(Single Tx 60microns)Microlaser Peel

(Single Tx 60microns)Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Microlaser Peel(Single Tx 60microns)Microlaser Peel

(Single Tx 60microns)Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

UV PHOTO(After 20 then 30 micron

MicroLaser Peel)

UV PHOTO(After 20 then 30 micron

MicroLaser Peel)

Profractional(4 weeks after 3rd tx )

Profractional(4 weeks after 3rd tx )

Photos courtesy of G. Todd Bessinger, M.D. PhDPhotos courtesy of G. Todd Bessinger, M.D. PhD

Profractional & MLP(4 weeks after 2nd tx )Profractional & MLP(4 weeks after 2nd tx )

Photos courtesy Adam Baker, MD

Profractional(3 weeks after 2nd tx )

Profractional(3 weeks after 2nd tx )

Photos courtesy of G. Todd Bessinger, M.D. PhDPhotos courtesy of G. Todd Bessinger, M.D. PhD

Healing(20 micron MLP with 250 Pfxc)

Healing(20 micron MLP with 250 Pfxc)

Before &Immediately

After tx

Before &Immediately

After tx

Day 1 to Day 2

Day 1 to Day 2

Day 2 to Day 3

Day 2 to Day 3

Perioral ResurfacingPerioral ResurfacingPhotos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Perioral ResurfacingPerioral ResurfacingPhotos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Custom Repair(Fraxel Repair and Erbium)

Custom Repair(Fraxel Repair and Erbium)

Photos courtesy of Ross VanAntwerp, DOPhotos courtesy of Ross VanAntwerp, DO

Custom Repair(Fraxel Repair and Erbium)

Custom Repair(Fraxel Repair and Erbium)

Photos courtesy of Ross VanAntwerp, DOPhotos courtesy of Ross VanAntwerp, DO

Mole RemovalMole RemovalPhotos courtesy of Ross VanAntwerp, DOPhotos courtesy of Ross VanAntwerp, DO

Mole RemovalMole RemovalPhotos courtesy of Ross VanAntwerp, DOPhotos courtesy of Ross VanAntwerp, DO

Custom Repair(Fraxel Repair and Erbium)

Custom Repair(Fraxel Repair and Erbium)

Photos courtesy of Ross VanAntwerp, DOPhotos courtesy of Ross VanAntwerp, DO

Custom Repair(Fraxel Repair and Erbium)

Custom Repair(Fraxel Repair and Erbium)

Photos courtesy of Ross VanAntwerp, DOPhotos courtesy of Ross VanAntwerp, DO

Perioral ResurfacingPerioral ResurfacingPhotos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Fraxel RepairFraxel RepairPhotos courtesy of Ross VanAntwerp, D.O.Photos courtesy of Ross VanAntwerp, D.O.

Longevity(5yr. Post deep Resurface)

Longevity(5yr. Post deep Resurface)

Photos courtesy of Pozner, Jason, M.D.Photos courtesy of Pozner, Jason, M.D.

Photos courtesy of Jared Mallalieu, DOPhotos courtesy of Jared Mallalieu, DO

SkinTyte - 4 weeks s/p 4 treatmentsSkinTyte - 4 weeks s/p 4 treatments

SkinTyte - 4 weeks s/p 4 treatmentsSkinTyte - 4 weeks s/p 4 treatmentsPhotos courtesy of Jared Mallalieu, DOPhotos courtesy of Jared Mallalieu, DO

Adjuvant Surgical Procedures

• Can treat the submental region with single 3mm incision

• Two stage process

• Fat melting - 1064 nm

• Skin tightening - 1319 nm

Laser Assisted Liposuction

Blepharoplasty• Upper and lower procedures may be done at the same time

as other services

Adjuvant ProceduresLaser ASsisted Liposuctionwith SkinTyte 4 sessions

Adjuvant ProceduresLaser ASsisted Liposuctionwith SkinTyte 4 sessions

Photos courtesy of Jared Mallalieu, DO.Photos courtesy of Jared Mallalieu, DO.

Laser ASsisted LiposuctionLaser ASsisted Liposuction

Photos courtesy of Jared Mallalieu, DO.Photos courtesy of Jared Mallalieu, DO.

Laser Assisted Liposuction NeckLaser Assisted Liposuction NeckPhotos courtesy of Jared Mallalieu, DOPhotos courtesy of Jared Mallalieu, DO

Laser Resurfacing with Upper and Lower Blepharoplasty

Laser Resurfacing with Upper and Lower Blepharoplasty

Photos courtesy of Jared Mallalieu, DOPhotos courtesy of Jared Mallalieu, DO

Dermal Fillers

• Minimal downtime - “liquid lift” and “lunchtime lift”

• Multiple Products on Market

• Hylauronic Acids - Juvaderm, Restylene, Belotaro etc

• laser 9-12 months

• Semi-permanent - Artefill (polymethylmethacrylate microspheres and bovine collagen

• lasts 2 plus years

• Sculptra (Poly L-lactic acid) - restores volume to face

Facial Fat and Bone

Lip Filler - Juvaderm 1ccLip Filler - Juvaderm 1cc

Photos courtesy of Jared Mallalieu, DO.Photos courtesy of Jared Mallalieu, DO.

NLF - 2cc fillerNLF - 2cc filler

Photos courtesy of Jared Mallalieu, DO.Photos courtesy of Jared Mallalieu, DO.

Filler - Sculptra 3 sessionswith Profractional Laser

Filler - Sculptra 3 sessionswith Profractional Laser

Photos courtesy of Jared Mallalieu, DO.Photos courtesy of Jared Mallalieu, DO.

Argyria

• Case of a 25 year old Russian male who had previously taken elemental silver as dietary supplement

• Skin and mucous membranes develop blue discoloration

• Treated with Q switch 1064 nm laser

Treatment of ArgyriaTreatment of Argyria

Photos courtesy of Ross J. VanAntwerp, DO.Photos courtesy of Ross J. VanAntwerp, DO.