volume was seen in 63 patients at 21.6 months post-HA injection and 2.5 years after calcium hydroxylapatite injection.24-25 Poly-L- Lactic acid stimulates long-term neocollagenesis beginning 3-6 months post treatment and lasting up to 2 years or more.
Lasers Skin laxity in this age group may be treated with various fractionated and non-fractionated, ablative and nonablative laser types. Although ablative lasers are known to be most efficacious,26 laser choice depends on patient budget and tolerance of downtime. Microfocused Ultrasound Skin laxity on the face, neck, chest, and arms may be treated with microfocused ultrasound (MFU), which causes thermal coagulation and neocollagenesis. In a retrospective study of 45 patients, face and neck laxity improved after MFU treatment in 75% and 77.8% of subjects, respectively, at 90 and 180-day follow-up, as per subject reporting.27 Radiofrequency Monopolar radiofrequency (MRF) causes thermal damage via high-frequency electric current and stimulates neocollagenesis. It is FDA approved for body laxity, facial lines, and cellulite. Upper eyelid tightening and reduced hooding was seen in 88% and 86% of patients, respectively, in a study of 63 subjects who underwent MRF treatment.28
The aging process is chronologically predictable, with outward manifestations beginning in the late 20’s and progressing with each decade. Appropriate cosmetic counseling, preventions, and interventions for younger populations are justified based on standard physiologic aging and individual concerns.
Sabrina Guillen Fabi is an Investigator, Consultant, and Advisor for Galderma, Valeant, Allergan, and Merz. Dr Fabi serves on the Speakers bureau for Galderma, Allergan, Merz, Lumenis, and Coolsculpting. Lauren Meshkov Bonati has no conflicts of interest to declare.
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- Kaminer MS, Coleman WP 3rd, Weiss RA, et al. Multicenter pivotal study of vacuum-assisted precise tissue release for the treatment of cellulite. Derma- tol Surg. 2015;41(3):336-7.
- Katz B. Quantitative and qualitative evaluation of the efficacy of a 1440 nm Nd:YAG laser with novel bi-directional optical ber in the treatment of cel- lulite as measured by 3-dimensional surface imaging. J Drugs Dermatol. 2013;12(11):1224-30.
- Fabi SG, Goldman MP. Comparative study of hydroquinone-free and hydro- quinone-based hyperpigmentation regimens in treating facial hyperpigmen- tation and photoaging. J Drugs Dermatol. 2013;12(3):S32-7.
- Mendelson BC, Hartley W, Scott M, et al. Age-related changes of the orbit and midcheek and the implications for facial rejuvenation. Aesthetic Plast Surg. 2007;31:419–423.
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Lauren Meshkov Bonati MD E-mail:................................................... [email protected]