Pre- and Post-Procedural Care Best Practices to Enhance Energy-Based Treatment Outcomes

August 2019 | Volume 18 | Issue 8 | Supplement Individual Articles | 187 | Copyright © August 2019

Suzanne L. Kilmer MD,a Roy G. Geronemus MD,b Nazanin Saedi MD,c Elizabeth Tanzi MD,d Kian Karimi MD,e A. Jay Burns MDf

aLaser & Skin Surgery Center of Northern California, Sacramento, CA bLaser & Skin Surgery Center of New York, New York, NY cJefferson Laser Surgery and Cosmetic Dermatology Center, Philadelphia, PA dCapital Laser & Skin Care, Chevy Chase, MD eRejuva Medical Aesthetics, Los Angeles, CA fDr. A Jay Burns Cosmetic Surgery, Dallas, TX

Dr. Tanzi: “I'm interested to have this conversation because I've recently started to place a poly-L-lactic acid overlay after microneedling and ablative fractional resurfacing procedures in an attempt to enhance the neocollagenesis from the treatments. My timing is to place the PLLA solution on immediately after treatment then the Alastin Regenerating Skin Nectar over it. This order of placement seems like common sense to me because of the differences in viscosity, however others may have a different take on this. I’m interested to hear what everyone is doing.”

Dr. Kilmer: “This is interesting because I actually do inject PLLA beforehand because a lot of those same people need volume, and you get the numbing from it. I've not done it as much topically for laser-assisted drug delivery. I don't have enough data to really know how much topical helps delivery. Most of my experience has been to inject it the normal way, then do the resurfacing, then do the Alastin Regenerating Skin Nectar right on the top, whether it's fractional ablative or fully ablative.”

Dr. Karimi: “I don't use poly-L-lactic acid, but we do use plateletrich plasma and more commonly platelet-rich fibrin and we try to let that sit for a good 5 minutes before applying any Regenerating Skin Nectar or anything else.”

Summary: When applying topical treatments, such as poly-Llactic acid, they are allowed to dry thoroughly before applying Regenerating Skin Nectar.


  • As devices and products improve, making outcomes more predictable, the overall treatment experience becomes an important new criterion for patient satisfaction.
  • Preconditioning prior to performing energy-based procedures has become more widely accepted as a new advancement during the past 5 years.
  • Previously, pigmentation issues were the primary reason for pretreatment. Preconditioning as a stimulus to improve the skin bed and reduce subsequent post-procedure healing time is gaining more attention.
  • The use of corticosteroids and vinegar soaks is being replaced by other products, such as Alastin Regenerating Skin Nectar, which reduces patient discomfort and enhances recovery.
  • It is beneficial to have control over pre- and post-procedure treatments to ensure safety and speed recovery.


S. Kilmer has served on the Medical Advisory Board for Cutera, Cytrellis, Alastin Skincare, Allergan, Dominion Aesthetics, Lumenis, Lutronic, Merz, Miramar, Pulse Biosciences, Sciton, Sienna Labs, Syneron/Candela, Venus Concepts, and Solta/Valeant; and has received research support from Cutera, Cytrellis,
Alastin Skincare, Allergan, Dominion Aesthetics, Lumenis, Lutronic, Merz, Miramar, Pulse Biosciences, Sciton, Sienna Labs, Syneron/Candela, Venus Concepts, BTL Industries, Galderma, R2 Derm, and Revance; and has stock options with Avava, Cutera, Cytrellis, and HintMD.

R. Geronemus has served on the Medical Advisory Board for Allergan, Candela, Cearna, Cynosure, Cytrellis, Lutronics, and Soliton; and has served as Investigator and received research support for Allergan, ArchiMedus, Avava, Candela, Cynosure, Cytrellis Endo Pharmaceuticals, Galderma, Kerastem, Lutronic, Merz, New York Stem Cell Foundation, Pulse, Biosystem, Revance, Sciton, and Sienna Labs; and is a Stockholder in Cytrellis.

N. Saedi has served as a consultant for Alastin and Cartessa; has served on the advisory board for Aerolase, Cynosure, and Cartessa; and has received equipment from Cynosure and Cartessa.

A.J. Burns has served as a consultant for SkinMedica and Alastin, on the Advisory Board for Revision Skin Care and Allergan; and has served on the Advisory Committee for Sciton; has performed research and received equipment for InMode and Cytrellis; and is an investor in HintMD.

L. Tanzi is a consultant for Sciton, Allergan/Coolsculpting, and is on the Advisory Board for Allergan/Coolsculpting.

K. Karimi is Medical Director for CosmoFrance, Inc, NovaThreads, Inc, Prollenium, Inc; a consultant for Alastin, Inc, Sciton, Inc, CynoSure, Inc, InMode Inc, and serves on the Advisory Board and is a trainer for Galderma, Inc.


This study was sponsored by Alastin Skincare®, Inc., Carlsbad, CA. The authors acknowledge the editorial assistance of Dr. Carl S. Hornfeldt, Apothekon, Inc., during the preparation of this manuscript.


Suzanne L. Kilmer MD