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The Multi-synchronous Facial rejuvenation study was done in 3-phases over a period of three weeks. Phase I included Dysport® at dilution 3.5:1 in 3 areas, glabellar, frontalis and periorbital. Phase 2 introduced intense fibroblast stimulation and modification through microneedling, PRP growth factor induction and near-red phototherapy. Phase 3 included low–level (CO2) Ultrapulse laser with settings (Energy) 100 mJ (Rate) 14w CPG 3/5/2 and adjunct near-red 633nm phototherapy. The study evaluated post procedural aesthetic results at two weeks, four weeks and twelve weeks. The length of downtime, patient discomfort and adverse side effects were noted for each phase. Clinical assessment of patients in each grouping was made at 2 weeks, I month and 3 months postoperatively in the presence of two aesthetic staff. The degree of improvement in photoageing was based on the degree of re-epithelialization rate, reduction of rhytides, reduction of tactile roughness and loss of hyperpigmentation and telangiectasias. The efficacy of treatment was evaluated using a variation of the five-point scale originally suggested by Dover et al.. Investigators and patients evaluated efficacy using palpability assessments and change from baseline score at 0, 6 and 12 weeks. A total global score was recorded in each patient based on the addition of points obtained from six photodamage variables. The degree of perceived improvement in overall aesthetic effect reflecting chronological age was assessed separately by patients and physicians using the Wrinkle Severity Rating Scale and the Global Aesthetic Improvement Scale. The WSRS is recognised as a valid and reliable instrument for quantitative assessment of facial skin folds, with good inter- and intra-observer consistency]. Wrinkle severity is measured by using a wrinkle severity rating scale with 1 being absent and 5 being extreme. By allowing objective grading of data, these proved useful clinical tools for assessing the effectiveness of facial volumisation with PRP and MN-633.
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Multiprocedural Synchronous Facial Rejuvenation
Introducing the DUBLiN method
Dr. Patrick J. TreacyMedical DirectorAilesbury Clinics Ltd
SKIN CANCERSKIN CANCER
SALLOW SKINSALLOW SKIN COARSE
RHYTIDS
COARSE RHYTIDS
FINE RYTHIDS
FINE RYTHIDS
THREAD VEINSTHREAD VEINS PIGMENTATION
PIGMENTATION
TitleTitlePHOTOAGEING
WRINKLESWRINKLES
ECTROPION ECTROPION ENTROPION
ENTROPION
FATPROTRUSION
FATPROTRUSION
EPIPHORA EPIPHORA SKIN LAXITY
SKIN LAXITY
TitleTitleCHRONOAGEING
Treating Facial Ageing
A great variety of stand alone facial rejuvenation treatments are presently available including Botox©,Dermaroller©, RioBlush©,Radiofrequency Devices Syneron Polaris©RF, Thermage© InfraRed Titan©, CO2 fractionalised resurfacing AFX© SmartXide© Fraxel Repair©,
WRINKLESWRINKLES
TEAR TROUGH TEAR TROUGH WRINKLES
WRINKLES
FATPROTRUSION
FATPROTRUSION
PIGMENTATION PIGMENTATION SKIN LAXITY
SKIN LAXITY
TitleTitleCOLLAGEN
FAT PROTRUSION
FAT PROTRUSION
SALLOW SKINSALLOW SKIN THREAD VEINS
THREAD VEINS
COARSE RYTHIDS
COARSE RYTHIDS
FINERHYTIDS
FINERHYTIDS
PIGMENTATIONPIGMENTATION
TitleTitlePositive
CO2 FRSL
• Patient CM 2 passes under R eye with obvious reduction in rhytides and neocollogenesis
MarionetteLines
MarionetteLines
Eyebrow HeightEyebrow Height Youthful Look
Youthful Look
Nasolabial Lines
Nasolabial Lines
CheekAugmentation
CheekAugmentation
Volume loss Volume loss
TitleTitleNegative
CO2 FRSL
New Collagen
Fibroblast Stimulatio
n
CO2 Laser
Botox
Although, many feel that ultrapulsed fractionalised
CO2 laser skin resurfacing is the best treatment option for photo aged facial skin, could we improve on this
modality.
The DUBLiN method uses different methods and technologies in order to activate fibroblasts and direct them towards neocollogenesis. It also uses low level pulsed lasers to reduce skin laxity, accelerate growth factors and cause tightening.
The DUBLiN method incorporates
D Dermaroller
U Ultrapulse Laser
B Blood Factors
Li Light – 633nm
N Neurotoxin
Induction of FIBROBLASTS
A fibroblast is a type of cell that synthesizes the extracellular matrix and collagen, the structural framework (stroma) for animal tissues, and plays a critical role in wound healing. Fibroblasts are the most common cells of connective
tissue in animals.
Comparative study over three months
• Over 3 months, 15 patients (Group 1) received FLSR at normal settings
• Results were compared to 29 patients (Group 2) received low energy FLRS + adjunctive treatments
• Both group received BTXA one week prior to other treatments
Group 2 received a 3-phase combination
multi-rejuvenation technique over 3 weeks.
• Phase I included Dysport® at dilution 3.5:1 in 3 areas
• Phase 2 introduced intense fibroblast
stimulation and modification through microneedling, PRP growth factor induction and near-red phototherapy.
• Phase 3 included low–level (CO2) Ultrapulse laser with settings (Energy) 100 mJ (Rate) 14w CPG 3/5/2 and adjunct near-red 633nm phototherapy.
Near Red Light 633Near Red Light 633
Dermaroller Dermaroller
TitleTitleFibroblast Generation
PHASE 2 multi-combination technique
PRP Growth Factor Signals
Near Red Light 633Near Red Light 633
Dermaroller Dermaroller
TitleTitleFibroblast Activation
PHASE 2a fibroblast activation
PRP Growth Factor Signals
Near Red Light 633Near Red Light 633
Dermaroller Dermaroller
TitleTitleFibroblast
Stimulation
PHASE 2b fibroblast stimulation
PRP Growth Factor Signals
DERMAROLLER
Keratinocyte GF Keratinocyte GF
Vascular Endothelial GFVascular Endothelial GF Fibroblast GF
Fibroblast GF
Transforming GF-BTransforming GF-B
Connective Tissue GF Connective Tissue GF
Platelet Derived GFPlatelet Derived GF
TitleTitleCOLLAGEN
BLOOD FACTORS
GROWTH FACTORS
The efficacy of certain growth factors in forming collagen and healing various injuries is the theoretical basis for the use of PRP in tissue repair. The platelets collected in PRP are activated by the addition of thrombin and calcium chloride. This induces the release of these factors from alpha granules
LiGHT 633nm
Migrating cells exert forces against the substrate to move forward. These forces are part of the contraction phase of migration in which the rear of the cell is detached from the substrate and the body of the cell is moved forward.
Near Red Light 633Near Red Light 633
Post NTa Post NTa
TitleTitleCollagen
Synthesis
PHASE 2
Co2 Laser
ULTRALASE LASER
Laser specialists non-sequential fractionalised CO2 laser ablation is the most effective modality for repairing photo damaged skin
The benefits are more precise control of ablation depth, faster recovery time and reduced risk of post procedural problems
WSRS = Wrinkle Severity Rating Scale
5 Extreme Extremely deep and long folds, detrimental to facial appearance.
2-4mm Visible V-shaped fold when stretched
Unlikely to have satisfactory correction with injectable implant alone.
4 Severe Very long and deep folds; prominent facial feature.
Less than 2mm visible fold when stretched.
Significant improvement is expected from injectable implant.
3 Moderate Moderately deep folds.
Clear facial feature visible at normal appearance but not when stretched.
Excellent correction is expected from injectable implant.
2 Mild Shallow but visible fold with a slight indentation; minor facial feature.
Implant is expected to produce a slight improvement in appearance.
1 Absent No visible fold, continuous skin line.
GAIS = Global Aesthetic Improvement Scale
5 Very Much Improved Optimal cosmetic result for the implant in this patient.
4 Much Improved Marked improvement in appearance but not completely optimal for this patient. A touch-up would slightly improve the result.
3 Improved Obvious improvement in appearance from the initial condition, but a touch-up or re-treatment is indicated.
2 No Change The appearance is essentially the same as the original condition.
1 Worse The appearance is worse than the original condition.
DUBLIN Lift Periorbital Area
Dover Photoageing Scale
Wrinkle Severity Rating Scale
% Patient satisfaction
BTX
Wrinkle Severity Rating Scale
% Patient satisfaction
PRP
www.ailesburyclinic.ie
Спасибо!
