Body Rejuvenation (eBook)

Contents 5
Contributors 8
Part I Neck and Upper Chest 13
Chapter 1 14
Treatment of Platysmal Bands with Botulinum Toxin 14
Introduction 14
Clinical Examination 14
Treatment Indications 14
Setting Selection 14
Treatment Technique 15
Alternative Treatment Methods 17
Combinations of Botulinum Toxins with Other Modalities 18
Conclusion 18
References 18
Chapter 2 19
Treatment of Neck Laxity with Radiofrequency and Infrared Light 19
Introduction 19
Clinical Examination and Patient History 19
Method of Device or Treatment Application 19
Radiofrequency 19
Dose/Settings 19
Postoperative Care 22
Management of Adverse Events 22
Infrared Wavelengths 23
Infrared Light (1,100–1,800 nm, Titan, Cutera) 23
1,310 nm Diode Laser (Candela) 24
Minimally-Invasive Radiofrequency (Miratone System, Primaeva Medical, Inc., Pleasanton, CA) 24
Conclusion 25
Chapter 3 26
Treatment of Neck Laxity with Therapeutic Ultrasound 26
Introduction 26
Patient History and Clinical Examination 26
Method of Device or Treatment Application 28
Dose/Setting Selection 28
Treatment Technique 28
Alternative Treatment Methods 29
Postoperative Care 29
Management of Adverse Events 29
Conclusion 30
References 30
Chapter 4 31
Treatment of Neck Fat with Injectable Adipolytic Therapy 31
Introduction 31
Clinical Examination and Patient History 31
Method of Treatment Application 33
Adverse Effects 35
Local Effects 35
Immediately After Injection – Day 1 35
Days 2–3 35
Day 3 to 1 Week 35
Weeks 2–4 35
Weeks 4+ 36
Systemic Effects 36
Conclusion 36
Suggested Reading 36
Chapter 5 38
Treatment of Poikiloderma with Fractional Resurfacing 38
Introduction 38
Clinical Examination and Patient History 38
Method of Device or Treatment Application 39
Direction for the Future and Conclusions 42
References 44
Chapter 6 45
Treatment of Poikiloderma with Chemical Peeling 45
Introduction 45
Clinical Examination and Patient History 46
Preoperative Evaluation 46
Patient Evaluation 46
Treatment Application 47
Preoperative Patient Preparation 47
Chemical Peels 47
Postoperative Care 50
Conclusion 50
References 51
Chapter 7 52
Treatment of Poikiloderma by Pigment and Vascular Lasers 52
Introduction 52
Method of Device on Treatment Application 52
Argon Laser 53
Potassium-titanyl-phosphate Laser 53
Pulsed Dye Laser 53
Intense Pulsed Light 54
Alternative Treatment of Poikiloderma of Civatte 55
Conclusion 56
References 56
Part II Back and Chest 57
Chapter 8 58
Treatment of Truncal Acne Scarring 58
Introduction 58
Patient History and Clinical Examination 58
Therapeutic Considerations and Applications 58
Excision 58
Pulsed Dye Laser 60
Ablative Lasers 61
Semi-ablative Lasers 61
Nonablative Lasers 61
Intralesional Corticosteroids 62
Fillers 62
Conclusion 62
References 62
Chapter 9 63
Truncal Hair Removal 63
Introduction 63
Clinical Examination 63
Treatment Application 63
Conclusion 65
References 66
Chapter 10 67
Revision of Disfiguring Surgical Scars of the Back 67
Introduction 67
Clinical Examination and Patient History 67
Treatment Methods 69
Topical Treatments 69
Intralesional Injections 70
Cryosurgery 70
Laser Treatments 70
Surgical Treatments 71
Conclusion 72
References 72
Part III Breast 73
Chapter 11 74
Breast Reduction Through Liposuction 74
Introduction 74
Clinical Examination and Patient History 74
Method of Device and Treatment Application 74
Results and Postoperative Care 76
Management of Adverse Events 76
Conclusion 77
References 77
Chapter 12 78
Botulinum Toxin A for Upper Thoracic Posture and the Appearance of a “Breast Lift” 78
Introduction 78
Clinical Examination 78
Patient Selection 78
Treatment Application 78
Treatment Technique 79
Clinical Trial 80
Special Considerations 81
Conclusion 82
References 83
Part IV Hands (and Feet) 84
Chapter 13 85
Treatment of Keratoses and Lentigines with Peels and PDT 85
Introduction 85
Patient History and Clinical Examination 85
Method of Device and Treatment Application 86
Photodynamic Therapy 86
Chemical Peeling 87
Conclusion 88
References 88
Chapter 14 89
Off-Face Laser Treatment of Keratoses and Lentigines 89
Introduction 89
Clinical Examination and Patient History 89
Method of Device and Treatment Application 89
532 nm Q-Switched Nd:YAG and 694 nm QS Ruby Lasers 89
1,550 nm Erbium-Doped Fractional Photothermolysis (Fraxel™) 92
Laser-Mediated Photodynamic Therapy with Pulsed Dye Laser (PDL) (595 nm) 96
Conclusion 98
References 98
Chapter 15 99
Treatment of Hand Veins with Sclerotherapy 99
Introduction 99
Clinical Examination and Patient History 100
Method of Device and Treatment Application 100
Conclusion 103
References 103
Chapter 16 104
Treatment of Hand Atrophy with Fat Transplantation 104
Introduction 104
Clinical Examination 104
Treatment Application 104
Anesthesia Considerations 104
Fat Harvesting 105
Fat Processing 106
Fat Injections 106
Postoperative Management 107
Reference 107
Part V Arms (and Legs) 108
Chapter 17 109
Reduction of Arm Fat by Liposuction 109
Introduction 109
Indications 109
Clinical Examination and Patient History 109
Contraindications 109
Treatment Application 109
Procedural Protocol 109
Tray Setup 109
Relevant Anatomical Structures 110
Anesthesia 110
Technique 110
Postoperative Instructions 111
Complications 113
Pearls 113
Conclusion 113
References 113
Chapter 18 114
Reduction of Excess Arm Skin via Surgical Excision 114
Introduction 114
Clinical Examination and Patient History 114
Treatment Application 115
Outcomes and Complications 117
Conclusion 117
References 117
Chapter 19 118
Skin Tightening of the Arms and Legs with Radiofrequency and Broadband Light 118
Introduction 118
Clinical Examination 120
Treatment Application 120
Conclusion 121
References 122
Chapter 20 123
Sclerotherapy of Leg Veins 123
Introduction 123
Clinical Exam and Patient Selection 123
Treatment Application 124
Sclerosants 124
Treatment Algorithm for Large and Small Vessels 124
Foam Sclerotherapy 127
Compression 128
Postoperative Care 128
Management of Adverse Events 129
Conclusion 129
References 129
Chapter 21 130
Ambulatory Phlebectomy 130
Introduction 130
Indications 130
Contraindications 130
Relative Contraindications 130
Clinical Examination and Patient History 130
Treatment Application 131
Procedural Protocol 131
Tray Setup 131
Technique (Fig. 21.3) 131
Postoperative Instructions 136
Alternative Treatment Methods 136
Complications 136
Pearls 136
Conclusion 137
References 138
Chapter 22 139
Endovenous Laser and Radiofrequency Treatment of Leg Veins 139
Introduction 139
Endovenous Laser Therapy1–7 139
Endovenous Radiofrequency Ablation3,6,8 140
Indications for Endovenous Ablation 141
Contraindications 141
Relative Contraindications 142
Clinical Examination and Patient History 142
Preoperative Evaluation 142
Treatment Application 142
Procedural Protocol 142
Postoperative Instructions 145
Alternative Treatment Methods 145
Complications 145
Pearls 146
Conclusion 146
References 146
Part VI Abdomen, Thighs, Hips, and Buttocks 147
Chapter 23 148
Noninvasive Body Rejuvenation 148
Introduction 148
Patient History and Clinical Examination 148
Method of Device or Treatment Application 154
Dosages and Settings 154
Treatment Techniques by Device 154
Postoperative Care 156
Management of Adverse Events 156
Conclusion 156
References 158
Chapter 24 160
Reduction of Cellulite with Subcision® 160
Introduction: Evidence from Literature 160
*Levels of Evidence 160
Clinical Examination and Patient Selection 160
Contraindications 160
Method of Device and Treatment Application 161
Preoperative Recommendations 161
Treatment of Cellulite with Subcision® Technique 161
Postoperative Recommendations 162
Results 162
Complications, Postoperative Care, and Management of Adverse Events 162
Conclusion 164
References 164
Chapter 25 165
Body Contouring with Tumescent Liposuction 165
Introduction 165
Clinical Examination and Patient History 165
Method of Treatment 166
Liposuction of the Arms 172
Liposuction of the Trunk 172
Upper and Lower Abdomen 172
Hips 173
Mid-lower Back and Waistline 174
Liposuction of the Buttock 175
Liposuction of the Legs 175
Outer Thighs 176
Inner Thighs and Knees 179
Love Handles and Abdomen on Men 180
Postoperative Clinical Considerations 182
Conclusion 183
Box 25.1 166
Box 25.2 Cannulas 167
Box 25.3 Commonly Used Infusion and Aspiration Pumps 168
Box 25.4 Commonly Used Sedatives and Anal­gesics15 170
Box 25.5 Liposuction Cosmetic Units 171
Box 25.6 Anatomic Sites and Liposuction Aggres­sive­ness17 171
Appendix A: Medications Which Inhibit Cytochrome P450 183
Appendix B: Medications that May Affect Bleeding 184
References 184
Chapter 26 185
Skin Tightening Off the Face with Radiofrequency and Broadband Light 185
Introduction 185
Clinical Examination/Patient Selection 185
Method of Device/Treatment Application 185
Dose/Setting Selection 185
Treatment Technique when using RF 187
Treatment Technique when using IBBL 189
Postoperative Care 189
Number and Frequency of Treatments 189
Management of Adverse Events 190
Direction for the Future/Conclusion 191
References 191
Chapter 27 192
Female Genital Surgery 192
Introduction 192
Functional and Aesthetic Labia Minora Reduction 192
Introduction and Definition 192
Clinical Examination and Patient History 192
Treatment Application 193
Vulvar Reshaping and Vaginal Rejuvenation 195
Introduction and Definition 195
Clinical Examination and Patient History 195
Treatment Application 195
Volume Augmentation of the Mons Veneris and Labia Majora 195
Re-structuring, Hydration, and Turgescence of Vulvo-vaginal Mucosae 196
References 196
Chapter 28 197
Reduction of Excess Abdominal Skin via Liposuction and Surgical Excision 197
Introduction 197
Clinical Examination and Patient History 197
Method of Device and Treatment Application 198
Postoperative care 199
Possible Complications 201
Conclusion 202
References 202
Part VII Advanced and General Topics 203
Chapter 29 204
Ablative Laser Resurfacing Off the Face 204
Introduction 204
Patient Selection 204
Method of Device and Treatment Application 204
Fractional Resurfacing 205
Treatment of Lesions on the Leg 207
Chapter 30 209
Prepackaged Injectable Soft-Tissue Rejuvenation of the Hand and Other Nonfacial Areas 209
Introduction 209
Clinical Examination 209
Treatment Application 210
Administration of CaHA in the Hand 210
CaHA in Other Nonfacial Areas 211
Conclusion 212
References 213
Chapter 31 214
Cosmeceuticals Off the Face 214
Introduction 214
Clinical Examination 214
Body Cosmeceutical Treatment Application 216
Cleansers 216
Exfoliants 216
Moisturizers 216
Sunscreens 217
Skin Lightening Agents 217
Antiaging Therapies 218
Conclusion 219
References 219
Chapter 32 220
Special Considerations in Asian Patients 220
Introduction 220
Treatment Applications 220
Botulinum Toxin A (Botox®) 220
Laser and Radiofrequency Skin Rejuvenation 220
Laser Considerations in Asian Skin 220
Neck Rejuvenation 221
Body Contouring 221
Hypertrophic and Keloid Scars 223
Hair Removal 223
Conclusion 223
References 224
Chapter 33 225
Treatment and Prevention of Dyspigmentation in Patients with Ethnic Skin 225
Introduction 225
Clinical Examination and Patient History 225
Treatment Application of Dyspigmentation in Ethnic Skin 226
Hydroquinone 227
Dose Selection 227
Treatment Technique 227
Alternative Treatment Methods 227
Management of Adverse Effects 227
Azelaic Acid 228
Dose Selection and Treatment Techniques 228
Management of Adverse Effects 228
Keratolytic Agents (a-Hydroxy Acids and b-Hydroxy Acid) 228
Dose Selection and Treatment Technique 228
Management of Adverse Effects 228
Topical Glucocorticoids 228
Examples of Class V–VII Glucocorticoids 228
Laser Therapy 228
Conclusion 229
References 229
Index 230