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      Tratamiento simultáneo secuencial con ultrasonidos focalizados de alta intensidad, láser de CO2 fraccionado y plasma rico en plaquetas para rejuvenecimiento facial en fototipos altos Translated title: Sequential simultaneous treatment with high-intensity focused ultrasound, fractional CO2 laser and platelet-rich plasma for facial rejuvenation in dark phototypes

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          Abstract

          Resumen Introducción y objetivo. La combinación de técnicas mínimamente invasivas es muy frecuente para tratar el envejecimiento de la piel. El objetivo de este ensayo es evaluar un protocolo de tratamiento intensivo para rejuvenecimiento facial en una sesión única, combinada y secuencial, empleando ultrasonidos focalizados de alta intensidad (HIFU), láser de CO2 fraccionado y plasma rico en plaquetas (PRP) autólogo. Material y método. Ensayo piloto para evaluar la eficacia y seguridad del tratamiento combinado en una muestra seleccionada de 15 pacientes (fototipos III-V) con signos evidentes de envejecimiento facial. La eficacia fue evaluada de forma enmascarada por 2 expertos independientes mediante comparación de fotografías antes del tratamiento y 3 meses después. Las variables analizadas (grado de dolor, laxitud, rejuvenecimiento global y satisfacción) se cuantificaron mediante escalas ordinales cuantitativas o cualitativas. La seguridad se evaluó mediante anotaciones de seguimiento en las historias clínicas. Resultados. Obtuvimos mejorías significativas en la reducción de la laxitud en los tercios superior, medio e inferior de la cara (p=0.026, p=0.011, p=0.003). En la escala de mejoría estética global, según los evaluadores expertos, 14 participantes (93%) se consideraron “mejorados” o “muy mejorados”. Todos los pacientes reconocieron algún tipo de mejoría, 9 indicaron estar “muy satisfechos”, 3 “satisfechos” y 3 “moderadamente satisfechos”. El tratamiento fue doloroso, pero suficientemente tolerado por la mayoría de pacientes. No aparecieron efectos adversos inesperados ni complicaciones importantes, con buena recuperación postoperatoria. En general los pacientes se reincorporaron a sus actividades laborales 10 días después del tratamiento. Conclusiones. El perfil de eficacia/seguridad del método ensayado ha sido muy favorable en la serie investigada.

          Translated abstract

          Abstract Background and objective. The combination of minimally invasive techniques is very common to treat aging skin. The objective of this trial is to evaluate an intensive treatment protocol for facial rejuvenation, in a single, combined and sequential session, using high intensity focused ultrasound (HIFU), fractional CO2 laser and autologous platelet rich plasma (PRP). Methods. Pilot trial to evaluate the efficacy and safety of the combined treatment in a selected sample of 15 patients (phototypes III-V) with evident signs of facial aging. Efficacy was assessed blinded by 2 independent experts by comparing photographs before treatment and 3 months later. The variables analyzed (degree of pain, laxity, global rejuvenation and satisfaction) were quantified using ordinal quantitative or qualitative scales. Safety is assessed by follow-up notes in medical records. Results. Significant improvements in laxity reduction were achieved in the upper, middle, and lower thirds of the face (p=0.026, p=0.011, p=0.003). On the scale of global aesthetic improvement, according to the expert evaluators, 14 participants (93%) consider themselves "improved" or "very improved". All patients recognized some kind of improvement, 9 indicated being "very satisfied", 3 "satisfied" and 3 "moderately satisfied". The treatment was painful, but sufficiently tolerated by the majority of patients. There were no unexpected side effects or major complications, with good postoperative recovery. In general, the patients returned to their work activities 10 days after treatment. Conclusions. The efficacy/safety profile of the tested method has been very favorable in the series investigated.

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          Most cited references24

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          The Role of the CO2 Laser and Fractional CO2 Laser in Dermatology.

          Tremendous advances have been made in the medical application of the laser in the past few decades. Many diseases in the dermatological field are now indications for laser treatment that qualify for reimbursement by many national health insurance systems. Among laser types, the carbon dioxide (CO2) laser remains an important system for the dermatologist.
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            The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial.

            Ablative carbon dioxide (CO(2) ) fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and edema, which may affect the daily lives of patients. Autologous platelet-rich plasma (PRP) is known to enhance wound healing and has applications in many areas of medicine.
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              Autologous platelet rich plasma: topical versus intradermal after fractional ablative carbon dioxide laser treatment of atrophic acne scars.

              A proposal has recently been made regarding the potential adjuvant use of platelet-rich plasma (PRP) with fractional carbon dioxide laser (FCL) for the correction of acne scars.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                June 2023
                : 49
                : 2
                : 147-160
                Affiliations
                [3] orgnameAmerican Board de Láser en Cirugía Plástica-Estética
                [1] Tacna orgnameCentro de Estética Renova Láser Perú
                [2] Sabadell Barcelona orgnameIMC-Investiláser orgdiv1Unidad de Ensayos Clínicos España
                Article
                S0376-78922023000200007 S0376-7892(23)04900200007
                10.4321/s0376-78922023000200007
                35a7af79-7462-4098-877d-7ddefddf07c4

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 25 March 2022
                : 15 May 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 14
                Product

                SciELO Spain

                Categories
                Estética

                Rejuvenecimiento facial,Flacidez,Ultrasonidos focalizados de alta intensidad,HIFU,Láser CO2 fraccionado,Plasma rico en plaquetas,PRP,Facial Rejuvenation,Flaccidity,High intensity focused ultrasound,Fractional CO2 laser,Platelet-rich plasma

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