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Light Years
Less
Scalpel, More
Laser and
Non-Surgical
Techniques
Lasers,
fillers,
botulinum
toxins . . .
The arsenal
that tackles
the signs of
aging is ever
expanding with
the use of less
invasive
techniques,
postponing the
need for more
invasive
procedures. To
present new
uses of
fractional
lasers, one of
the most
popular
techniques, Dr.
Cameron
Rokhsar, a
graduate of
Harvard
University and
a fellow of the
American
Academy of
Dermatology,
arrived in
Buenos Aires,
(Argentina).
Dr. Rokhsar
presented his
techniques a
few days ago,
during the
Third Annual
International
Plastic Surgery
Symposium held
in Buenos
Aires.
For what
do you use
fractional
lasers (Fraxel
Laser)?
Its a laser
that has a much
shorter
recovery period
than an
ablative laser,
without post-op
down time and
without its
risks. The
general
applications
approved by the
FDA are
rejuvenation,
wrinkles around
the eyes, fine
and medium
depth wrinkles,
acne, surgical
or traumatic
scars and
melasma.
Everything that
can be
rejuvenated can
be done with
this laser. In
the past, we
were limited to
the face and
neck with
traditional
resurfacing
lasers. Today,
we can
resurface other
parts of the
body. The
ablative lasers
of yesterday
have been
largely
replaced by
fractional
lasers.
How does
it work on
stretch marks?
Stretch
marks can be
treated with a
pulse dye
laser. But
afterwards, if
you resurface
stretch marks
with an
ablative laser,
you would cause
a scar. Now,
with a
fractional
laser, both
things are done
at the same
time, without
damaging the
epidermis and
the risk for
scarring.
Does it
make them
better or does
it get rid of
them?
It makes
them better.
Nothing can
eradicate scars
or stretch
marks. What
you see is that
the skin is
more taught and
the appearance
of the stretch
marks is
improved.
Does it
delay the
worsening of
the stretch
mark?
Stretch
marks are
produced by
stretching of
the skin during
pregnancy, or
rapid expansion
of the skin,
i.e. weight
lifting etc.
Its like a
wrinkle. With
treatment it
gets better
and, if theres
no other abrupt
change in
volume, these
should not
appear again.
Can dark
circles under
the eyes be
treated?
Dark circles
under the eyes
are due to
genetic
factors,
increased
vascularity,
true
pigmentation or
a shadowing
effect due to
fat
protrusion.
Depending on
the origin of
the dark
circles under
the eye,
different
treatment
approaches can
be used. If
the dark
circles are
truly due to
pigmentation,
they can be
treated with
the fraxel
laser. There
is no risk to
the eye because
protective
eyewear is used
to protect the
cornea.
Are these
applications
approved?
The
equipment and
each of the
applications
has been
approved. The
only thing
thats in a
trial phase is
treatment of
stretch marks.
It is
anticipated
that FDA
approval for
this
application
will be
obtained within
the next six
months.
For aging
due to sun
exposure, is it
recommended
that this be
complemented by
some other
procedure?
I recommend
the use of
botox prior
to the use of
fraxel to
smoothen the
wrinkles as the
effects of
fractional
lasers (Fraxel)
will be
enhanced on the
flat surface
created by
botox. Also,
it can be used
in conjunction
with fillers,
pulse dye
lasers and
other pulsed
light sources
if need be.
Are
non-invasive
treatments at
their peak?
We are at
the beginning
of fractional
systems. The
future involves
fractionating
various
wavelengths of
light for other
applications
including the
CO2 laser
beam. Also,
ultrasound
techniques are
going to be
advanced for
destroying fat
(in the United
States this is
still not
approved but in
Argentina it
is).
What are
the
possibilities
for fractional
lasers in the
future?
Its about
taking it to
the minimum
expression.
Before pulse
laser had a
larger
diameter. If
you used too
much energy, it
would melt the
skin. What you
look for is a
minimal
diameter,
microscopic,
placing much
energy deep in
a microscopic
column. It is
intended to go
as deep in as
small a column
as possible to
obtain the best
result.
Will
these
advancements
continue to be
used for
photorejuvenation?
Yes, the non
invasive
approaches will
only grow the
treatment of
aging due to
sun damage.
What is
the future of
scalpels, will
it tend to
disappear or
are there
techniques that
wont be
replaced?
Surgery is
becoming less
and less
popular.
Today, with the
technologies
available,
patients are
beginning to
treat
themselves at a
younger age.
The focus has
been largely
shifted to
prevention.
Is the
scalpel being
passed over?
The use of
the scalpel is
being passed
over and
surgery is
becoming less
popular because
of the issues
of surgical
risk,
anesthesia and
recovery
periods. For
example now I
can do a nose
job with the
use of
injections
rather than the
scalpel. This
was
unfathomable a
few years back.
What is
this technique
like?
With
injections, we
can change the
shape of the
nose for
approximately
one year and it
can be repeated
every year.
The procedure
takes ten
minutes. I
fill in behind
the bone to
smoothen the
nasal profile
as well as to
raise the nasal
tip. Its done
with resorbable
substances,
like calcium
hydroxyl
appetite which
is a natural
mineral present
in our body.
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