Abstracts

A summary of the latest clinical studies

Title: Fractional CO2 Laser Versus Combined Platelet-Rich Plasma and Fractional CO2 Laser in Treatment of Acne Scars Authors: Galal O, Tawfik AA, et al. Published: Journal of Cosmetic Dermatology, April 2019 Keywords: CO2 laser, acne, PRP Abstract: Fractional CO2 laser and platelet-rich plasma (PRP) treatments have been used in the treatment of acne scars. Thirty patients with atrophic acne scar lesions were included in this study. Patients were randomized to receive fractional CO2 laser therapy to one side of the face while the other side of the face was treated with fractional CO2 laser followed by intradermal PRP injection. Follow-up using the skin analysis camera system and photography was done for three months. A dramatic improvement was observed in the scar depth on both sides of the face. However, the combined fractional CO2 laser and PRP showed more significant improvement. Although 70% of our patients were of a dark skin type, no hyperpigmentation was reported. The combined use of fractional CO2 laser and PRP achieved better results. It reduced the downtime of the fractional CO2 laser. The use of the skin analysis camera provided an objective assessment of the results.

Title: The Use of HIFEM Technology in the Treatment of Pelvic Floor Muscles as a Cause of Female Sexual Dysfunction Authors: Hlavinka TC, Turčan P, and Bader A Published: Journal of Women’s Health Care, March 2019 Keywords: Pelvic floor, menopause, HIFEM Abstract: Pelvic Floor Muscles (PFM) supports the pelvic floor organs, control continence and is crucial for adequate genital arousal and attainment of an orgasm. Due to the aging process, post-delivery condition or menopause, the PFM weaken. Therefore, they do not provide sufficient support to pelvic organs, bladder control, and they may negatively affect intimate satisfaction. We aimed to investigate the High-Intensity Focused Electromagnetic (HIFEM) technology for strengthening of PFM in women with impeded sexual functioning. 30 women (average age 36.41 ± 5.62) with limited arousal, ability to achieve orgasm and painful intercourse participated in the study. Patients underwent 6 treatments (28 minutes each) scheduled twice a week. Standardized Female Sexual Function Index (FSFI) questionnaire was used pre-, post-treatment, and at the 3 month follow-up visit. FSFI scores were statistically evaluated through student´s t-test (ɑ=0.05). Subsequently, Pearson correlation coefficient was calculated for sections arousal/lubrication, lubrication/orgasm, orgasm/satisfaction, and pain/desire. The average total FSFI score significantly (p<0.001) increased from 20.06 ± 6.55 to 30.69 ± 7.55 posttreatment and to 30.29 ± 7.37 during the 3-month follow-up. A significant improvement was observed in all FSFI sections. The most significant change at the 3-month follow-up was observed in desire (76%), satisfaction (76%) and orgasm (60%) items. The overall FSFI score was improved in 93% (n=28) of patients post-treatment. All patients (n=30; 100%) showed improvement during the 3-month follow-up. Our initial experience shows that HIFEM technology is a promising method in addressing women’s decreased sexual satisfaction through the strengthening of PFM. Title: The Efficacy of Ultrasound-guided Selective Botulinum Toxin Type A Therapy for Finger Spasticity Following Stroke Authors: Furukawa T, Kurihara Y, Masakado Y Published: The Tokai Journal of Experimental and Clinical Medicine, April 2019 Keywords: Botulinum toxin, spasticity Abstract: A 64-year-old man had spasticity of digits 3 and 4 of the right hand for 22 years following a stroke. Activities of daily living (ADL) were impaired due to the disuse of the right arm. The flexor digitorum superficialis and flexor digitorum profundus muscles of digits 3 and 4 of the patient’s right forearm were identified using ultrasound guidance, and botulinum toxin type A was selectively injected into those sites. Furthermore, following the injections, occupational therapy was performed for the right arm and fingers, and spasticity was assessed after 2 weeks and at 1, 2, 3, 4, and 5 months. The patient showed improvement in all the evaluations (the Modified Ashworth Scale, Disability Assessment Scale, functional independence measure, active range of motion angle, and movement of holding a cup), and function was maintained throughout the evaluation period. Performing botulinum toxin type A injection under ultrasound guidance to selectively identify the flexor digitorum superficialis and flexor digitorum profundus muscles involved in finger spasticity helped restore finger functioning and improve ADL.

Title: Adjustable Depth Fractional Radiofrequency Combined with Bipolar Radiofrequency: A Minimally Invasive Combination Treatment for Skin Laxity Authors: Dayan E, Chia C, et al. Published: Aesthetic Surgery Journal, April 2019 Keywords: Radiofrequency, microneedling Abstract: Increasingly, patients are seeking minimally invasive methods to tighten skin and remodel adipose tissue. A large treatment gap exists among 3 types of patients: (1) the younger demographic, who increasingly desire soft tissue tightening without traditional operations, scars, and downtime; (2) patients with soft tissue laxity who are not “severe enough” to justify an excisional procedure, but not “mild enough” to rely on liposuction with soft tissue contraction alone; and (3) those with recurrent laxity who already underwent traditional excisional procedures. In these populations, plastic surgeons risk under- or overtreating with traditional methods. The purpose of this supplement is to describe the utility of radiofrequency (RF) microneedling (Fractora modified to Morpheus8 InMode Aesthetic Solutions, Lake Forest, CA) in combination with bipolar RF (FaceTite/BodyTite, InMode Aesthetic Solutions). By combining these procedures, the aforementioned treatment gap can be addressed. The RF microneedling allows for subdermal adipose remodeling and skin tightening. Addition of bipolar RF also tightens the skin by contraction of the underlaying fibroseptal network in addition to induction of neocollagenesis, elastogenesis, and angiogenesis at skin surface temperatures of 40° to 50°C. In our experience, these technologies have been effective and safe in these patient populations.