No-incision dual-laser facelift a viable option for properly chosen patients


Preliminary results from a prospective study indicate that a no-incision, dual-laser facelift procedure can be a viable option for properly chosen patients interested in a minimally invasive alternative to a traditional surgical facelift.

Dr. Nease

The procedure combines laser lipolysis of the lower face and neck with fractional CO2 laser resurfacing and was developed by Carey Nease, M.D., to satisfy patient demands for a procedure that would provide good cosmetic results with less downtime than a traditional facelift and no visible scars. Dr. Nease is a fellowship-trained, board-certified cosmetic surgeon in private practice with offices in Chattanooga, Tenn., and Calhoun, Ga.

“Dr. Nease was looking to meet the needs of patients who did not want a traditional facelift either because of the downtime, the cost, or because they were not emotionally or clinically ready for it,” says Vincent Gardner, M.D., who conducted the research as a cosmetic surgery fellow. The fellowship training program is approved by the American Academy of Cosmetic Surgery (AACS) and is under the direction of Dr. Nease. “Having achieved good outcomes using laser lipolysis to contour the neck and jowls and with the fractional CO2 laser for facial skin resurfacing and tightening, he decided to investigate combining the two technologies.”

PROCEDURE DETAILS The dual-laser facelift is performed using modified tumescent anesthetic solution and light intravenous sedation and is completed in less than 60 minutes. Its efficacy and safety are being evaluated in a study that enrolled 27 nonsmoking patients ages 40 to 55 with Fitzpatrick skin types I-III who had no prior surgical procedures to the neck, jowls or facial skin.

Final data collection was at six months, and at the AACS meeting in January of this year, Dr. Gardner reported results from the first 15 patients that showed that outcomes varied but were generally positive. About two-thirds of patients reported that they felt they looked younger, but only about half thought the procedure met their expectations and said they would recommend it to friends. The remaining patients were split about 2 to 1 between being dissatisfied and neutral, Dr. Gardner says.

Providing an update in a Cosmetic Surgery Times interview a few months after the meeting, however, Dr. Nease says as more patients reached the six-month visit, the overall results improved. Based on follow-up from about 20 patients, three-fourths were satisfied or highly satisfied, he says.

Post-treatment sequelae included some minor bruising and swelling from injection of the tumescent solution. Downtime for the majority of patients was only four to five days, however, and there have been no significant complications, although one dissatisfied patient went on to a traditional facelift prior to six months of follow-up.

PATIENT SELECTION The availability of more patient data is also allowing insight as to who are the best candidates for the dual-laser facelift, Dr. Nease says.

“It appears this procedure is best for women and men in their 40s who have very mild skin laxity with mild jowling and mild-to-moderate excess fat deposits in the neck and submental region. In fact, a significant proportion of such patients we treated felt the procedure made them look five years younger, and several considered themselves looking five to 10 years younger. That is an impressive result for a one-hour procedure with such reasonable downtime,” Dr. Nease says. “However, for older individuals, above 50, who have more skin laxity, the laser treatment itself does not seem to provide sufficient tightening, and these patients were less satisfied with their cosmetic outcome.”

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