Upper face rejuvenation using botulinum toxin and hyaluronic acid fillers.

The demand for facial rejuvenation is increasing, with each passing day, in all age groups. A number of procedures like chemical peels, microdermabrasion, laser and light therapies, and minimally invasive procedures like botulinum toxin injections (BTX A) and hyaluronic acid (HA) fillers are being extensively used by the dermatologist and plastic surgeons to meet this growing demand. A good knowledge of use of these techniques is becoming imperative for the dermatologist. In the present article, we discuss in detail the use of botulinum toxin injections and hyaluronic acid fillers for rejuvenation of upper face. Special emphasis has been placed on the complications associated with treatment of each area and on how to manage the same.

Long pulsed Nd: YAG laser with inbuilt cool sapphire tip for long term hair reduction on type- IV and V skin: A prospective analysis of 200 patients.

Background: Laser hair reduction has become a very popular means to get rid of unwanted hair. Aims: We conducted the current study to evaluate the safety and efficacy of Nd: YAG laser on dark skin. We also evaluated the effect of increasing the gap between sessions on the long term efficacy of hair reduction achieved with long pulsed Nd: YAG laser. Methods: A prospective study was conducted on 200 consecutive female patients who underwent laser hair reduction for unwanted hair over the face, at Kaya skin clinic Delhi, with long pulsed Nd: YAG laser, from May 2006 to May 2009. The gap between sessions was increased from 2 nd session itself. Results were evaluated 6 months after 6 sessions. Also a note was made of worsening of hair growth or any side effects experienced the patient during any of the sessions. Results: A total of 200 female patients (160 skin type IV and 40 skin type V) were followed up. Of these, 64 enrolled for lower face, 88 for chin or upper neck and 48 for upper lip. 6 months after 6 sessions, more than 50% improvement was seen in 68.7% of lower face, 89.69% cases of chin and 59% of upper lip cases. None of the patients had any worsening. Conclusions: The current study shows that long pulsed Nd: YAG is a very safe and effective means of hair reduction in skin types IV and V. Adequate fluences and increasing the gap between sessions from the 2 nd session could be the key to achieving long term hair reduction with Nd: YAG laser. Adequate cooling and proper shaving are the key factors determining the safety.