Efficacy and Tolerability of a Procedure Enhancement System with TriHex Technology®as a Pre- and Post-Radiofrequency Microneedling Regimen.

Postoperative recovery is an important consideration for patients planning dermal rejuvenation procedures. A topical procedure enhancement system (PES) containing a tripeptide and hexapeptide (TriHex Technology®; Alastin Skincare®, Carlsbad, CA) hastens recovery from facial rejuvenation procedures, such as laser resurfacing. We assessed the efficacy and tolerability of the PES compared to a standard-of-care antioxidant regimen for improving recovery following three monthly facial radiofrequency (RF) microneedling treatments. Assessments included grading pre- and posttreatment digital images by two blinded physicians and a subject satisfaction questionnaire. Digital images revealed significantly less post-RF erythema following the introduction of the PES in a crossover study. Similarly, the side treated with the PES in a split-face study demonstrated significantly less post-RF erythema than the antioxidant regimen. Participants expressed preference for the PES. Expected adverse effects included immediate, posttreatment erythema, edema, and burning/stinging. Other adverse effects included acneiform eruptions in patients treated with the antioxidant regimen (n = 2) and the PES regimen (n = 1) and mild dermatitis in another PES-treated patient. A topical PES containing a tripeptide and hexapeptide appears to be a safer and effective regimen for reducing posttreatment erythema and accelerates recovery following RF microneedling.

Patient satisfaction and our clinical experience with 459 microfocused ultrasound treatments.

PURPOSE: Microfocused ultrasound (MFUS) is a safe and effective method for noninvasive skin tightening. Previous clinical studies demonstrate a 60-100% patient satisfaction after MFUS. We used an anonymous online platform after MFUS to assess patient satisfaction. DESIGN: Patients treated with MFUS between January 2013 and 2016 were invited to complete an anonymous online survey at least 4 months post-treatment. Patients were asked to rate improvement in skin tightening as none (0%), mild (0-25%), moderate (26-50%), significant (51-75%), or dramatic (76-100%) and treatment satisfaction as disappointed, neutral, satisfied, or extremely satisfied. SUMMARY: Between January 2013 and 2016, 253 patients received 459 MFUS treatments at our center. A total of 83 surveys were received with data. Nearly 80% of responders reported at least mild improvement, with 14.5% indicating significant improvement, 27.7% indicating moderate, 37.3% indicating mild, and 20.5% indicating none. In addition, 53.1% of responders reported being satisfied or extremely satisfied with the results. 44.6% of responders did not feel treatment results met expectations. CONCLUSION: Patient satisfaction with elective cosmetic procedures is an important indicator of success. Our current study demonstrates a high response rate, with almost 80% of responders indicating at least mild tightening with MFUS treatment. Interestingly, only 53.1% of patients reported satisfaction after treatment, a lower satisfaction rate than reported in previous non-anonymous studies and lower than patients report in our office follow-up appointments. This discrepancy may be due to gratitude bias. Anonymous surveys likely provide a more accurate assessment of patients' perceptions and will improve physician's future counseling efforts. Lasers Surg. Med. 51:495-499, 2019. © 2019 Wiley Periodicals, Inc.

A Comparative Split-Face Trial of Plant-Based Hypoallergenic Ointment vs Petroleum-Based Ointment Following Fractionated Carbon Dioxide Laser Resurfacing of the Face

Purpose: Fractionated carbon dioxide (CO2) laser resurfacing uses fractional photothermolysis with an ablative 10,600-nm wavelength for treatment of rhytides and photodamage. Although associated with reduced side effect profile from traditional ablative lasers, fractionated lasers can lead to significant erythema, edema, crusting, and exudation for 14 days. Post-care includes regular distilled water soaks and healing ointment. This study evaluated efficacy and patient satisfaction of a novel plant-based hypoallergenic ointment (Doctor Rogers RESTORE®Healing Balm; Product 1) compared to petroleum-based lanolin-containing ointment (Aquaphor® Healing Ointment; Product 2) to accelerate wound healing post-laser resurfacing of the face. Design: This was a single-center, prospective randomized, double-blinded, split-face comparative study of 10 subjects with photo-aging and rhytids who received treatment with fractionated CO2 laser between September 2017 and January 2018. Product 1 and Product 2 were randomized to each half of the face and applied from days 0 to 7 with an option to continue to day 14. The primary outcome measures were Investigator-rated degree of erythema, edema, crusting, exudation, and percentage healing, with follow-up evaluations performed at days 2, 4, 7, 14, and 30. The secondary outcome measure was patient satisfaction. Summary: Based on investigator post-resurfacing scores, day 4 showed improved erythema (50%), edema (50%), crusting (40%), and percentage healing (60%) on the Product 1-treated side compared to Product 2, with the majority of remaining patients scoring the same as Product 2. On day 14, Product 1 demonstrated improvement in erythema (50%), edema (30%), and percentage healing (30%) compared to Product 2, with all remaining patients scoring the same as Product 2. Crusting was the same between the two products on day 14. Ninety percent of patients preferred Product 1 over Product 2, found it easier to use, and were more likely to use it in the future. Conclusion: Product 1 is a plant-based hypoallergenic ointment that is safe and effective post-laser treatment and is associated with high patient satisfaction and preference.

Self-reported Patient Motivations for Seeking Cosmetic Procedures.

Importance: Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood. Objective: To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. Design, Setting, and Participants: This prospective, multicenter observational study was performed at 2 academic and 11 private dermatology practice sites that represented all US geographic regions. Adult patients presenting for cosmetic consultation or treatment from December 4, 2016, through August 9, 2017, were eligible for participation. Exposures: Participants completed a survey instrument based on a recently developed subjective framework of motivations and a demographic questionnaire. Main Outcomes and Measures: Primary outcomes were the self-reported most common motivations in each quality-of-life category. Secondary outcomes were other frequently reported motivations and those associated with specific procedures. Results: Of 529 eligible patients, 511 agreed to participate, were enrolled, and completed the survey. Typical respondents were female (440 [86.1%]), 45 years or older (286 [56.0%]), white (386 [75.5%]), and college educated (469 [91.8%]) and had previously received at least 2 cosmetic procedures (270 [52.8%]). Apart from motivations pertaining to aesthetic appearance, including the desire for beautiful skin and a youthful, attractive appearance, motives related to physical health, such as preventing worsening of condition or symptoms (253 of 475 [53.3%]), and psychosocial well-being, such as the desire to feel happier and more confident or improve total quality of life (314 of 467 [67.2%]), treat oneself or celebrate (284 of 463 [61.3%]), and look good professionally (261 of 476 [54.8%]) were commonly reported. Motivations related to cost and convenience were rated as less important (68 of 483 [14.1%]). Most motivations were internally generated, designed to please the patients and not others, with patients making the decision to undergo cosmetic procedures themselves and spouses seldom being influential. Patients younger than 45 years were more likely to undertake procedures to prevent aging (54 of 212 [25.5%] vs 42 of 286 [14.7%] among patients ≥45 years; P < .001). Patients seeking certain procedures, such as body contouring (19 of 22 [86.4%]), acne scar treatment (36 of 42 [85.7%]), and tattoo removal (8 of 11 [72.7%]), were more likely to report psychological and emotional motivations. Conclusions and Relevance: This initial prospective, multicenter study comprehensively assessed why patients seek minimally invasive cosmetic procedures. Common reasons included emotional, psychological, and practical motivations in addition to the desire to enhance physical appearance. Differences relative to patient age and procedures sought may need further exploration.