The synergy between lasers and adipose tissues surgery in cervicofacial rejuvenation: histopathological aspects.

BACKGROUND AND AIMS: Nowadays patients want a long-lasting youthful appearance but through a less invasive approach. Our unique approach, "AdipoLASER reJuvenation (ALJ)", involves a variety of less invasive techniques based on simultaneous laser resurfacing, and lipolysis together with adipose tissue graft and redistribution. Recently, we added to this platelet-rich plasma therapy. We conducted a study aiming to emphasize the histopathological changes occurred following these procedures. PATIENTS AND METHODS: Between 2011-2012, we included 50 patients that were preparing for abdominoplasty (tummy tuck) in which we applied ALJ procedures, in two comparative zones of inferior abdomen. Histological examination varied from 10 days to four months, according to the time of the abdominoplasty. RESULTS: There was a notable histological difference between stimulated and non-stimulated fat graft regarding adipose cells structure and number, neocollagenesis, and dermal matrix remodeling. CONCLUSIONS: The low level laser therapy effect (LLLT) of the fractional CO2 laser combined with the effect of the growth factors derived from activated platelets (PRP) prolonged the life and improved the take of the facial fat graft, increase collagen formation and lead to a better remodeling of the dermal matrix. This unique surgical combination of all four approaches in our ALJ with additional PRP offers a real less invasive but strongly visible - yet natural result - as an alternative to the classic facelift.

The sinergy between lasers and adipose surgery in face and neck rejuvenation: a new approach from personal experience.

BACKGROUND AND AIMS: Patients now want a long-lasting youthful appearance but with a minimally-invasive approach. Our unique approach, "AdipoLASER reJuvenation (ALJ)", involves a variety of minimally-invasive laser- and lipolysis-based techniques, and the present study assessed the impact of this ALJ approach. SUBJECTS AND METHODS: From 2008 - 2011, we prospectively enrolled 221 patients into the study. 71 of them, underwent the ALJ approach: 2 reductive techniques via microliposuction and laser-assisted lipolysis (LAL); and 2 regenerative techniques via autologous fat graft and fractional CO2 laser resurfacing. The remaining 150 patients underwent only 1 or 2 of these techniques. Patients were monitored through 1 to 18 months, clinical photography was taken and histological assessments were performed. RESULTS: ignificantly better and long-lasting results were obtained for the complete ALJ approach regarding all aspects of the face, mandible and neck compared with controls. The combination of the regenerative and the reductive approaches delivered on excellent balance, restoring a youthful, natural appearance to the face. CONCLUSIONS: The fractional CO2 laser has both a photodestructive, or HLLT, effect and an LLLT component in the beam periphery. This LLLT effect possibly prolonged the life and improved the take of the fat grafts, with the well-documented HLLT effect inducing swift collagenesis and better remodeling of the dermal matrix. A natural look in depressed areas was thus restored with the combination of fat redistribution and the HLLT/LLLT effect. Microlipolysis and laser-assisted lipolysis (LAL) could at the same time remove those areas of redundant and prolapsed fat while countering skin laxity, and address both jowl formation and submental flaccidity. The unique combination of all four approaches in our "AdipoLASER reJuvenation" proved to be superior to any other lesser approach in both the long- and short term with very little patient downtime, but did not present much more in terms of treatment time and cost to the patient. We believe that the ALJ approach offers a real minimally-invasive alternative to the classic surgical facelift.