Background Facial aging is a process that involves many different changes. Therefore, in many patients, it may be necessary to perform a combined treatment. Botulinum toxin A and dermal fillers are the two most popular nonsurgical cosmetic procedures performed globally to treat age-associated changes. However, there are not many studies reporting the concomitant use of dermal fillers and laser technology for facial rejuvenation. This review aims to assess the concomitant use of dermal hyaluronic acid (HA) fillers and laser technology for facial rejuvenation. Methods The present updated consensus recommendations are based on the experience and opinions of the authors and on a literature search. Results If a combined procedure (HA and light treatments) is to be performed, on the same day, the panel recommends starting always with the light treatments, avoiding skin manipulations after having injected HA. To customize the therapeutic management, it is crucial to establish a precise diagnosis of the photodamage and loss of volumes suffered by the patients. Conclusions The currently available scientific evidence about the combined use of HA fillers and laser–radiofrequency–intense pulsed light (laser/RF/IPL) is limited and encompasses mainly small and nonrandomized studies. Nevertheless, most of these studies found that, on average, the concomitant use (same day) of laser and HA fillers for facial rejuvenation represents an effective and safe strategy which improves clinical results and patient’s satisfaction. Future well-designed clinical studies are needed regarding the effectiveness and safety of combination filler/laser treatments. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Objective Different devices are currently used for treating facial vascular lesions (FVL). This paper presents the aesthetic outcomes using different light‐based and laser devices, including narrow band spectrum intense pulsed‐light dye (NB‐Dye‐VL), Pulsed dye laser (PDL)–neodymium‐doped yttrium‐aluminum‐garnet (Nd:YAG) dual‐therapy, and either PDL or LP Nd:YAG for treating FVL in a clinical setting. Methods A retrospective and single‐center study conducted on subjects ≥18 years with FVL. Patients underwent treatment with either PDL + LP Nd:YAG dual‐therapy, NB‐Dye‐VL, PDL, or LP Nd:YAG, according to the patient and lesion characteristics. The primary outcome was the weighted degree of satisfaction. Results The cohort consisted of fourteen patients, nine women (64.3%) and five men (35.7%). The most prevalent FVL types treated were rosacea (28.6%; 4/14) and spider hemangioma (21.4%; 3/14). Seven patients underwent PDL + Nd:YAG (50.0%), three were treated with NB‐Dye‐VL (21.4%), and PDL or LP Nd:YAG was performed in two patients each (14.3%). Eleven patients rated their treatment outcome as excellent (78.6%), and three as very good (21.4%). Practitioners 1 and 2 classified treatment results as excellent in eight cases (57.1%) each. No serious or permanent adverse events were reported. Two (14.3%) patients, one treated with PDL and the other with PDL + LP Nd:YAG dual‐therapy, had post‐treatment purpura, which was successfully resolved with topical treatment after 5 and 7 days, respectively. Conclusions NB‐Dye‐VL and the PDL + LP Nd:YAG dual‐therapy devices achieve excellent aesthetic outcomes for treating a wide range of FVL.
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