Correction of nasolabial folds wrinkle using intraoral non-ablative Er:YAG laser

Ebrahim, Howyda Mohamed; Gharib, Khaled

doi:10.1080/14764172.2018.1439964

Cited by 9 publications

(16 citation statements)

References 14 publications

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“…Additionally, as the Er:YAG laser wavelength is limited to its very shallow optical penetration depth, it has been hypothesized that instead of having to rely on the pulse sequence heat‐pumping technique, devices with a deeper penetration depth and longer pulse durations may represent a more suitable means for deep thermal remodeling [ 58 ]. However, the published clinical results using the smooth‐resurfacing technique [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], suggest that the superficial heat shocking resulting from individual short laser pulses within a SMOOTH sequence may represent an additional, indirect mechanism of action for regenerating epithelial and deeper‐lying connective tissues [ 36 , 37 , 38 , 39 , 40 , 41 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ], which is complementary to the conventional direct slow stimulation of fibroblasts [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

“…More recently, however, excellent clinical results have been reported for procedures using “SMOOTH” mode Er:YAG laser pulse sequences, characterized by moderate cumulative fluences that are not only below the ablation threshold but also below the patient′s pain threshold [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. The SMOOTH mode Er:YAG laser energy has been found to induce changes in the deeper skin or mucosa, initiating a process of cell activation, production of extracellular matrix, and tissue remodeling, without causing unwanted direct epithelial ablation [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

“…The SMOOTH mode Er:YAG laser energy has been found to induce changes in the deeper skin or mucosa, initiating a process of cell activation, production of extracellular matrix, and tissue remodeling, without causing unwanted direct epithelial ablation [ 33 ]. The SMOOTH mode Er:YAG lasers have been, for example, very successfully used for non‐ablative laser treatment of vaginal [ 21 , 22 , 23 , 24 , 25 , 26 ] and oral tissues [ 27 , 28 , 29 , 30 , 31 , 32 ], and as well for skin tightening [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Non‐Ablative Resurfacing of Soft Tissues by Repetitive Er:YAG Laser Pulse Irradiation

Lukač

Zorman²,

Lukač

et al. 2021

Lasers Surg Med

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Background and Objectives Recently, several minimally invasive gynecological, ENT and esthetic procedures have been introduced that are based on delivering “smooth” sequences of Er:YAG laser pulses to cutaneous or mucosal tissue at moderate cumulative fluences that are not only below the ablation threshold but typically also do not require local anesthesia. To explain the observed clinical results using “smooth‐resurfacing,” it has been suggested that in addition to the direct heat injury to deeper‐lying connective tissues, there is an additional mechanism based on indirect triggering of tissue regeneration through short‐exposure, intense heat shocking of epithelia. The goal of this study is to improve understanding of the complex dynamics of the exposure of tissues to a series of short Er:YAG laser pulses, during which the thermal exposure times transition from extremely short to long durations. Study Design/Materials and Methods A physical model of laser‐tissue interaction was used to calculate the temperature evolution at the irradiated surface and deeper within the tissue, in combination with a chemical model of tissue response based on the recently introduced variable heat shock (VHS) model, which assumes that the tissue damage represents a combined effect of two limiting Arrhenius′ processes, defining cell viability at extremely long and short exposure times. Superficial tissue temperature evolution was measured during smooth‐resurfacing of cutaneous and mucosal tissue, and compared with the model. Two modalities of non‐ablative resurfacing were explored: a standard “sub‐resurfacing” modality with cumulative fluences near the ablation threshold, and the “smooth‐resurfacing” modality with fluences below the patient′s pain threshold. An exemplary skin tightening clinical situation was explored by measuring pain tolerance threshold fluences for treatments on abdominal skin with and without topical anesthesia. The obtained temperature data and pain thresholds were then used to study the influence of Er:YAG laser sequence parameters on the superficial (triggering) and deep (coagulative) tissue response. Results The simulations show that for the sub‐resurfacing modality, the parameter range where no excessive damage to the tissue will occur is very narrow. On the other hand, using pain tolerance as an indicator, the smooth‐resurfacing treatments can be performed more safely and without sacrificing the treatment efficacy. Two preferred smooth‐resurfacing treatment modalities were identified. One involves using optimally long pulse sequence durations (≈1–3 seconds) with an optimal number of pulses ( N ≈ 10–30), resulting in a maximal short‐exposure superficial tissue response and moderate coagulation depths. And for deeper coagulation, without significant superficial heat shocking, very long pulse sequences (>5 seconds) with a large number of delivered pulses are to be used in combination with topical anesthesia...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of Non‐Ablative Resurfacing of Soft Tissues by Repetitive Er:YAG Laser Pulse Irradiation

Lukač

Zorman²,

Lukač

et al. 2021

Lasers Surg Med

View full text Add to dashboard Cite

show abstract

“…It was also recently found effective in treating nasolabial folds (NLFs) with an intraoral approach [8][9][10]13]. The efficacy of the intraoral fractional Er:YAG SMOOTH™ mode in rejuvenation of NLFs has been investigated in a few non-comparative studies with promising results [16][17][18]. A prospective randomized split-face comparative pilot study investigated the safety and efficacy of the intraoral approach of Er:YAG laser SMOOTH™ mode and an extraoral approach in the rejuvenation of NLFs (4 J/cm 2 , five sessions with 4-week interval).…”

Section: Discussionmentioning

confidence: 99%

“…The positive results of this laser on vaginal mucosal tissue have subsequently led to its intraoral use for the treatment of nasolabial folds (NLFs) and wrinkles. Oral and maxillofacial surgeons have also noticed improvement of perioral and facial rhytides on repeated usage of intraoral Er:YAG laser [14][15][16][17][18]. Additionally, a recent study presented a treatment option using non-ablative Er:YAG SMOOTH™ mode with a trans-conjunctival approach to tighten the periorbital skin below the eye, resulting in wrinkle and eye bag improvement [19].…”

Section: Introductionmentioning

confidence: 99%

Periocular rejuvenation using a unique non-ablative long-pulse 2940 nm Er:YAG laser

Badawi

Sobeih

Jasmina³

2021

Lasers Med Sci

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The periocular region is challenging for cosmetic laser surgeons. Surgery and laser resurfacing have traditionally been used to correct periorbital lines and wrinkles. Although effective, the associated downtime with these methods has made many people reluctant to decide for such treatments. More recently, the non-ablative long-pulse 2940 nm Er:YAG laser is being used to improve the structure and function and hence the appearance of skin in the periorbital region. The objective of this study is to evaluate the safety and efficacy of long-pulse 2940 nm Er:YAG laser for non-ablative treatment of periorbital static wrinkles and skin laxity. This is a prospective analysis of 30 patients treated for periorbital rejuvenation using three sessions of non-ablative long-pulse Er:YAG laser over a 3-month period. All patients were assessed according to Fitzpatrick’s classification of periorbital wrinkles to class I, II, or III and were treated with 2940 nm Er:YAG laser using a fluence of 3.75 J/cm2, a repetition rate of 1.7–2 Hz, and with the SMOOTH™ pulse mode (250 ms). The treatment sessions were performed on each patient, 4 weeks apart. Patient improvement was assessed before each laser session as well as at 12 months after the final treatment. Blind photographic evaluations were performed by three independent physicians using unlabeled before and after photos arranged in non-chronological order. Reviewers were asked to determine the before and after photos. Patients were asked to answer a questionnaire measuring satisfaction 4 weeks after each session, and to report any adverse reactions. There was statistically and clinically significant improvement in the Fitzpatrick classification of the periorbital wrinkles. Blinded evaluators correctly identified the before and after photos in all cases. All patients reported mild edema and erythema, which persisted for 1 to 2 days, and superficial peeling of the skin for 4 to 6 days after each laser treatment. No long-term adverse effects were reported. The non-ablative long-pulse 2940 nm Er:YAG laser seems to be a safe and effective treatment for periocular rejuvenation with minimal and tolerable adverse reaction. The improvement attained from the laser sessions was persisting after 1 year denoting the long-term efficacy of the procedure.

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Preparation and application of iron oxide/persimmon tannin/ graphene oxide nanocomposites for efficient adsorption of erbium from aqueous solution

Gao

Wang

Qin

et al. 2020

Journal of Rare Earths

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Correction of nasolabial folds wrinkle using intraoral non-ablative Er:YAG laser

Cited by 9 publications

References 14 publications

Characteristics of Non‐Ablative Resurfacing of Soft Tissues by Repetitive Er:YAG Laser Pulse Irradiation

Characteristics of Non‐Ablative Resurfacing of Soft Tissues by Repetitive Er:YAG Laser Pulse Irradiation

Periocular rejuvenation using a unique non-ablative long-pulse 2940 nm Er:YAG laser

Preparation and application of iron oxide/persimmon tannin/ graphene oxide nanocomposites for efficient adsorption of erbium from aqueous solution

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