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Dublin LIft IMCAS

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It concludes that although fractionalised CO2 laser resurfacing is recognised as the gold standard procedure for tissue that has lost its elasticityit has adverse risks and does not adequately address …

It concludes that although fractionalised CO2 laser resurfacing is recognised as the gold standard procedure for tissue that has lost its elasticityit has adverse risks and does not adequately address the problems associated with chronological aging. He addresses the requirement to apply adjunct methods such as plasma rich platelets to address nasolabial or marionette lines and volume deficits resulting from the loss and repositioning of facial fat. It establishes the benefit of using other facial rejuvenating therapies including microneedling, PRP growth factors, 633 nm light to limit the depth of laser penetration and decrease the risk of scarring and permanent pigmentary alteration. The novel technique is called the DUBLiN facelift as an acronym of the procedures involved: Dermaroller, UltraPulse laser, Blood growth factors, Light (near-red 633 nm), and Neurotoxin.

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  • 1. MultiproceduralSynchronousFacial Rejuvenation Introducing the DUBLiN method Dr. Patrick J. Treacy Medical Director Ailesbury Clinics Ltd
  • 2. PIGMENTATION THREAD VEINSSKIN CANCER Title PHOTOAGEING FINE RYTHIDS SALLOW SKIN COARSE COARSE RHYTIDS RHYTIDS
  • 3. SKIN LAXITY SKIN LAXITY EPIPHORAWRINKLESWRINKLES Title CHRONO AGEING FAT FAT PROTRUSION PROTRUSION ECTROPION ENTROPION
  • 4. Treating Facial AgeingA great variety of stand alone facialrejuvenation treatments are presentlyavailable includingBotox©,Dermaroller©,RioBlush©,Radiofrequency DevicesSyneron Polaris©RF, Thermage©InfraRed Titan©, CO2 fractionalisedresurfacing AFX© SmartXide© FraxelRepair©,
  • 5. SKIN LAXITY PIGMENTATIONWRINKLES Title COLLAGEN FAT PROTRUSION TEAR TROUGH WRINKLES
  • 6. PIGMENTATION PIGMENTATION FINE RHYTIDS Positive FAT FAT PROTRUSIONPROTRUSION Title CO2 COARSE COARSE RYTHIDS RYTHIDS FRSL SALLOW SKIN THREAD VEINS THREAD VEINS
  • 7. Patient CM 2 passes under R eye with obvious reduction in rhytides and neocollogenesis
  • 8. Volume loss Volume loss Cheek Augmentation NegativeMarionetteMarionette Lines Lines Title CO2 FRSL Nasolabial Nasolabial Lines Lines Eyebrow Height Youthful Look Youthful Look
  • 9. BotoxCO2 Laser Although, many feel that ultrapulsed fractionalised CO2 laser skin resurfacing is the best treatment option for photo aged facial skin, could we improve on this modality. Fibroblast Stimulation New Collagen
  • 10. The DUBLiN method uses differentmethods and technologies in orderto activate fibroblasts and directthem towards neocollogenesis. Italso uses low level pulsed lasers toreduce skin laxity, accelerate growthfactors and cause tightening.
  • 11. The DUBLiN method incorporates D Dermaroller U Ultrapulse Laser B Blood Factors Li Light – 633nm N Neurotoxin
  • 12. Induction of FIBROBLASTSA fibroblast is a type of cell thatsynthesizes the extracellular matrixand collagen, the structuralframework (stroma) for animaltissues, and plays a critical role inwound healing. Fibroblasts are themost common cells of connectivetissue in animals.
  • 13. Comparative study over three months• Over 3 months, 15 patients (Group 1) received FLSR at normal settings• Results were compared to 29 patients (Group 2) received low energy FLRS + adjunctive treatments• Both group received BTXA one week prior to other treatments
  • 14. Group 2 received a 3-phase combination multi-rejuvenation technique over 3 weeks.• Phase I included Dysport® at dilution 3.5:1 in 3 areas• Phase 2 introduced intense fibroblast stimulation and modification through microneedling, PRP growth factor induction and near-red phototherapy.• Phase 3 included low–level (CO2) Ultrapulse laser with settings (Energy) 100 mJ (Rate) 14w CPG 3/5/2 and adjunct near-red 633nm phototherapy.
  • 15. PHASE 2 multi-combination technique PRP Growth Factor Signals Fibroblast Title Generation Dermaroller Dermaroller Near Red Light 633 Near Red Light 633
  • 16. PHASE 2a fibroblast activation PRP Growth Factor Signals Fibroblast Title Activation Dermaroller Dermaroller Near Red Light 633 Near Red Light 633
  • 17. PHASE 2b fibroblast stimulation PRP Growth Factor Signals Fibroblast Title Stimulation Dermaroller Dermaroller Near Red Light 633 Near Red Light 633
  • 18. DERMAROLLER
  • 19. BLOOD FACTORS Platelet Derived GFConnective Tissue GFKeratinocyte GF Title COLLAGEN Transforming GF-B Fibroblast GF Vascular Endothelial GF
  • 20. GROWTH FACTORSThe efficacy of certain growthfactors in forming collagen andhealing various injuries is thetheoretical basis for the use of PRPin tissue repair. The plateletscollected in PRP are activated bythe addition of thrombin and calciumchloride. This induces the release ofthese factors from alpha granules
  • 21. LiGHT 633nmMigrating cells exert forcesagainst the substrate tomove forward. These forcesare part of the contractionphase of migration in whichthe rear of the cell isdetached from the substrateand the body of the cell ismoved forward.
  • 22. PHASE 2 Co2 Laser Collagen Title Synthesis Post NTa Post NTa Near Red Light 633 Near Red Light 633
  • 23. ULTRALASE LASERLaser specialists non-sequentialfractionalised CO2 laser ablationis the most effective modality forrepairing photo damaged skinThe benefits are more precisecontrol of ablation depth, fasterrecovery time and reduced risk ofpost procedural problems
  • 24. WSRS = Wrinkle Severity Rating Scale5 Extreme Extremely deep and long folds, detrimental to facial appearance. 2-4mm Visible V-shaped fold when stretched Unlikely to have satisfactory correction with injectable implant alone.4 Severe Very long and deep folds; prominent facial feature. Less than 2mm visible fold when stretched. Significant improvement is expected from injectable implant. Moderately deep folds.3 Moderate Clear facial feature visible at normal appearance but not when stretched. Excellent correction is expected from injectable implant. Shallow but visible fold with a slight indentation; minor facial feature.2 Mild Implant is expected to produce a slight improvement in appearance.1 Absent No visible fold, continuous skin line.
  • 25. GAIS = Global Aesthetic Improvement Scale5 Very Much Improved Optimal cosmetic result for the implant in this patient.4 Much Improved Marked improvement in appearance but not completely optimal for this patient. A touch-up would slightly improve the result.3 Improved Obvious improvement in appearance from the initial condition, but a touch-up or re-treatment is indicated.2 No Change The appearance is essentially the same as the original condition.1 Worse The appearance is worse than the original condition.
  • 26. DUBLIN Lift Periorbital Area
  • 27. Dover Photoageing Scale
  • 28. Wrinkle Severity Rating Scale % Patient satisfaction BTX
  • 29. Wrinkle Severity Rating Scale % Patient satisfaction PRP
  • 30. www.ailesburyclinic.ie

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