Multiprocedural
Synchronous
Facial Rejuvenation
Introducing the DUBLiN method
Dr. Patrick J. Treacy
Medical Director
Ailes...
SKIN CANCER
SALLOW SKIN COARSE
RHYTIDS
FINE
RYTHIDS
THREAD VEINS
PIGMENTATION
TitlePHOTOAGEING
WRINKLES
ECTROPION ENTROPION
FAT
PROTRUSION
EPIPHORA
SKIN LAXITY
TitleCHRONO
AGEING
Treating Facial Ageing
A great variety of stand alone facial
rejuvenation treatments are presently
available including
Bot...
WRINKLES
TEAR TROUGH WRINKLES
FAT
PROTRUSION
PIGMENTATION
SKIN LAXITY
TitleCOLLAGEN
FAT
PROTRUSION
SALLOW SKIN THREAD VEINS
COARSE
RYTHIDS
FINE
RHYTIDS
PIGMENTATION
Title
Positive
CO2
FRSL
Patient CM 2 passes under R eye with obvious reduction in rhytides and neocollogenesis
Marionette
Lines
Eyebrow Height Youthful Look
Nasolabial
Lines
Cheek
Augmentation
Volume loss
Title
Negative
CO2
FRSL
New Collagen
Fibroblast
Stimulation
CO2 Laser
Botox
Although, many feel that
ultrapulsed fractionalised
CO2 laser skin res...
The DUBLiN method uses different
methods and technologies in order
to activate fibroblasts and direct
them towards neocoll...
The DUBLiN method incorporates
D Dermaroller
U Ultrapulse Laser
B Blood Factors
Li Light – 633nm
N Neurotoxin
Induction of FIBROBLASTS
A fibroblast is a type of cell that
synthesizes the extracellular matrix
and collagen, the struct...
Comparative study over three months
• Over 3 months, 15 patients
(Group 1) received FLSR
at normal settings
• Results were...
Group 2 received a 3-phase combination
multi-rejuvenation technique over 3 weeks.
• Phase I included Dysport® at dilution
...
Near Red Light 633
Dermaroller
Title
Fibroblast
Generation
PHASE 2 multi-combination
technique
PRP Growth Factor Signals
Near Red Light 633
Dermaroller
Title
Fibroblast
Activation
PHASE 2a fibroblast activation
PRP Growth Factor Signals
Near Red Light 633
Dermaroller
Title
Fibroblast
Stimulation
PHASE 2b fibroblast stimulation
PRP Growth Factor Signals
DERMAROLLER
Keratinocyte GF
Vascular Endothelial GF
Fibroblast GF
Transforming GF-B
Connective Tissue GF
Platelet Derived GF
TitleCOLL...
GROWTH FACTORS
The efficacy of certain growth
factors in forming collagen and
healing various injuries is the
theoretical ...
LiGHT 633nm
Migrating cells exert forces
against the substrate to
move forward. These forces
are part of the contraction
p...
Near Red Light 633
Post NTa
Title
Collagen
Synthesis
PHASE 2
Co2 Laser
ULTRALASE LASER
Laser specialists non-sequential
fractionalised CO2 laser ablation
is the most effective modality for
repa...
WSRS = Wrinkle Severity Rating Scale
5 Extreme Extremely deep and long folds, detrimental to facial appearance.
2-4mm Visi...
GAIS = Global Aesthetic Improvement Scale
5 Very Much Improved Optimal cosmetic result for the implant in this
patient.
4 ...
DUBLIN Lift Periorbital Area
Dover Photoageing Scale
Wrinkle Severity Rating Scale
% Patient satisfaction
BTX
Wrinkle Severity Rating Scale
% Patient satisfaction
PRP
www.ailesburyclinic.ie
Спасибо!
'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013
'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013
'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013
'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013
'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013
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'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013

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The Multi-synchronous Facial rejuvenation study was done in 3-phases over a period of three weeks. Phase I included Dysport® at dilution 3.5:1 in 3 areas, glabellar, frontalis and periorbital. 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. The study evaluated post procedural aesthetic results at two weeks, four weeks and twelve weeks. The length of downtime, patient discomfort and adverse side effects were noted for each phase.
Clinical assessment of patients in each grouping was made at 2 weeks, I month and 3 months postoperatively in the presence of two aesthetic staff. The degree of improvement in photoageing was based on the degree of re-epithelialization rate, reduction of rhytides, reduction of tactile roughness and loss of hyperpigmentation and telangiectasias. The efficacy of treatment was evaluated using a variation of the five-point scale originally suggested by Dover et al.. Investigators and patients evaluated efficacy using palpability assessments and change from baseline score at 0, 6 and 12 weeks. A total global score was recorded in each patient based on the addition of points obtained from six photodamage variables. The degree of perceived improvement in overall aesthetic effect reflecting chronological age was assessed separately by patients and physicians using the Wrinkle Severity Rating Scale and the Global Aesthetic Improvement Scale. The WSRS is recognised as a valid and reliable instrument for quantitative assessment of facial skin folds, with good inter- and intra-observer consistency]. Wrinkle severity is measured by using a wrinkle severity rating scale with 1 being absent and 5 being extreme. By allowing objective grading of data, these proved useful clinical tools for assessing the effectiveness of facial volumisation with PRP and MN-633.

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'Multi-synchronous Facial rejuvenation' with Dr. Patrick Treacy Moscow 2013

  1. 1. Multiprocedural Synchronous Facial Rejuvenation Introducing the DUBLiN method Dr. Patrick J. Treacy Medical Director Ailesbury Clinics Ltd
  2. 2. SKIN CANCER SALLOW SKIN COARSE RHYTIDS FINE RYTHIDS THREAD VEINS PIGMENTATION TitlePHOTOAGEING
  3. 3. WRINKLES ECTROPION ENTROPION FAT PROTRUSION EPIPHORA SKIN LAXITY TitleCHRONO AGEING
  4. 4. Treating Facial Ageing A great variety of stand alone facial rejuvenation treatments are presently available including Botox©,Dermaroller©, RioBlush©,Radiofrequency Devices Syneron Polaris©RF, Thermage© InfraRed Titan©, CO2 fractionalised resurfacing AFX© SmartXide© Fraxel Repair©,
  5. 5. WRINKLES TEAR TROUGH WRINKLES FAT PROTRUSION PIGMENTATION SKIN LAXITY TitleCOLLAGEN
  6. 6. FAT PROTRUSION SALLOW SKIN THREAD VEINS COARSE RYTHIDS FINE RHYTIDS PIGMENTATION Title Positive CO2 FRSL
  7. 7. Patient CM 2 passes under R eye with obvious reduction in rhytides and neocollogenesis
  8. 8. Marionette Lines Eyebrow Height Youthful Look Nasolabial Lines Cheek Augmentation Volume loss Title Negative CO2 FRSL
  9. 9. New Collagen Fibroblast Stimulation CO2 Laser Botox 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.
  10. 10. The DUBLiN method uses different methods and technologies in order to activate fibroblasts and direct them towards neocollogenesis. It also uses low level pulsed lasers to reduce skin laxity, accelerate growth factors and cause tightening.
  11. 11. The DUBLiN method incorporates D Dermaroller U Ultrapulse Laser B Blood Factors Li Light – 633nm N Neurotoxin
  12. 12. Induction of FIBROBLASTS A fibroblast is a type of cell that synthesizes the extracellular matrix and collagen, the structural framework (stroma) for animal tissues, and plays a critical role in wound healing. Fibroblasts are the most common cells of connective tissue in animals.
  13. 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. 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. 15. Near Red Light 633 Dermaroller Title Fibroblast Generation PHASE 2 multi-combination technique PRP Growth Factor Signals
  16. 16. Near Red Light 633 Dermaroller Title Fibroblast Activation PHASE 2a fibroblast activation PRP Growth Factor Signals
  17. 17. Near Red Light 633 Dermaroller Title Fibroblast Stimulation PHASE 2b fibroblast stimulation PRP Growth Factor Signals
  18. 18. DERMAROLLER
  19. 19. Keratinocyte GF Vascular Endothelial GF Fibroblast GF Transforming GF-B Connective Tissue GF Platelet Derived GF TitleCOLLAGEN BLOOD FACTORS
  20. 20. GROWTH FACTORS The efficacy of certain growth factors in forming collagen and healing various injuries is the theoretical basis for the use of PRP in tissue repair. The platelets collected in PRP are activated by the addition of thrombin and calcium chloride. This induces the release of these factors from alpha granules
  21. 21. LiGHT 633nm Migrating cells exert forces against the substrate to move forward. These forces are part of the contraction phase of migration in which the rear of the cell is detached from the substrate and the body of the cell is moved forward.
  22. 22. Near Red Light 633 Post NTa Title Collagen Synthesis PHASE 2 Co2 Laser
  23. 23. ULTRALASE LASER Laser specialists non-sequential fractionalised CO2 laser ablation is the most effective modality for repairing photo damaged skin The benefits are more precise control of ablation depth, faster recovery time and reduced risk of post procedural problems
  24. 24. WSRS = Wrinkle Severity Rating Scale 5 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. 3 Moderate Moderately deep folds. Clear facial feature visible at normal appearance but not when stretched. Excellent correction is expected from injectable implant. 2 Mild Shallow but visible fold with a slight indentation; minor facial feature. Implant is expected to produce a slight improvement in appearance. 1 Absent No visible fold, continuous skin line.
  25. 25. GAIS = Global Aesthetic Improvement Scale 5 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. 26. DUBLIN Lift Periorbital Area
  27. 27. Dover Photoageing Scale
  28. 28. Wrinkle Severity Rating Scale % Patient satisfaction BTX
  29. 29. Wrinkle Severity Rating Scale % Patient satisfaction PRP
  30. 30. www.ailesburyclinic.ie
  31. 31. Спасибо!

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