MIAMI BEACH – Sublative skin rejuvenation is a resurfacing technology that seeks to provide the best of both worlds – efficacy closer to more intensive ablative procedures and an adverse event profile more akin to gentler, nonablative techniques.
Sublative rejuvenation can be performed on the full face, with good results around the eyes and the neck, Dr. Robert A. Weiss said at the symposium.
Dr. Robert A. Weiss
"We've gotten some very nice skin contraction and smoothing in the periorbital area," he said.
The fractional radiofrequency eMatrix system (Syneron) offers deep volumetric heating into the dermis with minimal epidermal disruption, said Dr. Weiss, director of the Maryland Laser, Skin, and Vein Institute in Hunt Valley. Subsequent dermal remodeling with minimal downtime are other advantages of this treatment.
The Food and Drug Administration cleared marketing of the applicator for use in dermatologic procedures requiring ablation of soft tissue and skin resurfacing.
The device tip is a grid of negatively- and positively-charged electrodes between which bipolar radiofrequency energy flows. The current can be controlled and varied depending on individual patient factors. Because this is a fractional technology, intact tissue is left between the electrode pins to speed healing and recovery.
The standard protocol is three to four treatment sessions spaced 4-6 weeks apart. Touch-up sessions, as indicated, are generally every 6 months or so.
The full face can be treated in 20 minutes, said Dr. Weiss, also of the department of dermatology at Johns Hopkins University, Baltimore. Improvements in acne scarring and wrinkles can be observed as well.
Ask patients to return 2-3 days after treatment to check for any adverse events, he said. Postoperative discomfort, significant pain, erythema, edema, and pigmentary changes can arise in the short or long term. Patient discomfort is usually tolerable and can be managed with topical anesthetics.
Postprocedure redness with nonablative techniques typically lasts a few hours to 1-2 days; with ablative procedures, 5-7 days (and sometimes up to 10 days); and with sublative treatment, a patient will have red dots on their skin and redness that lasts for a day or 2, Dr. Weiss said. "So it's really somewhere in the middle between ablative and nonablative."
Contraindications include any facelift or eyelid surgery 1 year prior to sublative resurfacing; injections of botulinum toxin, collagen, or fat (or any biomaterial augmentation) within the last 6 months; and any facial dermabrasion, resurfacing, or deep chemical peeling within the last 3 months.
Treat a hidden test spot to gauge individual response prior to full treatment, Dr. Weiss recommended. Gauge response after 24-48 hours for skin types I-III and 5-7 days for skin types IV-VI to ensure safety.
Cold packs or Synercool (Syneron) can be used immediately after treatment to cool the area if patients are uncomfortable. Advise patients to apply emollient cream and to use at least 30 SPF or greater sunscreen for at least a month.
"It's a promising technology, and I think we will know more a year from now," Dr. Weiss said.
He is a researcher for Syneron and received some initial free use of equipment.