A revision and summary of injectable fillers

Tin Hau Sky Wong 대한미용의학회 2020 대한미용의학회지 Vol.4 No.1

Background: Injectable fillers are common and useful tools in aesthetic medicine for reconditioning, restoring, or recontouring the quality and structure of the corresponding skin and body parts. Various choices with different properties are available, each unique and with its own advantages and disadvantages, which result in diverse indications and applications. Moreover, improper use of fillers also leads to complications and drawbacks. Awareness of the risks and management of the adverse effects are important and brief ideas of those injectables are essential. Objective: This article provides a brief revision and summary of the common injectable fillers in terms of properties, functions, complications, and management. Methods: Peer-reviewed articles published from 1984 to 2017 were identified from PubMed and Google Scholar, and qualitatively reviewed with respect to concurrent common injectable materials. Results and conclusion: Knowledge of different injectables are important for proper application in different indications and safety of use. This article gives a brief revision.

Solar lentigines and ephelides removal in Asians using a combination of a novel 670 nm picosecond and 1,064 nm laser

Wong Tin Hau Sky 대한미용의학회 2021 대한미용의학회지 Vol.5 No.1

Background: Picosecond (PS) lasers have evolved over the years, and several new wavelengths have been adopted for more efficient and safe treatment of various skin conditions. We specifically studied the 670 nm wavelength for its high melanin-hemoglobin ratio, effectiveness, and safety in laser-unfriendly Asian skin. Objective: This study evaluated the effectiveness, safety, and patient satisfaction following treatment of solar lentigines and ephelides with a combination of a novel 670 nm PS and 1,064 nm wavelength laser in a series of Asian patients. Methods: This retrospective study evaluated 30 patients who underwent treatment for solar lentigines and ephelides. A PS laser of wavelength 670 nm and 660 PS pulse width was adopted at a spot size of 2.0–3.5 mm, fluence of 0.7–0.8 J/cm2, and repetition of 2.0–3.3 Hz. Treatment intervals ranged from 3–5 weeks for a total of 3–6 sessions. Skin pigmentations in the patients were documented with a high-resolution camera and the results were assessed by physicians. In addition, patient satisfaction was evaluated. Results: Thirty patients (27 females, 3 males), aged 21–66 years, with Fitzpatrick skin type III or IV were treated and evaluated. It was observed that 100% of the patients achieved at least good results (>50% improvement), 80% achieved good results (>75% improvement), and 40% achieved clinical clearance (>90% improvement). The average downtime with mild redness was 2–3 days and transient darkening of pigmentation (crème brulee reaction) was observed for 5–7 days. Higher-contrast lesions demonstrated better responses. The post-inflammatory hyper- and hypopigmentation rates were 3.3% and 6.67%, respectively. Conclusion: PS laser is effective for the treatment of solar lentigines and ephelides. The 670 nm wavelength is beneficial in improving the efficacy and safety of the PS laser treatment, which is especially important in Asian skin that is prone to laser complications.

Clinical responses of subcutaneous abdominal fat and rectus abdominis muscle thicknesses following treatment with a high-intensity focused electromagnetic field device

Tin-Hau Wong 대한미용의학회 2022 대한미용의학회지 Vol.6 No.1

Background: High-intensity focused electromagnetic waves (HIFEM) can achieve optimal body contours by training muscle mass, strength, and toning, as well as fat reduction. Objective: This study aimed to define the effect of HIFEM devices on muscle training and subcutaneous fat reduction. Methods: This is the first-time report of a clinical case series by using a modified protocol. The study was a single-centre evaluation in Hong Kong, China, involving 13 participants, of whom nine were female. Each subject underwent six treatments, 1-2 times a week for 3–6 weeks, and each treatment session lasted for 60 minutes. Body contours were recorded using 2D and 3D high-resolution images. Ultrasonography was performed for standardized areas in each participant. The above assessments were performed at the first and last treatment visits, and then at the 1- and 3-month follow-up visits. Data were quantified and compared. The main outcomes were percentage improvement, satisfaction levels, and adverse events. Results: A significant improvement in muscle thickness of the rectus abdominis with a corresponding decrease in subcutaneous fat thickness was demonstrated in the subjects. The mean decrease of subcutaneous fat was 0.31 cm (19.9%), 0.40 cm (25.6%), and 0.53 cm (34.0%) at the last visit, 1 month after the treatment, and 3 months after the treatment, respectively (p=0.017, p=0.014, and p<0.001, respectively). The rectus abdominis demonstrated a mean increase of 0.29 cm (27.8%), 0.28 cm (26.2%), and 0.28 cm (26.2%) at the last visit, 1 month after the treatment, and 3 months after the treatment, respectively (p=0.001, p=0.006, and p<0.001, respectively). No significant discomfort was reported by the subjects, and 100% of the subjects were satisfied with their results. Conclusion: HIFEM is an effective method for training the rectus abdominis and reducing fat in the abdomen, offering participant satisfaction, comfort, and sustainability.

Picosecond laser treatment for Asian skin pigments: a review

Tin Hau Sky Wong 대한미용의학회 2019 대한미용의학회지 Vol.3 No.2

Picosecond (PS) laser is a novel dermatological laser technology that is useful in treating various cutaneous benign pigmentary disorders (BPDs), including freckles, solar lentigines, melasma, Hori macule, nevus of Ota, post-inflammatory hyperpigmentation, and tattoo. Treating Asian BPDs can be troublesome as Asian skin is typically associated with a high incidence of laser complications, such as burns, hyperpigmentation/hypopigmentation, and textural changes, which can result in various cosmetic and even psychosocial problems. This study aimed to describe the PS laser treatment for common Asian BPDs compared with traditional laser treatments. Peer-reviewed articles published from 1965 to 2018 were identified from PubMed and Google Scholar, and qualitatively reviewed with respect to the treatment of Asian BPDs. PS lasers achieved greater effectiveness and potentially fewer complications in the treatment of Asian BPDs through breakthrough mechanisms including photomechanical effects and laser-induced optical breakdown. PS laser is especially suitable and effective for treating various BPDs in Asian skin.

Laser resurfacing in acne scarring: a review

Lee Cheuk Hung,Lee Kar Wai Alvin,Chan Kwin Wah,Lam Kar Wai Phoebe,Wong Tin Hau 대한미용의학회 2022 대한미용의학회지 Vol.6 No.1

Scarring can complicate acne vulgaris and lead to considerable psychosocial implications. Resurfacing and collagen regeneration treatments for acne scars include cryotherapy, chemical peeling, lasers and lights, and radiofrequency. Lasers have become popular among these options. A range of lasers with varying designs, wavelengths, and fractional technologies have become available as treatment choices for acne scars. This review compares the efficacy and adverse effects of these treatments. This is a literature review to determine whether the use of a combination of laser treatments yields superior outcomes compared to a single-device method in the management of acne scars. Our literature review revealed that patient factors, including Fitzpatrick skin phenotype and acne scar subtype, are essential determinants of outcome success in acne treatment with laser. Evidence suggests that ablative CO2 and Er:YAG lasers provide the best curative effects on acne scars in all skin types. Both non-fractional and fractional techniques can effectively treat atrophic acne scars. However, when using a pulse-dye laser to treat hypertrophic scars, the outcomes are variable. Potential complications of ablative lasers include acne flares, infections, and scarring.