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Biomedical subjects

Gregory S Keller

Publications and source records attributed to Gregory S Keller.

5 recordsLinked to original sources

Microcoblation: nonablative skin rejuvenation.

Microcoblation is the application of a controlled high-energy plasma field to intact aging skin. The treatment is nonablative and yields predictable, reversible histological changes in the epidermis, which result in skin rejuvenation. Recovery time and side effects are minimal. Although the mechanism of action is different, patient satisfaction with microcoblation compares very favorably with microdermabrasion, the traditional method of superficial skin rejuvenation.

Adult↗

Clinical evaluation of non-ablative radiofrequency facial rejuvenation.

OBJECTIVE: To evaluate the clinical efficacy of non-ablative cutaneous radiofrequency (RF) facial rejuvenation. DESIGN: Prospective study with longitudinal follow-up of a validation cohort set in an urban, private practice of an ambulatory facial plastic surgery center in southern California. METHODS: A consecutive sample was enrolled of 35 healthy adults with moderate facial aging, manifested by skin laxity, rhytids, and ptosis (brow, midface, jowls). Following intravenous sedation anesthesia, the study area was treated with 115-144 J/cm2 using the non-ablative RF device (ThermaCool TC). The main outcome measures were the objective measurement of brow height, investigator evaluation of skin parameters, a patient satisfaction questionnaire, and standardized photography, at fixed time intervals. RESULTS: At 12 weeks, a statistically significant increase in mean vertical brow height of 1.6-2.4 mm was observed in patients treated exclusively with the RF device (p<0.0001). All skin parameters (laxity, wrinkles, clarity, pore size) were improved. Complications and side effects were minimal. Patients were uniformly satisfied. CONCLUSIONS: The ThermaCool TC RF system represents a promising non-invasive method of obtaining moderate facial rejuvenation in the appropriately selected patient. Long-term results are pending.

Adult↗

Current techniques in midface lifting.

Midface elevation is an evolving procedure. The current trends toward less manipulation of the midface soft tissues with less visible incisions and use of endoscopic and percutaneous techniques have allowed for the rejuvenation of the facial features of younger patients. The creation of a natural, unoperated, and youthful appearance to the midface are readily accomplished with these newer procedures. For patients with significant facial skin excess, the endoscopic and percutaneous or transblepharoplasty procedures can be combined with a traditional face or neck lift to restore a youthful facial and neck harmony and balance.

Blepharoplasty↗

Elevation of the malar fat pad with a percutaneous technique.

OBJECTIVE: To describe a simplified method of malar fat pad elevation to rejuvenate the midface, nasolabial folds, labiomental folds, infraorbital hollows, and jowls via a percutaneous approach. PATIENTS AND DESIGN: One hundred eighteen patients were evaluated over a 12-month period in a prospective fashion by the operating surgeon. Preoperative and postoperative photographs were used for comparison. SETTING: Private practice. MAIN OUTCOME MEASURES: Elevation of the malar fat pad by a measured amount. RESULTS: At 3 months, all patients had a significant elevation of the malar fat pad (3-7 mm), with the exception of 2 early patients who underwent revision surgery, with satisfactory results. CONCLUSIONS: A simplified method of malar fat pad elevation is described. This method allows for elevation of the malar fat pad without extensive dissection. Excellent results are obtained with very little morbidity.

Adipose Tissue↗

Dose response of combination photorejuvenation using intense pulsed light-activated photodynamic therapy and radiofrequency energy.

OBJECTIVE: To report the results of a dose-response study using a novel photorejuvenation regimen consisting of intense pulsed light-activated photodynamic therapy and radiofrequency energy in patients with Fitzpatrick skin types I through III. METHODS: A combination intense pulsed light and radiofrequency device (Syneron Medical Ltd, Yokneam, Israel) was used in combination with the topical photosensitizer aminolevulinic acid (ALA) (Levulan Kerastick; DUSA Pharmaceuticals Inc, Wilmington, Mass). Duplicate titration trials were performed on the dorsal forearm skin of 3 patients with Fitzpatrick skin types I through III. Multiple treatments, with varying times of application of ALA (30 minutes and 1, 2, and 3 hours) and intense pulsed light fluence (24-30 J/cm(2)), were completed to determine a minimal erythema dose and a maximal tolerated dose based on epidermal reaction (erythema and crusting) and patient discomfort. Radiofrequency energy levels were constant in all treatment groups. RESULTS: The ALA application time of 1 to 2 hours for all skin types and fluence levels of 26 to 28 and 24 to 26 J/cm(2) for Fitzpatrick skin types I/II and III, respectively, were determined to be the minimal erythema dose. The ALA application times of 2 to 3 hours and fluence levels of 28 to 30 and 26 to 28 J/cm(2) for skin types I/II and III, respectively, were determined to be the maximal tolerated dose and resulted in severe erythema and crusting. The presence of severe erythema and discomfort precluded longer ALA exposure and higher fluence levels. No epithelial breakdown was observed at any treatment levels. CONCLUSION: The dose-response results defining the minimal erythema dose and the maximal tolerated dose of intense pulsed light-activated photodynamic therapy and radiofrequency energy have led to the development of 2 photorejuvenation protocols based on skin type and severity of photodamage.

Cosmetic Techniques↗