Leonardo Marini: Spotless Multilayer Laser Rejuvenation
Premature aging is very often heralded by irregularly distributed, blotchy pigmentations, micro-textural alterations and more evident dynamic wrinkles. Age and environmental factors work together to progressively worsen skin quality and function, particularly on sun-exposed areas. There is no single treatment, except for deep chemical peels and full-face ablative laser resurfacing, that is able to simultaneously address all signs of aging. Deep peels and deep photo-thermal resurfacing require long recovery times and might be associated with potentially important side effects and serious complications. Modern dermatologic strategies try to sequentially combine different technologies and procedures to concentrate their positive effects just on the alterations they can treat at their best without pushing too hard on skin tissues. This kind of approach can generate a “gentler” yet effective rejuvenation without asking patients too much in terms of down-time, post-operative pain, side effects, and complications. Irregular skin pigmentation is perceived by observers as a clear sign of aging, therefore, all multi-layer rejuvenation procedures should aim at producing “spotless” textural and functional improvements. We have developed a complex, yet reliably reproducible, multilayer procedure consisting of a series of photo-thermal, photo-acoustic, and chemical passes, each with a specific aim: trans-epidermal short- and long-pulse 1064 Nd:YAG laser to stimulate dermal fibroblasts and activate HSPs; gentle 532 nm Q-S laser to eliminate unattractive superficial hyperpigmentations; 500-950 nm spectral band IPPL to optimize color uniformity; ablative/non ablative fractional 2940 nm Er:YAG to induce a controlled micro-wounding of epidermal keratinocytes; 15-20% TCA chemical peel to “seal” all positive growth factors and pro-healing cytokines under a “micro-coat” of precipitated proteins. No anatomical limitations and acceptable post-treatment downtime make spotless multilayer laser rejuvenation an ideal strategy to effectively rejuvenate the skin.
