April 2020 HSC Section 4 - Plastic and Reconstructive Problems

Volume 143, Number 1 • Perioral Rhytide Correction Assessment

Video 5. Supplemental Digital Content 5 demonstrates midreticular dermis bleeding, the maximum depth of treatment, available in the “RelatedVideos”section of the full-text article on PRSJournal.comor, for Ovid users, available at http://links.lww.com/PRS/D150 .

and left on for 2 days. The dressing is removed on postoperative day 3, followed by careful meticulous débridement. At this point, if the patient is noncom- pliant or has wounds that look slow to heal, Flexan dressing is reapplied and removed on postopera- tive day 5; otherwise, the patient uses Aquaphor or EltaMD (Swiss-American CDMO, Carrollton, Texas) postlaser kit to keep the skin moisturized. The patient is brought back again on postopera- tive days 5 and 7 for wound check and cleansing with warm water and a gentle skin cleanser. The heavy occlusive ointment is exchanged for a lighter moisturizing ointment that is compatible with the patient’s skin sensitivity once they are healed but still erythematous. The importance of meticulous postoperative wound care is key to avoiding compli- cations using this specific technique. RESULTS Forty-five patients had complete photographic documentation and were eligible for inclusion in the study. Of the 45 patients included in the study, 100 percent were women. Fitzpatrick scores were delineated and ranged from 1 to 3, with an average Fitzpatrick score of 2.0 (Table 1). Age distribution was delineated with an average patient age of 60.4 years, ranging from 46 to 77 years. Average follow- up was 13 months, ranging from 6 to 26 months Of the 45 patients included in the study, 31 (69 percent) underwent concurrent face lift and 14 (31 percent) underwent laser resurfacing alone. The average preoperative score was 4.6 and the average postoperative score was 2.4, showing a statistically significant average absolute score improvement of 2.2 ( p < 0.05). Those patients

times per day, starting the day before the proce- dure and continuing for 10 days afterward, was used. In patients with a history of recurrent her- pes, the dosage was increased to 1000 mg three times per day. After the procedure, a Flexan occlusive dress- ing (Polymedical Industries, Inc., Sugarland, Texas) was applied. ( See Video, Supplemental Digital Con- tent 6 , which demonstrates placement of postlaser dressing, available in the “Related Videos” section of the full-text article on PRSJournal.com or, for Ovid users, available at http://links.lww.com/PRS/ D151 .) Flexinet (Integra Life Sciences, Plainsboro, N.J.) is used to hold the dressing in place. The dress- ing is removed and replaced on postoperative day 1 Video 6. Supplemental Digital Content 6 demonstrates place- ment of postlaser dressing, available in the “Related Videos” sec- tion of the full-text article on PRSJournal.com or, for Ovid users, available at http://links.lww.com/PRS/D151 .

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