Margaret A. Weiss

Hyaluronic acid fillers: a comprehensive review.

Over the past decade, the popularity of nonsurgical cosmetic procedures has increased exponentially. Last year, according to the American Society of Aesthetic Plastic Surgery, more than 5 million procedures were performed using cosmetic injectables such as botulinum toxin and dermal filling agents. According to the societys recent statistics, more than 85% of all dermal filler procedures occurred with a hyaluronic acid derivative.These numbers are expected to rise in the future as there is currently no other class of filling agent that rivals the popularity of hyaluronic acid. The popularity of hyaluronic acid specifically stems from its effectiveness, ease of administration, and safety profile.

Treatment of poikiloderma of Civatte with an intense pulsed light source.

Background. Effective treatment of poikiloderma of Civatte combines elimination of both the vascular and pigmented components simultaneously. A broad spectrum, noncoherent, intense pulsed light (IPL) source delivers multiple wavelengths with software controlled pulse durations and sequencing, which permits treatment of both vascular and pigmented lesions simultaneously. Objective. To determine response and side effects of poikiloderma of Civatte of the neck and chest when treated by IPL. Methods. One hundred and thirty‐five patients randomly selected with typical changes of poikiloderma of Civatte on the neck and/or upper chest were treated with one to five treatments using IPL. Results. Clearance of more than 75% of telangiectasias and hyperpigmentation comprising poikiloderma was observed. The incidence of side effects was 5%, including pigment changes. In many cases, improved skin texture was noted both by physician and patient. Conclusion. IPL is an effective mode of therapy for poikiloderma of Civatte. It offers a reduction of pigment and telangiectasias with a low risk profile. Additional benefits include subjective changes of improvement in skin texture.

Hair removal with a non-coherent filtered flashlamp intense pulsed light source†

To evaluate the effects on disruption of hair growth of the non‐coherent filtered flashlamp intense pulsed light (IPL) source.

Periorbital skin resurfacing using high energy erbium:YAG laser: results in 50 patients.

To evaluate Erbium:YAG regional periorbital laser resurfacing clinically and histologically.

Treatment of Reticular and Telangiectatic Leg Veins: Double-Blind, Prospective Comparative Trial of Polidocanol and Hypertonic Saline

Background Sixty‐three subjects’ legs were randomized to receive treatment with polidocanol (POL) or hypertonic saline (HS) for telangiectasias and reticular leg veins. Objective To compare the safety and efficacy of two sclerosing agents in three dermatologic surgery practices. Methods After exclusion of saphenofemoral junction incompetence, each subjects veins were categorized (telangiectasias <1 mm and reticular veins 1–3 mm) and randomized. Telangiectasias were treated with POL 0.5% or 11.7% HS and reticular veins with POL 1% or 23.4% HS. An independent, blinded physician determined efficacy and adverse events. Subject satisfaction questionnaires were administered and global clinical improvement assessments performed. Results All patients completed four visits at 0, 1, 4, and 12 weeks. Patients reported significantly greater pain during treatment with HS (2.42) than POL (1.03) (p < .001). There were no significant differences in physician‐assessed improvement of reticular leg veins or telangiectasias; subject‐ or physician‐assessed overall improvement; or physician‐assessed phlebitis, pigmentation, edema, or matting in either of the three practices or the entire cohort. Two subjects developed ulcerations with HS. No ulcerations or allergic reactions developed after POL injections. Conclusion Both agents provided effective treatment, but HS caused 2.35 times as much pain during injections and resulted in two episodes of tissue necrosis.

Consensus for sclerotherapy.

BACKGROUND The American Society for Dermatologic Surgery (ASDS) periodically develops consensus documents for its members concerning various aspects of dermatologic surgery. Unwanted and painful leg veins are a very widespread problem. Many advances in sclerotherapy of varicose and telangiectatic leg veins have occurred since the previous consensus documents. OBJECTIVE In 2013, the ASDS Board of Directors voted to have a committee of experts in the field to develop consensus documents on sclerotherapy. MATERIALS AND METHODS An expert panel reviewed the literature on sclerotherapy and discussed the findings. A consensus was reached with evidence-based recommendations on diagnostic evaluation and treatment of varicose and telangiectatic leg veins. RESULTS The consensus documents include discussion of indications for treatment, patient selection, contraindications, diagnostic testing, treatment approaches, use of compression, and expected outcome. Common sclerosants and their mechanisms of action, advantages and disadvantages of foam sclerotherapy, and minimizing and treating complications are presented. CONCLUSION The ASDS consensus documents on sclerotherapy will be helpful in educating their members on safe and effective sclerotherapy of varicose and telangiectatic leg veins.

Safety and efficacy of a novel diffractive lens array using a picosecond 755 nm alexandrite laser for treatment of wrinkles.

Picosecond lasers have been reported to be effective for removal of tattoo pigment. This prospective study evaluated the efficacy and safety of the treatment of peri‐oral and ‐ocular wrinkles using a novel diffractive lens array coupled with a picosecond 755 nm alexandrite laser.

Comparative outcomes of different endovenous thermal ablation systems on great and small saphenous vein insufficiency: Long-term results.

This study examined the outcomes of over a decade of endovenous thermal ablation (EVTA) treatments for great and small saphenous vein (GSV and SSV) insufficiency, utilizing three different endovenous thermal ablation systems.

Soft Tissue Augmentation Using a Two‐Way Connector to Supplement Hyaluronic Acid Filler with 1% Lidocaine Hydrochloric Acid with Epinephrine 1:100,000: Our Experience and Observations

The popularity of noninvasive aesthetic procedures continues to grow in the United States and elsewhere. A survey revealed that more than 1 million aesthetic procedures in 2008 involved the injection of a hyaluronic acid (HA)-based dermal filler. The popularity of HA-based fillers for soft tissue and dermal augmentation stems from their effectiveness, ease of administration, and safety profile. The procedure is quick to perform, and patients feel little discomfort when appropriate pain-management techniques are used. Our technique uses a two-way connector to supplement the HA filler with local anesthesia, which in our experience makes the procedure virtually pain free.

Continuous Wave Venous Doppler Examination for Pretreatment Diagnosis of Varicose and Telangiectatic Veins

BACKGROUND Doppler examination of varicosities is an essential part of accurate venous diagnosis prior to treatment. Doppler examination is the most fundamental of diagnostic techniques and must be familiar to all dermatologic surgeons treating the venous system of the leg. Those physicians presently concentrating primarily on telangiectasia will find their ability to judge when treatment will be effective greatly enhanced by Doppler‐assisted diagnosis. OBJECTIVE To describe the indications, basic principles, and a detailed, logical, rapid protocol for venous continuous wave Doppler examination. CONCLUSION Continuous wave Doppler examination is a rapid, precise method to determine sources of reverse physiologic flow (reflux) prior to treatment of varicose and telangiectatic leg veins. Doppler‐assisted mapping of physiologic abnormalities of the venous system should be the second step following physical examination.