Lecture to FACE Conference London by Dr. Patrick Treacy about split face study comparing two recent CO2 resurfacing lasers. Lasers compared were the Lumenis ActiveFx and the Deka SmartXide DOT

1. ActiveFx vs SmartXide Comparative Split Face Study Dr. Patrick J. Treacy Medical Director Ailesbury Clinics Ltd

2. Fractionalised laser skin resurfacing (FLSR) has become an important component of facial rejuvenation surgery as patients continue the trend of seeking less invasive procedures with low downtime and low risks

4. This behavioural change in attitude has also been prompted by a realisation of both doctors and patients that the recent much hyped non-ablative methods are not comparable with ablative skin resurfacing and were often subject to extravagant claims in terms of efficacy.

5. Many proceduralists feel the CO2 laser was the most effective modality for repairing years of skin exposure to harmful ultraviolet light and photodamaged skin

6. Although non sequential fractionalised technology is relatively new, benefits are faster recovery time, more precise control of ablation depth, and reduced risk of post procedural problems

7. ActiveFx vs SmartXide Comparative Split Face Study

8. Perioral split face study showing the different skin eschar results from the two fractionalised lasers immediately after treatment

9. Objective Methods Results Conclusion 1 2 3 4 Conclusions

17. TACTILE ROUGHNESS SALLOW SKIN THREAD VEINS FINE RYTHIDS COARSE RHYTIDS PIGMENTATION Title PHOTOAGEING

19. Efficacy of treatment + scoring system Score 0 1 2 3 4 Fine Lines None Rare Several Moderate Many Pigment None Patchy Moderate Heavy Severe Facial Veins None Rare Several Heavy Severe Coarse Lines None Rare Several Moderate Many

20. Efficacy of treatment + scoring system Score 0 1 2 3 4 Touch Even Rare Mild Moderate Severe Complexion Pink Pale Grey Partial Yellow Grey Distinct Yellow Grey

21. prolonged postoperative recovery pigmentary changes erythema infection Although, ultrapulsed CO2 laser skin resurfacing was largely considered the best option for treatment of this type of photoaged facial skin, it also had certain post- procedural problems

22. Efficacy of treatment - scoring system Score 0 1 2 3 4 Erythema None Rare Several Moderate Severe Crusting None Rare Several Moderate Severe Pain None Rare Several Moderate Severe Herpes None Rare Several Moderate Severe

23. 5 days Immediate Random

26. Biopsy Staining Histology Histology was performed to determine the amount of tissue ablation, residual thermal damage, inflammation and neocollagenesis Lesion penetrative dimensions were assessed histologically using haematoxylin & eosin Skin biopsies were obtained from 5 patients intraoperatively from each side, after one laser pass, and at 3 months postop .

27. Thermal effect at 100 µm seen histologically using haematoxylin & eosin Treacy Dublin

28. 3 months post

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