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Multiprocedural
Synchronous
Facial Rejuvenation
Introducing the DUBLiN method
Dr. Patrick J. Treacy
Medical Director
Ailesbury Clinics Ltd
SKIN CANCER
SALLOW SKIN COARSE
RHYTIDS
COARSE
RHYTIDS
FINE
RYTHIDS
THREAD VEINS
PIGMENTATION
TitlePHOTOAGEING
WRINKLESWRINKLES
ECTROPION ENTROPION
FAT
PROTRUSION
FAT
PROTRUSION
EPIPHORA SKIN LAXITYSKIN LAXITY
TitleCHRONO
AGEING
Treating Facial Ageing
A great variety of stand alone facial
rejuvenation treatments are presently
available including
Botox©,Dermaroller©,
RioBlush©,Radiofrequency Devices
Syneron Polaris©RF, Thermage©
InfraRed Titan©, CO2 fractionalised
resurfacing AFX© SmartXide© Fraxel
Repair©,
WRINKLES
TEAR TROUGH WRINKLES
FAT
PROTRUSION
PIGMENTATION
SKIN LAXITY
TitleCOLLAGEN
FAT
PROTRUSION
FAT
PROTRUSION
SALLOW SKIN THREAD VEINSTHREAD VEINS
COARSE
RYTHIDS
COARSE
RYTHIDS
FINE
RHYTIDS
PIGMENTATIONPIGMENTATION
Title
Positive
CO2
FRSL
Patient CM 2 passes under R eye with obvious reduction in rhytides and neocollogenesis
Marionette
Lines
Marionette
Lines
Eyebrow Height Youthful LookYouthful Look
Nasolabial
Lines
Nasolabial
Lines
Cheek
Augmentation
Volume lossVolume loss
Title
Negative
CO2
FRSL
New Collagen
Fibroblast
Stimulation
CO2 Laser
Botox
Although, many feel that
ultrapulsed fractionalised
CO2 laser skin resurfacing is
the best treatment option for
photo aged facial skin, could
we improve on this modality.
The DUBLiN method uses different
methods and technologies in order
to activate fibroblasts and direct
them towards neocollogenesis. It
also uses low level pulsed lasers to
reduce skin laxity, accelerate growth
factors and cause tightening.
The DUBLiN method incorporates
D Dermaroller
U Ultrapulse Laser
B Blood Factors
Li Light – 633nm
N Neurotoxin
Induction of FIBROBLASTS
A fibroblast is a type of cell that
synthesizes the extracellular matrix
and collagen, the structural
framework (stroma) for animal
tissues, and plays a critical role in
wound healing. Fibroblasts are the
most common cells of connective
tissue in animals.
Comparative study over three months
• Over 3 months, 15 patients
(Group 1) received FLSR
at normal settings
• Results were compared to
29 patients (Group 2)
received low energy FLRS
+ adjunctive treatments
• Both group received BTXA
one week prior to other
treatments
Group 2 received a 3-phase combination
multi-rejuvenation technique over 3 weeks.
• Phase I included Dysport® at dilution
3.5:1 in 3 areas
• Phase 2 introduced intense fibroblast
stimulation and modification through
microneedling, PRP growth factor
induction and near-red phototherapy.
• Phase 3 included low–level (CO2)
Ultrapulse laser with settings (Energy)
100 mJ (Rate) 14w CPG 3/5/2 and
adjunct near-red 633nm
phototherapy.
Near Red Light 633Near Red Light 633
DermarollerDermaroller
Title
Fibroblast
Generation
PHASE 2 multi-combination
technique
PRP Growth Factor Signals
Near Red Light 633Near Red Light 633
DermarollerDermaroller
Title
Fibroblast
Activation
PHASE 2a fibroblast activation
PRP Growth Factor Signals
Near Red Light 633Near Red Light 633
DermarollerDermaroller
Title
Fibroblast
Stimulation
PHASE 2b fibroblast stimulation
PRP Growth Factor Signals
DERMAROLLER
Keratinocyte GF
Vascular Endothelial GF
Fibroblast GF
Transforming GF-B
Connective Tissue GF
Platelet Derived GF
TitleCOLLAGEN
BLOOD FACTORS
GROWTH FACTORS
The efficacy of certain growth
factors in forming collagen and
healing various injuries is the
theoretical basis for the use of PRP
in tissue repair. The platelets
collected in PRP are activated by
the addition of thrombin and calcium
chloride. This induces the release of
these factors from alpha granules
LiGHT 633nm
Migrating cells exert forces
against the substrate to
move forward. These forces
are part of the contraction
phase of migration in which
the rear of the cell is
detached from the substrate
and the body of the cell is
moved forward.
Near Red Light 633Near Red Light 633
Post NTaPost NTa
Title
Collagen
Synthesis
PHASE 2
Co2 Laser
ULTRALASE LASER
Laser specialists non-sequential
fractionalised CO2 laser ablation
is the most effective modality for
repairing photo damaged skin
The benefits are more precise
control of ablation depth, faster
recovery time and reduced risk of
post procedural problems
WSRS = Wrinkle Severity Rating Scale
5 Extreme Extremely deep and long folds, detrimental to facial appearance.
2-4mm Visible V-shaped fold when stretched
Unlikely to have satisfactory correction with injectable implant alone.
4 Severe Very long and deep folds; prominent facial feature.
Less than 2mm visible fold when stretched.
Significant improvement is expected from injectable implant.
3 Moderate Moderately deep folds.
Clear facial feature visible at normal appearance but not when stretched.
Excellent correction is expected from injectable implant.
2 Mild Shallow but visible fold with a slight indentation; minor facial feature.
Implant is expected to produce a slight improvement in appearance.
1 Absent No visible fold, continuous skin line.
GAIS = Global Aesthetic Improvement Scale
5 Very Much Improved Optimal cosmetic result for the implant in this
patient.
4 Much Improved Marked improvement in appearance but not
completely optimal for this patient. A touch-up
would slightly improve the result.
3 Improved Obvious improvement in appearance from the initial
condition, but a touch-up or re-treatment is
indicated.
2 No Change The appearance is essentially the same as the
original condition.
1 Worse The appearance is worse than the original
condition.
DUBLIN Lift Periorbital Area
Dover Photoageing Scale
Wrinkle Severity Rating Scale
% Patient satisfaction
BTX
Wrinkle Severity Rating Scale
% Patient satisfaction
PRP
www.ailesburyclinic.ie
Спасибо!

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Dr Patrick Treacy lectures to AMWC Eastern Europe 2013 (Moscow)

  • 1. Multiprocedural Synchronous Facial Rejuvenation Introducing the DUBLiN method Dr. Patrick J. Treacy Medical Director Ailesbury Clinics Ltd
  • 2.
  • 3. SKIN CANCER SALLOW SKIN COARSE RHYTIDS COARSE RHYTIDS FINE RYTHIDS THREAD VEINS PIGMENTATION TitlePHOTOAGEING
  • 5. Treating Facial Ageing A great variety of stand alone facial rejuvenation treatments are presently available including Botox©,Dermaroller©, RioBlush©,Radiofrequency Devices Syneron Polaris©RF, Thermage© InfraRed Titan©, CO2 fractionalised resurfacing AFX© SmartXide© Fraxel Repair©,
  • 7. FAT PROTRUSION FAT PROTRUSION SALLOW SKIN THREAD VEINSTHREAD VEINS COARSE RYTHIDS COARSE RYTHIDS FINE RHYTIDS PIGMENTATIONPIGMENTATION Title Positive CO2 FRSL
  • 8. Patient CM 2 passes under R eye with obvious reduction in rhytides and neocollogenesis
  • 9.
  • 10. Marionette Lines Marionette Lines Eyebrow Height Youthful LookYouthful Look Nasolabial Lines Nasolabial Lines Cheek Augmentation Volume lossVolume loss Title Negative CO2 FRSL
  • 11. New Collagen Fibroblast Stimulation CO2 Laser Botox Although, many feel that ultrapulsed fractionalised CO2 laser skin resurfacing is the best treatment option for photo aged facial skin, could we improve on this modality.
  • 12. The DUBLiN method uses different methods and technologies in order to activate fibroblasts and direct them towards neocollogenesis. It also uses low level pulsed lasers to reduce skin laxity, accelerate growth factors and cause tightening.
  • 13. The DUBLiN method incorporates D Dermaroller U Ultrapulse Laser B Blood Factors Li Light – 633nm N Neurotoxin
  • 14. Induction of FIBROBLASTS A fibroblast is a type of cell that synthesizes the extracellular matrix and collagen, the structural framework (stroma) for animal tissues, and plays a critical role in wound healing. Fibroblasts are the most common cells of connective tissue in animals.
  • 15. Comparative study over three months • Over 3 months, 15 patients (Group 1) received FLSR at normal settings • Results were compared to 29 patients (Group 2) received low energy FLRS + adjunctive treatments • Both group received BTXA one week prior to other treatments
  • 16. Group 2 received a 3-phase combination multi-rejuvenation technique over 3 weeks. • Phase I included Dysport® at dilution 3.5:1 in 3 areas • Phase 2 introduced intense fibroblast stimulation and modification through microneedling, PRP growth factor induction and near-red phototherapy. • Phase 3 included low–level (CO2) Ultrapulse laser with settings (Energy) 100 mJ (Rate) 14w CPG 3/5/2 and adjunct near-red 633nm phototherapy.
  • 17. Near Red Light 633Near Red Light 633 DermarollerDermaroller Title Fibroblast Generation PHASE 2 multi-combination technique PRP Growth Factor Signals
  • 18. Near Red Light 633Near Red Light 633 DermarollerDermaroller Title Fibroblast Activation PHASE 2a fibroblast activation PRP Growth Factor Signals
  • 19. Near Red Light 633Near Red Light 633 DermarollerDermaroller Title Fibroblast Stimulation PHASE 2b fibroblast stimulation PRP Growth Factor Signals
  • 21. Keratinocyte GF Vascular Endothelial GF Fibroblast GF Transforming GF-B Connective Tissue GF Platelet Derived GF TitleCOLLAGEN BLOOD FACTORS
  • 22. GROWTH FACTORS The efficacy of certain growth factors in forming collagen and healing various injuries is the theoretical basis for the use of PRP in tissue repair. The platelets collected in PRP are activated by the addition of thrombin and calcium chloride. This induces the release of these factors from alpha granules
  • 23. LiGHT 633nm Migrating cells exert forces against the substrate to move forward. These forces are part of the contraction phase of migration in which the rear of the cell is detached from the substrate and the body of the cell is moved forward.
  • 24. Near Red Light 633Near Red Light 633 Post NTaPost NTa Title Collagen Synthesis PHASE 2 Co2 Laser
  • 25. ULTRALASE LASER Laser specialists non-sequential fractionalised CO2 laser ablation is the most effective modality for repairing photo damaged skin The benefits are more precise control of ablation depth, faster recovery time and reduced risk of post procedural problems
  • 26.
  • 27. WSRS = Wrinkle Severity Rating Scale 5 Extreme Extremely deep and long folds, detrimental to facial appearance. 2-4mm Visible V-shaped fold when stretched Unlikely to have satisfactory correction with injectable implant alone. 4 Severe Very long and deep folds; prominent facial feature. Less than 2mm visible fold when stretched. Significant improvement is expected from injectable implant. 3 Moderate Moderately deep folds. Clear facial feature visible at normal appearance but not when stretched. Excellent correction is expected from injectable implant. 2 Mild Shallow but visible fold with a slight indentation; minor facial feature. Implant is expected to produce a slight improvement in appearance. 1 Absent No visible fold, continuous skin line.
  • 28. GAIS = Global Aesthetic Improvement Scale 5 Very Much Improved Optimal cosmetic result for the implant in this patient. 4 Much Improved Marked improvement in appearance but not completely optimal for this patient. A touch-up would slightly improve the result. 3 Improved Obvious improvement in appearance from the initial condition, but a touch-up or re-treatment is indicated. 2 No Change The appearance is essentially the same as the original condition. 1 Worse The appearance is worse than the original condition.
  • 30.
  • 31.
  • 33. Wrinkle Severity Rating Scale % Patient satisfaction BTX
  • 34. Wrinkle Severity Rating Scale % Patient satisfaction PRP