Aging, Photo damaged Skin

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1 ARTG No :

2 Aging, Photo damaged Skin Sagging skin on the neck, decollete, face along with wrinkles and body are common problems associated with aging. RF & ULTRASOUND system is the most commonly used procedure to stimulate the tissue production and strengthen the skin structure. HIFU enables skin tightening and improvement of the skin s appearance painlessly without post-op downtime of classic surgery applications or other invasive methods.

3 SKIN Sebaceous gland Hair Sweet gland

4 BEFORE AFTER FOCUS ( HIFU ) Though many things contribute to a younger, healthier appearance; one of the most important element is an amazing molecule called tissues. About 80% of your skin is made from tissues, giving the skin its basic structure. Tissue makes skin stronger, thicker and more supple, which is what makes skin smooth, firm and strong - and young looking. But unfortunately, as we age, the skin loses tissues and our body gradually produces less and less.

5 Scientists now understand that the gradual loss of tissue with age results in fine lines, wrinkles, acne scars and other blemishes associated with aging. This process is further accelerated by exposure to the sun and other elements. As tissues lessens, the skin begins to weaken, gets thinner and less supple, and prone to fine lines, wrinkles and other blemishes.

6 Melaninogenesis Neural Crest Basal layer of Epidermis Tyrosinase Activation Melanin Synthesis Melanosome Formation Transferred to Keratinocytes

7 SKIN TISSUE 3-D

8 Ultrasound (HIFU)

9 ULTRASOUND ENERGY TDS 지적용능동적 TDS

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12 High Intensity Focused Ultrasound Ultrasound which is generated from transducer heat-irradiation treatment into skin cell Thermal Effects from Focused point

13 Mechanism of Action HIFU Dual Action Tissue Tightening Immediate tissue contraction tissue remodeling and tightening over time + HEAT tissue triple helix molecule Denatured tissue Fibers Source: Histological and Ultrastructural Evaluation of the Effects of a Radiofrequency- Based Nonablative Dermal Remodeling Device Archives of Dermatology February 2004, B.Zelickson, MD et al

14 Volumetric Heating: 3-D D Tightening along X,Y & Z Planes Epidermis Y X Z Z Visualize tightening in 3 dimensions

15 HIFU Proposed more than 50years ago (1942, Lynn) Remained research field until 1990s Several clinical trials for the treatment of benign and malignant tumors of the prostate, bladder and kidney Applied in dermatology area only a few years ago

16 Clinical effects Immediate shrinkage induced by focused tissue denaturation wound contraction or neocollagenesis during thermal wound healing process Each dermal layer dependent the degree of contractility Dermal layer Sub Q

17 Clinical application - Cartridge (A type 4.5mm) Energy < or = 1.2J Spacing 1mm Interval < or =2mm - Cartridge(B type 3mm) Energy < or = 0.45J Spacing 1mm Interval < or =2mm - Contact the probe precisely. - Turning the probe upside down, US exposure is disturbed!

18 Experimental data I 1. Thermal injury zone

19 Experimental data II 2. Immediate contraction

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21 Thermal wound healing Wound contraction Neocollagenesis Residual thermal injury Active thermal bystander effect (ATBE)

22 Phases of Wound Healing Inflammation Proliferation Wound Contraction 5-15 days Synthesis 3 days to 4 weeks Tissue Formation Remodeling 3 weeks to 1 year Days Macrophages Mast Cells Fibroblasts

23 After Treatment After 2 days After 7 days After 30 days After 90 days H&B Staining tissue which is make Fibroblast is in creased in trea tment site Hsp 72 Staining When the Initial Thermal damage it is appeared. After 2 days, it is appeared clearly Hsp 47 Staining It is indicate th at new developed tissue. After 90 days, It is appeared clearly

24 Technique

25 Technique

26 The mean ± SD depths of the facial nerve main nerve trunk, 20.1±3.1 mm, and nerve exit from the parotid edge, 9.1±2.8mmfor temporal, 9.2±2.2mmfor zygomatic, 9.6±2.0 mm for buccal, 10.6±2.7 mm for mandibular branches.