Plastic Surgery Research Council

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Objective Analysis of Effectiveness of Facial Skin Laser Treatment using 0.33 mm in Diameter Microbiopsy Punches
Mikaela Kislevitz, BSN, RN, Mason Bartels, BS, Karen B. Lu, BA, Jeffrey Kenkel, MD, Yucel Akgul, MD, PhD.
UTSW, Dallas, TX, USA.

PURPOSE: Patient reported outcomes and blinded observer rating scales have been utilized to evaluate effectiveness of cosmetic office based treatments including ablative lasers. These assessments are subjective and unreliable. To evaluate the effectiveness of the combination 1470nm/2940 nm laser treatment of the facial skin objectively, microbiopsy punches 0.33 mm in diameter were utilized.
METHODS: Twelve patients who received treatment with the combination 1470nm/2940 nm laser had microbiopsies of their facial skin taken before, and after ablation 7 days and 3 months post treatment. Their facial skin was histologically evaluated from paraffin embedded biopsies for extracellular matrix molecules (Collagen I, Collagen III, Elastin and Hyaluronic acid), injury marker HSP 70, proliferation marker (Ki67), cell death marker (TUNEL), and inflammatory cells (hematoxylin-Eosin, neutrophil, elastase, CD68). Expression of collagen related genes (Col1a1, Col3a1, Lox, Mmp2, Mmp9 and Timp), elastin related genes (Eln, Fbln5, Emilin1, and Emilin2) and inflammatory genes (IL-1beta) were measured with RT-qPCR following RNA amplification.
RESULTS: Hyaluronic acid expression, especially in the epidermis, was greater in the histological sections of day 7 biopsies post treatment compared to untreated or 3 months after treatment. Other histological staining did not reveal major changes between groups. Expression of inflammatory genes IL-1 beta was significantly upregulated in day 7 post treatment biopsies compared to untreated or 3 months. There were no statistical changes in collagen or elastin related genes between groups.
CONCLUSION: Microbiopsies can objectively evaluate the effectiveness of lasers to change properties of the facial skin. The combination 1470nm/2940nm laser treatment resulted in higher inflammatory response as hyaluronic acid expression and IL-1beta gene elevated 7 days after treatment. However, the laser treatment did not yield to lasting changes in the collagen and elastin levels suggesting no effect on skin firmness and elasticity with treatment.


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