title: Nonablative remodeling: a 14-month clinical ultrasound imaging and profilometric evaluation of a 1540 nm Er:Glass laser.
abstract: BACKGROUND
  Nonablative remodeling has been recently proposed as a new antiaging treatment with no downtime.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of nonablative skin remodeling with a 1540 nm Er:glass laser and contact cooling on perioral and periorbital rhytides at 14 months follow-up.
  
  
  METHODS
  Forty-two female patients (mean age 47 years), Fitzpatrick skin types I-IV were treated five times at 6-week intervals and checked 6 months after the last treatment. Patients were evaluated using clinical data, patient satisfaction (scale 1-4), digital pictures, ultrasound imaging, and profilometry data from silicone imprints in order to quantify the degree of improvement.
  
  
  RESULTS
  All subjects reported an improvement in the quality and visual aspect of their skin at 6 months (mean patient satisfaction 3.06/4) and at 14 months after enrollment (mean patient satisfaction 2.90/4). This was confirmed by a 43.41% reduction of anisotropy (P < 0.001) 6 weeks after the fourth treatment, reaching 44.85% reduction 6 months after the fifth treatment (P <.001). Ultrasound imaging demonstrated a 17% increase in dermal thickness (P <.001) at 6 months and 11% 6 months after the last treatment (P <.05). A lack of immediate or late adverse effects was noted at all stages of the procedure.
  
  
  CONCLUSIONS
  This study demonstrated that irradiation with a 1540 nm Er:glass laser emitting in a pulsed mode and coupled with an efficient cooling system increased dermal thickness, reduced the anisotropy of the skin, and improved clinical aspects. The lack of adverse effects within the 14 months confirmed that this procedure was safe. Overall the stability of the results many months after the treatment was remarkable.
authors.affiliation: Center Commercial La Croisée, Clapiers, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fournier
authors.forename: Serge
authors.initials: S
authors.lastname: Dahan
authors.forename: Gilbert
authors.initials: G
authors.lastname: Barneon
authors.forename: Céline
authors.initials: C
authors.lastname: Rouvrais
authors.forename: Stéphane
authors.initials: S
authors.lastname: Diridollou
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Lagarde
authors.forename: Serge
authors.initials: S
authors.lastname: Mordon
mesh_terms: D000328:Adult; D000368:Aged; D016880:Anisotropy; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D015361:Rhytidoplasty / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional