title: Short review on face rejuvenation procedures: focus on preoperative antiseptic and anesthetic delivery by JetPeel™-3 (a high pressure oxygen delivery device).
abstract: OBJECTIVE
  Nowadays there is great attention in trying to slow and reverse the facial aging process. Esthetic medicine has been primarily based on the surgical approach for many years, but now, in order to solve the problem of aging skin, there is an increasing interest into non-invasive, possibly painless, procedures that can guarantee the patient a quick recovery. In this perspective the use of chemical peeling and dermabrasion, to achieve skin rejuvenation, is growing worldwide. These techniques are also relevant to treat skin pigmentation irregularities and to remove keratoses, lentigines, acne and other skin related conditions. One of the most interesting, safe and painless devices, useful for the effective antiaging face treatment, is JetPeel™-3. The aim of this study was to assess the device efficacy starting from a short review on face rejuvenation procedures.
  
  
  METHODS
  The basic action mechanism of this medical device is a constant high pressure air flux delivery, including oxygen, mixed with different chemical compounds such as peeling molecules, antioxidants, vitamins and hyaluronic acid, which are mechanically forced across the skin surface. Here we report a new approach in the clinical use of JetPeel™-3, tested in 20 adult volunteers, consisting in the addition to the standard protocol of an anesthetic, carbocaine and a sterilizing and disinfectant agent, that is chlorexidine. In fact disinfection and sterilization of the skin surface is a peculiar step for every antiaging or therapeutic procedure. The procedure has been completed with multiple hyaluronic acid injections of the skin in order to achieve face rejuvenation. The anesthetic power of the JetPeel™-3-carbocaine protocol has been compared to the Emla cream one.
  
  
  RESULTS
  The spontaneous pain sensation perceived by the patients in the hemiface treated with JetPeel™-3 was significantly lower compared to the hemiface treated with Emla cream (P<0.001) showing, consequently, that JetPeel™-3-carbocaine protocol had the best anesthetic performance either in dermal, subdermal or subcutaneous injections compared with Emla cream.
  
  
  CONCLUSIONS
  JetPeel™-3 has proved to be a good non-invasive approach and its use is recommended since it induces local anesthesia in a short time.
authors.affiliation: Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK. tommaso.iannitti@gmail.com
authors.forename: T
authors.initials: T
authors.lastname: Iannitti
authors.forename: S
authors.initials: S
authors.lastname: Capone
authors.forename: B
authors.initials: B
authors.lastname: Palmieri
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000295:instrumentation* / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D002615:Chemexfoliation / Q000379:methods; D002710:Chlorhexidine / Q000008:administration & dosage; D003357:Cosmetic Techniques; D003869:Dermabrasion / Q000379:methods; D004202:Disinfectants / Q000008:administration & dosage; D005145:Face; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007271:Injections, Intradermal; D007279:Injections, Subcutaneous; D007641:Keratolytic Agents / Q000008:administration & dosage; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D009824:Ointments / Q000008:administration & dosage; D010147:Pain Measurement; D017060:Patient Satisfaction; D010865:Pilot Projects; D012060:Rejuvenation; D015595:Skin Aging; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D004202:Disinfectants; D007641:Keratolytic Agents; D009824:Ointments; D055675:Viscosupplements; D006820:Hyaluronic Acid; D008012:Lidocaine; D008619:Mepivacaine; D002710:Chlorhexidine