title: The sinergy between lasers and adipose surgery in face and neck rejuvenation: a new approach from personal experience.
abstract: OBJECTIVE
  Patients now want a long-lasting youthful appearance but with a minimally-invasive approach. Our unique approach, "AdipoLASER reJuvenation (ALJ)", involves a variety of minimally-invasive laser- and lipolysis-based techniques, and the present study assessed the impact of this ALJ approach.
  
  
  METHODS
  From 2008 - 2011, we prospectively enrolled 221 patients into the study. 71 of them, underwent the ALJ approach: 2 reductive techniques via microliposuction and laser-assisted lipolysis (LAL); and 2 regenerative techniques via autologous fat graft and fractional CO2 laser resurfacing. The remaining 150 patients underwent only 1 or 2 of these techniques. Patients were monitored through 1 to 18 months, clinical photography was taken and histological assessments were performed.
  
  
  RESULTS
  ignificantly better and long-lasting results were obtained for the complete ALJ approach regarding all aspects of the face, mandible and neck compared with controls. The combination of the regenerative and the reductive approaches delivered on excellent balance, restoring a youthful, natural appearance to the face.
  
  
  CONCLUSIONS
  The fractional CO2 laser has both a photodestructive, or HLLT, effect and an LLLT component in the beam periphery. This LLLT effect possibly prolonged the life and improved the take of the fat grafts, with the well-documented HLLT effect inducing swift collagenesis and better remodeling of the dermal matrix. A natural look in depressed areas was thus restored with the combination of fat redistribution and the HLLT/LLLT effect. Microlipolysis and laser-assisted lipolysis (LAL) could at the same time remove those areas of redundant and prolapsed fat while countering skin laxity, and address both jowl formation and submental flaccidity. The unique combination of all four approaches in our "AdipoLASER reJuvenation" proved to be superior to any other lesser approach in both the long- and short term with very little patient downtime, but did not present much more in terms of treatment time and cost to the patient. We believe that the ALJ approach offers a real minimally-invasive alternative to the classic surgical facelift.
authors: Departments of Department of Aesthetic Surgery, General Surgery and Dermatology, ProEstetica Medical Center, Plastic, Bucharest, Romania.
authors: D M
authors: DM
authors: Jianu
authors: Departments of Department of Aesthetic Surgery, General Surgery and Dermatology, ProEstetica Medical Center, Plastic, Bucharest, Romania.
authors: M
authors: M
authors: Filipescu
authors: Departments of Department of Aesthetic Surgery, General Surgery and Dermatology, ProEstetica Medical Center, Plastic, Bucharest, Romania.
authors: S A
authors: SA
authors: Jianu
authors: Departments of Department of Aesthetic Surgery, General Surgery and Dermatology, ProEstetica Medical Center, Plastic, Bucharest, Romania.
authors: A C
authors: AC
authors: Nita
authors: Domina Sana Medical Center, Bucharest, Romania.
authors: D A
authors: DA
authors: Chirita
keywords: HLLT-LLLT synergy; LLLT effect; cervico-facial incision-less skin rejuvenation; fat redistribution; laser-assisted lipolysis