title: Micro-fractional, directional skin tightening: A porcine model.
abstract: OBJECTIVE
  Skin changes are among the most visible signs of aging. Fractional ablative lasers improve skin quality by making small skin wounds that heal rapidly without scarring. While they improve skin texture and discoloration, there is minimal effect on skin laxity. This study was performed to assess skin shrinkage performed by removing multiple small full-thickness skin columns with coring needles combined with wound closure.
  
  
  METHODS
  In 5 swine 116 squares (3 cm(2) ) were demarcated for treatment and control sites. In treatment sites 10% of the skin was removed by full-thickness skin coring needles (19 gauge) and afterwards closed and compressed with an elastic adhesive dressing. This procedure was compared to puncturing the skin with standard hypodermic needles (without tissue removal) and subsequent closure with compressive dressing. Area and shape of sites were measured before and 28 days after treatment.
  
  
  RESULTS
  Test and control sites healed within a week without scarring. Coring with wound closure caused significant shrinkage after 28 days. The treated skin area was reduced by 9% (P < 0.0001) and the direction of shrinkage was influenced by the direction of wound closure. Coring without wound closure and puncturing the skin without tissue removal produced an insignificant 3% decrease in area.
  
  
  CONCLUSIONS
  Significant minimally invasive skin tightening in a preferred direction can be achieved by removing skin with coring needles followed by wound closure. The direction of shrinkage is influenced by the direction of micro-hole closure, irrespective of the skin tension lines. This approach may allow reshaping the skin in a desired direction without scarring.
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.|Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzige Brüder, Teaching Hospital of the Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Russe
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Martin
authors.initials: M
authors.lastname: Purschke
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: William A
authors.initials: WA
authors.lastname: Farinelli
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Apostolos G
authors.initials: AG
authors.lastname: Doukas
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Wikunda
authors.initials: W
authors.lastname: Limpiangkanan
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Fernanda H
authors.initials: FH
authors.lastname: Sakamoto
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Joshua
authors.initials: J
authors.lastname: Tam
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzige Brüder, Teaching Hospital of the Medical University Salzburg, Kajetanerplatz 1, 5020 Salzburg, Austria.
authors.forename: Gottfried
authors.initials: G
authors.lastname: Wechselberger
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114.
authors.forename: Richard Rox
authors.initials: RR
authors.lastname: Anderson
mesh_terms: D000818:Animals; D005260:Female; D023421:Models, Animal; D009339:Needles; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000295:instrumentation / Q000379:methods*; D015595:Skin Aging; D013552:Swine; D058106:Wound Closure Techniques; D014945:Wound Healing
keywords: coring needle; fractional ablative laser; photoaging; scarless facelift; skin aging; skin rejuvenation; wound closure