PMID- 17224484
OWN - NLM
STAT- MEDLINE
DCOM- 20070315
LR  - 20220331
IS  - 1521-2491 (Print)
IS  - 1521-2491 (Linking)
VI  - 9
IP  - 1
DP  - 2007 Jan-Feb
TI  - Selective creation of thermal injury zones in the superficial musculoaponeurotic 
      system using intense ultrasound therapy: a new target for noninvasive facial 
      rejuvenation.
PG  - 22-9
AB  - OBJECTIVES: To transcutaneously deliver intense ultrasound (IUS) energy to target 
      the facial superficial musculoaponeurotic system (SMAS), to produce discrete 
      thermal injury zones (TIZs) in the SMAS, and to demonstrate the relative sparing 
      of adjacent nontargeted layers superficial and deep to the SMAS layer. METHODS: 
      In 6 unfixed human cadaveric specimens, the SMAS layer was visualized and 
      targeted using the ultrasound imaging component of the IUS device. Using 2 IUS 
      handpieces, 202 exposure lines were delivered bilaterally in multiple facial 
      regions by varying combinations of power and exposure time (0.5-8.0 J). Tissue 
      was then excised and examined grossly and histologically for evidence of thermal 
      injury using nitroblue tetrazolium chloride viability stain. RESULTS: 
      Reproducible TIZs were produced selectively in the SMAS at depths of up to 7.8 
      mm, and sparing of surrounding tissue including the epidermis. Higher energy 
      settings and high-density exposure line pattern produced a greater degree of 
      tissue shrinkage. CONCLUSIONS: In human cadaveric facial tissue, IUS can 
      noninvasively target and selectively produce TIZs of reproducible location, size, 
      and geometry in the SMAS layer. The ability to produce focused thermal collagen 
      denaturation in the SMAS to induce shrinkage and tissue tightening has not been 
      previously reported and has significant implications for aesthetic facial 
      rejuvenation.
FAU - White, W Matthew
AU  - White WM
AD  - Division of Facial Plastic and Reconstructive Surgery, Department of 
      Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 
      Boston, MA 02114, USA.
FAU - Makin, Inder Raj S
AU  - Makin IR
FAU - Barthe, Peter G
AU  - Barthe PG
FAU - Slayton, Michael H
AU  - Slayton MH
FAU - Gliklich, Richard E
AU  - Gliklich RE
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Facial Plast Surg
JT  - Archives of facial plastic surgery
JID - 100883500
SB  - IM
MH  - Aged
MH  - Burns/etiology
MH  - Cadaver
MH  - Connective Tissue
MH  - *Cosmetic Techniques
MH  - Elasticity
MH  - *Face
MH  - Facial Muscles
MH  - Female
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Male
MH  - Middle Aged
MH  - *Rejuvenation
MH  - Reproducibility of Results
MH  - Skin Physiological Phenomena
MH  - Ultrasonic Therapy/*methods
EDAT- 2007/01/17 09:00
MHDA- 2007/03/16 09:00
CRDT- 2007/01/17 09:00
PHST- 2007/01/17 09:00 [pubmed]
PHST- 2007/03/16 09:00 [medline]
PHST- 2007/01/17 09:00 [entrez]
AID - 9/1/22 [pii]
AID - 10.1001/archfaci.9.1.22 [doi]
PST - ppublish
SO  - Arch Facial Plast Surg. 2007 Jan-Feb;9(1):22-9. doi: 10.1001/archfaci.9.1.22.