Minimally invasive treatment for facial wrinkles, scars and cellulite

I believe most people, sooner or later, will think of getting rid of their facial wrinkles, scars (created by surgeries or accidents), or even the dreaded cellulite, which appears due to numerous causes.

There is a procedure called Subcision, which is a process used to treat deep scars left by skin diseases (eg. deep acne scars), accidents, surgery, or even expression lines and facial wrinkles caused by aging. Essentially the process involves separating the skin tissue in the affected area from the deep scar tissue using a regular needle (not designed for that purpose, but which can be used for the procedure). This allows blood to pool in the affected area, causing the deep scar to level off with the remaining skin area, softening the effect of the scar. The result can be improved with an ancillary treatment with fillers, such as fat or dermis taken from other areas of the body, collagen/hyaluronic acid, etc. Once the skin has leveled, treatments such as laser resurfacing, microdermabrasion or chemical peels can be used to further smooth the scar tissue.

                                   Subcision with Regular Needle

An innovation has recently become available with the introduction of a 12-strand braided wire with an attached solid diamond tip straight trocar needle. It is custom-designed for this type of subcutaneous dissection. The diamond tip smooth and precise penetration of the skin, simplifying the procedure. The tightly wound braided wire allows efficient and controlled dissection and release of connections between skin wrinkles, folds, scars, and subcutaneous planes of fat, muscle, or fibrotic bed.

                                            Cellulite Treatment

                                     Nasolabial Fold treatment

Treatment areas:

Transverse rhytids and interbrow frownlines of the forehead

Dominant crow’s feet rhytids

Nasolabial folds

Marionette folds

Radial and vertical lip lines

Mental curvilinear crease line between the lower lip and chin

Transverse rhytids of the neck

Depressed acne scars and other body scars or irregularities (cellulite)

Facial and body areas for large subcutaneous plane dissection prior to skin adjustments

Advantages: Predictable and consistent results. The technique is simple and there are several potential areas to be treated. In addition, the procedure is well tolerated by the patients and can be safely performed under local anesthesia.

Main drawback: The price. The wire costs between $ 50 and $ 70, and the manufacturers claim that the surgeon should use a new wire for every 3 treated areas.

Personal opinion: Great procedure in select patients, especially as an adjunct to other cosmetic procedures (eg. Liposuction, facelift)

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References:

1. Gravier M. Wire subcision for complete release of depressions, subdermal attachments, and scars.  Aesthetic Surg J; Volume 26, Issue 4, Pages 387-394, 2006.

2. Sasaki GH. Comparison of Results of Wire Subcision. Performed alone, with fills, and/or with adjacent surgical procedures. Aesthetic Surg J; Volume 28, Issue6, Pages 619-626, 2008.

3. Han S, Hong YG. The inverted nipple: Its grading and surgical correction. Plast Reconstr Surg. 1999;104:389–395.

4. Lee MJ, DePoli PA, Casas LA. Aesthetic and predictable correction of the inverted nipple. Aesthetic Surg J; 23:353–356, 2003.

5. Orentreich DS, Orentreich N. Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles. Dermatol Surg;21:543–549, 1995.

6. Sulamanidze M, Salti G, Maschett M, Sulamanidze G. Wire scalpel for surgical correction of soft tissue contour defects by subcutaneous dissection. Dermatol Surg;108:1735–1750, 2000. 

7. www.diamondwire.com (Diamond Wire ®) 

8. www.microaire.com (Release wire ®)