**5.1 Resurfacing results**

The resulting contraction, lift and wrinkle reduction achieved with the Renuvion handpiece are evident in the before and after photos. In fact, the authors did not originally plan to pursue a study of this modality, but after noticing significant results when comparing before and after photos, they began measuring and compiling the data. Immediately following the procedure there is some swelling from the numbing and trauma that resolves during the healing process and over time continued contraction and neocollagenesis occurs.

Resurfacing results had a quantitative measurements as seen in **Figure 20**. With aging, the cutaneous lip elongates and the pink portion of the lip deflates and starts to roll inward. Resurfacing the cutaneous upper lip causes the pink portion of the lip to become more oblique or more in a vertical direction on a planar view which decreases the appearance of a disappearing pink lip creating a plumper three dimensional upper lip. The same is noticed with the lower lip. The skin contraction that was noted has shortened the cutaneous portion of the lip which has proven to have longevity. The rhytids will almost disappear and the texture will improve. Some of the dynamic lines will return, but the lines at rest will resolve.

#### **Figure 12.**

*This patient underwent an open platysmaplasty with subdermal renuvion, no skin removal, only infrauricular entry point incisions were made and communicated with a midline submittal incision through which the platysmaplasty was performed. - 1 year post op.*

**Figure 13.** *This patient underwent a SubSMAS rhytidectomy with subdermal renuvion - 2 year results.*

#### **Figure 14.**

*This patient had a facelift 10 years prior and wanted a better neck and jawline. She had a subSMAS rhytidectomy with subdermal Renuvion on the neck and jawline and full face Renuvion resurfacing - 6 month results.*

**Table 2** demonstrates the improvement with lip lifting and the contraction has longevity over 1.5 years for 35 patients.

Particularly of note, the data shows that patients had an average lip contraction of 16.6% immediately following treatment, and one year later, the results remained essentially the same, with an average of 16.5%.

*Applications of Helium Plasma in Rejuvenation of the Face and Neck DOI: http://dx.doi.org/10.5772/intechopen.100162*

**Figure 15.** *This patient had Subsmas rhytidectomy with subdermal renuvion and lower blepharoplasty - 3 year results.*

**Figure 16.** *This patient was treated with full face ablative resurfacing 1 pass 20% 4 L - 1 year result.*

The forehead skin, upper and lower lids contract similarly to the upper cutaneous lip. The brow and the hairline actually move closer together especially at the temple. The authors noticed a more natural brow lift than with endoscopic brow lifts. The deep, heavy glabella is lifted and the dynamic lines are reduced with longevity noticed without creating a widened midbrow. Minimal to moderate dermatochalasis of the upper and lower eyelids will resolve with this technique

#### **Figure 17.**

*This patient had deep wrinkles around her perioral and mid cheek area only. Two passes at 30% 2 liters were performed to the upper lip and one pass everywhere else. She has signifiant reduction of wrinkles and contraction of her upper lip. However, she does have mild hypo pigmentation. This is 2 year results.*

#### **Figure 18.**

*This patient had minifacelift with fractional CO2 laser to her cheeks and renuvion resurfacing to her upper lip only - 2 passes at 20% 4 liters. She is Fitzpatrick III and she did not have hypo pigmentation. These are 2 year results.*

simulating a skin pinch. The horizontal lines of the forehead, oblique lines of the brow and crow's feet are significantly diminished (**Figure 5**).

**Table 3** demonstrates the improvement of the lift in the brow and its longevity over 1.5 years for 35 patients.

Of note in this section is the continued improvement in contraction over time. Immediately following treatment the average contraction was 11.5%. However, a year later the average improvement was 35.4%, indicating continued contraction.

The overall texture and pore size is significantly improved after it has healed. The redness will take the longest to resolve and it fades in blotches. It seems to be worse for 3–4 months after a shower or after exercise. Lentigines have decreased in number and shade. There has been permanent hypopigmentation and demarcation

*Applications of Helium Plasma in Rejuvenation of the Face and Neck DOI: http://dx.doi.org/10.5772/intechopen.100162*

#### **Figure 19.**

*This patient had cheeks, lateral brows, and upper lids only renuvion resurfacing - on pass 30% 4 liters which improved her jowls, deep wrinkles and skin texture.*

#### **Figure 20.**

*Mid forehead - procerus line to the hairline at the mid forehead. Right and left medial brow- top of most medial brow hairs to hairline. Right and left lateral brow - top of most lateral brow hairs perpendicular to hairline. Right and left temporal brow - lateral brow obliquely to hairline. Mid upper lip - vermillion border to junction of columella and cutaneous lip. Right and left upper lip - vermillion border to junction of ala and cutaneous upper lip.*

### **Table 2.**

*Lip data compiled by Abby Miller - medical student. The contraction of the upper lip has shown longevity.*

noted which will be discussed later. Those patients are typically Fitzpatrick I and II and have thinner skin. Darker Fitz II and III have not had long term color changes in their skin.
