Smartlook Procedure.... Facial Sculpting, Tightening & Rejuvenation

The Aesthetic Guide — March/April 2010 
 

Smartlook Procedure Achieves Laser Facial Sculpting, Tightening And Rejuvenation
Bob Kronemyer, Associate Editor

SmartLook from Cynosure, Inc. (Westford, Mass.) Is a minimally invasive procedure enabling moderate facial and neck tightening with a freshened appearance to the skin. SmartLook combines the Smartlipo laser system for treatment under the skin and a fractional resurfacing laser on top.

“For the first time, we have the ability to use lasers to treat facial and subcutaneous tissues – both above and below the plane of the skin,” said Richard Gentile,

M. D., a facial plastic surgeon in private practice in Boardman, Ohio. “SmartLook is an ideal procedure for those patients not yet ready for a face-lift.” This single treatment session consists of two 45 minute steps: subdermal laser facial sculpting with the 1064 nm Nd:YAG Smartlipo (including shaping jowls, reducing submental fat and tightening skin), followed by facial laser skin rejuvenation with a micro-ablative, fractional SmartSkin CO2 laser to achieve wrinkle reduction and additional skin tightening. Patients can be treated comfortably with local and topical anesthesia, or mild-to-moderate sedation.

According to Dr. Gentile, the 1064 nm wavelength performs well for three rejuvenation processes: photothermolysis for hemoglobin, fat removal and tissue tightening.

“This wavelength seals off the blood vessels very well, for a shorter recovery period,” he said. “It is also effective in breaking down and melting fat. It has been used safely in thousands of patients to perform laser lipolysis, so you can contour and shape the face and neck.” Additionally, by heating the skin to pre-determined levels, “you observe substantial tissue tightening, up to three times as much as would be possible with liposuction only,” Dr. Gentile said.

With the Smartlipo, a 600 micron fiber is threaded through a small stainless steel cannula. An aiming beam is also provided, “so you can always see the laser under the skin,” Dr. Gentile conveyed. In addition, small cannula liposuction is performed with thermal endpoints to prevent heat related injury. “Monitoring temperatures are critical,” he said. The downtime is a maximum of ten days, and frequently within five to seven days.

SmartLook is a natural extension to other innovative, minimally invasive procedures.

In 2007, Dr. Gentile was one of the first surgeons to advocate using the Smartlipo laser under the skin on the face. Shortly thereafter, in 2008, “we started to treat people who exhibited early aging and had some unwanted fat deposits, often combined with a mild-to-moderate amount of actinic sun damage,” he said. Thus, SmartLook was born.

Most competing minimally invasive facial treatments (such as radiofrequency) “do not usually change the facial contour,” observed Dr. Gentile, an associate professor of facial plastic surgery at Northeastern Ohio University College of Medicine (Rootstown, Ohio). ”You might end up with a little skin tightening and slight wrinkle reduction, but you will still have a large double chin or a large beefy jowl unless you undergo an invasive procedure like liposuction or even a mini-lift.

SmartLook offers greater advantages for those patients desiring contour adjustments who don’t have a suitable alternative to a minimally invasive approach. We are finding great results and happy patients.” Nasolabial folds and jowls can be softened, and the neck can be tightened.

“You can also actually reduce a turkey neck, which has a substantial amount of redundant tissue,” Dr. Gentile noted. “We believe that results maintained at one year will last for at least five years.” The best candidates are generally under the age of 55 (late 30s to 50s), lacking severe laxity but with contour concerns, some wrinkling and sun damage. “Patient selection is the most important part of the procedure,” Dr. Gentile concluded.