
==== Front
Plast Reconstr Surg Glob Open
Plast Reconstr Surg Glob Open
GOX
Plastic and Reconstructive Surgery Global Open
2169-7574
Lippincott Williams & Wilkins Hagerstown, MD

GOX-D-24-00774
00004
10.1097/01.GOX.0001063824.26292.03
3
PSTM Abstract Supplement
PSTM Top Abstracts/Posters 2024
Take Your Facelifts to the Next Level: Safety and Efficacy of PLASMA Resurfacing with Face and Necklifts
Lacerna Kimbrell Melinda MD, FACS 1
Board Certified Plastic Surgeon
1LA PLASTIC SURGERY-THE SKIN PLASMA CENTER (owner), Bradenton, FL USA
9 2024
18 9 2024
12 Suppl 2-3Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

OPEN-ACCESSTRUE
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pmcGOALS/PURPOSE: Deep facial skin resurfacing with radio-frequency (RF) plasma technology started in the early 2010’s. When compared to other deep facial resurfacing techniques such as phenol chemical peels or C02 and erbium ablative laser skin resurfacing, plasma resurfacing results in better correction of superficial and deep rhytids, photo-damage and more tissue contraction resulting and improved skin and tissue tightening. Performing deep plasma skin resurfacing at the same time as the rhytidectomy procedure offers the patient improved facial rejuvenation results in one surgical session and recovery period.

METHODS/TECHNIQUE: A retrospective review of a single surgeon’s experience from 2017-current is presented. A total of 90 patients were treated in one session, combining a face and necklift procedure with fat grafting and full face deep plasma skin resurfacing. Patients ages range from 50-86, with 88 females and 2 males. The procedures were performed under IV sedation (88 patients) and 2 under general anesthesia (2 patients).

Once adequate general or IV sedation was administered, tumescent solution was infiltrated into the face and neck (average volume of 180 cc total). Rhytidectomy techniques performed included SMAS plication, SMAS imbrication or Deep plane techniques (surgeon choice depending on the patient’s facial anatomy). A concurrent necklift and platysmaplasty was also performed. Next, full face resurfacing was performed with helium RF plasma in a majority of the patients (80), while nitrogen RF plasma was performed in 8 patients. Settings for the helium RF plasma were at 40% energy at 4 liter flow, single pass on the whole face, a second pass was performed on the chin and peri-oral areas. The energy was decreased to 20% at 4 liter flow on the areas of the rhytidectomy lateral elevated skin flaps. For the 8 patients treated with the nitrogen plasma, energy settings were at 4 kilojoules (kj), single pass, and was lowered to 3 kj over the areas of the lateral elevated skin flaps.

Finally, fat grafting was performed on the face via Coleman’s technique. The patients were followed the next day, weekly, then monthly. Longest follow-up is at 7 years post-operative.

RESULTS/COMPLICATIONS: There were three complications. One patient experienced a late onset cellulitis on her forehead at 7 weeks post-operative, and this resolved with a one week course of oral antibiotics. Two patients had small areas of hypertrophic scarring on their chin areas that resolved completely with light C02 resurfacing combined with laser-assisted drug delivery of kenalog 40. There were no incidents of skin necrosis on the areas of the elevated rhytidectomy or necklift skin flaps. Aesthetic results showed very good correction of deep and superficial rhytids, photo damage and much improved overall quality of the skin.

CONCLUSION: This small series over the course of seven years shows the safety and efficacy of performing deep RF plasma resurfacing immediately after rhytidectomy procedures. The elevated skin flap can be treated effectively by lowering the energy settings of the plasma devices. Patients can appreciate a single session surgical procedure that results in comprehensive facial and neck rejuvenation, with less downtime when compared to a staged procedure.
