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Multicenter Evaluation of Concurrent Treatment

J. David Holcomb, MD; Kriston J. Kent, MD; Daniel E. Rousso, MD

Arch Facial Plast Surg. 2009;11(3):184-193.

Objective  To evaluate the safety and efficacy of aesthetic facial surgery with concurrent nitrogen plasma skin regeneration.

Methods  During a 28-month period, we independently completed 272 concurrent procedures in 95 patients aged 42 to 80 years in whom nitrogen plasma skin regeneration was performed immediately on completion of various aesthetic procedures, including brow-lift, blepharoplasty, lateral canthoplasty, midface-lift, rhytidectomy, cheek augmentation, lip vermillion advancement, filler injections, and augmentation mentoplasty. The treatment variables evaluated included nitrogen plasma pulse energy, pass number, and pulse count, and outcomes monitored included complications and subjective aesthetic improvement.

Results  The various treatment combinations were well tolerated at all anatomical sites. Rhytidectomy flap treatment included escalation of single-pass low-energy to high-energy nitrogen plasma treatment. Although perioperative complications did not otherwise negatively affect results, they included erythema with acneiform eruption (in 2 patients) and presumed herpes simplex virus infection, brief healing delay, and postinflammatory hyperpigmentation (in 1 patient each). In general, the treatment combinations were synergistic.

Conclusions  Combining nitrogen plasma skin regeneration with aesthetic facial surgery enhances outcomes for procedures in the forehead and in the periorbital, midface, and perioral regions. It does not seem to increase the risk of dermatologic or surgical complications for the procedures described herein.

Author Affiliations: Department of Surgery, University of Florida College of Medicine, Gainesville (Dr Kent); and Department of Surgery and Otolaryngology, University of Alabama at Birmingham (Dr Rousso). Drs Holcomb, Kent, and Rousso are in private practice in Sarasota, Florida; Naples, Florida; and Birmingham, respectively.

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