Photos: Dinesh Maini, MD, UK

3 Months Post 1 CO₂RE Treatment

Before and 1 month after 1 CO2RE Treatment

Photos: Dinesh Maini, MD, UK

3 Months Post 1 CO₂RE Treatment

Post Treatment ProgressionUpper Orbital – Light/50%/45mJ Upper Mouth – MID/35%/90mJ Lower Orbital MID/35%/60mJ

Baseline 4-6 wk FU4-7 days Post Tx.1 12 wk FU

E. Victor Ross MD

Post Treatment ProgressionALL FACE – Light/50%/60mJ Cheeks – Mid/40%/90mJ Peri-Orbital & Peri-Oral Fusion/40%/90mJ

Baseline

4-6 wk FU

Baseline

4-6 wk FUE. Victor Ross MD

Post-Treatment ProgressionLower Cheeks/Forehead Mid/30%/75mJ Nose & Upper Cheeks Mid/40%/90mJ Peri-Oral Fusion/40%/90mJ

Baseline 4-6 wk FU4-7 days Post Tx.1

E. Victor Ross MD

Baseline

4-6 wk FU

Baseline

4-6 wk FU

Post-Treatment Progression Lower Cheeks/Forehead Mid/30%/75mJ Nose & Upper Cheeks Mid/40%/90mJ Peri-Oral Fusion/40%/90mJ

E. Victor Ross MD

Baseline

4-6 wk FU

4-7 days Post Tx.1

12 wk FU

Post-Treatment Progression #6 Lower Cheeks/Forehead Mid/30%/75mJ Nose & Upper Cheeks Mid/40%/90mJ Peri-Oral Fusion/40%/90mJ

E. Victor Ross MD

Baseline 4-6 wk FU4-7 days Post Tx.1

Post-Treatment ProgressionPeri-Oral & Chin Fusion/40%/90mJ Peri-Orbital Fusion/30%/70mJ Forehead/Nose/Cheeks Mid/40%/90mJ

Jawline Light/50%/60mJ

E. Victor Ross MD

Baseline

4-6 wk FU

4-7 days Post Tx.1

12 wk FU

Post-Treatment ProgressionPeri-Orbital/Peri-Oral/Cheeks Fusion/25%/70mJ Forehead Light/40%/45mJ

E. Victor Ross MD

Peri-orbital areas with the mid setting: 40% FRACTIONAL COVERAGE, RING SIZE 1, 70-75 mJ, 0.75 SEC REPEAT.

Steven Eubanks MDDenver, CO

Cheeks CORE MID: 30% FRACTIONAL COVERAGE, RING SIZE 3, 70-75 mJ, 0.75 SEC REPEAT 3 weeks post procedure

Texture

Steven Eubanks MD

Fusion settings: 25-30% FRACTIONAL COVERAGE, RING 70mJ, CORE 65 mJ, 0.75 SEC REPEAT.

Pigment, Texture, and LaxitySteven Eubanks MDDenver, CO

Cheeks CORE MID: 30% FRACTIONAL COVERAGE, RING SIZE 3, 70-75 mJ, 0.75 SEC REPEAT

Texture and Laxity Steven Eubanks MDDenver, CO

Cheeks CORE MID: 30% FRACTIONAL COVERAGE, RING SIZE 3, 70-75 mJ, 0.75 SEC REPEAT

Texture and Laxity

Jawline and deep folds CORE Deep: 2% Fractional45mJ, .75 SEC Repeat

Steven Eubanks MDDenver, CO

Forehead CORE mid setting: 30% FRACTIONAL COVERAGE, RING SIZE 2 70-75 mJ, 0.75 SEC REPEAT

Pigment and Texture

Steven Eubanks MDDenver, CO

2/28/2012 3/27/2012

CO2RE light 30% Ring size: 1    Ring: 25.5 MJ  

Pattern size: 8.0x9.1 D: 9.0mm Shape: Hex Treatment: 1

Jill Waibel MD Miami, FL

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Before Post Treatment

Clinical Results

Fusion: 40% fractional coverage, Ring 1, 50mJ, CO2RE 70mJ

Texture/PigmentCO2RE Mid, Ring 3: 111mJ: 30%5 days post

Dr. Susan Tanne, Livingston NJ

Texture/PigmentCO2RE Mid, Ring 3: 111mJ: 30%5 days post

Dr. Susan Tanne, Livingston NJ

• Peri Oral: CO2RE Fusion: 50mJ Ring: 55mJ Core: 36%Cheeks: CO2RE Mid, Ring 3: 128mJ: 34%Forehead: CO2RE Mid, Ring 3: 110mJ: 34%5 Days Post

Dr. Susan Tanne, Livingston NJ

Cheeks: CO2RE Mid, Ring 3: 128mJ: 34%7 Days Post

Dr. Susan Tanne, Livingston NJ

Why does skin wrinkle with age?

• Suzan Obagi, assistant professor in dermatology at the University of Pittsburgh and director of the Cosmetic Surgery and Skin Health Center, explains.

• Normal healthy skin has a nice epidermis with a smooth cornified, or outer, layer that acts as a good barrier to water and environmental injury. Skin color and tone is even and unblemished. Components such as collagen (which provides skin firmness), elastin (which supplies skin elasticity and rebound) and glycosaminoglycans or GAGs (which keep the skin hydrated) are all abundant. It is interesting to note that under a microscope a biopsy of a wrinkle exhibits no telltale signs that reveal it to be a wrinkle. So what causes the skin to look wrinkled? It is probably a multi-factorial process of intrinsic aging and extrinsic aging.

• Intrinsic aging is the natural aging process that takes place over the years regardless of outside influences. After the age of 20, a person produces about 1 percent less collagen in the skin each year. As a result, the skin becomes thinner and more fragile with age. There is also diminished functioning of the sweat and oil glands, less elastin production, and less GAG formation. Wrinkle formation as a result of intrinsic aging is inevitable, but it will always be slight.

• Extrinsic aging occurs in addition to intrinsic aging as a result of sun and environmental damage (tobacco use and exposure to pollution, for example). Extrinsic aging shows up as thickening of the cornified layer, precancerous changes such as lesions called actinic keratosis, skin cancer (including basal cell carcinoma, squamous cell carcinoma, lentigo maligna melanoma), freckle and sun spot formation, and exaggerated loss of collagen, elastin, and GAGs. Alone or in concert, these processes give the skin the appearance of roughness, uneven tone, brown patches, thin skin and deep wrinkles.

Chronological Aging and WrinklesAs a person ages the epidermal cells become thinner and less sticky. The thinner cells make the skin look noticeably thinner. The decreased stickiness of the cells decreases the effectiveness of the barrier function allowing moisture to be released instead of being kept in the skin. This causes dryness. The number of epidermal cells decreases by 10% per decade and they divide more slowly as we age making the skin less able to repair itself quickly.The effects of aging on the dermal layer are significant. Not only does the dermal layer thin, but also less collagen is produced, and the elastin fibers that provide elasticity wear out. These changes in the scaffolding of the skin cause the skin to wrinkle and sag. Also, sebaceous glands get bigger but produce less sebum, and the number of sweat glands decreases. Both of these changes lead to skin dryness.The rete-ridges of the dermal-epidermal junction flatten out, making the skin more fragile and making it easier for the skin to shear. This process also decreases the amount of nutrients available to the epidermis by decreasing the surface area in contact with the dermis, also interfering with the skin's normal repair process.In the subcutaneous layer the fat cells get smaller with age. This leads to more noticeable wrinkles and sagging, as the fat cells cannot "fill in" the damage from the other layers.

Effects of Sunlight, Free Radicals, Hormones, Muscle Use, and GravityFrom Heather Brannon, MD,

• Aging Effects of the Sun and WrinklesExposure to ultraviolet light, UVA or UVB, from sunlight accounts for 90% of the symptoms of premature skin aging. Most of the photo aging effects occur by age 20. The amount of damage to the skin caused by the sun is determined by the total lifetime amount of radiation exposure and the person's pigment protection.

• Changes in the connective tissue reduce the skin's strength and elasticity. This is known as elastosis and is especially pronounced in sun-exposed areas.

Effects of Sunlight, Free Radicals, Hormones, Muscle Use, and GravityFrom Heather Brannon, MD