Mr David T Gault
Consultant Plastic Surgeon
Plasma Skin Regeneration (PSR)
One of the dilemmas facing aesthetic surgeons is the enormous range of choice now available from amongst the vast array of techniques for rejuvenating the face. From facelifts, through lasers and peels to fillers and Botox, most techniques have an established role. Whilst “gentle” lasers promise minimal down time, the results are mild and only after multiple treatments can improvement be observed. Deep resurfacing, mainly with carbon dioxide lasers, has excellent results on fine wrinkles and skin laxity but there is more downtime and a risk of complications such as loss of pigmentation. Plasma Skin Regeneration (PSR) was developed as the middle ground, to have the benefits of serious resurfacing but with minimal downtime.
How does it work?
Plasma skin regeneration uses a plasma of highly excited nitrogen molecules which appear as a purple plume through the exit nozzle. When the plasma hits the skin, energy is released, causing localised and rapid heating to almost 1500o Centrigrade. The controlled thermal damage promotes the formation of new collagen within the skin.
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What does it treat?
This device treats fine and deep wrinkles, open pores, superficial pigmentation, acne scarring and overall skin laxity. At lower powers there is improvement in fine lines, skin texture and abnormal skin pigmentation. At higher power skin tightening is achieved. The device can also be used at low power to treat the neck, chest and hands.
Within a couple of weeks of the treatment the skin usually shows an obvious improvement which some patients describe as a lustre or glow. Over the course of some six to twelve months after treatment, skin becomes a little thicker and plumper, with continued improvement due to collagen remodelling in the deeper layers of the skin. It is important not to assess the results of treatment too early.
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Treatment Technique
The treatment is usually given using local anaesthetic creams, with or without nerve blocks. Painkillers before treatment minimise any discomfort. At the end of a treatment, the skin will feel warm and a fan or ice pack is often helpful. The skin should be kept moisturised during the healing phase; patients are usually pink for three to four days after full power treatment and a little flaking of the skin occurs on days four and five. It is not uncommon for patients to return to full normal activities on the fifth and sixth day after treatment wearing normal make-up.
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Results
Formal measurements of the depth of wrinkles and acne pits have been taken before and after PSR treatment. Fine wrinkles improved by an observable 24% at six months and acne scars were 34% improved. Skin tightening has been assessed by measuring between fixed points on the face, and up to 11.6% of shortening between such points has been observed. As with all systems, some patients respond better than others. It is especially important to be patient if you have very thin skin as the most observable improvement is seen once late plumping of the dermis occurs.
General tips
PSR treatment for both women and men is performed at The Portland Hospital, London.
This treatment technique is not at present recommended for dark skin (types 4-6) although studies are showing that such patients may be suitable for treatment either at low or high power but not at intermediate powers where complications may occur. Repeat treatments after full power plasma skin resurfacing, are best delayed for at least six months.
The future
With the low risk of complications and the short downtime compared to CO2 lasers, this is an ideal treatment for younger patients who wish to delay a facelift, or for older patients in whom skin wrinkling is a problem. It may also have a role in improving the results achieved in patients after excisional surgery such as facelifting or blepharoplasty, rather like a polish. The treatment is especially good around the eyes. PSR has been used successfully in men, where it can tighten skin like a facelift without the sometimes unfortunate complication of moving beard skin behind the ears.