الفهرس 
Electro-optical synergy (ELOSOnly 14 pages are availabe for public view
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Abstract
Laxity of the cheeks and neck skin is a common cosmetic complaint of patients as they age. Improvement of skin laxity can be difficult to achieve without invasive surgical lifting procedures (Alster & Tanzi, 2004).
lifting facial tissues using APTOS (Anti Ptosis) thread is a simple, constructive, and time-saving technique. It helps to avoid scar formation and the need for implants.
These ”APTOS” threads are polypropylene sutures that have been modified by designing many dents along their lengths. It holds tissue firmly because of the sharp edges to the dents. They proved successful in lifting various ptotic areas of the face, improving facial contour (Sulamanidze et al., 2002).
The use of the ”APTOS” threads for lifting the tissues of the face and neck is a simple, conservative, saving-up, and sparing procedure leaving no visible traces of intervention on the skin. At the same time, the proposed technique proved efficient for correction of the jaw line and for lifting the flabby ptosed tissues in involutional facial alterations (Sulamanidze et al., 2005).
Radiofrequency application through a proprietary device has recently been used for facial tissue tightening. Uniform volumetric heating of the dermis is created by passage of electrical current, while protection of the epidermis is maintained by concurrent cryogen cooling. The application of radiofrequency to the face provides quantitative changes. The brow along the midpupillary line is elevated to a greater degree than the lateral brow. This is consistent with acute angle changes seen in the eyebrow. Improvements in the lower part of the face with radiofrequency application can be quantified by demonstrating a decrease jowl surface (Nahm et al., 2004).
Nonablative laser systems that integrate optical conducted radiofrequency (RF) energies are a novel technology for the treatment of wrinkles (Sadick & Trelles, 2005). A new method for skin renewal is the electro-optical synergy (ELOS), which combines intense pulsed optical energy and conducted bipolar radiofrequency (RF) energy into a single pulse, has been introduced. Intense pulsed optical energy and bipolar RF energy have been used in dermatologic surgery for many years. However, the therapeutic impact of the combined energies has been recently studied (Sadick et al., 2005).
Further development of Monopolar radiofrequency (MRF) technology and refinement of treatment protocols may allow even greater tightening of the skin and more dramatic modulation of underlying deeper structures, making the treatment more universally applicable for patients desiring facial rejuvenation (Abraham & Vic Ross, 2005).
Laser skin resurfacing by means of ablative techniques that use CO2 and erbium:YAG lasers has proved to be a promising therapeutic option for treating cutaneous photodamage, perioral and periorbital wrinkles, and acne scars (Grema et al., 2003). Heating dermal collagen has been shown to induce collagen shrinkage and reactive dermal neocollagen formation (Alster et al., 1999).
Topical retinoids like tretinoin and tazarotene have been approved by the Food and Drug Administration (FDA) for the “palliation” of the fine wrinkles and irregular pigmentation of photoaging (Irvine & Calif, 2002). Tretinoin can directly induce collagen synthesis (Angeles et al., 1990), it can also decrease the breakdown of collagen by inducing tissue inhibitors of collagenase (Clark et al., 1987).
Most patients undergoing cosmetic surgery have a good outcome in psychological and psychosocial terms. None the less, several predictors of poor outcome do emerge suggesting that surgeons should be cautious in performing cosmetic procedures on individuals with these characteristics (Honigman et al., 2004).