SANTA MONICA, CALIF. — The volume loss and wrinkled skin that appears in the décolleté area of some older women can be significantly softened with filler followed by fractionated laser treatments, Dr. Joel L. Cohen said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation.
This cosmetic defect, which Dr. Cohen has dubbed "the peach pit," responds well to injections of hyaluronic acid fillers along with fractionated laser sessions.
Photo courtesy Dr. Joel L. Cohen
A patient with "peach pitting" of the chest.
"Over the course of many years, I've noticed that many patients become concerned about their décolleté area," said Dr. Cohen, director of AboutSkin Dermatology and DermSurgery, Englewood, Colo., in an interview. "I've tried botulinum toxin [type A]. And despite some reports of efficacy, I haven't been able to actually see this type of efficacy myself. People have topically treated it with retinoids and although that can be helpful, there are patients who have more severe crumpling of the skin."
Instead, he uses Juvéderm (Allergan) or Restylane (Medicis). With such hyaluronic acid fillers, "If you do get lumps or bumps, or the patients aren't happy with it, you could inject the enzyme hyaluronidase and make it go away," he said. "It's easier to mold out little contour irregularities with these types of agents as well."
Using only topical anesthesia, Dr. Cohen injects two or sometimes three syringes of the hyaluronic acid product, after which he asks a female assistant to massage it in. He follows up a few weeks later with two or more treatments with a fractionated laser, often combined with a light erbium laser peel for more texture improvement.
Pharmaceuticals Inc. Skin Disease Education Foundation (SDEF) and this news organization are owned by Elsevier.