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Background: Microneedling and fractional lasers have been used in facial rejuvenation with acceptable results and low adverse effects., Aims: To compare the efficacy of microneedling with fractional Er:YAG in facial skin rejuvenation., Patients/methods: This study was planned as a split-face clinical trial. Volunteers were randomly allocated to receive three monthly treatments on each side of the face, one with fractional Er:YAG laser and one with microneedling. The assessments included investigating clinical outcomes by two blinded dermatologists accompanied by measuring skin biophysical characteristics including cutaneous resonance running time (CRRT) and transepidermal water loss (TEWL). Moreover, possible adverse effects, downtime, and patients' satisfaction were recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT20160820029436N3)., Results: Of the 32 selected volunteers, 24 subjects completed the study. The clinical assessment showed a significant improvement of the face appearance along with a significant reduction in dyschromia, and periorbital wrinkling (P-value < .05), with both procedures without any considerable difference between two methods. Moreover, the patients showed substantial satisfaction with both modalities with no statistically significant difference. Mean TEWL and CRRT values also decreased significantly in both groups with no considerable difference. The downtime was significantly shorter in the microneedling-treated side. There were no long-lasting or severe adverse effects after treatment with both methods., Conclusion: Microneedling and fractional Er:YAG laser have comparable efficacy in facial rejuvenation, but little downtime of the former makes it preferable for many patients., (© 2020 Wiley Periodicals, Inc.)

Background: Lateral brow-lifting surgical procedures in conjunction with upper blepharoplasty may prevent secondary descent following upper blepharoplasty., Objective: To compare the results of internal browpexy (IBP) and temporal brow lift (TBL) in patients with dermatochalasis undergoing simultaneous upper blepharoplasty., Methods: This study was a single-center, parallel-group randomized controlled trial conducted on 32 female patients suitable for upper blepharoplasty. Patients were divided into two groups: the IBP group and the TBL group. The brow lift was measured using change in the distance between the ala nasi and lateral tail of the eyebrow as nasal ala to lateral brow (NALB) in millimeter (mm), and the vertical line between the lateral tail of eyebrow and horizontal line extending the lateral cantus as lateral brow plump line (LBPL) in mm before and after the surgery. The follow-up time was 6 months., Results: The mean ± SD age of patients was 55.93 ± 7.1 years and 53.94 ± 7.7 years in the TBL and IBP groups, respectively (P > .05). No significant change in mean LBPL at 6 months compared to baseline was observed in the TBL group (baseline: 15.7 ± 1.6 mm vs 6 month: 15.8 ± 1.3 mm; P = .602). In the IBP group, a significant increase in mean LBPL at 6 months compared to baseline was observed (baseline: 15.09 ± 2.13 mm vs 6 months: 17. 43 ± 2.68 mm; P < .001)., Conclusions: Internal browpexy combined with blepharoplasty could be considered the better procedure in patients with upper eyelid dermatochalasis in terms of long-lasting stability and lateral brow elevation., (© 2017 Wiley Periodicals, Inc.)