Ablative radiofrequency microplasma for lateral dermatochalasis-indications and treatment recommendations

To determine in which cases ablative radiofrequency microplasma is preferred for the treatment of lateral dermatochalasis over a surgical approach as well as discussing each method's benefits and limitations. Twenty-one patients underwent 3 interventions of plasma exeresis. Photographic and RCM images were acquired at baseline and 4 weeks after final plasma exeresis. The eyes were categorized into 3 groups based on the dermatochalasis severity (1- mild, 2- moderate, 3- severe). Additionally, a further division was conducted to assess the degree of enhancement observed after the treatment (1- slight improvement, 2- moderate improvement, 3- significant improvement). The classifications and assessments were performed by was graded by two trained dermatologists as blinded observers. A total of 21 eyes with a mean age of 54 years (range45-67 years) and 100% females were included in this study. The severity of dermatochalasis directly affects the clinical improvement (P=0.039) and the higher the severity, the more the improvement (R = -0.62). Noninvasive ablative microplasma may offer safe and effective therapy for upper eyelid dermatochalasis and can even be performed in patients at surgical risk. However, it may be suitable for grades 0 and 1 of DC. For more advanced grades a surgical solution achieves better results for the treatment of dermatochalasis of the upper eyelid.