UltraClear® for Facial Surgeons | Anthony MacQuillan, BAAPS President
Surgery can reposition almost any tissue. It cannot change the skin covering it, and that is often what separates a good result from a stand-out one. Anthony MacQuillan, consultant facial surgeon and BAAPS President, explains why UltraClear® now sits in his surgical pathway: before theatre, in theatre, and at every follow-up after it.
Watch this three-minute video as BAAPS President, Anthony MacQuillan, explains how UltraClear® is enhancing surgical practice and patient outcomes.
UltraClear® adoption in the UK is moving beyond the aesthetic clinic and into surgical practice. Facial surgeons are now asking a different question: not whether skin quality belongs in the surgical plan, but where in the plan it sits.
Every facial surgeon knows the limitation. A facelift or blepharoplasty repositions structure. The photodamage, uneven texture, pigmentation and fine lines arrive in theatre with the patient, and they leave with the patient too.
Anthony saw the difference this makes when comparing UK outcomes with those shared by surgeons in the US, where skin treatment is routinely part of the surgical plan.
“When you look at Instagram, a lot of the results, especially in America, people get treated with the whole nine yards. So it’s not just the surgery. They get all the skin treatments as well. That’s what really makes the result pop. And I was looking to try and replicate that.”
Dr Anthony MacQuillan, BAAPS President
The patient judges the result on how they look, not on how well the tissue was repositioned. Skin quality is a large part of what they see. Before UltraClear®, Anthony’s in-house options for that half of the result were limited.
“That was definitely something I didn’t have in my armoury before. Prior to that it was operating for nothing.”
UltraClear® is the world’s first cold ablative fractional fibre laser. It operates at 2910 nm, the peak of water absorption in human tissue. Energy goes into ablating tissue rather than heating the tissue around it.
For a surgeon, the familiar reference point is fractional CO2. Anthony explains the difference in the terms he uses in theatre.
“It’s more specific for the chromophore of water, and causes less ‘innocent bystander’ damage. So you don’t get as much thermal transfer. If you imagine the laser beam drilling a core down into the dermis, you get less spread from the core of tissue than you do with a CO2, where you heat up the area around it quite a bit.“
He had worked with erbium before, on a multi-platform system. It did not deliver the change he wanted.
“I was looking for something that was a bit more powerful. The erbium, although good in that platform, certainly in my hands, I could never get it to do the kind of changes you can see with the UltraClear®.”
Compared with other lasers, UltraClear® offers faster healing with less risk and discomfort. On surgical skin, where the tissue is already managing the work of recovery, that difference carries more weight.
SEE IT FOR YOURSELF:
UltraClear® turns skin quality from an afterthought into a planned part of the surgical journey. Because its modes run from superficial to deep, the same device can be used at every stage, each at the depth that stage calls for.
“What I was looking for was something I could use in conjunction with the facelift at the time of the surgery, to treat the central portion of the face, and then do the second part, the periphery, where you’ve lifted the skin up. You wouldn’t want to treat that at the same time as the surgery, but you can use it on that part of the skin maybe three or four weeks later.”
The fourth stage is where Anthony sees a genuine change in what surgery can offer. Surgery always leaves the skin to do some settling of its own.
“I can use it post-operatively to tweak the results once the skin has done what it’s done. So it gives you the option to modify things again after the surgery, when the skin has perhaps restructured a little, which is inevitable with surgery.”
A device that works well in a clinic room can still fail in theatre. The patient is anaesthetised and cannot reposition, space around the table is tight, and every handpiece change costs time. UltraClear® was the first laser Anthony found that suits that environment.
“It’s just got a cable, so you can move from any angle. Your movement in space is a lot easier. It’s not a big machine. Some of the CO2s can be quite large.”
“In an anaesthetised patient, that is actually quite nice, because you can’t get the patient to move, or there’s a limited amount of movement you can get. If you’ve got a cable that just moves as you want it to go, and you’re not working with a clunky handpiece or bits you need to change, it’s a lot easier for you as the surgeon.”
Set-up is equally simple. Protocols are saved as presets, and there are no consumables to fit, replace or budget for.
“You press the buttons on the screen, you have a recipe that you like, press a button and away you go. There’s nothing you have to change on it. There are no consumables or anything. So it allows a lot of freedom.”
DISCOVER THE DIFFERENCE FIRSTHAND:
In most surgical pathways, the post-operative review monitors the result. With UltraClear®, it can improve the result. The patient comes back to see visible progress, not just to be signed off.
That changes the shape of the surgical package. Skin treatment becomes part of the surgical plan from the first consultation, rather than something the patient is referred elsewhere for once the surgeon has let go of the result. The surgeon keeps control of the whole outcome, and the relationship with the patient continues well beyond the final post-op appointment.
The same device then serves the patient for years afterwards, through superficial maintenance treatments that protect the investment they have made in surgery.
“I think it has masses of potential. I can see the tremendous results you can get.”
Dr Anthony MacQuillan, BAAPS President
If you recognise any of the following in your practice:
Then the question is no longer whether skin quality matters to your result. It is whether your surgical pathway accounts for it.
See how facial surgeons are building UltraClear® into the surgical journey:
UltraClear® is intended for use by qualified medical practitioners. Treatment protocols described reflect individual clinical practice and are at the discretion of the treating surgeon. Individual results may vary.