Loma Linda University

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Gordon Sasaki, MD
Clinical Professor, Plastic & Reconstructive Surg
School of Medicine
Publications    Scholarly Journals--Published
  • Gordon Sasaki, "An Objective Comparison of Holding, Slippage, and Pull-Out Tensions for Eight Suspension Sutures in the Malar Fat Pads of Fresh-Frozen Human Cadavers", Aesthetic Surgery Journal, Volume 28, Number 4, July/August 2008. ( 7/2008 )
    Abstract
     
    In recent years, a number of designed suspension sutures have been rapidly introduced into clinical practices. The benefits, deficiencies and limitations of this applied emerging technology are defined by clinical experiences. This study compares the Holding Tension, Slippage Tension and Pull-out Tension for each of eight suspension suture systems randomly positioned in the midface soft tissue in four fresh-frozen cadaver heads. Photo micrografts of the fixation sites (barbs, cones, knots, pulleys) on the extracted sutures were examined and compared to their pre-insertion state. The results of this study clarifies our understanding of the safety, benefits and limitations of these systems.
  • Gordon Sasaki, M.D., "Release-Wire Subcision and Fills for Wrinkles, Folds, and Scars; A Comparison of Results After Surgical Procedures and Fills", Aesthetic Surgery Journal, July/August 2008.  ( 7/2008 )
    Abstract     Background:  Because of the fixed attachments or muscle-SMAS insertions to the undersurface of wrinkle lines, folds and retracted scars, the use of fills alone has resulted in unpredictable and unsatisfactory improvements.   Objectives: The use of a wire dissector to completely release these attachments and accompanied with an immediate fill and/or an adjacent aesthetic surgical procedure may optimize the final results.   Methods: The subcision wire was positioned under various wrinkles, folds and scars in a triangulated outline and then zig-zagged to uniformly release any subdermal attachments. A number of depressions underwent only a ReleaseWire procedure (Category 1). The Category 2 group was filled immediately with a strip of autogenous filler or a xenograft material. The Category 3 group combined the ReleaseWire procedure without fill and an adjacent aesthetic procedure. Category 4 sites involved the ReleaseWire procedure, fill and an adjacent aesthetic surgical procedure. The benefits of each of the added  procedures on ReleaseWire subcisioned sites were rated with a photographic Wrinkle/Fold Assessment Scale (mean ± SD) by two masked evaluators at least after 6 months. Assessment was based on a Quartile Grading Scale: 0 = less than 25%, 1 = 25-50%, 2 = 51-75%, and 3 = greater than 76% improvement.   Results:  Eighty-five patients experienced 338 ReleaseWire procedures at eight facial sites, one posterior neck site and four sites of thigh cellulite. The longest follow-up was 1.5 years, with a mean of 6.3 months. The cumulative Quartile Grading Scale was recorded as: Category 1 (1 ± 1.5 SD); Category 2 (3.1 ±0.1 SD); Category 3 (2.5 ± 0.2); and Category 4 (3.6 ± 0.2). When fills were employed as spacers under the release tracts in Category 2 and 4 sites, strips of SMAS and dermis and microfat droplets were the favored fills in the areas of the nasolabial and marionette folds because of the capacity of the graft’s volume and tissue acceptance. For shallower depressions, such as the glabellar frown lines and crow’s feet, strips of deep temporal fascia or muscle were more effective. Complications after ReleaseWire procedures with or without fill were few and transient.   Conclusions: The use of this type of subcision for resistant wrinkles, folds or scars can result in a satisfactory outcome when use as a solitary procedure with minimal complications. Enhancement of the surgical result may be further optimized with the immediate addition into the released tract. An adjacent aesthetic surgical procedure that impacts at the subcised site may provide additional benefit to the site but not as much as observed with the usage of an immediate fill. Autogenous fills that are substantitive provide longer lasting effects because of volume and tissue acceptance.  
  • Gordon Sasaki, M.D., Kerby Oberg, M.D., Barbara Tucker, RN., Margaret Gaston, "The Effectiveness and Safety of Topical PhotoActif Phosphatidylcholine-Based Anticellulite Gel & LED (Red and Near-Infrared) Light on Grade II-III Thigh Cellulite", Journal of Cosmetic and Laser Surgery, June 2007.  ( 7/2008 )
    Abstract   Background:   Cellulite of the upper lateral and posterior thighs and lower buttocks represents a common, physiological and unwanted condition whose etiologies and effective management are subjects of continued debate.   Objective: The purpose of this controlled double-blinded study is to evaluate the efficacy and safety of a novel phosphatidylcholine based, cosmeceutical anti-cellulite gel combined with a light emitting diode (LED) array at the wavelengths of red (660 nm) and near-infrared (950 mn), designed to counter the possible mechanisms that purportedly accentuate the presence of thigh cellulite.   Methods: Nine healthy female volunteers with Grade II-III thigh cellulite were randomly treated twice daily with either an active gel on one thigh or a placebo gel on the control thigh for three months. Twice weekly, each thigh was exposed for a 15-minute treatment with LED light for a total of 24 treatments. At 0, 6, and 12 weeks on study, the following clinical determinants were obtained: standardized digital photography, height and weight measurements, standardized thigh circumference tape measurements, pinch testing, body mass index (kg/m2), body fat analysis (Futrex-5500/XL near-infrared analyzer), and digital high resolution ultrasound imaging of the dermal-adiposal border. In selected patients, full-thickness biopsies of the placebo and active-treated sites were obtained. At 18 months, repeat standardized digital photography, height and weight measurements, and body mass index measurements were obtained.   Results: At the end of 3 months, eight of nine thighs treated with the phosphatidylcholine-based, anticellulite gel and LED treatments were down-graded to a lower cellulite grade by clinical examination, digital photography, and pinch test assessment. Digital ultrasound at the dermal-adiposal interface demonstrated not only a statistically significant reduction of immediate hypodermal depth, but also less echo-like intrusions into the dermal layer. Three of six biopsies from thighs treated for three months with the active gel and LED treatments demonstrated less intrusion of subcutaneous fat into the papillary and reticular dermis. In nine placebo-LED treated thighs and one of the actively treated thighs, minimal clinical changes were observed or measured by the clinical determinants throughout the 3 month study. At the 18th month evaluation period for the eight responsive thighs, five thighs reverted back to their original cellulite grading, while three thighs continued to maintain their improved status.   Patients experienced minimal and transient side effects that included puritus, erythema and swelling.      Conclusions: The results of this small but well-documented randomized double-blinded study affirms that eight of nine grade II-III cellulite of the thighs responded positively to a novel combined three month treatment program of a phosphatidylcholine-based, anticellulite gel and LED exposure, as determined by the obtained clinical determinants. Patients experienced minimal and transient side effects. At the 18th month evaluation period (15 months off-treatment), five responsive thighs reverted back to their original cellulite gradings, indicating a need for maintenance treatment.   Future studies are needed to verify these tentative positive observations.  
  • Gordon Sasaki, M.D., Barbara Tucker, RN, Margaret Gaston, "Clinical Parameters for Predicting Efficacy and Safety with Non-Ablative Monopolar Radiofrequency Treatments to Forehead, Face and Neck", Aesthetic Surgery Journal, 2007. ( 7/2007 )
    ABSTRACT   Background: Patient selection is key to obtaining a successful outcome after non-ablative monopolar radiofrequency treatments to the forehead, face and neck. The purpose of this study was to discover at baseline any predictors from patient demographics, skin and fat characteristics, measurable degrees of tissue mobility and photoaging that may be useful to predict a positive result under a standardized treatment algorithm.   Methods: Twenty-five patients (22 females, 3 males; average age 52.3 years) were selected randomly for NMRF treatments (2 non-overlapping passes, additional passes for vectored contraction and contouring) between 350-450 firings with 1.5 cm tips to the forehead, periorbitum, face and upper neck. Patients were evaluated at baseline and followed for outcomes beyond 1 year by a number of quantitative assessments.   Results: At baseline, 3, 6 and l2 months, measurements of skin thickness, subcutaneous fat depth, tissue mobility, and wrinkle and fold depth were obtained at nine different reference sites on each patient. Nineteen patients (76%), who progressively responded to NMRF energy over 12 months, were observed at baseline to have a global mobility score (mean ± S.D.) of 3.4 ± 0.27 mm; six patients, who were assessed to be non-responders over l year of evaluation, began with more tissue laxity and exhibited at baseline a larger global mobility score (mean ± S.D.) of 4.4 ± 0.60 mm. Other factors, that were more likely to be associated with a positive response to NMRF treatment, included minimal degrees of photoaging and shallower wrinkle/fold development. The variables of skin thickness and fat depth did not play significant roles in predicting positive responses to treatment. Side effects and complications were minimal throughout the study. Conclusions:   This study represents one of the first investigations that attempts to identify systematically objective baseline parameters that are more likely to be associated with positive responses to NMRF treatments to the forehead, face and neck. Longer follow-ups of our patients and further studies will be required to verify our preliminary findings.
  Scholarly Journals--Accepted
  • Gordon Sasaki, M.D., "Personal Approach to the Aging Lower Lid and Face", Clinics in Plastic Surgery, September 2008. ( 7/2008 )
  Books and Chapters
  • Gordon Sasaki, "Advances in LED (Light Emitting Diodes) Technology and Therapy", Chapter 11, Elsevier Publishing, 2008. ( 7/2008 )
  Non-Scholarly Journals
  • Michael Moretti, Editor"ASPS Annual Meeting Blends New Technologies with Surgery." Aesthetic Buyers Guide 01 09 2005: 62 - 110 ( 9/2005 )
  • "Rejuvenating Sunken Cheeks." Anti-Aging and Cosmetic Surgery Magazine 01 03 2005: Issue 6 ( 3/2005 )
  • Dr. Gordon H. Sasaki"A Myriad Of Interests." New Beauty Magazine 01 01 2005: 194 - 195 ( 1/2005 )
  • Naomi Hirahara and Gwenn M. Jensen"." Silent Scars of Healing Hands 01 01 2005: Book ( 1/2005 )
  • "Stick To It, Tissue Sealants and Glues: Updtae 2004." Plastic Surgery Products 01 12 2004: 36 - 38 ( 12/2004 )
  • "The Center for Oral and Public History at California State University Fullerton." Silent Scars of Healing Hands 01 01 2004: ( 1/2004 )
  • Naomi Hirahara and Gwen M. Jensen"Silent Scars of Healing Hands." 01 01 2004: 1 - 197 ( 1/2004 )
  • Naomi Hirahara and Gwen M. Jensen"Multicultural Publication Series." Silent Scars of Healing Hands 01 01 2004: 1 - 197 ( 1/2004 )