Facial tissue strengthening and tightening device and methods

• US 20050055073A1
• Filed: 07/30/2004
• Published: 03/10/2005
• Est. Priority Date: 05/28/1998
• Status: Active Grant

• Current Assignee: Pearl Technology Holdings LLC
• Original Assignee: Pearl Technology Holdings LLC
• Inventors: Weber, Paul Joseph
• Granted Patent: US 7,494,488 B2
• Time in Patent Office: Days
• US Class Current: 607/99
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/201 with beam delivery through a hollow tube, e.g. forming an articulated arm through a flexible conduit A61B18/22; Hand-pieces therefor
• CPC Class Codes: A61B 18/203 applying laser energy to the outside of the body
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00761 Removing layer of skin tissue, e.g. wrinkles, scars or cancerous tissue
• CPC Class Codes: A61B 2017/00792 Plastic surgery
• CPC Class Codes: A61B 2017/00853 low friction, hydrophobic and corrosion-resistant fluorocarbon resin coating (ptf, ptfe, polytetrafluoroethylene)
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00452 Skin
• CPC Class Codes: A61B 2018/1807 using light other than laser radiation
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61N 2007/0008 Destruction of fat cells
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

A device is described that can be used quickly and accurately by surgeons to provide uniform facial tissue planes that are tunnel-free and wall-free thus optimizing face lifting, tightening, and implant delivery. The device is comprised of a shaft with a substantially planar tip further comprised of relative protrusions and energized relative recession lysing segments. Forward motion of the device precisely divides and energizes various tissue planes causing contraction, especially via the fibrous tissues. Other forms of energy and matter can be delivered down the shaft to further enhance desirable tissue modification and contraction.

Claims

1. A face tightening apparatus, comprising:

a tip, shaft and handle; and

a plurality of relatively protruding members on said distal end of said tip separated by at least one energized, relatively recessed lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recession are defined as being seen from at least one viewing angle.

2. The apparatus of claim 1, further comprising a means connected to said shaft or tip location for providing matter or additional energy to targeted tissue (tissue-altering-window/zone).

3. The apparatus of claim 1, wherein a lysing segment of said at least one, relative recession'"'"'s lysing segment comprises an electrode, wherein means for providing energy comprises means for providing radiofrequency radiation from said proximal end of said shaft to said electrode in said relatively recessed, lysing segment so that radiofrequency energy can be transmitted through said electrode.

4. The apparatus of claim 1, wherein tip is comprised of material that is both electrically nonconductive and of low thermal conductivity.

5. The apparatus of claim 4, wherein tip is comprised of material selected from a group consisting of plastics, plastics including Teflon®

, silicon, carbon, graphite, graphite-fiberglass composites, porcelain, epoxy, ceramic, glass-ceramics.

6. The apparatus of claim 1, wherein said relatively recessed lysing segment is radiofrequency energized.

7. The apparatus of claim 6, wherein said radiofrequency energy is applied to relatively recessed lysing segment at an electrode.

8. The apparatus of claim 6, wherein said radiofrequency energy is applied to relatively recessed lysing segment at an electrode comprised of material selected from a group consisting of iron, steel, alloys, platinum, palladium, nickel, titanium, gold, silver, and copper.

9. The apparatus of claim 6, wherein said electrode is seated in an area of the relatively recessed lysing segment in a location selected from a group consisting of:

a) protruding from the relative recession, b) flush with the relative recession, and c) further recessed in the relative recession.

10. The apparatus of claim 6, wherein planned obsolescence is increased or decreased to said radiofrequency energy delivery segment by covering electrodes with an oxidation reducing material.

11. The apparatus of claim 10, wherein said oxidation reducing material is selected from the group of Silverglide®

, Silverglide®

-like coatings, alloys, gold, platinum, rhodium, and palladium.

12. The apparatus of claim 1, further comprising means for controlling heating of said tip or shaft.

13. The apparatus of claim 12, wherein said means for controlling the heating of said shaft or tip comprises a means for thermally isolating said shaft from said means for providing energy.

14. The apparatus of claim 12, wherein said means for controlling the heating of said shaft or tip comprises a means for flowing an inert gas through said shaft or tip.

15. The apparatus of claim 1, further comprising at least one lumen associated with the shaft in a manner selected from the following group:

lumen is coupled to exterior of shaft, lumen is located within shaft.

16. The apparatus of claim 1, additionally including an optional ultrasonic transducer piezoelectric located within the handle and thus may impart ultrasonic energy to the shaft and thereby the tip.

17. The apparatus of claim 1, wherein tip is comprised of material that is electrically conductive, and tip is not insulated in at least one portion of a relatively recessed lysing segment, and tip is not insulated at least one immediate point of contact with a means for providing radiofrequency, and elsewhere tip is completely insulated.

18. The apparatus of claim 17, wherein said tip is part of an electro-conductive means to deliver energy to a non-insulated, tissue exposed, relatively recessed, lysing segment.

19. The apparatus of claim 2, further comprising control means for controlling energy delivery to said relatively recessed lysing segment and said location of additional energy to targeted tissue (tissue-altering-window/zone).

20. The apparatus of claim 2, further comprising a least one thermal sensor that senses thermal conditions at the distal end of said shaft or tip, wherein said sensor sends a signal to control means, and wherein said control means controls the delivery of said energy to said distal end to modulate thermal conditions.

21. The apparatus of claim 2, further comprising a least one inductance sensor that senses tissue inductance around the distal end of said shaft or tip, wherein said sensor sends a signal to control means, and wherein said control means controls the delivery of said energy to said distal end to modulate said inductance.

22. The apparatus of claim 6, wherein said radiofrequency energized lysing segment is of a physical characteristic chosen from the group of:

sharpened plate, dull plate, sharpened point, dull point, sharpened wire edge, dull rounded wire, brush like wire, scalloped, geometric, rounded, saw-toothed, flat.

23. The apparatus of claim 1, whereupon said relative protrusions viewed from the front may be a shape selected from the following group:

oval, circular, square, rectangular, triangular, trapezoidal, linear, geometric.

24. The apparatus of claim 1, wherein said relative protrusions when viewed together from the front, appear in a substantially planar arrangement selected from the following group:

completely planar, slightly arced, non-uniformly saw-toothed, uniformly saw-toothed, geometric within a rectangular band.

25. The apparatus of claim 2, wherein said location for providing a additional energy to targeted tissue (tissue-altering-window/zone) is selected from a group consisting of:

on the top side, on the bottom side, or both.

26. The apparatus of claim 2, wherein said means for providing energy comprises means for providing radiofrequency energy.

27. The apparatus of claim 26, wherein said means for providing radiofrequency energy is furthermore operator select-ably pulsed or gated in a range between 1 per second to 200 per second.

28. The apparatus of claim 26, wherein said means for providing radiofrequency energy provides nonuniform radiofrequency energy.

29. The apparatus of claim 26, wherein said means for providing radiofrequency energy is an internally placed, percutaneous, or subcutaneous mechanism to create small, spot-like zones of tissue damage in the overlying skin while leaving relatively undisturbed interspersed areas of living tissue.

30. The apparatus of claim 29, wherein said small zones of tissue damage measure in the range of 0.01 mm to 5 mm in any diameter.

31. The apparatus of claim 26, wherein said means for providing radiofrequency energy is selected from a group consisting of the plural or singular of:

electrodes, wires, electro-conductive strips, laminates, metals in an elsewhere insulated handle, shaft or tip.

32. The apparatus of claim 26, wherein said electrodes are monopolar electrodes.

33. The apparatus of claim 26, wherein said electrodes are bipolar electrodes.

34. The apparatus of claim 26, wherein said electrodes are positioned about the tissue-altering-window/zone in pattern selected from a group consisting of:

random pattern, organized pattern, or organized array.

35. The apparatus of claim 2, wherein said means for providing energy comprises means for providing LASER radiation.

36. The apparatus of claim 35, wherein said means for providing LASER radiation is selected from a group consisting of fiberoptics, waveguides, and mirrors.

37. The apparatus of claim 35, wherein said LASER radiation is selected from a group consisting of:

carbon dioxide, combination yttrium-aluminum-garnet (YAG), Erbium-YAG, Neodymium-YAG, holmium, pulsed dye, tunable dye, diode lasers.

38. The apparatus of claim 35, wherein said means for providing LASER radiation includes use of a window to allow egress of LASER radiation.

39. The apparatus of claim 35, wherein said means for providing egress of LASER radiation includes optical fibers.

40. The apparatus of claim 39, wherein said window to allow egress of LASER radiation is comprised of Germanium.

41. The apparatus of claim 39, wherein said means for providing LASER radiation is an internally placed, percutaneous, or subcutaneous mechanism to create small zones of tissue damage from the inside outward without passing energy into the epidermis of the overlying skin while leaving relatively undisturbed interspersed areas of living tissue.

42. The apparatus of claim 41, wherein said small zones of tissue damage measure in the range of 0.01 mm to 5 mm in any diameter.

43. The apparatus of claim 41, wherein said small zones of tissue damage are created internally by coupling the apparatus to a fractional photothermolysis LASER generating device.

44. The apparatus of claim 41, wherein said small zones of tissue damage are created by further pulsing or gating the output of a standard continuous LASER in the range of 1-1000 pulses/second.

45. The apparatus of claim 44, said further pulsing or gating the output of a standard continuous LASER is in the range of 1-1000 pulses/second.

46. The apparatus of claim 41, wherein said small zones of tissue damage are created by modifying the beam diameter output of a standard continuous emission LASER.

47. The apparatus of claim 2, wherein said means for providing energy comprises means for providing intensed pulsed light radiation.

48. The apparatus of claim 47, wherein said means for providing for providing intensed pulsed light radiation is selected from the group of:

flashlamps, fiberoptics, waveguides, reflectors, mirrors.

49. The apparatus of claim 2, wherein said means for providing energy comprises means for providing microwave radiation.

50. The apparatus of claim 49, wherein said means for providing microwave radiation is a phased array of antennas.

51. The apparatus of claim 2, wherein said means for providing energy comprises a uniform heating element connected to a controllably electrified, insulated, conductive element.

52. The apparatus of claim 51, wherein said means for controllably electrifying, insulated, conductive element is by feedback from thermal sensors.

53. The apparatus of claim 52, wherein said thermal sensors are selected from the group of infrared type, optical fiber type, electronic type or optical fluorescence type.

54. The apparatus of claim 2, wherein said means for providing energy comprises a frictional heating device or piezoelectric.

55. The apparatus of claim 2, wherein said means for providing energy comprises a hot filament.

56. The apparatus of claim 55, wherein said means for providing energy is a hot filament held rigidly in position within a reflective cavity by strength of the wire.

57. The apparatus of claim 55, wherein said means for providing energy is a filament fixedly attached to the distal shaft/tip area.

58. The apparatus of claim 55, wherein said means for providing energy is a hot filament located in the handle wherein its emission is reflected off a mirror adjacent to the shaft or tip location providing said additional energy to targeted tissue (tissue-altering-window/zone).

59. The apparatus of claim 2, wherein said means for providing energy comprises contact to resistive load connected to a controllably electrified, insulated, conductive element.

60. The apparatus of claim 2, wherein said means for providing a resistive load comprises is chosen from the group of thin film resistor, hot side of a Peltier thermoelectric cooler.

61. The apparatus of claim 2, wherein the emitted matter from shaft or tip location (tissue-altering-window/zone) changes targeted tissue.

62. The apparatus of claim 2, wherein the emitted matter from shaft or tip location (tissue-altering-window/zone) to change targeted tissue is delivered via a lumen within the shaft.

63. The apparatus of claim 2, wherein the emitted matter from shaft or tip location (tissue-altering-window/zone) to change targeted tissue is delivered via a lumen externally associated with the shaft.

64. The apparatus of claim 61, wherein the emitted matter from shaft or tip location (tissue-altering-window/zone) changes targeted tissue is chosen from the group of:

reported prolotherapy chemicals, hypertonic glucose (D-glucose), sodium morrhuate, phenol, concentrated salt solutions, and detergents, sodium deoxycholate, polidocanol, sodium docecyl sulfate, and hypertonic saline, acids, trichloroacetic acid, glycolic acid, bases, tissue-inflammation inducing chemicals, tissue-traumatizing chemicals, fibrosis-inducing chemicals in liquid, gel, foam, suspension, or powder form, silicones, collagen suspensions, fat globule/oil water suspensions, sand, glass, plastic granules, other insoluble granules, soaps, ground microbiological, plant or animal matter.

65. The apparatus of claim 2, wherein obsolescence of the apparatus is modified by obsolescence means.

66. The apparatus of claim 65, wherein obsolescence means is comprised by one or more rate controlling items chosen from the group of:

smart card, integrated circuit with limiting values, memory card with limiting values, CPU controller, alteration in the protective electrode coatings, thermal characteristics of materials surrounding electrodes, thermal characteristics of materials surrounding electrodes.

67. A method for treating targeted tissue comprising:

delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recessions are defined as being seen from at least one viewing angle;

controlling the energy applied to target tissue using energy controlling means.

68. The method of claim 67 for treating targeted tissue wherein energy controlling means is chosen from the group of:

surgeon'"'"'s touch control, thermal sensors, impedance sensors, feedback via central processing unit, analog visual monitoring, digital monitoring.

69. A method for treating targeted tissue comprising:

Forming at least one target tissue plane by delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recessions are defined as being seen from at least one viewing angle;

delivering additional energy to a shaft or tip location, that is not located within the relatively recessed, lysing segment, thus providing additional energy to targeted tissue (tissue-altering-window/zone); and

,

controlling the energy applied to target tissue using energy controlling means.

70. The method of claim 69 wherein said additional energy is delivered through means chosen from the group of:

radiofrequency, LASER, intense pulsed light, noncoherent electromagnetic radiation, microwave, thermal, uniform heating elements, hot filaments.

71. The method of claim 70 wherein said thermal energy is derived from the human environment whereupon the heat of thawing target tissues subject to a cold inert gas causes tissue alteration.

72. A method for treating targeted tissue comprising:

Forming at least one target tissue plane by delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recessions are defined as being seen from at least one viewing angle;

delivering emitted matter from shaft or tip location (tissue-altering-window/zone) to change targeted tissue;

controlling the energy applied to target tissue using energy controlling means;

controlling the emitted matter delivery.

73. The method of claim 72 wherein said emitted matter is chosen from the group of:

cold fluids, cold gasses, hot fluids, hot gasses, gasses, fibrosis inducing matter, tissue-traumatizing matter, tissue-irritating matter, tissue-inflammation inducing matter, fibroblast growth inducing matter, collagen production inducing matter, fibrosis-inducing chemicals in liquid, gel, foam, suspension, or powder form.

74. The method of claim 73 wherein collagen production inducing matter is chosen from the group of:

prolotherapy chemicals, hypertonic glucose (D-glucose), sodium morrhuate, phenol, concentrated salt solutions, detergents, sodium deoxycholate, polidocanol, sodium docecyl sulfate, and hypertonic saline.

75. A method for treating targeted tissue comprising:

Forming at least one target tissue plane by delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recessions are defined as being seen from at least one viewing angle;

controlling the energy applied to target tissue using energy controlling means;

delivering emitted matter from at least one separate means to change targeted tissue;

controlling the emitted matter delivery of the separate means.

76. The method of claim 75 wherein said separate means is chosen from the group of catheter, probe, tubing, intravenous tubing, needle and endoscopes with lumen.

77. The method of claim 76 wherein said separate means'"'"' emitted matter is chosen from the group of:

cold gasses, hot gasses, cold liquids, cold gasses, fibrosis inducing matter, tissue traumatizing matter, tissue-inflammation inducing matter, fibroblast growth inducing matter, collagen production inducing matter, fibrosis-inducing chemicals in liquid, gel, foam, suspension, or powder form.

78. A method for hair removal comprising:

delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recessions are defined as being seen from at least one viewing angle;

controlling the energy applied to target tissue using energy controlling means.

79. A method for hair removal comprising:

delivering energy to target tissue via means connected to said shaft or tip location for providing additional energy to targeted tissue (tissue-altering-window/zone);

controlling the energy applied to target tissue using energy controlling means.

80. A method for treating targeted tissue comprising:

Forming at least one target tissue plane by delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane, wherein a relative protrusion and recession is defined as being seen from at least one viewing angle;

Inserting implantable matter in the tissue planes formed by the passage of relative protrusions and recessions to modify human appearance.

81. The method of claim 80 wherein said implantable matter is chosen from the group of:

absorbable and nonabsorbable matter.

82. The method of claim 81 wherein said implantable matter is mechanically tightened during and after implantation to alter the human appearance in a manner chosen from the group of:

stitching, stapling, fastening, screwing or fixation.

83. The method of claim 81 wherein said implantable matter for any length of time, alters the human appearance by occupying, at least some of the space, between said planes formed by the passage.

84. The method of claim 81 wherein said implantable absorbable and nonabsorbable matter is chosen from the group of:

polyglactic acid, polyglycolic acid, polydioxanone, glycolic acid, poliglecaprone 25, glycoer 631, nylon, polypropylene, silk, cotton, polyester, polybutester, surgical Stainless steel, expanded polytetrafluoroethylene (ePTFE), polyethylene, polyglactin, polyethylene, terephthalate, Dacron®

, Alloderm®

, Sepramesh®

(polypropylene mesh coated on one side with sodium hyaluronate and carboxymethylcellulose), Seprafilm®

(sodium hyaluronate and carboxymethylcellulose), silicone, PROCEED®

Surgical Mesh, ULTRAPRO®

Partially Absorbable Lightweight Mesh, Surgical Titanium Mesh®

, bovine or human or porcine-derived collagen, cadaveric fascia lata (Fascian®

), hyaluronic acid derivatives, temperature setting foams, thermally setting foams, chemical-reaction setting foams, Alloderm®

(acellular allograft dermal matrix), polyethylene terephthalate (Mersilene®

), Proplast®

, Medpor®

, titanium metal alloy, vitallium metal alloy, hydroxyapatite, bioglass, and nonceramic hydroxyapatite.

85. A face tightening apparatus, comprising:

a tip, shaft and handle; and

a plurality of relatively protruding members on said distal end of said tip separated by at least one energized, relatively recessed lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane in a tunnel-free and wall-free fashion, wherein a relative protrusion and recession are defined as being seen from at least one viewing angle.

86. A method for treating targeted tissue comprising:

delivering energy to target tissue via at least one energized, relatively recessed, lysing segment, wherein a plurality of relatively protruding members together with said at least one recessed lysing segment are configured for lysing tissue substantially in a plane for tissue tightening or tissue contraction, wherein a relative protrusion and recession are defined as being seen from at least one viewing angle;

controlling the energy applied to target tissue using energy controlling means.