Deborah S Sarnoff

NYU Langone Medical Center, New York, New York, United States

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Publications (24)36.66 Total impact

  • Deborah S Sarnoff · Robert H Gotkin
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    ABSTRACT: We report significant changes in the appearance of the periorbital area, beyond eyelash enhancement, induced by the topical application of bimatoprost ophthalmic solution, 0.03% (Latisse®, Allergan, Inc., Irvine, CA). To our knowledge, this is the first report in the dermatology or plastic surgery literature describing the rejuvenating effect and overall improvement in the appearance of the periorbital area resulting from applying Latisse to the upper eyelid margins. To date, reports in the literature discuss side-effects and potential complications of topical bimatoprost therapy causing a constellation of findings known as PAP (prostaglandin-associated periorbitopathy). While periorbitopathy implies pathology or a state of disease, we report changes that can be perceived as an improvement in the overall appearance of the periorbital area. We, therefore, propose a name change from PAP to PAPS - prostaglandin- associated periorbital syndrome . This better describes the beneficial, as well as the possible negative effects of topical bimatoprost. Although there is a risk for periorbital disfigurement, when used bilaterally, in properly selected candidates and titrated appropriately, bimatoprost can be beneficial. The striking improvement in the appearance of some individuals warrants further research into the potential use of topical bimatoprost to achieve a "chemical blepharoplasty."
    No preview · Article · May 2015 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff

    No preview · Article · Feb 2015 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff

    No preview · Article · Jan 2015 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff · Robert H Gotkin
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    ABSTRACT: Cervicofacial aging is often characterized by a combination of skin and subcutaneous tissue laxity, midfacial deflation, an accumulation of excess submental fat, an obtuse cervicomental angle, jowls, and rhytides of the face and neck. Traditional treatment, and the "gold standard" against which other treatments are compared, is a facelift. OBJECTIVE: To demonstrate that a combination technique called ACELIFT - an acronym for the Augmentation of Collagen and Elastin using Lasers, Injectable neurotoxins, Fillers, and Topicals - in selected patients, is a viable, safe, and effective alternative to a facelift. METHODS: Ten healthy women, ages 50 to 62 (mean age = 58), with cervical and facial stigmata of aging were enrolled in a prospective study conducted in the authors' private practice. Patients underwent a two-step procedure; the first step was laser lipolysis of the submental and anterior cervical areas with a pulsed 1440nm Nd:YAG laser with a side-firing fiber (PrecisionTx, Cynosure, Westford, MA). Three months later, the patients were treated in a single session that combined injectable neurotoxin, fillers, and fractional (Fx) CO<sub>2</sub> laser resurfacing delivered in a novel "hammock" distribution. After two weeks, following complete re-epithelialization, the patients were started on a topical regimen that included daily use of sunscreen and antioxidants and nightly use of retinoids and peptides. This regimen was continued for a period of six months when all patients returned for final evaluation. RESULTS: Nine months following the initiation of treatment, all patients were evaluated by the following: Global Aesthetic Improvement Scale, cervicomental angle scale, physician, and subject evaluation. Clinical improvement was evident, and often marked, for all subjects. Both physician and subject satisfaction scores were high, indicating overall satisfaction with the procedure and the outcomes. Side-effects were mild and transient; there were no incidents of adverse scarring, thermal injuries, permanent nerve injury, or dyschromia, hematomas, seromas, or infection. Subjects were likely to recommend the procedure to a friend. CONCLUSIONS: In properly selected patients, the ACELIFT proved to be a safe and effective, minimally invasive alternative to a facelift. There was little downtime and high patient satisfaction. J Drugs Dermatol . 2014;13(9):1038-1046.
    No preview · Article · Sep 2014 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff
    No preview · Article · May 2014 · Journal of drugs in dermatology: JDD
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    Robert H Gotkin · Deborah S Sarnoff
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    ABSTRACT: Building upon the fractional CO<SUB>2</SUB> technology incorporated into the first generation SmartXide DOT (DEKA / ElEn, SpA, Calenzano, Italy) introduced in the U.S. in 2008, a second generation SmartXide Quadro has recently been introduced. This is a versatile device that has the ability to combine fractional CO<SUB>2</SUB> laser output for skin resurfacing with the synchronous delivery of bipolar radiofrequency (RF) energy for deeper, more diffuse heating. A pilot study was undertaken to demonstrate the safety and efficacy of the SmartXide Quadro, employing both fractional CO<SUB>2</SUB> laser output combined with the synchronous delivery of radiofrequency energy for the treatment of facial rhytides and acne scars. Ten patients, all women, six with facial rhytides and four with acne scarring, were treated with the SmartXide Quadro, a variably pulsed CO<SUB>2</SUB> laser with Pulse Shape Design® technology, a microablative DOT scanner and synchronized bipolar RF emission. Each patient was treated with a single fractional CO<SUB>2</SUB> laser-RF treatment; laser and RF parameters varied according to the severity of the rhytides or acne scars and were based upon both manufacturer-recommended settings and surgeon experience. Follow-up was at three days, one week, 2 weeks, and one month, three months, and six months after treatment. Results were judged by comparison of preoperative and post-operative photos evaluated by independent physicians, preoperative and post-operative grading by treating physicians, subjective evaluation of results by the patients themselves, and tabulation and categorization of adverse events (AEs). The SmartXide Quadro variably pulsed CO<SUB>2</SUB> laser with a microablative DOT scanner, with synchronous delivery of bipolar RF energy emission, proved to be both safe and effective in the treatment of facial rhytides and acne scars. The single treatment protocol was well tolerated and recovery was similar to fractional CO<SUB>2</SUB> laser skin resurfacing alone. The AEs were minimal and no significant complications occurred. J Drugs Dermatol. 2014;13(3):299-304.
    Full-text · Article · Mar 2014 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff
    No preview · Article · Jan 2014 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff
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    ABSTRACT: Laser lipolysis is a less invasive approach to neck rejuvenation than open surgery or liposuction. Wavelengths utilized for lipolysis liquefy fat and induce collagen remodeling, which tightens skin. A new Nd:YAG device has recently been developed that emits energy at a wavelength of 1440nm; this wavelength is more highly absorbed by adipose tissue and water than other wavelengths currently available. To test the safety and efficacy of a pulsed 1440nm Nd:YAG wavelength and side-firing fiber for the treatment of subcutaneous fat and skin laxity associated with the aging neck. Twenty-four subjects aged 40 to 65 years underwent laser lipolysis of the submental and anterior cervical areas. An average of 1205J per 5x5cm square was delivered, with a maximum internal temperature setting of 47 degrees C. Cervicomental Angle Score (CAS), Global Aesthetic Improvement Scale (GAIS), subject and investigator satisfaction, and safety were assessed. At six months post-treatment, 79% of subjects had a significant improvement in the CAS (P<.001) and 79% demonstrated an improvement on the GAIS. Clinical improvement was marked and evident for all but one subject, with physician and patient satisfaction scores indicating overall satisfaction with the procedure and outcomes. Adverse events were mild and transient with no incidence of burns, seromas, hematomas, infection, or nerve damage. The 1440nm Nd:YAG device with the side-firing fiber was safe and effective for the treatment of subcutaneous fat and skin laxity in the neck. This device offers an alternative to selected individuals aged 40 and over who do not wish to undergo rhytidectomy. J Drugs Dermatol. 2013;12(12):1382-1388.
    No preview · Article · Dec 2013 · Journal of drugs in dermatology: JDD
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    Deborah S Sarnoff · Robert H Gotkin
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    ABSTRACT: Full lips have always been associated with youth and beauty. Because of this, lip enhancement is one of the most frequently requested procedures in a cosmetic practice. For novice injectors, we recommend hyaluronic acid (HA) as the filler of choice. There is no skin test required; it is an easily obtainable, "off-the-shelf" product that is natural feeling when skillfully implanted in the soft tissues. Hyaluronic acid is easily reversible with hyaluronidase and, therefore, has an excellent safety profile. While Restylane® is the only FDA-approved HA filler with a specific indication for lip augmentation, one can use the following HA products off-label: Juvéderm® Ultra, Juvéderm Ultra Plus, Juvéderm Ultra XC, Juvéderm Ultra PLUS XC, Restylane-L®, Perlane®, Perlane-L®, and Belotero®. We present our six steps to achieve aesthetically pleasing augmented lips. While there is no single prescription for a "perfect" lip, nor a "one size fits all" approach for lip augmentation, these 6 steps can be used as a basic template for achieving a natural look. For more comprehensive, global perioral rejuvenation, our 6-step technique can be combined with the injection of neuromodulating agents and fractional laser skin resurfacing during the same treatment session.
    Full-text · Article · Sep 2012 · Journal of drugs in dermatology: JDD
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    ABSTRACT: Laser skin resurfacing has shifted over the past two decades from standard ablative resurfacing to non-ablative resurfacing and most recently, to fractional laser resurfacing. In this most recent category, fractional non-ablative lasers were first introduced followed by fractional ablative lasers, which offer an improved balance between safety and efficacy. In the current article, a review of fractional ablative resurfacing is presented alongside the results from a multi-center clinical study employing the fractional carbon dioxide (CO2) laser (SmartXide DOT, DEKA) for the treatment of rhytides, photoaging, scars and striae distensae.
    Full-text · Article · Apr 2011 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff
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    ABSTRACT: Currently, there is no standard of care for postlaser resurfacing treatment of the face. Ideally, treatment should speed re-epithelialization and reduce downtime, with minimal irritation. This study compared the wound healing efficacy and safety of Aquaphor Healing Ointment (AHO) (Beiersdorf Inc, Wilton, CT) and Biafine Topical Emulsion (BTE) (OrthoNeutrogena, Los Angeles, CA) treatment after laser resurfacing of the perioral area. In this double-blind, split-face study, 20 subjects with perioral rhytides received fractional carbon dioxide laser resurfacing. AHO and BTE were applied to opposite sides of the face 4 times daily after the resurfacing procedure. Clinical grading of erythema, edema, epithelial confluence, crusting/scabbing, subjective irritation, and general wound appearance were assessed using 5-point scales on days 2, 4, 7, and 14. Subjects ranked the two treatment sites daily as to which side of their face looked better. AHO resulted in significantly less erythema (days 2 and 7) and crusting/scabbing (days 2, 4, and 7) and higher epithelial confluence (day 4) than BTE (P ≤ .042). Subjective irritation assessments demonstrated significantly less stinging, itching, and tightness at day 2 and tightness at day 7 with AHO than with BTE (P ≤ .049). General wound appearance was graded significantly higher for AHO on days 2 and 7 (P ≤ .049). Significantly more subjects preferred AHO to BTE (P ≤ .046). This was a small study in a homogenous population of white women. AHO exhibited superiority to BTE in several wound healing parameters and in overall wound condition.
    No preview · Article · Mar 2011 · Journal of the American Academy of Dermatology
  • Ritu Saini · Stephanie Lehrhoff · Deborah S Sarnoff
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    ABSTRACT: The incidence of malignant melanoma has reached more than 62,000 people this past year alone. Much is unknown about the genetic predisposition of this cancer. The authors present a 62-year-old woman with a history of Charcot-Marie-Tooth disease (CMTD), diagnosed at age five, who has also developed multiple primary cutaneous malignant melanomas since 2003. The patient presented to the authors' clinic with a pigmented lesion on the left thigh, which was increasing in size and changing color. The patient was diagnosed with malignant melanoma in situ on biopsy. As both CMTD and malignant melanoma are neural crest derived disorders, this may suggest a shared underlying genetic defect. A gene locus of particular interest is 1p36, both previously recognized in the proposed pathogenesis of CMTD and malignant melanoma (MM).
    No preview · Article · Feb 2010 · Journal of drugs in dermatology: JDD
  • Ritu Saini · Deborah S Sarnoff

    No preview · Article · Mar 2009 · Journal of drugs in dermatology: JDD
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    ABSTRACT: Carbon dioxide (CO2) laser skin resurfacing has been a mainstay of facial rejuvenation since its introduction in the mid 1990s. Recently, a new generation of fractional or microablative CO2 lasers has been introduced to the marketplace. According to the concept of fractional photothermolysis, these lasers ablate only a fraction of the epidermal and dermal architecture in the treatment area. An array of microscopic thermal wounds is created that ablates the epidermis and dermis within very tiny zones; adjacent to these areas, the epidermis and dermis are spared. This microablative process of laser skin resurfacing has proven safe and effective not only for facial rejuvenation, but elsewhere on the body as well. It is capable of improving wrinkles, acne scars, and other types of atrophic scars and benign pigmented lesions associated with elastotic, sun-damaged skin. Because of the areas of spared epidermis and dermis inherent in a procedure that employs fractional photothermolysis, healing is more rapid compared to fully ablative CO2 laser skin resurfacing and downtime is proportionately reduced. A series of 32 consecutive patients underwent a single laser resurfacing procedure with the a new microablative CO2 laser. All patients were followed for a minimum of 6 months and were asked to complete patient satisfaction questionnaires; a 6 month postoperative photographic evaluation by an independent physician, not involved in the treatment, was also performed. Both sets of data were graded and reported on a quartile scale. Results demonstrated greater than 50% improvement in almost all patients with those undergoing treatment for wrinkles, epidermal pigment or solar elastosis deriving the greatest change for the better (>75%).
    Full-text · Article · Feb 2009 · Journal of drugs in dermatology: JDD
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    ABSTRACT: Cellulite is an alteration of the topography of the skin that occurs in body areas where fat deposition seems to be under the influence of estrogen: mainly the hips, buttocks, thighs, and abdomen. The presence of cellulite is a significant source of patient dissatisfaction. There is currently no cure or consistently effective treatment for cellulite. The authors sought to show that the subdermal application of the neodymium-doped yttrium aluminium garnet (Nd:YAG) laser combined with autologous fat transplantation is a safe and effective treatment for cellulite. From January 2003 to December 2006, 52 female patients with Curri grade III to IV cellulite were treated with subdermal 1064-nm Nd:YAG laser lipolysis combined with autologous fat transplantation. Patient assessment was collected for data analysis. After the treatment, tissue samples were obtained in some subjects in order to ascertain the histologic effects of the laser treatment. This treatment resulted in significant clinical improvement in cellulite. The adverse effects were mild and temporary, and the postoperative period was well tolerated. A majority of patients (84.6%) rated the results of treatment as either good or excellent. The treatment of severe cases of cellulite (Curri grades III and IV) by a combination of 1064-nm Nd:YAG laser lipolysis and autologous fat transplantation proved to be both safe and effective. In addition, subdermal laser lipolysis has the advantage of inducing neocollagenesis and stimulating postoperative skin tightening. This represents a new treatment option for the ubiquitous cellulite disorder. Although this treatment has shown promising results in this pilot study, further studies are necessary in order to draw final conclusions.
    Full-text · Article · Nov 2008 · Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery
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    Deborah S Sarnoff · Ritu Saini · Robert H Gotkin
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    ABSTRACT: The authors discuss various filling agents currently available that can be used to augment the lips, correct perioral rhytides, and enhance overall lip appearance. Fillers are compared and information provided about choosing the appropriate agent based on the needs of each patient to achieve the much coveted "pouty" look while avoiding hypercorrection. The authors posit that the goal for the upper lip is to create a form that harmonizes with the patient's unique features, taking into account age and ethnicity; the goal for the lower lip is to create bulk, greater prominence, and projection of the vermillion.
    Preview · Article · Sep 2008 · Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery

  • No preview · Article · Sep 2008 · Journal of drugs in dermatology: JDD
  • Deborah S Sarnoff · Ritu Saini
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    ABSTRACT: Epidermolytic hyperkeratosis is a rare genetic disorder of keratinization. In childhood, patients are erythrodermic and have a compromised stratum corneum, replaced with generalized hyperkeratosis as the patients age. Treatment consists of topical emollients as well as, topical and oral retinoids. Ultraviolet (UV) light, often in combination with psoralen ultraviolet A (PUVA) is widely used as a therapeutic modality for a multitude of hyperproliferative disorders. Although not strictly indicated for epidermolytic hyperkeratosis, it has been utilized as experimental treatment, particularly in the days prior to retinoids. Psoralen ultraviolet A has also been implicated in the development of nonmelanoma skin cancers, especially, squamous cell carcinoma (SCC). Retinoids are well-known to protect against nonmelanoma skin. A patient with epidermolytic hyperkeratosis with multiple nonmelanoma skin cancers, previously treated with PUVA and long-standing oral retinoids is reported.
    No preview · Article · May 2008 · Journal of drugs in dermatology: JDD
  • Ritu Saini · Deborah S Sarnoff
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    ABSTRACT: Basal cell carcinoma (BCC) is the most common human malignancy, which often occurs as a result of ultraviolet light on sun-exposed areas. A more rare location for the presentation of BCC is the non-sun-exposed genital area, where squamous cell cancer occurs frequently in the setting of human papilloma virus and chronic inflammatory lesions (i.e., lichen sclerosus et atrophicus). Consequently, such tumors may escape detection by the dermatologist and be mistaken by the gynecologist for an inflammatory condition. A delay in diagnosis can result in wider surgical margins and potential recurrences. We present a case of BCC of the vulva with involvement of the clitoris presenting with unilateral pruritus and treated as an allergic contact dermatitis with topical corticosteroids. The patient was treated with Mohs micrographic surgery in conjunction with topical imiquimod to spare surrounding tissue.
    No preview · Article · Apr 2008 · Journal of drugs in dermatology: JDD

  • No preview · Article · Jan 2004 · Journal of drugs in dermatology: JDD