Ablative laser resurfacing has been considered the most effective treatment option for skin rejuvenation. However, the epidermis is significantly damaged during this process, and this can be associated with potential adverse effects, including transient erythema, pigmentary disturbances, infection, and scarring, especially in Asians (Nanni and Alster 1998). Nonablative skin resurfacing involves selective thermal damage to a subepidermal layer. It is achieved by a combination of laser radiation reaching the dermis and the concurrent use of cooling to protect the epidermis. Although nonablative techniques are associated with less downtime, the degree of improvement appears to be limited (Chan and Kono 2004).

On the other hand, recent advances in fillers and neurotoxins have allowed the use of these agents in Asians, with minimal complications. Both fillers and neurotoxins are effective in producing an optimal cosmetic result. Currently the use of fillers and neurotoxins ranks as the most commonly performed cosmetic procedure in Asia.

Patient selection: differences and similarities from Caucasians to Asians

The demand for wrinkle reduction is very high, and patient selection is similar to patient selection for Caucasians. The efficacy and complication rate of fillers and neurotoxins in Asians are also similar to those in Caucasians (Nanni and Alster 1998). However, there are some histologic differences between Asian skin and Caucasian skin, for example, Asian skin tends to have a thicker dermis with more abundant collagen fiber.

With regard to the injection of fillers, certain areas, such as the nasolabial fold and tear trough, can be tricky.