The Science

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The Science Behind Plasma Soft Surgery

Plasma Physics. Published Evidence. Clinical Precision.

Every claim Arbour Longevity makes about plasma is traceable to published, peer-reviewed clinical evidence. The following is the scientific foundation for how plasma works, why it works better than alternatives for specific applications, and what the clinical evidence actually shows, not what it implies.

The Physics: What Actually Happens to the Tissue

Plexr Plus: Plasma Sublimation

Solid · Gas. Directly. Cleanly.

Plasma energy converts targeted surface tissue directly from solid to gas, sublimation. No intermediate liquid phase. No thermal column left behind. The tissue is removed with precision and the surrounding structures are unaffected.

What follows: the treated zone initiates a clean collagen remodeling response: new collagen synthesis in the absence of thermal injury to resolve. The healing is structural repair, not scar tissue management.

CO₂ Laser: Thermal Vaporization

Solid · Liquid · Charcoal.

CO₂ laser targets water molecules inside tissue, heating them until the tissue vaporizes. This leaves a column of thermally damaged charcoal tissue beneath the treatment zone. The body must resolve this thermal injury before regeneration can begin.

The clinical consequence: recovery involves healing thermal damage, not just healing the ablation site. This is why CO₂ requires melanin-based precautions, and why it cannot be safely used on darker skin tones year-round.

300×

More Ablation Volume Per Shot vs CO₂ Laser

The Published Mathematics

Why One Device Achieves What Another Cannot

The mathematical comparison of tissue volume per plasma shot versus CO₂ laser: VPLEXR/VCO2 = 3(rPLEXR/rCO2)² = 3(0.5/0.05)² = 300×. Published physics confirm plasma achieves 300× more ablation volume per shot than CO₂ laser, removing more tissue with greater precision while the laser burns and leaves thermal residue.
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One Plexr session achieves what requires many CO₂ sessions, with significantly less risk, less recovery time, and a cleaner biological response. For patients with darker skin tones, this advantage becomes a clinical imperative: plasma doesn't rely on chromophore absorption, so it produces the same result regardless of melanin concentration.

Plexr Plus vs. CO₂ Laser: Clinical Comparison

Parameter

Plexr Plus (Plasma)

CO₂ Laser

Mechanism

Sublimation: solid to gas, no thermal column

Thermal vaporization: residual damaged tissue

Skin Tone Safety

All Fitzpatrick types I–VI, chromophore-independent

Risk with Fitzpatrick IV–VI: melanin absorption

Seasonal Restriction

None: year-round treatment

Sun avoidance required: seasonal limitation

Depth Control

3 calibrated tiers: nano, semi, ablative

Less granular, operator-dependent

Recovery (surface)

3–14 days depending on depth tier

7–21 days for fractional; longer for full ablative

Collagen Remodeling

Clean remodeling response: confirmed by RCM histology

Remodeling begins after thermal injury resolution

Anesthesia Required

None (Shower) to topical only (deep ablative)

Topical to nerve block for deep ablative

Portability

Cordless · Handheld · 3 handpiece system

Fixed system · Requires dedicated room

FDA Clearance

FDA-Cleared for tissue removal and coagulation

FDA-Cleared

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Published Clinical Evidence

Clinical Evidence Behind Plasma Soft Surgery

Published clinical evidence supports the use of plasma technology for non-surgical skin resurfacing and rejuvenation treatments.

Published Clinical Evidence: Ann Arbor

Study

Journal / Year

Key Finding

Protocol

Clinical Application

Hassan et al. (El-Domyati)

J Dermatolog Treat · 2020

90% of patients (36/40) showed significant decrease in eyelid laxity (p<0.001). Blinded assessment by 2 dermatologists + 2 ophthalmologists.

3 sessions · 1-month intervals · n=40 women

The strongest blinded evidence for non-surgical blepharoplasty. Arbour Longevity's primary blepharoplasty positioning study.

Rossi et al.

Dermatol Surg · 2018

Clinical improvement of 2.6 ratings on facial laxity scale. Collagen type III remodeling confirmed by reflectance confocal microscopy in vivo. No serious adverse events.

3 sessions · Pilot study · n=10

Histological confirmation of collagen remodeling. The only in-vivo RCM confirmation of collagen type III synthesis from plasma exeresis.

Abdollahimajd et al.

J Cosmet Dermatol · 2022

Significant improvement in dermatochalasis vs. baseline (p<0.001). Objective measurement by Reviscometer instrument, not subjective photo assessment.

3 sessions · n=56 women

Objective instrument confirmation adds clinical credibility beyond photography. Supports blepharoplasty and laxity claims.

Ferreira et al.

J Cosmet Dermatol · 2021

Significant satisfaction improvement at Day 7 (p=.038). Described as minimally invasive with low impact on quality of life. 87.5% female, mean age 50.5.

Single course · n=16 · Observational

Patient quality-of-life data supports "minimal disruption" positioning. Satisfaction data relevant to patient communication.

Tsioumas et al.

JCAD / PMC · 2021

52.9% reported being extremely satisfied. 33% upper eyelid, 18% lower eyelid treatment. 710 patients, 124 working days.

Real-world cohort · n=710

Largest real-world plasma cohort published. Demonstrates clinical feasibility and volume. Upper/lower eyelid dominant indication confirmed.

Karapantzou et al.

Arch Clin Med Case Rep · 2022

n=60, bilateral plasma blepharoplasty. Histopathology confirms Plexr spots respect the basal membrane without penetration. Collagen type III confirmed within 1 month.

2 sessions · n=60

Histological confirmation of surface precision, supports "no deep thermal damage" positioning throughout all copy.

Delavar et al.

J Lasers Med Sci · 2023

n=24 keloid scars. Mean keloid thickness 2.20mm · 0.54mm (p=0.000) on Vancouver Scar Scale. Pilot trial.

2–3 sessions · Pilot study

First published pilot for plasma keloid treatment. Supports Arbour Longevity's scar revision positioning with objective thickness data.

Paganelli et al.

J Cosmet Dermatol · 2020

Plasma exeresis combined with non-cross-linked HA for neck skin laxity. Synergistic effect confirmed. Supports the plasma + active ingredient combination approach.

Clinical trial · Neck laxity

Supports the ERA/PLEXR FUSION concept: plasma opening channels for active ingredient delivery. Informs Arbour Longevity neck lift and GlassLIFT protocols.

Candidacy: Who Plasma Is and Is Not Appropriate For

Clinical Honesty About Candidacy

Arbour Longevity will always tell you honestly whether you are an appropriate candidate for plasma, including when you are not. The following is the complete candidacy picture.

Appropriate candidates include:

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Adults with mild to moderate skin laxity, excess eyelid skin, or dermatochalasis

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All Fitzpatrick skin types I–VI, no exclusion by skin tone

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Patients who have been excluded from laser resurfacing due to skin tone or season

✓

Post-surgical or post-weight-loss patients with structural skin changes

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Patients seeking an alternative to surgical procedures due to recovery concerns or anesthesia risk

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Patients with keloid or hypertrophic scar history, with modified protocol and expectation management

Contraindications and cautions:

Active herpes simplex infection at or near the proposed treatment area: treat and clear first

Isotretinoin (Accutane) within the past 6–12 months, minimum washout period required

Pregnancy or active breastfeeding: all elective aesthetic treatments deferred

Active skin infection, open wounds, or inflammatory dermatosis at the treatment site

Significant ptosis or severe dermatochalasis where surgical blepharoplasty is the more appropriate intervention, your clinician will tell you honestly at consultation

Unrealistic expectations regarding outcome: managed through comprehensive consultation and honest communication

Plasma Soft Surgery · The Science · Ann Arbor

Questions the Science Raises. The Consultation Answers.

The evidence is the foundation. Your anatomy is the variable. Your clinician bridges the two, translating published protocols into a treatment plan that is specific to your skin, your concern, and your goals. Book a consultation and get honest answers.

Book Consultation · (734) 436-3357

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