Psychological Analysis of Non-surgical Rhinoplasty.

The aim of this study is to analyze the psychological outcomes for patients undergoing non-surgical correction of nasal defects using injections of cross-linked hyaluronic acid. We assessed changes in the subjective perception of nasal appearance after non-surgical rhinoplasty using the Rhinoplasty Outcomes Evaluation (ROE) questionnaire, which is validated and widely used in the literature. One hundred adult subjects without prior history of surgical or non-surgical rhinoplasty underwent non-surgical recontouring using the hyaluronic acid filler from December 2016 to December 2018. The points of inoculation have been standardized by the authors and are divided according to the aesthetic subunits of the nose. A final 74 patients (65 females and 9 males) completed a one-year follow-up and were included in the present study. The ROE questionnaire consists of six questions and assesses the way patients perceive the appearance of their nose and the way they think the people around them view the appearance of their nose. The results of each question were analyzed for each patient, comparing the preoperative results over a 12-month time-frame. Candidates for rhinoplasty, either medical or surgical, are among the most difficult to treat and, interestingly, there is substantial literature showing that among these patients, there is a higher rate of psychiatric disorders. Many of these patients seek aesthetic surgery and are often dissatisfied with the outcome of their surgery. The authors suggest that the use of ROE is not only a valid method of assessing patient satisfaction, but it could also be used as a tool to highlight some of the psychological characteristics of patients long before performing any treatment and could help identify potentially problematic patients.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

New Regenerative and Anti-Aging Medicine Approach Based on Single-Stranded Alpha-1 Collagen for Neo-Collagenesis Induction: Clinical and Instrumental Experience of a New Injective Polycomponent Formulation for Dermal Regeneration.

This study explores the efficacy of a novel polycomponent formulation (KARISMA Rh Collagen® FACE, Taumedika Srl, Rome, Italy), containing 200 mg/mL of non-crosslinked high-molecular-weight hyaluronic acid (HMW-HA), 200 µg/mL of a human recombinant polypeptide of collagen-1 alpha chain, and 40 mg/mL of carboxymethyl cellulose (CMC) as a regenerative medicine for skin regeneration and rejuvenation. This formulation combines non-crosslinked high-molecular-weight hyaluronic acid, human recombinant polypeptide of collagen-1 alpha chain, and carboxymethyl cellulose to stimulate collagen type I production and enhance skin hydration. This study involved 100 subjects with varying skin conditions, divided into three groups based on skin aging, smoking history, and facial scarring, to evaluate the product's effectiveness in skin regeneration and aesthetic improvement. The methodology included two injections of Karisma (2 mL for each injection) one month apart, with evaluations conducted using FACE-Q questionnaires, the SGAIS Questionnaire, and Antera 3D skin scanner measurements at baseline, 30 days, and 60 days post-treatment. The results demonstrated a significant reduction in skin roughness and an improvement in skin quality across all the groups, with no correlation between the outcomes and the patient's age. The subjective assessments also indicated high satisfaction with the treatment's aesthetic results. The analyzed data allow us to conclude that the single-stranded collagen with hyaluronic acid and carboxymethyl-cellulose formulation is able to stimulate the skin's regenerative response, yielding significant results both in vitro and, through our study, also in vivo. This new polycomponent formulation effectively stimulates skin regeneration, improving skin quality and texture, with significant aesthetic benefits perceived by patients, and a low incidence of adverse events, marking a promising advancement in regenerative medicine.

Hyaluronic acid filler injections for tear-trough deformity: injection technique and high-frequency ultrasound follow-up evaluation.

UNLABELLED: This study aimed to describe the technique used by the authors in treating tear-trough deformity and to illustrate the effectiveness of high-frequency diagnostic ultrasound in the assessment of dermal filler longevity. In this consecutive interventional nonrandomized case series, 22 patients (18 women and 4 men) were evaluated. They ranged in age from 29 to 65 years (mean, 46.59 years ± 10.0 years). The patients were given multiple hyaluronic acid injections in the tear-trough area between 2009 and 2011. The injected areas then were evaluated with sonographic scans during the follow-up period. All the patients were examined preoperatively, 7 days after injection, then after 1, 6, and 12 months, and finally once a year. Pre- and postoperative photographs using standard positioning and lighting were taken as well as high-frequency ultrasound scans using a 15-MHz scanner with an axial resolution of 15 mm. The injection technique consisted of three to five injections perpendicular to the skin. These were administered just under the orbital rim, creating three column-shaped hyaluronic acid deposits deep in the orbicularis oculi muscle, from 0.2 mm to 0.5 mm below the orbital rim. Approximately 0.1 ml-0.3 ml was injected at a time. This technique creates a deep scaffolding that can fill the orbital hollow. The amount of filler used in each area ranged from 0.1 ml to 0.3 ml (mean, 0.267 ml ± 0.128 ml), whereas the mean filler quantity in each eyelid was 0.45 ml ± 0.14 ml. During the follow-up visit 1 week after the treatment, 21 patients (90 %) required a second series of injections either in the exact same areas or right next to the injected area to obtain a smoother appearance of the skin surface. During the sonographer examination, it was always possible to identify and measure the filler at the site of the injection. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .