Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report.

BACKGROUND: The aging process starts in the center of the face, in the periocular region and around the mouth, with a combination of volume loss, tissue descent, deepened wrinkles, and the loss of skin structure and quality. Recently, several studies have demonstrated the efficacy of therapies based on autologous adipose tissue grafting, which leverages the properties of stromal vascular fraction (SVF) and adipose-derived mesenchymal stem cells (ADSCs) to accelerate the regenerative processes of the skin. This study aims to verify the ability of guided superficial enhanced fluid fat injection (SEFFI) in the facial area to correct volume loss and skin aging, proving that this standardized procedure has a very low rate of complications. METHODS: We retrospectively collected data from 2365 procedures performed in Italian centers between 2019 and 2021. Guided SEFFI was performed alone or combined with cosmetic treatments, including the use of hyaluronic acid filler, suspension threads, synthetic calcium hydroxylapatite, botulin toxin, and microneedling. RESULTS: guided SEFFI was used alone in more than 60% of the patients and in all facial areas. In about one-tenth of the patients, guided SEFFI was combined with a botulin toxin treatment or hyaluronic acid filling. Other procedures were used more rarely. Ecchymosis in the donor or injection sites was the most frequent adverse event but was only observed in 14.2% and 38.6% of the patients, respectively. CONCLUSIONS: The guided SEFFI technique is standardized and minimally invasive, leading to very few complications. It constitutes a promising antiaging medical treatment that combines effectiveness, safety, and simplicity.

Combined laser treatment for ear keloids: Case series: Comparison between two mini-invasive protocols: Comparison between two mini-invasive protocols.

BACKGROUND: Keloids are benign fibrous tumors derived by excessive proliferation of fibroblasts and collagen synthesis after an injury, and they do not regress spontaneously. Earlobes keloids may develop either on the helix or on the anterior or posterior lobe, up to several years after piercing. AIMS: To evaluate the effectiveness of a combined protocol of CO2 laser + dye laser versus CO2 laser + dye laser + Enerjet. METHODS: Eighty patients with a total of 83 ear keloids were divided in two groups: One group has been treated in the same session with a single CO2 laser procedure + a pulsed Dye laser procedure; the second group has been treated as the group one with an adjunctive Enerjet procedure. RESULTS: Of the 40 patients for a total of 41 treated keloids in the first group, 85.4% of keloids did not recur during a follow-up period (3 months-7 years), 14.6% of the lesions recurred (6/41) with mild thickening of the scar and underwent to further treatments. The second group (40 patients, 42 keloids) results showed a 90.5% of keloids which did not recur during a follow-up period (3 months-2 years), while 9.5% of the lesions recurred (4/42) with mild thickening of the scar and underwent to further treatments. CONCLUSIONS: Lasers demonstrated a synergistic effect when combined together and an excellent outcome has been obtained in the 88% of treated lesions, with a slighter higher prevalence of excellent outcome of the group treated with a further procedure with Enerjet.

Attitudes, Concerns, and Expectations of Consumers of Aesthetic Medicine and Surgery During the COVID-19 Outbreak: An Italian Online Survey.

As a consequence of the coronavirus disease 2019 (COVID-19) emergency, Italian physicians working in the field of aesthetic medicine and surgery considered appropriate to stop their activity in order to preserve patients' safety. This drastic measure obviously had an important impact on the medical aesthetic market causing growing concerns. To catch the current attitudes of the Italian consumers toward the aesthetic medicine and surgery, a medical advisory board devised an online survey; 216 clinicians finally participated in this survey and sent the online link through e-mail. A total of 8080/8640 (93.5%) questionnaires were returned, while 70 were removed. Approximately 49.0% (n = 3944) did not feel influenced in their desire for aesthetic treatments in spite of the pandemic emergency. Being influenced was not correlated with the uneven situation experienced on the Italian territory (r = -0.30, P = 0.196); 45.4% (n = 3636) declared to be ready for rescheduling their visit, and 60.5% (n = 4844) declared that they want to allocate the same amount of resources as before. The most missed aesthetic treatment was the face (71.1% [n = 5696]). Approximately 47.0% (n = 3759) and 46.0% (n = 3679) will come back to their physician without any request or with the need for an explanation about the security protocols, respectively. Approximately 40% (n = 3314) declared that their physical appearance affects their mood fairly, 27.0% (n = 2168) strongly or very strongly, and 71.3% (n = 5708) declared physical and/or psychological decline. Looked at together, the results give us some optimistic predictions, and, therefore, the authors are confident that their patients will come back to their clinics without any particular issues. However, ensuring patient safety must be our paramount task.

Multicenter study of vacuum-assisted precise tissue release for the treatment of cellulite in a cohort of 112 Italian women assessed with cellulite dimples scale at rest.

Objectives and background: Tissue stabilized-guided subcision (TS-GS) treatment has emerged as a single session treatment for cellulite dimples. To date, studies on a few patients were reported. We present data concerning efficacy and safety of TS-GS for cellulite in a cohort of Italian patients.Patients and Methods: This is a retrospective study involving 122 patients requiring cellulite treatment, classified according to validate cellulite dimples scale at rest, at T0. TS-GS technique is assessed in terms of efficacy (masked evaluations of pre- and post-treatment pictures, satisfaction of patients and variations in cellulite dimples scale at rest), safety of results at 12 months follow-up (T1). U nivariate and multivariate analyses were carried out to evaluate variables associated with the size effect.Results: Masked evaluations of 112 patients completing the study resulted in the correct selection of pre- and post-treatment images in all cases and all patients were satisfied. The mean cellulite dimples scale at rest score improved ≥1 point at T1. We found a significant association between size effect, higher satisfaction (p < .01), cellulite grading at T0 (p < .01), higher BMI (p = .037); a higher BMI was correlated to an increased cellulite grading at T0 (p = .02). Only minor and temporary adverse events were reported.Conclusions: We confirm herein the clinical efficacy and safety of TS-GS for cellulite dimples treatment in a cohort of Italian patients assessed with the validated cellulite dimples scale at rest.

Endovenous and perivenous 808-nm laser treatment of lower limb collateral, reticular and telangiectasiac veins.

BACKGROUND: Visible leg veins are not only a mere aesthetic problem, but may also be manifestation of altered microcirculation and superficial venous incompetency. Sclerotherapy is the first-line treatment for leg veins < 4 mm, but it often needs multiple sessions and sometimes fails. The main limitations of transcutaneous laser treatment are the diameter and the depth of the veins: the greater, the harder photothermolysis is, so that higher powers may lead to aesthetic complications. MATERIALS AND METHODS: We report our experience in the treatment of small collateral (< 4 mm), reticular and telangiectasiac veins with endovenous and perivenous 808-nm laser. RESULTS: Overall, 325 treatments were performed on 113 patients. The endovenous and perivenous treatment proved to be a safe, quick, well-tolerated and effective procedure. It ensured an optimal closure of the target veins right from the first treatment in most patients. Sometimes, a second treatment of the same vein was needed. CONCLUSIONS: The endovenous and perivenous 808-nm laser photothermal sclerosis ensures a quick coagulation-fibrosis of the veins of the lower limbs, thus allowing rapid healing and good aesthetic results (stable in 95% of patients after an average follow-up of 18 months). It may be an effective alternative to sclerotherapy.

Phosphatidylcholine and sodium deoxycholate in the treatment of localized fat: a double-blind, randomized study.

BACKGROUND: Recent articles have introduced the novel concept of chemical lipolysis through local injections. Phosphatidylcholine is the active drug in the commercial preparation used for this purpose, but some studies have suggested that sodium deoxycholate, an excipient of the preparation, could be the real active substance. AIM: We decided to investigate whether phosphatidylcholine and sodium deoxycholate have any clinical efficacy in chemical lipolysis and their respective roles. We also studied the safety and side effects of the treatments. MATERIALS AND METHODS: Thirty-seven consecutive female patients were studied for the treatment of localized fat in gynoid lipodystrophy. Each patient received injections of a phosphatidylcholine/sodium deoxycholate preparation on one side and sodium deoxycholate on the contralateral side, each single patient being herself the control. Four treatments were carried out every 8 weeks in a double-blind, randomized fashion. Metric circumferential evaluations and photographic and ultrasonographic measurements throughout the study allowed for final judgment. A statistical evaluation concluded our study. RESULTS: An overall reduction of local fat was obtained in 91.9% of the patients without statistically significant differences between the treated sides. Reduction values on the phosphatidylcholine/sodium deoxycholate-treated sides are in the order of 6.46% metrically and 36.87% ultrasonographically, whereas on the deoxycholate-treated sides they are in the order of 6.77% metrically and 36.06% ultrasonographically. Both treatments, at the dose used in the study, proved safe in the short term. The most common side effects were local and few, but were more pronounced on the deoxycholate-treated sides. No laboratory test was carried out. CONCLUSION: Both treatments have shown moderate and equivalent efficacy in treating localized fat, with sodium deoxycholate having a slower postoperative resolution, suggesting that sodium deoxycholate could be sufficient by itself to determine fat cell destruction and that phosphatidylcholine could be useful for obtaining a later emulsification of the fat.