A Tensioned Human Skin Explant Model Used for Preliminary Assessment of Chemexfoliant-Stimulated Bioeffects.

A tensioned ex vivo full-thickness human skin explant platform was used to assess the bioeffects arising from application of several commercial chemexfoliation agents. Although such treatments are well-established, and improved understanding of the underlying mechanistic processes continues to emerge, research into the optimum treatments for specific skin types/conditions is still needed for enhanced efficacy while minimizing recovery time. The 3 commercial chemexfoliation agents employed all contained trichloroacetic acid at well-defined concentrations (6, 10, and 20%) and were applied to the explants' stratum corneum. Subsequently, measurements of dermal remodeling factors (COL1A1, ELN, HAS2, HAS3, and procollagen type I) and inflammatory marker (IL-1b) were undertaken using qPCR and immunofluorescent analyses. Statistical analysis of these data facilitated the establishment of benchmarking biological responses to these trichloroacetic acid-containing agents against untreated controls. The performance of an innovative trichloroacetic acid-free chemexfoliation agent was then measured and, upon comparison with the previous benchmarking data, indicated that dermal remodeling factors could be upregulated in fashion comparable with that of the trichloroacetic acid-containing agents but with significant suppression of inflammatory response. Our measurements thus underscore the promise of the tensioned explant over prolonged study periods and also that potentially valuable insights to guide preclinical strategies may be forthcoming from the protocol developed.

A simple cell proliferation assay and the inflammatory protein content show significant differences in human plasmas from young and old subjects.

Some studies showed a "rejuvenating" effect of exposing aging tissues to a young environment. In mouse heterochronic parabiosis experiments, in response to young organisms, old animals lived longer than isochrony old age-matched conjoint animals. Comparable "rejuvenating" effects were obtained by injecting young plasma in old mice. This raised great hopes of slowing down the senescence process in humans by the injection of young plasma, as well as to prevent or cure age-related diseases. Some clinical trials are currently being performed or were recently completed. However, these studies are small and of limited duration, and we still lack convincing evidence to support the effectiveness of young plasma injection. It is urgent to perform additional investigations, including the development of an assay to measure the cell proliferation induction capability of different human plasmas, before one can seriously think of a large-scale treatment of humans. We adopted a simple method to measure the potential of different plasmas in supporting cell line proliferation, regardless of the co-presence of a platelet lysate. By comparing plasmas from young and old subjects, we observed a decreased activity in plasmas from old individuals. The young plasma effect may be attributed to specific proteins and growth factors more abundant in younger individuals that could decrease with age. Alternatively, or at the same time, the reduced cell proliferation support could be due to inhibitors present in the old plasma. Studying the different protein content of young and old plasmas was out of the scope of this article. Such differences should be adequately investigated by proteomics using many samples. However, a preliminary study of the different protein content of young and old plasmas was part of the assay validation using a commercially available cytokine array for parallel determination of the relative levels of 105 selected human proteins. We could show the existence of specific differences between young and old plasmas and that plasmas from old individuals presented a higher concentration of "inflammatory" proteins.

Direct Excision of Malar Bags: Back to the Basics.

INTRODUCTION: The pursuit of periorbital rejuvenation to counteract signs of aging is a focal point in cosmetic surgery, with eyelid surgery being a prominent choice among patients. Addressing inferior blepharoplasty, especially in cases involving chronic malar edema, malar mounds, and festoons, presents unique challenges. The terminology and classification of these conditions vary, hindering effective management. In this study, we use the term "malar bags" to encompass the spectrum of fluid-associated mounds over the malar eminence. OBJECTIVES: This study aims to demonstrate the effectiveness of direct excision as a surgical choice for treating the aesthetic concerns associated with malar bags. MATERIALS AND METHODS: A retrospective study was conducted on 53 patients who underwent direct excision of malar bags between 2013 and 2023 at our clinic. RESULTS: No major complications were encountered, overall high level of satisfaction for both patients and surgeons. CONCLUSION: Direct excision of malar bags proved to be a safe and effective technique, yielding satisfactory results in terms of both aesthetic outcomes and patient satisfaction. LEVEL OF EVIDENCE III: 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 .

HArmonyCa™ hybrid filler to restore connective tissue: An Italian real-life retrospective study.

BACKGROUND: Facial aging and dermal conditions may negatively influence the quality of life, leading patients to seek aesthetic procedures to restore a more satisfying appearance. HArmonyCa™ is a recently developed hybrid filler that combines the actions of the most common dermal fillers, hyaluronic acid (HA) and calcium hydroxylapatite (CaHA). AIMS: This study investigates the efficacy and safety of HArmonyCa™ in patients affected by chrono- and photoaging and several facial skin conditions. PATIENTS/METHODS: One hundred and twenty-nine patients, affected by chrono- and photoaging, and skin conditions such as oily and acne-prone skin, rosacea, or scarring, were treated with HArmonyCa™. Injections followed the retrograde linear fanning technique. A physicians' consensus identified five optimal entry points. The physician and patients assessed treatment outcomes using the Global Aesthetic Improvement Scale (GAIS) 9 months after treatment (including immediate lift effect, skin firmness, and elasticity), and 3D images were taken for documentation. Adverse events (AEs) were evaluated immediately after the procedure and after 9 months. RESULTS: According to the physician's assessments, all patients displayed an improvement in facial appearance, particularly during movement, with the patients' evaluation showing agreement. Only minor AEs were reporte, which resolved spontaneously. Moreover, HArmonyCa™ treatment proved compatible with different medications and aesthetic procedures. CONCLUSIONS: This study shows that one treatment with HArmonyCa™ yields highly satisfactory outcomes in patients affected by skin conditions. For the first time, we show that HArmonyCa™ is a dynamic filler that improves facial laxity during movement. The treatment proved to be safe and fully compatible with other cosmetic procedures and medications.

Efficacy of Picosecond Laser in Clinical, Histopathology, and Immunohistochemistry Examination in Indonesian Wrinkled Skin.

Introduction: The elderly population wants to improve skin function and maintain a youthful appearance without wrinkles. Laser is one of the highly developed and widely used therapeutic modalities of skin aging by stimulating dermal collagen formation. Picosecond laser therapy is performed on skin with wrinkles to determine the mechanism of wrinkle improvement with a picosecond laser through an increasing in tissue inhibitor of metalloproteinases 1 (TIMP-1), and a decrease in matrix metalloproteinase-1 (MMP-1), which was confirmed by collagen density. Methods: The study was started from March 2021 to July 2021 at URJ Dr. Soetomo Hospital Surabaya and Surabaya Skin Centre. Twenty patients meeting the inclusion criteria of being 36-55 years of age and having a wrinkle in the forearm were enrolled by random sampling. Each sample data was recorded, the average TIMP-1, MMP-1, collagen density, and clinical wrinkles were calculated, and the laser was performed by using a picosecond 755 nm laser. Results: All patients showed a moderate pre-test wrinkle scale. The figure for TIMP-1 and MMP-1 after therapy was higher. The MMP-1/TIMP-1 ratio in wrinkles treated by using a picosecond laser was lower but insignificant than before. The picture of collagen density indicates that collagen density after laser therapy was higher than before. Conclusion: The result of clinical examination, histopathology, and immunohistochemistry in this research explained that a picosecond 755 nm laser with DLA is an effective therapy for wrinkles in Indonesian patients without any adverse effects.

Autologous fat grafting for cosmetic temporal augmentation: a systematic review.

Background: Autologous fat grafting for temporal augmentation is increasingly popular in aesthetic surgery. However, its high absorption rate, unpredictable volume retention rate, and potential safety risks are significant drawbacks. Evaluation methods for the fat graft survival rate, especially volume retention in the temporal area, vary widely and tend to be more subjective than objective. Therefore, this systematic review aims to analyze the unpredictable volume retention rate, associated safety concerns, and the various assessment strategies following autologous fat grafting for cosmetic temporal augmentation. Methods: We conducted a systematic review of manuscripts listed in the MEDLINE/PubMed database on autologous fat grafting for cosmetic temporal augmentation. Articles had to be available in full text and written in English. Studies not presenting human data or not discussing cosmetic indications were excluded. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Eight articles were included. The average fat volume injected into each temporal region was 10.69 ml (range 6-17.5) on the right and 10.64 ml (range 5.9-17.4) on the left side. All included articles utilized photographic documentation before and after treatment, along with various questionnaires and scales (37.5% Likert Scale, 12.5% Hollowness Severity Rating Scale, 12.5% Visual Analogue Scale, 12.5% Allergan Temple Hollowing Scale). For objective assessment, one article (12.5%) used computed tomography, and another (12.5%) employed a three-dimensional scanning system to objectively evaluate fat graft survival. Conclusion: Autologous fat grafting effectively addresses temporal hollowness, with high patient satisfaction and a favorable safety profile. However, the variability in fat retention rates highlights the need for more controlled studies to establish reliable, validated methods for evaluating fat graft survival in the temporal area, and to further assess the safety of this procedure.

Correction of Infraorbital Dark Circles Using Autologous Adipose-Derived Collagen Filler: A Novel Regenerative Option.

BACKGROUND: Numerous intrinsic and extrinsic factors, notably the aging process, contribute to the development of infraorbital dark circles. These features, commonly associated with old age and fatigue, are caused by a disruption of dermal melanin and impairment of skin barrier function. Common aesthetic concerns affecting patients with infraorbital dark circles are primarily owing to lean and translucent lower eyelid skin overlying the orbicularis oculi muscle. This study aimed to present a novel technique for correcting infraorbital dark circles utilizing an adipose-derived extracellular matrix concentrate-adipose collagen fragment (ACF)-to correct infraorbital dark circles. METHODS: Female patients (n = 94) aged 20-38 who presented infraorbital dark circles were enrolled to assess the efficacy of this technique for an eight-month follow-up. Following intradermal injections with ACF filler, the clinical outcome was determined by responses to GAIS and patient satisfaction surveys. Statistical analysis was performed with the one-way ANOVA test, and a p value of < 0.05 was considered statistically significant. RESULTS: Patients (n = 92) completed a single treatment session and underwent an eight-month follow-up. Eighty patients (86%) reported being "highly satisfied" or "satisfied" with the outcome and responded that the technique resulted in brighter, tighter, and smoother infraorbital skin. Over 97% of patients were rated as "improved," "much improved" and "Very much improved" throughout the follow-up on GAIS by three independent surgeons (p < 0.05). The statistical analyses demonstrated the percentage differences among groups are highly significant (p < 0.0001). No irregularity or lump was observed during the follow-up. Two patients were excluded from the study due to having undergone cosmetic eyelid surgery. CONCLUSION: Intradermal ACF filler represents a novel approach to addressing infraorbital dark circles and yields significantly high patient satisfaction. ACF fillers provide a degree of bio-stimulation, and adipose-derived concentrate is a natural filler with regenerative effects used in periorbital rejuvenation. 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 .

Therapeutic Performance of Needle Injection Versus Needle-Free Jet Injector System for Polynucleotide Filler in Skin Rejuvenation.

BACKGROUND: Polynucleotide (PN) filler often causes pain and can lead to delivery inaccuracies when applied via intradermal injection using a traditional needle. AIMS: To evaluate the efficacy of treatment and the pain during the procedure using conventional needle injection versus a needle-free jet system for intradermal PN filler application. METHODS: In this split-face clinical trial, 10 Korean subjects were enrolled. Each subject received an intradermal injection of PN filler on one side of the face and a needle-free jet injection using CureJet on the other side. Assessments included global and 3D skin imaging at each visit. Pain intensity was evaluated using visual analogue scale (VAS) scores during the injection. Additionally, patient satisfaction and adverse events were documented. RESULTS: Findings revealed that Global Aesthetic Improvement Scale scores and patient satisfaction were significantly higher with the CureJet compared to the needle injection method. VAS scores were notably lower on the CureJet side. Improvements in both pore and wrinkle indices were observed from baseline, with a more pronounced improvement rate on the CureJet side compared to the needle injection side. CONCLUSIONS: Needle-free injection of PN for aging skin was found to be effective in enhancing pore and wrinkle improvement, while reducing associated discomfort.

Injectable Platelet-Rich Fibrin and Hyaluronic Acid Mesotherapy for Management of Actinic Elastosis of Lower Eyelids: A Case Series.

Rejuvenating the skin on the lower eyelids is often complicated. Treatment alternatives that have been practiced in the past had several complications. Additionally, they were not completely effective in addressing skin aging or actinic elastosis symptoms such as dark circles under the eyes. A minimally invasive therapy approach that improves the above-mentioned issues in a desirable way has been discussed in this case series. The patients selected were of the age group between 20-40 years who had actinic elastosis of the lower eyelid. The patients were injected twice at one-month intervals with a combination of injectable platelet-rich fibrin (iPRF) and hyaluronic acid. The patients were examined on the day of treatment and one month after the second injection. A progressive improvement in the esthetic outcome and a high level of patient satisfaction were observed. Apart from the predicted visible swelling right away following the iPRF injection. The outcomes have shown that a series of iPRF with hyaluronic acid injections in the lower eyelid region is a safe, proficient, pain-free, simple and rapid treatment option for actinic elastosis.

Picosecond Alexandrite Laser With Diffractive Lens Array Combined With Long-Pulse Alexandrite Laser for the Treatment of Facial Photoaging in Chinese Women: A Retrospective Study.

BACKGROUND AND OBJECTIVES: Facial photoaging is a type of facial skin aging induced mainly by exogenous factors (ultraviolet radiation) and often manifests itself in the form of hyperpigmentation, telangiectasia, roughness, increase in fine lines/wrinkles, and enlarged pores. Recently, picosecond lasers have become an emerging option for the treatment of facial photoaging, and long-pulse alexandrite lasers (LPAL) have demonstrated promising potential in the treatment of photoaging-related symptoms. This study aimed to evaluate the efficacy and safety of picosecond alexandrite laser (PSAL) with diffractive lens array (DLA) combined with LPAL for facial photoaging. METHODS: This is a retrospective study of 20 Chinese female patients with facial photoaging who received PSAL with DLA combined with LPAL during a 1-year period. All patients were treated every 4 weeks for a total of three treatments. Objective indicators of facial photoaging and patient satisfaction were evaluated before each treatment, and pain scores and adverse effects were recorded after each treatment. RESULTS: Compared with baseline, patients showed significant differences in all facial photoaging indices (p < 0.01). After receiving three treatments, there was a 20.1% decrease in the pigmentation index, a 23.9% decrease in the erythema index, a 34.5% decrease in the texture index, a 28.4% decrease in the fine lines index, a 56% decrease in the pore index, a 9.3% elevation and a 17.1% decrease in elasticity R2 and F4, respectively, and a 55% decrease in sebum content. The mean satisfaction score for the three treatments was 4.67 (3.33, 5.00), and the mean visual analogue scale (VAS) pain score was 7.00. No serious adverse effects such as post-inflammatory hyperpigmentation (PIH), hypopigmentation, or blistering were observed at the treatment site during the treatment period. CONCLUSION: PSAL with DLA combined with LPAL for the treatment of facial photoaging with significant efficacy, high patient satisfaction, and minimal adverse effects.

Rejuvenation of human mesenchymal stem cells using a nonintegrative and conditionally removable Sendai virus vector.

Human mesenchymal stem cells (hMSCs) with extended lifespan and differentiation potential that can recapitulate in vivo characteristics could significantly contribute to basic research, drug development, and cell therapy. Specifically, they could ensure a stable supply of specific cellular resources, and possibly extracellular vesicles. Here, we established a technology for extending the lifespan while maintaining differentiation potential, termed "rejuvenation," of hMSCs (rej-hMSCs) using nonintegrative and conditionally removable temperature-sensitive Sendai virus (SeV) vectors. Various immortalizing factors (i.e., Bmi-1, hTERT, SV40T, and/or HPV E6/E7) were first introduced by the SeV vector into the cells. A combination of three SeVs with Bmi-1, hTERT, or SV40T conferred markedly improved cell proliferation and cloning ability while maintaining differentiation potential and a normal karyotype. An extended lifespan was also demonstrated in other cell types. The rejuvenation of long-passaged or aged hMSCs was also confirmed. SeV vectors were rapidly removed as a function of cell doubling by increasing the temperature from 35 °C to 37 °C or higher, while proliferative ability was maintained. Following FACS sorting, the complete removal of SeV vectors was confirmed by qPCR analyses. Therefore, our cell rejuvenation technology could contribute to research and clinical applications by enabling the supply of modified cells without damaging host chromosomes.

The Redefinition and Volumization of the Lip Area with Hyaluronic Acid: A Case Series.

Background: The increasing popularity of non-surgical cosmetic enhancements for the lower face and perioral area, particularly through hyaluronic acid (HA) fillers, reflects the growing desire for improved lip volume and definition. This study showcases the effects of a specific HA filler on lip fullness, shape, and overall perioral rejuvenation. Methods: We conducted a retrospective single-site observational analysis of adult female patients treated with Genefill Soft Fill HA injections in the lips and perioral areas. Both patient and physician satisfaction were evaluated using the Likert scale and Global Aesthetic Improvement Scale (GAIS), respectively. The outcomes for natural appearance, volume, and durability were assessed using a five-point scale. The patients were followed up with for up to six months to monitor any adverse events. Results: The cohort included thirteen female patients with an average age of 55.3 ± 8.3 years. Approximately 1.2 ± 0.4 mL of filler was used per patient. The results indicate high satisfaction, with scores above 4 for naturalness, volume, and durability. Over 92% of patients reported a significant improvement in appearance. No moderate or severe adverse events were reported. Conclusions: Genefill Soft Fill HA filler is both effective and safe for enhancing lip esthetics, with high satisfaction rates among recipients and no significant adverse events observed.

Insights into upper blepharoplasty: Conservative volume-preserving techniques.

This editorial commentary critically examines the systematic review by Miotti et al, which discusses the evolving trends in upper lid blepharoplasty towards a conservative, volume-preserving approach. The review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity, paralleling broader trends in panfacial rejuvenation. Miotti et al delve into the nuances of fat pad management, advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic outcomes. This perspective is supported by comparative studies and empirical data, such as those from Massry and Alghoul et al, highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic longevity. The review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics, particularly in addressing distinct features such as the Asian upper eyelid. However, it identifies a significant gap in long-term comparative research, underscoring the need for future studies to substantiate the safety and efficacy of these minimalist techniques. Overall, Miotti et al.'s work contributes profoundly to the discourse on personalized, conservative cosmetic surgery, urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.

Senescence Rejuvenation through Reduction in Mitochondrial Reactive Oxygen Species Generation by Polygonum cuspidatum Extract: In Vitro Evidence.

Oxidative stress caused by reactive oxygen species (ROS) is one of the major causes of senescence. Strategies to reduce ROS are known to be important factors in reversing senescence, but effective strategies have not been found. In this study, we screened substances commonly used as cosmetic additives to find substances with antioxidant effects. Polygonum cuspidatum (P. cuspidatum) extract significantly reduced ROS levels in senescent cells. A novel mechanism was discovered in which P. cuspidatum extract reduced ROS, a byproduct of inefficient oxidative phosphorylation (OXPHOS), by increasing OXPHOS efficiency. The reduction in ROS by P. cuspidatum extract restored senescence-associated phenotypes and enhanced skin protection. Then, we identified polydatin as the active ingredient of P. cuspidatum extract that exhibited antioxidant effects. Polydatin, which contains stilbenoid polyphenols that act as singlet oxygen scavengers through redox reactions, increased OXPHOS efficiency and subsequently restored senescence-associated phenotypes. In summary, our data confirmed the effects of P. cuspidatum extract on senescence rejuvenation and skin protection through ROS reduction. This novel finding may be used as a treatment in senescence rejuvenation in clinical and cosmetic fields.

Integrating SMAS plication and deep plane techniques in facial rejuvenation: A novel approach.

INTRODUCTION: In facial rejuvenation surgeries, deep plane facelift and superficial musculoaponeurotic system (SMAS) plication techniques have been applied with notable efficacy over an extended period, yielding aesthetically pleasing outcomes. Both methods have their own advantages and disadvantages depending on the individual circumstances. We endeavored to formulate an effective facelift method by integrating these approaches, aiming to harness the advantageous aspects of each method while addressing their respective drawbacks in a comprehensive manner. METHODS: Following the preparation of the subcutaneous plane overlying the fixed SMAS, the mobile SMAS was elevated from the deep plane, and a SMAS flap was fashioned. The SMAS flap in the prezygomatic and premasseteric areas was inwardly folded, and a plication procedure was applied using loop sutures from its most medial to lateral aspects. Subsequently, it was secured to the preauricular area with U stitches. The results were statistically evaluated preoperatively and postoperatively using the wrinkle severity rating scale (WSRS) scores. RESULTS: A total of 40 patients underwent the operative procedures effectively performed by the senior author (F.C.). Preoperative WSRS scores were 4.2 ± 0.52. Postoperative WSRS scores at 3 months were significantly lower at 1.25 ± 0.44 (p < 0.05). The facelift procedure was effectively applied in all patients without the development of major complications. CONCLUSIONS: This method combines deep plane facelift and surgical SMAS plication, using the advantages of both techniques to directly address the nasolabial folds and achieve gratifying outcomes in facial and neck rejuvenation.

Poly-d,l-lactic Acid (PDLLA) Application in Dermatology: A Literature Review.

Poly-d,l-lactic acid (PDLLA) is a biodegradable and biocompatible polymer that has garnered significant attention in dermatology due to its unique properties and versatile applications. This literature review offers a comprehensive analysis of PDLLA's roles in various dermatological conditions and wound-healing applications. PDLLA demonstrates significant benefits in enhancing skin elasticity and firmness, reducing wrinkles, and promoting tissue regeneration and scar remodeling. Its biodegradable properties render it highly suitable for soft tissue augmentation, including facial and breast reconstruction. We discuss the critical importance of understanding PDLLA's physical and chemical characteristics to optimize its performance and safety, with a focus on how nano- and micro-particulate systems can improve delivery and stability. While potential complications, such as granuloma formation and non-inflammatory nodules, are highlighted, effective monitoring and early intervention strategies are essential. PDLLA's applications extend beyond dermatology into orthopedics and drug delivery, owing to its superior mechanical stability and biocompatibility. This review underscores the need for ongoing research to fully elucidate the mechanisms of PDLLA and to maximize its therapeutic potential across diverse medical fields.

Evaluation of the photothermal effects of the subdermal high-power laser in the skin of an experimental rat model.

The aim of the present study was to evaluate the photothermal effects of a subdermal high-power diode laser at a wavelength (λ) of 1470 nm in the skin of rats. Twenty male Wistar rats were used, divided into 2 groups: placebo laser (PL) and active laser (AL). A high-power diode laser equipment was applied to 5 subdermal vectors on the animal's back region. The results demonstrated that active laser animals showed a better arrangement of collagen fiber bands, an increase in the thickness of the dermis and the number of vessels. Furthermore, animals treated with active laser showed an increased immunoexpression of TGF-ß and VEGF compared to the placebo. The present work demonstrated that the subdermal high-power diode laser increases the vascularization and the expression of factors that enhance skin regeneration and may be promising resource in the esthetic and dermatology clinical treatment of skin rejuvenation.

U-SMAS: ultrasound findings of the superficial musculoaponeurotic system.

The superficial musculoaponeurotic system (SMAS) is a complex fibrous network connecting facial muscles to the dermis, with varying morphological characteristics across different facial regions. Recent studies have identified five distinct types of SMAS morphology, highlighting the need for region-specific interventions in facial rejuvenation. This pictorial essay explores ultrasound imaging of the SMAS using ultra-high frequency (24-33 MHz) probes, known as U-SMAS. Analysis of 186 full-face U-SMAS scans revealed consistent patterns in the facial and neck layers, with regional variations aligning with the Sandulescu classifications: type I (preparotideal); type II (chin and lip); type III (eyelid); type IV (temporal and parotideal); and type V (cervical). Understanding these morphological differences is crucial for accurate interpretation of ultrasound images and for optimizing pre-procedural assessments to ensure that aesthetic treatments are safe and effective. Knowledge of the SMAS architecture enhances the ability to visualize facial and neck anatomy accurately, particularly through U-SMAS imaging, ensuring comprehensive patient care in rejuvenation procedures.

O sistema musculoaponeurótico superficial (SMAS) é uma rede fibrosa complexa que conecta os músculos faciais à derme, com características morfológicas variadas em diferentes regiões faciais. Estudos recentes identificaram cinco tipos distintos de morfologia do SMAS, destacando a necessidade de intervenções específicas em cada região para a rejuvenescimento facial. Este ensaio iconográfico explora a imagem por ultrassom do SMAS usando transdutores de ultra-alta frequência (24-33 MHz), conhecidas como U-SMAS. A análise de 186 exames de ultrassom de rosto completo revelou padrões consistentes nas camadas faciais e do pescoço, com variações regionais alinhadas com as classificações de Sandulescu: tipo I (preparotideal), tipo II (queixo e lábio), tipo III (pálpebra), tipo IV (temporal e parotideal) e tipo V (cervical). Compreender essas diferenças morfológicas é crucial para uma interpretação precisa do ultrassom e para otimizar avaliações pré-procedimento para tratamentos estéticos seguros e eficazes. O conhecimento da arquitetura do SMAS melhora a capacidade de visualizar com precisão a anatomia facial e do pescoço, especialmente por meio de imagens de ultrassom, garantindo cuidados abrangentes ao paciente em procedimentos de rejuvenescimento.

Deformation behavior of thermally rejuvenated Zr-Cu-Al-(Ti) bulk metallic glass.

The deformation behavior of metallic glasses has been shown in prior studies to be often dependent on its structural state, namely higher energy "rejuvenated" state versus lower energy "relaxed" state. Here, the deformation behavior of thermally rejuvenated Zr-Cu-Al-(Ti) bulk metallic glasses (BMGs) was evaluated. Rejuvenation was achieved by cryogenic thermal cycling with increase of free volume measured in terms of enthalpy of relaxation. Hardness, stiffness, and yield strength of the BMGs were all found to decrease while plasticity increased after rejuvenation. More free volume in the rejuvenated BMG resulted in homogeneous plastic deformation as was evident from the high strain rate sensitivity and more pronounced shear band multiplication during uniaxial compression. Shear transformation zone (STZ) volume was calculated by cooperative shear model and correlated well with the change in structural state after rejuvenation. The enhanced plasticity with the addition of 1 at. % Ti as well as after cryogenic thermal cycling was explained by lower activation energy for shear flow initiation due to increased heterogeneity induced in the system. Molecular dynamics simulation demonstrated that the variation in plastic deformation behavior is correlated with local atomic structure changes.

Intraovarian Platelet-Rich Plasma Administration for Anovulatory Infertility: Preliminary Findings of a Prospective Cohort Study.

Background/Objectives: Infertility constitutes a significant challenge for couples around the world. Ovarian dysfunction, a major cause of infertility, can manifest with anovulatory cycles, elevated follicle-stimulating hormone levels, and diminished ovarian reserve markers such as anti-Müllerian hormone (AMH) levels or the Antral Follicle Count (AFC). Blood-derived therapies including platelet-rich plasma (PRP) have been used in fertility treatments in women with low ovarian reserve or premature ovarian insufficiency. This prospective clinical cohort study aims to assess the effects of intraovarian PRP therapy on ovarian function in women diagnosed with anovulatory cycles. Methods: The preliminary findings of this prospective cohort study are based on the first 32 patients enrolled. In this study, patients over 40 years old with anovulatory infertility were included. Venous blood samples were collected from each participant for the preparation of autologous platelet-rich plasma (PRP). Each participant received two courses of intraovarian PRP injections using a transvaginal ultrasound-guided approach. Serum levels of reproductive hormones before and after PRP intervention were measured. Results: This study's results demonstrate a significant improvement in ovarian physiology following transvaginal ultrasound-guided PRP infusion. A 75% increase in Antral Follicle Count (AFC) was observed, which was statistically significant. Furthermore, statistically significant reductions in follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin levels were observed. Serum Vitamin D 1-25 levels were substantially increased after the injection. Conclusions: These findings highlight the beneficial impact of intraovarian PRP injection in optimizing ovarian function and other metabolic parameters. However, the published literature on this subject is limited and further clinical studies should be conducted to confirm the role of intraovarian PRP in fertility treatments.