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1.
Skin Res Technol ; 30(4): e13676, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38572585

RESUMEN

The pathogenesis of marionette lines involves a complex interplay of anatomical, physiological, and age-related factors leading to the development of wrinkles around the oral commissures. This exploration delves into the distinct anatomical predispositions observed among different ethnicities, emphasizing the role of compact modiolus structures and muscle compositions. Notably, individuals of East Asian descent exhibit inherent facial structures that predispose them to pronounced sagging around the oral commissures during aging. The emergence of distinct facial lines, such as the commissural line and the melolabial fold, contributes to the formation of marionette lines. This specific wrinkle pattern, resembling a marionette puppet's mouth contours, is influenced by various factors like bone resorption, gravitational forces, fat compartment variations, muscle compression, ligament tethering, and skin aging. Treatment strategies for marionette lines encompass diverse interventions, including filler injections, botulinum neurotoxin, surgeries targeting fat reduction, thread lifting, and volumizing fillers. These approaches aim to address the underlying causes and mitigate the appearance of marionette lines. Botulinum neurotoxin injections, for instance, weaken specific facial muscles, reducing downward strain and aiding in tissue retraction. Anatomical considerations during procedures are crucial to avoid nerve or vascular damage. Delicate manipulation and precise entry points are essential to prevent inadvertent injuries, particularly concerning blood vessels like the facial artery and nerves like the mental nerve. Technical guidelines for procedures targeting marionette lines involve specific techniques like cogged thread reverse methods and volumizing thread placements. Attention to entry points, tissue engagement, and the direction of threads is crucial for effective treatment outcomes, minimizing complications, and ensuring patient safety.


Asunto(s)
Toxinas Botulínicas , Técnicas Cosméticas , Envejecimiento de la Piel , Humanos , Cara , Músculos Faciales/diagnóstico por imagen , Labio
2.
Skin Res Technol ; 30(4): e13673, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38584590

RESUMEN

In this review article, our objective is to elucidate fundamental principles and offer practical illustrations concerning the procedures involved in facial and neck thread lifting. Moreover, we aim to explore associated concepts such as the fixing point, hanging point, and anchoring point terminologies, along with the elucidation of vectors. Additionally, we will provide anatomically oriented explanations of the lifting process required for each facial region using thread lifting methods like V, U, and I techniques using floating type threads (Secrete line, Hyundai Meditech., Inc., Wonjusi, Republic of Korea). Furthermore, our intention is to delve deeply into the concepts of tensile strength, anchoring strength, and holding strength, contextualizing their practical applications within this specific field.


Asunto(s)
Ritidoplastia , Humanos , Ritidoplastia/métodos , Rejuvenecimiento , Cara , República de Corea
3.
Skin Res Technol ; 30(3): e13650, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38497380

RESUMEN

INTRODUCTION: Face-lifting surgeries were once common among individuals over 60 years old due to skin laxity, but recent trends favor thread lifting in this age group. Understanding dynamic changes in facial anatomy during postural shifts is essential. METHOD: Fresh cadaver studies have demonstrated the passage of threads through the superficial musculoaponeurotic system (SMAS) layer, confirming the efficacy of the technique. Proper insertion depth targeting SMAS repositioning, rather than superficial skin layers, is crucial. RESULT: The natural movement of tissues secured by thread (N-Cog and N-Fix, N-Finders Inc., Korea) insertion results in lifting effects. However, complications may arise if threads affect deeper facial muscles, leading to discomfort. Fibrous septa play a significant role in guiding thread placement, with different densities influencing thread maneuverability and tissue response during lifting. CONCLUSION: Procedures targeting SMAS repositioning using threads aim to maintain the new position of relocated tissues. Understanding structural variations in facial regions informs thread selection and placement. Aligning threads with tissue movement and the intended SMAS layer positioning is vital to prevent complications. Balancing thread insertion depth and tissue traction is critical for successful outcomes. Modern thread lifting techniques prioritize SMAS repositioning, enhancing lifting effects while ensuring procedure safety and efficacy.


Asunto(s)
Ritidoplastia , Sistema Músculo-Aponeurótico Superficial , Humanos , Persona de Mediana Edad , Sistema Músculo-Aponeurótico Superficial/cirugía , Sistema Músculo-Aponeurótico Superficial/anatomía & histología , Ritidoplastia/métodos , Piel , Músculos Faciales/cirugía , Cadáver
7.
J Cosmet Dermatol ; 23(8): 2537-2542, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38679891

RESUMEN

OBJECTIVE: This review explores the utilization of thread lifting materials, distinct from traditional sutures, in aesthetic procedures. It aims to elucidate the varied composition, purpose, and performance of these slender materials. METHODS: The article contextualizes thread lifting materials by exploring their literal and material significance. The evolution of these materials is traced, emphasizing the preexistence of cog threads for tissue manipulation before their widespread adoption in plastic surgery. RESULTS: Observations regarding the efficacy and longevity of absorbable versus non-absorbable threads are discussed, with a particular emphasis on the efficiency of high-quality absorbable cog threads. CONCLUSION: The proliferation of thread lifting materials extends beyond PDO, necessitating consideration of multiple factors beyond duration when selecting threads for lifting procedures. This underscores the importance of comprehensive evaluation in choosing appropriate thread lifting materials.


Asunto(s)
Rejuvenecimiento , Ritidoplastia , Suturas , Humanos , Ritidoplastia/métodos , Ritidoplastia/instrumentación , Técnicas de Sutura , Envejecimiento de la Piel
8.
Diagnostics (Basel) ; 14(13)2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-39001342

RESUMEN

The study "Spaces of the Face for Filler Procedures: Identification of subSMAS Spaces Based on Anatomical Study" explores the anatomy of facial spaces crucial for safe and effective filler injections. By delineating the subSMAS (sub-superficial musculoaponeurotic system) spaces, this research highlights how these virtual compartments, bordered by fat, muscles, fascia, and ligaments, facilitate independent muscle movement and reduce the risk of damaging critical structures. The thicker and more robust skin of East Asians necessitates deeper filler injections, emphasizing the significance of accurately identifying these spaces. A cadaver study with dyed gelatin validated the existence and characteristics of these subSMAS spaces, confirming their safety for filler procedures. Key spaces, such as the subgalea-frontalis, interfascial and temporalis, and prezygomatic spaces, were examined, illustrating safe zones for injections. The findings underscore the importance of anatomical knowledge for enhancing facial aesthetics while minimizing complications. This study serves as a guide for clinicians to perform precise and safe filler injections, providing a foundation for further research on the dynamic interactions of these spaces and long-term outcomes.

9.
Clin Cosmet Investig Dermatol ; 17: 999-1006, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38737945

RESUMEN

Thread lifting involves the use of slender materials, reminiscent of threads, for aesthetic procedures. These materials are distinct from traditional sutures and vary in composition, purpose, and performance. The introduction delves into the literal and material significance of threads, establishing the broad concept of thread lifting materials. The article revisits the evolution of thread lifting materials, emphasizing the preexistence of cog threads for tissue manipulation before their widespread adoption in plastic surgery. Observations regarding the efficacy and longevity of absorbable versus non-absorbable threads are discussed, stressing the efficiency of high-quality absorbable cog threads. The conclusion underlines the proliferation of thread lifting materials beyond PDO, highlighting the importance of considering multiple factors beyond duration when selecting threads for lifting procedures.

10.
Diagnostics (Basel) ; 14(14)2024 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-39061692

RESUMEN

Vascular complications arising from dermal filler treatments pose significant risks, including ischemia, tissue necrosis, and severe outcomes like blindness and pulmonary embolism. This study investigates the mechanisms of vascular complications, categorizing them into extravascular compression and intravascular emboli. Extravascular compression occurs when injected fillers compress adjacent blood vessels, leading to ischemia and potential necrosis, while intravascular emboli result from fillers entering blood vessels, causing blockages. The study emphasizes the importance of anatomical knowledge, careful injection techniques, and early intervention. Management strategies include the use of hyaluronidase to dissolve HA fillers, vasodilators to improve blood circulation, and hyperbaric oxygen therapy. The regions most susceptible to complications align with major arterial pathways, particularly the nasolabial folds and nasal region. The study also highlights the need for meticulous injection techniques, the use of cannulas over needles in high-risk areas, and the aspiration test to detect vessel penetration. Early detection and immediate intervention are crucial to mitigate adverse outcomes. Continuous education and training for practitioners, along with advancements in filler materials and injection methods, are essential for improving the safety of cosmetic procedures. This comprehensive understanding aids in preventing and managing vascular complications, ensuring better patient outcomes. The field of dermal filler treatments is advancing with new techniques and technologies, such as High-Resolution Ultrasound, Infrared Imaging, self-crossing hyaluronic acid filler, biodegradable microspheres, and microinjection.

11.
Diagnostics (Basel) ; 14(7)2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38611629

RESUMEN

The classification of nasolabial folds into three types, each with distinct causative factors and mechanisms, is explored. Age-related changes in facial skin and connective tissues are examined in detail, revealing variations across different facial regions due to variances in tissue firmness and thickness. The innovative 'Reverse Technique,' involving cog threads to enhance tissue traction and effectiveness in thread-lifting procedures, is introduced. Detailed technical guidelines, anatomical considerations, and safety measures are provided, emphasizing the importance of identifying optimal vectors and fixing points to achieve maximum lifting effects while minimizing potential risks, particularly those associated with vascular structures. Additionally, the 'Cross Technique using volumizing thread' is discussed, designed to smooth tissue boundaries and rejuvenate sagging areas. Facial anatomy, including the positioning of arteries and ligaments, is underscored as essential for ensuring the safety and efficacy of procedures. In conclusion, this review stands as a comprehensive guide for practitioners, offering insights into innovative thread-lifting methods and their applications in addressing nasolabial folds. The primary focus is on achieving optimal aesthetic results while prioritizing patient safety.

12.
J Cosmet Dermatol ; 22(11): 3118-3124, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37313624

RESUMEN

BACKGROUND: The cross-linked hyaluronic acid (HA) fillers are the viscoelastic hydrogel with a dominant elasticity rather than a viscosity as a useful medical device in the soft tissue augmentation. These HA fillers undergo deformation to begin the biodegradation by the biochemical and physical environment of the body, and result of deformations are closely related to clinical performance. AIMS: The specific equation of molding index is newly generated and proved with Collin's equation, which is used for strong elastomers, for selecting optimal product in facial treatment. METHODS: In this study, the results of amplitude sweep test from five marketed HA fillers were mathematically demonstrated for the proper clinical application. RESULTS: The increment of loss modulus by deformation was evaluated as a useful factor for the maintenance of optimal shape molding performance and resistance to external deformation of the cross-linked HA gel. From this study, the equation of molding index for weak viscoelastic hydrogels like HA products can be applied for choosing which products even in aesthetic plastic field. This molding index equation is compared to Collins' equation that index of deformation as elastomer like rubber and then found the positive correlation between two equations. CONCLUSION: This study could provide a basic theory that achieve useful clinical performance according to characteristics among many types of medical devices based on the molding index.

13.
J Cosmet Dermatol ; 21(9): 3754-3758, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35041769

RESUMEN

BACKGROUND: The skin of the neck is often pinched during minimally invasive esthetic procedures for the double chin using a lipolytic agent in order to facilitate injecting into the subcutaneous fat layer rather than under the platysma muscle. However, how the neck tissue layers move during the pinch manipulation is not well understood. AIMS: To determine which layer of the neck is lifted during pinching and to evaluate the usefulness of the pinch manipulation during injection therapy. METHODS: The pinched submentum of a living person was scanned using MRI, and ultrasonography was also performed in the same area in both resting and pressed states. At four sites on a fresh cadaver, the skin of the neck was pinched and the elevated neck skin was excised. The exposed areas were grossly examined. RESULTS: MRI scanning revealed that the pinch manipulation extended the subcutaneous fat layer and moved the platysma muscle to a deeper location. Ultrasonography revealed that the thickness of each layer of the neck was reduced when pressing the neck. In the cadaver examination, pinching resulted in part of the subcutaneous fat lifting, and this was removed when the lifted skin was cut, leaving the platysma muscle intact. CONCLUSIONS: When performing an esthetic procedure that involves injecting a lipolytic agent into the submental area, the pinch manipulation is a very useful technique for ensuring a safe procedure that avoids injecting into the deep layer under the platysma muscle.


Asunto(s)
Cuello , Grasa Subcutánea , Cadáver , Mentón/anatomía & histología , Ácido Desoxicólico , Humanos , Cuello/diagnóstico por imagen , Grasa Subcutánea/diagnóstico por imagen
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