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.

OnabotulinumtoxinA from lines to facial reshaping: A new Italian consensus report.

BACKGROUND: Botulinum neurotoxin type A is the most widely used nonsurgical treatment for esthetic improvement of the face and neck. In 2015, an Italian consensus panel met to discuss the optimal methods for using onabotulinumtoxinA. However, clinical practice continues to evolve and the original report is now considered obsolete. AIMS: To provide updated guidance on the esthetic uses of onabotulinumtoxinA in the face and neck. METHODS: A panel of 10 Italian specialists (including plastic and maxillofacial surgeons, dermatologists, and esthetic doctors) individually completed a questionnaire on their own clinical practice, and then met to discuss their responses and agree on a revised treatment consensus. RESULTS: Recommendations are provided on patient assessment, reconstitution of onabotulinumtoxinA, and preferred procedures (injection sites, doses, anatomical targets, safety precautions, etc.) across a variety of treatment areas, including glabellar, crow's feet, and forehead lines; brow lifting and shaping; lower eyelid hypertrophy; bunny lines; sagging nasal tip; gummy smile; masseter hypertrophy; perioral lines; marionette lines and "sad mouth;" mentalis hypertonia; and platysma bands. Some of the recommended doses are substantially increased from the previous consensus (particularly in the upper third and masseter) for the purpose of achieving longer lasting results without affecting safety. Furthermore, two increasingly popular techniques-the Nefertiti lift and Microbotox-are included in the consensus for the first time. CONCLUSIONS: Optimal practice with onabotulinumtoxinA requires a systematic approach to maximize safety and effectiveness across the range of potential uses. The present consensus was developed to support these aims.

Minimally invasive aesthetic treatment of male patients: The importance of consultation and the lower third of the face.

BACKGROUND: Men worry disproportionately about potential negative consequences of facial aesthetic treatment with injectable therapies, such as side effects or appearing more feminine. Features of the lower third of the face (eg, prominent chin and jaw) are particularly important in perceptions of masculinity. A strategy has been developed for male patients based on an initial consultation emphasizing the safety and masculinizing potential of injectables, followed by treatment with a high G' hyaluronic acid filler targeting the lower third. AIMS: To assess this strategy in routine practice. METHODS: This was a retrospective analysis of male patients with poor definition of the lower third of the face wishing to undergo non-surgical correction. Initial consultation focused on detailed patient education and facial masculinization with injectables. Individuals were then treated in the lower third using VYC-25 based on the standardized MD Codes approach. Follow-up lasted ≤12 months. RESULTS: Forty patients were included (mean age: 40.9 ± 9.6 years). The mean volume of VYC-25 injected into the lower third was 7.8 ± 1.2 ml. Patient satisfaction was high, as assessed using the FACE-Q "Satisfaction with outcome" questionnaire (mean Rasch-transformed score: 88.1 ± 10.3). Complications included the following: soft tissue edema, n = 12 (30.0%); hematoma, n = 6 (15.0%); and telangiectasia, n = 2 (5.0%). All were early, transient, and minor; there were no major or delayed events. CONCLUSIONS: This approach to male subjects was practical and safe despite the large volumes of filler used. Focusing on the lower third may help to reassure patients and deliver results that respect masculine identity.

Skin Quality Improvement With VYC-12, a New Injectable Hyaluronic Acid: Objective Results Using Digital Analysis.

BACKGROUND: VYC-12 is a novel hyaluronic acid-based dermal filler designed to treat fine lines and improve skin quality. A specialist digital camera and proprietary Digital Analysis of the Cutaneous Surface (DACS) software have previously been used to objectively measure changes in skin features. OBJECTIVE: To assess the effect of facial treatment with VYC-12 on skin texture using the specialist camera. MATERIALS AND METHODS: This was a prospective, open-label, 2-center study of 40 women aged 35 to 60 years treated with multiple, microdepot intradermal injections of VYC-12 (2 mL in the face; 1 mL in the neck if required). Eight patients (20.0%) required a touch-up at Day 45. Images were acquired using the specialist camera at baseline and 45 days and 6 months after treatment, and were analyzed by DACS. Clinical improvements were also assessed subjectively using the Global Aesthetic Improvement Scale (GAIS). RESULTS: VYC-12 improved skin texture from baseline after 45 days (mean improvement: 25.9% ± 9.2%) and 6 months (mean improvement: 30.7% ± 18.2%). Improvements were also evident using the GAIS. There were no major adverse events. CONCLUSIONS: VYC-12 improves skin quality, as measured using an objective, fast, and reproducible measuring tool. VYC-12 represents a valuable addition to the treatment armamentarium.