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1.
Acta Biomed ; 92(5): e2021299, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34738590

RESUMO

BACKGROUND AND AIM: Despite several techniques are proposed, treatment of nasolabial folds is often challenging. During rejuvenation procedures, the SMAS could be redraped or partially resected during the procedure. The aim of this study is to investigate the use of obtained SMAS strip as autologous graft, because of its solid but pliable consistence and fatty composition, to correct nasolabial folds during procedures with SMAS resection.Methods Between 2015 and 2018, 23 patients underwent SMAS graft for nasolabial fold correction. All procedures were performed under local anesthesia and no other cosmetic treatments, including HA fillers, have been done in the past 12 months. RESULTS: 22 patients were declared eligible for the study. 20 patients were female, accounting for 90,91%. Mean age was 53 years old. Ancillary procedures were performed in 17 patients, including upper blepharoplasty (3, 13,63%), upper and lower blepharoplasty (5, 22,73%) and submental neck lift with platysma plication (15, 68,18%). Mean follow-up was 9 months. No major complications have been recorded: only 1 case of minimal hematoma in the retroauricular region have been recorded and 1 patient required laser treatment for pathological scars. At follow-up, graft is completely integrated into the mid-fat compartment. As evinced from the FACE-Q analysis, the overall satisfaction rate is extremely high. These are very convincing data regarding the effectiveness of the technique and, despite a little bit longer downtime, is not invasive and led to natural long-lasting results event during motion. CONCLUSIONS: The use of SMAS graft during face-lift as nasolabial fold filler results in a satisfactory but natural filling of the folds, reducing the need for lateral tension and therefore assuring more natural results. Since its nature, SMAS, reduced in width to properly fit into the nasolabial fold, can be considered as an optimal autologous graft for replenish loss volumes of the face with aging.


Assuntos
Sulco Nasogeniano , Ritidoplastia , Cicatriz , Feminino , Humanos , Pessoa de Meia-Idade , Sulco Nasogeniano/cirurgia , Pescoço/cirurgia , Rejuvenescimento
2.
Aesthetic Plast Surg ; 45(5): 2300-2316, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34255156

RESUMO

Tissue fillers injections remain to be one of the most commonly performed cosmetic procedures. The aim of this meta-analysis was to systematize and present available data on the aesthetic outcomes and safety of treating the nasolabial fold area with tissue fillers. We conducted a systematic review of randomized clinical trials that report outcomes concerning treatment of nasolabial fold area with tissue fillers. We searched the MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, Scopus, Cochrane Controlled Register of Trials, CNKI and Web of Science databases. Primary outcomes included aesthetic improvement measured using the Wrinkle Severity Rating Scale score and Global Aesthetic Improvement Scale. Secondary outcomes were incidence rates of complications occurring after the procedure. At baseline, the pooled mean WSRS score was 3.23 (95% CI: 3.20-3.26). One month after the procedure, the pooled WSRS score had reached 1.79 (95% CI: 1.74-1.83). After six months it was 2.02 (95% CI: 1.99-2.05) and after 12 months it was 2.46 (95% CI: 2.4-2.52). One month after the procedure, the pooled GAIS score had reached 2.21 (95% CI: 2.14-2.28). After six months, it was 2.32 (95% CI: 2.26-2.37), and after 12 months, it was 1.27 (95% CI: 1.12-1.42). Overall, the pooled incidence of all complications was 0.58 (95% CI: 0.46-0.7). Most common included lumpiness (43%), tenderness (41%), swelling (34%) and bruising (29%). Tissue fillers used for nasolabial fold area treatment allow achieving a satisfying and sustainable improvement. Most common complications include tenderness, lumpiness, swelling, and bruising. LEVEL OF EVIDENCE II: "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 ."


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Preenchedores Dérmicos/efeitos adversos , Humanos , Ácido Hialurônico , Sulco Nasogeniano , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
3.
PLoS One ; 16(7): e0254264, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34242334

RESUMO

Manual dissection and histologic examination are commonly used to investigate human structures, but there are limitations in the damage caused to delicate structures or the provision of limited information. Micro-computed tomography (microCT) enables a three-dimensional volume-rendered observation of the sample without destruction and deformation, but it can only visualize hard tissues in general. Therefore, contrast-enhancing agents are needed to help in visualizing soft tissue. This study aimed to introduce microCT with phosphotungstic acid preparation (PTA-microCT) by applying the method to different types of human tissue. Specimens from human cadavers were used to examine the orbicularis retaining ligament (ORL), nasolabial fold (NLF), and the calcaneal tunnel of the sole. Using PTA-microCT, relevant information of human structures was identified. In the ORL study, tiny and delicate ligamentous fibers were visualized in detail with multidirectional continuity. In the NLF study, complex structural formation consisting of various types of soft tissue were investigated comprehensively. In the calcaneal tunnel study, the space surrounded by diverse features and its inner vulnerable structures were examined without damage. Consequently, we successfully applied the PTA-microCT technique to the analysis of specific human soft tissue structures that are challenging to analyze by conventional methods.


Assuntos
Microtomografia por Raio-X , Humanos , Ligamentos , Sulco Nasogeniano , Ácido Fosfotúngstico , Coloração e Rotulagem
4.
J Drugs Dermatol ; 20(7): 760-766, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34232000

RESUMO

BACKGROUND: The reconstitution volume of a PLLA-containing injectable device has gradually increased in clinical practice, often in combination with adding lidocaine to the solution. OBJECTIVE: This study, SCRIPT (Sculptra Contemporary Reconstitution & Injection Procedure Trial) evaluated PLLA for correction of nasolabial folds after changes in reconstitution and injection procedures. Primary endpoint for effectiveness was change from baseline of nasolabial folds, assessed by blinded evaluation using a validated wrinkle assessment scale (WAS), at week 48. METHODS: Subjects were treated to optimal correction of nasolabial folds at a single treatment regimen consisting of ≤4 injection sessions, with PLLA reconstituted with 8 mL or 5 mL sterile water for injection (SWFI), randomized 2:1. The 8 mL product included an additional 1 mL 2%-lidocaine and was injected immediately following reconstitution. Assessments included wrinkle severity, aesthetic improvement and safety. RESULTS: A total of 80 subjects were included in the study. Most subjects were female (95%), mean age was 51.5 years. Primary endpoint was met and subjects from both study groups demonstrated high WAS responder rates (≥1-grade improvement from baseline) at week 24 (≥75%) and week 48 (≥67%). Aesthetic improvement was high (≥86%) throughout the study. Adverse events related to study product or injection procedure were mostly mild and transient. CONCLUSION: PLLA reconstituted with 8 mL SWFI demonstrated a comparable treatment effect to that of the reference group in reducing wrinkle severity of nasolabial folds. Safety was not compromised using a higher reconstitution volume including lidocaine, injected immediately after reconstitution. J Drugs Dermatol. 2021;20(7): 760-766.. doi:10.36849/JDD.6034THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Preenchedores Dérmicos/efeitos adversos , Feminino , Humanos , Ácido Hialurônico , Técnicas de Diluição do Indicador , Lidocaína , Masculino , Pessoa de Meia-Idade , Sulco Nasogeniano , Resultado do Tratamento
5.
J Cosmet Dermatol ; 20(8): 2472-2479, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34021962

RESUMO

BACKGROUND: Hyaluronic acid (HA) fillers are quite commonly used since several years for soft tissue augmentation. AIM: The purpose of this study was to evaluate primarily the safety and secondarily the clinical effectiveness of Cross-Linked Sodium Hyaluronate 24 mg with Lidocaine 3 mg (Jeunesso 24L) injection, in subjects undergoing treatment for facial wrinkles and lip augmentation. METHOD: Patients between the age groups of 18 and 75 years, who were seeking soft tissue augmentation treatment on the face and with wrinkle severity score (WSS) ≥2 for bilateral Nasolabial Folds (NLF), were included in the study. The appropriate quantity of the filler was injected at the treatment site. Clinical efficacy assessments were conducted independently at 3 and 6 months after baseline. Clinical efficacy was assessed using Wrinkle Severity Rating Scale (WSRS) and a Global Aesthetic Improvement Scale (GAIS). RESULTS: The mean pain score was found to be 2.57 ± 2.06 immediately after injection which was reduced to 0.1 ± 0.675 at 15 min and this further subsided to "No Pain" in any of the participants at 60 min post the injection. WSRS mean score before treatment was 2.76, which were significantly reduced to 2.14, at 3 months. Majority of participants found an improvement in the marionette line severity. Also, significant improvements were seen in the perioral and lip areas. The Study filler was well-tolerated and no side effects were reported. CONCLUSION: The study indicates that this particular filler, HA+L, is useful for cosmetic improvements in the nasolabial folds and for enhancement of the lips.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Adolescente , Adulto , Idoso , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Humanos , Ácido Hialurônico/efeitos adversos , Lidocaína/efeitos adversos , Lábio , Marketing , Pessoa de Meia-Idade , Sulco Nasogeniano , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
6.
J Cosmet Dermatol ; 20(10): 3315-3323, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33904256

RESUMO

BACKGROUND: Feeling beautiful and staying young have always been important to the people. Therefore, an extensive body of research has focused on the efforts made to remove the skin problems, especially wrinkles. Fibroblast cells of the skin are the various autologous cells currently used in repairing several wounds, scars, and skin aging. Thus, the present study was conducted to assess the efficacy of the transplantation of the fibroblast cells in eliminating the facial wrinkles using the biometric assessment and to optimize the application of this technique in this treatment. METHODS: The present study was conducted on 22 male and female patients aged between 35 and 60 years old. Samples were collected from the retro-auricular region, and the fibroblast cells were isolated and cultured. Subjects received three injections with autologous fibroblasts at 2-week intervals. The patients were followed up for 6 months, and structural changes in their wrinkles were assessed by the sonography and the VisioFace software, cutometer, tewameter, and colorimeter. RESULTS: The results obtained using the VisioFace software showed the significant phenotypic changes in the patients after the nasolabial injections (81.42 ± 23.97 vs. 60.91 ± 21.91, p = 0.0001). The results showed a significant increase in the total skin density (13.73 ± 6.30 vs. 26.27 ± 7.93, p = 0.0001), dermis density (11.28 ± 5.21 vs. 31.88 ± 7.96, p = 0.0001), epidermis density (27.68 ± 23.15 vs. 49.21 ± 45.68, p = 0.046), and dermis thickness (798.09 ± 133.51 µm vs. 905.59 ± 240.67 µm, p = 0.036) compared to pre-treatment. CONCLUSION: The findings of the study revealed that the injection of autologous fibroblasts can be effective in restoring the aging skin, especially in the nasolabial region, and can be used as a safe rejuvenating strategy.


Assuntos
Envelhecimento da Pele , Adulto , Feminino , Fibroblastos , Humanos , Masculino , Pessoa de Meia-Idade , Sulco Nasogeniano , Transplante Autólogo , Ultrassonografia
7.
Am J Otolaryngol ; 42(3): 103018, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33840513

RESUMO

OBJECTIVE: The aim of this study was to investigate the clinical effect of the removal of nasolabial cyst via intranasal endoscopic microwave ablation (MWA). METHODS AND MATERIALS: The patients with nasolabial cyst were ablated through intranasal endoscopic MWA. Postoperative pain intensity was measured via visual analogue scale (VAS), post-operative complications were recorded. RESULTS: Of the 31 patients with unilateral nasolabial cyst, the main complaint was a gradually increasing mass in the nasal alar and upper lip, other complaint included nasal obstruction (11/31,35.5%), localized pain (21,67.7%), and erythema (13/31,41.9%). All 31 patients were successfully treated with the intranasal endoscopic ablation technique in outpatient. The mean ablation duration was 5.86 ± 0.71 min. The mean VAS pain score was 2.36 ± 1.08 on postoperative. None of infection occurred. All the patients complained of mild numbness in the upper lip with an average last duration of 28.5 ± 7.9 h in patients. In addition, 4 (12.9%) patients had facial/perinasal swelling, acid bilge of maxillary teeth in 7(22.6%), and toothache in one (3.2%). The patients were followed up for 12 months without recurrence and oronasal fistula. The nasolabial cyst had integrated into a part of the nasal cavity. CONCLUSIONS: The intranasal endoscopic MWA is feasible and alternative to conventional transoral sublabial approach for removal of the nasolabial cysts in outpatient.


Assuntos
Cistos/cirurgia , Micro-Ondas , Sulco Nasogeniano/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Doenças Nasais/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Ablação por Radiofrequência/métodos , Adulto , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Ablação por Radiofrequência/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
8.
Cells ; 10(3)2021 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-33800325

RESUMO

Lipofilling is a popular technique to treat volume loss in aging patients. The isolated adipose tissue is composed of adipocytes and stromal vascular fraction cells, which include adipose-derived stem cells (ASC). We hypothesize that the patient's wrinkle severity scale (WSS) and patient's satisfaction on the global aesthetic improvement scale (GAIS) can be improved after using concentrated lipoaspirate. Fourteen patients (54 years ± 11.09 years) with volume loss in the midface area underwent waterjet-assisted liposuction (Human Med AG, Schwerin, Germany). Fat was centrifuged in an ACP Double Syringe (Arthrex GmbH, Munich, Germany) using Rotofix 32A centrifuge (Andreas Hettich, GmbH & Co.KG, Tuttlingen, Germany). Homogenization was performed using the double syringe and a 1.4 mm female-female luerlock connector. After a second centrifugation, patients received periorbital (PO) and nasolabial (NL) lipografting. ASC count was performed after enzymatical digestion. Vitality of cells was assessed using a resazurin assay. During long-term follow up (12 months, n = 10), we found a high patient's satisfaction (GAIS 1+/-0.52) and a good improvement of the WSS during short- and long-term follow-up. The ASC count of processed lipoaspirate was 2.1-fold higher than of unprocessed lipoaspirate (p < 0.001). The difference of ASC in sedimented and simply centrifuged lipoaspirate was also significant (p < 0.05). Facial rejuvenation with concentrated fat graft offers good results concerning objective aesthetic outcome and patient's satisfaction.


Assuntos
Adipócitos/transplante , Tecido Adiposo/transplante , Lipectomia/métodos , Sulco Nasogeniano/cirurgia , Qualidade de Vida/psicologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adipócitos/citologia , Tecido Adiposo/citologia , Adulto , Idoso , Centrifugação/métodos , Feminino , Seguimentos , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Procedimentos Cirúrgicos Reconstrutivos/psicologia , Rejuvenescimento/psicologia , Envelhecimento da Pele/fisiologia , Células Estromais , Transplante Autólogo
9.
J Drugs Dermatol ; 20(4): 402-408, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852235

RESUMO

BACKGROUND: Since lips have a significant role in facial aesthetic perception, lip augmentation is an increasingly popular aesthetic procedure. OBJECTIVE: To evaluate aesthetic improvement and facial dynamics with hyaluronic acid (HA) fillers in the lips and perioral region at 8 weeks after the last treatment compared to pre-treatment. METHODS AND MATERIALS: In this open-label study, all subjects received HARK in the lips, and an additional group also received HARR and/or HARD in nasolabial folds (NLFs) and marionette lines (MLs). Assessments included aesthetic improvement, naturalness of facial expressions, perception of age, and lip texture. RESULTS: Nineteen subjects received HARK only; 40 received HARK and HARR and/or HARD. The primary objective was met. All subjects experienced aesthetic improvement in lip fullness at week 8. The investigators also reported aesthetic improvement in all subjects. For the majority of subjects, aesthetic improvement was associated with maintenance of natural and youthful facial expressions, and improved lip texture. Most treatment-emergent adverse events were mild; none were serious. CONCLUSION: HARK is a well-tolerated and effective treatment for enhancing lip fullness, maintaining naturalness and youthfulness of facial expressions, and smoothing lip texture, whether used alone or in combination with HARR/ HARD in the NLFs and/or MLs. J Drugs Dermatol. 20(4): 402-408. doi:10.36849/JDD.2021.5525.


Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Adulto , Preenchedores Dérmicos/efeitos adversos , Estética , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Lábio , Masculino , Pessoa de Meia-Idade , Sulco Nasogeniano , Satisfação do Paciente , Vigilância de Produtos Comercializados , Rejuvenescimento , Envelhecimento da Pele/efeitos dos fármacos , Resultado do Tratamento
10.
Dermatol Surg ; 47(6): 797-801, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33731568

RESUMO

BACKGROUND: Dermal filler injection in the vicinity of the terminal facial artery (FA) can lead to vascular compromise with devastating consequences, including tissue necrosis, blindness, and stroke. OBJECTIVE: The purpose of this study was to examine lumen diameter and other anatomical features of the terminal FA relevant to dermal filler injection. MATERIALS AND METHODS: Eighteen embalmed adult cadavers were dissected along the distribution of the terminal FA. Gross and microscopic measurements were taken at predetermined points in its course. RESULTS: Mean lumen diameter was largest at the midpoint between the oral commissure and the lateral supra-alar crease (0.81 ± 0.36 mm; point P1) and smallest at the midpoint between the lateral supra-alar crease and the medial canthus (0.43 ± 0.23 mm; point P3). Mean cutaneous depth was deepest at the lateral supra-alar crease (5.06 ± 1.84 mm; point P2) and most superficial at the midpoint between the lateral supra-alar crease and the medial canthus (3.13 ± 2.07 mm; point P3). CONCLUSION: The large-caliber lumen diameter of the terminal FA creates the potential for intra-arterial injection with commonly used filler needles and blunt-tipped cannulas at all points in its course in the nasolabial fold and midface.


Assuntos
Artérias/anatomia & histologia , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Lábio/irrigação sanguínea , Sulco Nasogeniano/irrigação sanguínea , Idoso , Idoso de 80 Anos ou mais , Artérias/lesões , Cadáver , Preenchedores Dérmicos/administração & dosagem , Feminino , Humanos , Injeções Subcutâneas/efeitos adversos , Injeções Subcutâneas/métodos , Masculino , Pessoa de Meia-Idade
11.
J Craniofac Surg ; 32(2): 771-773, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33705033

RESUMO

ABSTRACT: The aim of this study was to elucidate the relationships between the nasolabial fold and superficial fascia on histology and P45 sheet plastination.Two centimeter width specimen of the nasolabial area were harvested from the skin to periosteum. Then, 10-µm sections were made, stained with Masson trichrome, and observed under a light microscope. Three head and neck specimens were sliced in horizontal sections (46 slices) using P45 sheet plastination (polyester resin corrosion-resistant method designed to preserve biological sectional specimens in situ). Through slicing, bleaching, dehydration, casting, forced impregnation, curing, cutting, and sanding the molds, P45 plastination provided good light transmission, allowing the internal structures within the sheet to be revealed clearly in their intact form.The observations on histology and P45 sheet plastination correlated well. The nasolabial fold consisted of the superficial fatty layer of superficial fascia (SFS). At the beginning of the alar groove level, the nasolabial groove was located on the point where the medial limit of SFS met the levator labii superioris. At the alar base level, the nasolabial groove was located where the medial limit of the SFS met levator labii superioris. At the mouth corner level, the nasolabial groove was located where the medial limit of the SFS met the modiolus, including the orbicularis oris. The superficial fascia became scanty near the nasolabial groove, and the SFS comprised the nasolabial fold.The results of the present study may be helpful for applying subcutaneous dissection or sub-superficial muscular aponeurotic system dissection in rejuvenation of the nasolabial area.


Assuntos
Plastinação , Dissecação , Músculos Faciais , Humanos , Lábio , Sulco Nasogeniano
12.
Dermatol Surg ; 47(7): 960-965, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33731572

RESUMO

BACKGROUND: Age-related changes affecting facial areas can be corrected using minimally invasive dermal fillers. The use of polycaprolactone-dermal filler (PCL-filler) in aesthetics is increasing. OBJECTIVE: To evaluate the long-term safety and efficacy of the PCL-filler, in a European, multicenter, prospective study. MATERIALS AND METHODS: Subjects (n = 90) with moderate/severe nasolabial folds (Wrinkle Severity Rating Scale [WSRS]: 3 to 4) were treated on Day 0 with a single injection of similar volume on each side; safety and efficacy assessments were performed over an 18-month period. In 1 of the 3 study centers, safety was evaluated at 30 months. RESULTS: At Month 12 (M12; primary endpoint), 84% of subjects showed a ≥1-point improvement on the WSRS (M6: 92%; M18: 64%). From the investigator/subject's evaluation, from Day 7 to M12, Global Aesthetic Improvement was reported for >90% of subjects, with the effect maintained for up to 18 months in >80% of patients. Subjects/investigators reported high satisfaction and skin quality improvement. Most of the immediate injection-site reactions disappeared after 2 to 4 days. No severe or unexpected adverse events were reported. CONCLUSION: This study demonstrated the long-term safety and efficacy of the PCL-filler, with safety confirmed for up to 30 months.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Sulco Nasogeniano , Poliésteres , Adulto , Idoso , Preenchedores Dérmicos/efeitos adversos , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Poliésteres/efeitos adversos , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
13.
J Cosmet Dermatol ; 20(5): 1499-1504, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33522714

RESUMO

BACKGROUND: The injection of hyaluronic acid (HA) dermal fillers is a popular minimally invasive approach to improve lip volume and contour, and with improved techniques has gained popularity because full lips are often associated with beauty and youth. Patient satisfaction is a key driver for successful aesthetic procedures, influencing individual treatment plans and future recommendations. OBJECTIVE: To evaluate subject and partner satisfaction with the hyaluronic acid (HA) dermal filler HARK for lip enhancement at 8 weeks after the last treatment. METHODS & MATERIALS: Subjects in this open-label study all received HARK in the lips, and an additional group also received HARR and/or HARD in nasolabial folds (NLFs) and marionette lines (MLs). Satisfaction was assessed at Weeks 4 and 8 after the last treatment using questionnaires (FACE-Q™ [subjects] and KISSABILITY [subjects and partners]). RESULTS: Nineteen subjects received HARK only; 40 also received HARR and/or HARD . Subjects reported a high level of satisfaction with their lips following treatment. Increases from baseline in the mean total satisfaction score were statistically significant at Weeks 4 and 8 (P ≤ .001). Most subjects (≥89%) reported satisfaction on all FACE-Q questions at Week 8. Both subjects and partners were satisfied with the kissability, appearance, and natural look and feel of the post-treatment results. CONCLUSION: This study demonstrated that HARK resulted in lip enhancement with high levels of subject and partner satisfaction, when used alone or in combination with HARR / HARD in NLFs and MLs.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Adolescente , Humanos , Ácido Hialurônico , Lábio , Sulco Nasogeniano , Satisfação do Paciente , Satisfação Pessoal , Rejuvenescimento , Resultado do Tratamento
14.
J Cosmet Dermatol ; 20(5): 1512-1519, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33533155

RESUMO

BACKGROUND: Agarose gel filler is a natural hydrocolloid with a three-dimensional structure similar to the extracellular matrix, with gel formed by hydrogen bonds and electrostatic interactions rather than through chemical cross-linking or polymerization. OBJECTIVE: To determine efficacy and safety of 2.5% agarose gel filler for the correction of nasolabial folds. METHODS: In this split-face study, efficacy, safety, and usability of 2.5% agarose gel were compared to those of NASHA-L. Assessments included the nasolabial fold (NLF) Wrinkle Severity Rating Scale (WSRS), Global Aesthetic Improvement Scale (GAIS [blinded investigator]), subject satisfaction, safety (adverse events), and usability. RESULTS: Sixty-six subjects were treated, and 46/66 (66.7%) were available for evaluation at 3 months, when mean change in WSRS was identical for both products (-1.1 ± 0.4 for 2.5% agarose; -1.1 ± 0.4 for NASHA-L). Scores for each product remained similar across all time points and began to return to baseline between 7 and 8 months. GAIS score followed a similar pattern, rising between months 7 and 8 (2.7 ± 0.6 for 2.5% agarose at month 7-3.3 ± 0.5 at month 8 and 2.7 ± 0.6 for NASHA-L at month 7-3.3 ± 0.5 at month 8). Ultrasound confirmed the longevity of both fillers between 7 and 8 months. All adverse events were transient in nature and resolved within 15 days. Most events were mild in nature, and the number of events was similar between the two fillers. CONCLUSION: Treatment with 2.5% agarose gel resulted in improvement that persisted for between 7 and 8 months. The treatment effect was equivalent to NASHA-L.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Preenchedores Dérmicos/efeitos adversos , Método Duplo-Cego , Humanos , Ácido Hialurônico/efeitos adversos , Sulco Nasogeniano , Sefarose , Resultado do Tratamento
15.
Facial Plast Surg ; 37(3): 383-389, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33621988

RESUMO

This study aimed to evaluate satisfaction in terms of facial appearance, quality of life, and adverse effects in patients undergoing the facial thread lifting procedure using the absorbable facial threads anchored on the superficial and deep temporal fascias. The charts of patients for whom facial anchored thread lifting was performed using absorbable threads between February 2017 and September 2019 were reviewed. Demographic data including age and gender as well as data from the Face-Q scales were collected. Descriptive analysis was made for the adverse effects 1 week after the procedure. The mean value of adverse effects scales was compared 1 and 2 weeks after the procedure and also the mean values of facial appearance and quality-of-life scales were compared at baseline, 6 months, and 12 months after the procedure. All recruited subjects were females with a mean age of 43.42 years. There was a statistically significant decrease in the rate of adverse effects following the procedure between the first and second week. The mean difference in patients' perceived age 6 and 12 months after the procedure was statistically significant when compared with baseline. The psychological distress significantly decreased and the psychological function improved 6 and 12 months after the procedure. The overall satisfaction with facial appearance increased significantly after 6 months with a mean of 20.08. This was maintained at 12 months. The satisfaction in skin appearance, cheeks, nasolabial folds, marionettes, lower face, and jawline appearances improved significantly 6 months after the procedure. This was also maintained at 12 months. Face lifting using the polycaprolactone threads anchored on the temporalis fascia showed a significant improvement in the quality of life and facial appearance. The adverse effects are tolerable starting 2 weeks after the procedure.


Assuntos
Satisfação do Paciente , Ritidoplastia , Adulto , Bochecha , Feminino , Humanos , Lactente , Masculino , Sulco Nasogeniano , Qualidade de Vida
16.
Acta otorrinolaringol. esp ; 72(1): 3-10, ene.-feb. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-200343

RESUMO

INTRODUCCIÓN: La leishmaniasis comprende un grupo de enfermedades provocadas por parásitos protozoos del género Leishmania que se transmiten mediante la picadura de la hembra de mosquitos flebotomos infectados desde reservorios animales, generando 3 formas clínicas diferentes: cutánea, mucocutánea y visceral. Presentamos los hallazgos en cabeza y cuello de esta enfermedad observados en nuestra área de salud. PACIENTES Y MÉTODOS: Revisión de los últimos 26 años en nuestro hospital, anotando las características clínicas, diagnósticas y terapéuticas de los casos detectados. RESULTADOS: Fueron identificados 13 casos, 7 con síndrome cutáneo, 4 mucocutáneo y 2 visceral o kala azar. Su edad media fue de 53,7 ± 10,8 años. En un 61% de los casos se verificó inmunodeficiencia. La incidencia de la enfermedad fue de 1,5:100.000 habitantes-año, con una prevalencia del 2%. El 69% de los infectados mostraron afectación del área otorrinolaringológica. En 12 casos el diagnóstico se estableció mediante biopsia de las lesiones. El tiempo desde el inicio clínico al diagnóstico osciló entre 3 y 10 meses. Como tratamiento se emplearon compuestos antimoniales en 11 pacientes y anfotericina B en 3, sola o combinada con el anterior. Una forma cutánea se resolvió con escisión de la lesión. El 92% mostró curación clínica y parasitológica. CONCLUSIONES: La leishmaniasis en España genera frecuentes cuadros de afectación cutánea y mucocutánea, a menudo en la piel de cabeza, cara y cuello o mucosa de vías altas. Su presentación clínica es muy variable, debiéndose sospechar ante la ausencia de respuesta a terapias convencionales y en condiciones de inmunodeficiencia


INTRODUCTION: Leishmaniasis comprises a group of diseases caused by protozoan parasites of the genus Leishmania that are transmitted by the bite of infected phlebotomine mosquitoes from animal reservoirs. Three different clinical forms are generated: cutaneous, mucocutaneous and visceral. We present the findings in the head and neck of this disease observed in our health area. PATIENTS AND METHODS: A review of the last 26 years in our hospital, noting the clinical, diagnostic and therapeutic characteristics of the cases detected. RESULTS: Thirteen cases were identified, 7 cutaneous, 4 mucocutaneous and 2 visceral or kala-azar. The mean age was 53.7 ± 10.8 years. Immunodeficiency was identified in 61% of the cases. The incidence of the disease was 1.5:100,000 inhabitants/year, with a prevalence of 2%. Of those infected, 69% had involvement of the ear-nose-throat area. In 12 cases the diagnosis was established by biopsy of the lesions. The time from clinical debut to diagnosis ranged from 3 to 10 months. Antimony compounds were used as treatment in 11 patients and amphotericin B in 3, alone or combined with the former. One cutaneous form resolved with excision of the lesion. Ninety-two percent healed clinically and parasitologically. CONCLUSIONS: Leishmaniasis in Spain frequently entails cutaneous and mucocutaneous involvement, often of the skin of the head, face and neck or upper-airway mucosa. Its clinical presentation varies greatly, and it should be suspected if there is no response to conventional therapies and in conditions of immunodeficiency


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Leishmaniose Cutânea/epidemiologia , Leishmania/isolamento & purificação , Leishmaniose Mucocutânea/diagnóstico , Leishmaniose Visceral/diagnóstico , Anfotericina B/uso terapêutico , Leishmaniose/diagnóstico , Antiprotozoários/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Mucocutânea/tratamento farmacológico , Biópsia , Estudos Longitudinais , Estudos Retrospectivos , Leishmaniose/tratamento farmacológico , Dor Abdominal/etiologia , Sulco Nasogeniano/parasitologia , Ensaio de Imunoadsorção Enzimática , Diagnóstico Diferencial
17.
Actas dermo-sifiliogr. (Ed. impr.) ; 112(2): 171-175, feb. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-200871

RESUMO

La reconstrucción del labio superior tras la cirugía de Mohs supone, en ocasiones, un reto para el cirujano dermatológico. Presentamos una serie de 15 pacientes (7 hombres y 8 mujeres; edad media de 65,6 años) con cáncer cutáneo (10 carcinomas basocelulares, 2 melanomas y 3 carcinomas escamosos) localizados en el labio superior intervenidos mediante cirugía de Mohs con defectos resultantes de 3-7,6 cm. Para la reconstrucción se empleó un colgajo en isla del labio superior diseñado escondiendo las incisiones en el pliegue nasolabial, en la línea de unión del bermellón con la piel y en las líneas de tensión de la piel relajada. Se explican las claves del diseño y la cirugía, enfatizando en la importancia de sacrificar en ocasiones pequeñas zonas de tejido sano. Se alcanzaron resultados satisfactorios cosméticos y funcionales, sin complicaciones posquirúrgicas en todos los pacientes


Upper-lip reconstruction after Mohs micrographic surgery is challenging for dermatologic surgeons. We describe a series of 15 patients (7 men and 8 women; mean age, 65.6 years) with skin cancer on the upper lip treated with Mohs surgery: 10 were basal cell carcinomas, 2 were melanomas, and 3 were squamous cell carcinomas. The resulting defects measured between 3 and 7.6cm. We used island flaps to reconstruct the defects in all cases, hiding the incisions in the nasolabial fold, at the line where the skin meets the vermillion border of the lip, and in the relaxed skin tension lines. We explain key aspects of the surgeries and design of the reconstructions, with emphasis on the importance of occasionally sacrificing small areas of healthy skin. Cosmetic and functional outcomes were satisfactory in all patients, and there were no postsurgical complications


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cirurgia de Mohs/métodos , Retalhos Cirúrgicos/cirurgia , Lábio/cirurgia , Neoplasias Labiais/cirurgia , Neoplasias Cutâneas/cirurgia , Melanoma/cirurgia , Carcinoma de Células Escamosas/cirurgia , Carcinoma Basocelular/cirurgia , Resultado do Tratamento , Sulco Nasogeniano/cirurgia
18.
J Cosmet Dermatol ; 20(5): 1467-1473, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33085170

RESUMO

BACKGROUND: Hyaluronic acid fillers are known to be effective for correction of nasolabial folds. Recently, a novel biphasic hyaluronic acid filler incorporating lidocaine, DIVAVIVA medium has been introduced. OBJECTIVES: We compared the efficacy and safety between DIVAVIVA medium and Restylane Perlane Lidocaine for moderate to severe nasolabial folds. METHODS: This was a multicenter, randomized, evaluator/subject-blind, active-controlled, split-face study. A study 1 evaluated the efficacy and safety until 24 weeks. Extension study, study 2, included subjects who wanted to enroll and evaluated the efficacy and safety until 52 weeks. The Wrinkle Severity Rating Scale (WSRS) score, Global Aesthetic Improvement Scale, and Visual Analogue Scale measuring pain were evaluated. All adverse events were monitored. RESULTS: The mean change of WSRS at week 24 was -0.61 ± 0.54 in DIVAVIVA medium group and -0.59 ± 0.49 in Restylane Perlane Lidocaine group. The difference between two groups was 0.08, which was lower than noninferior limit. In study 2, the mean change of WSRS score at week 52 from baseline was -0.01 ± 0.62 in DIVAVIVA group, 0.06 ± 0.57 in Restylane Perlane Lidocaine group. The primary and secondary efficacy outcomes were also achieved in study 1 and 2. There was no significant difference in the incidence of adverse events between the two groups. CONCLUSION: DIVAVIVA medium has comparable efficacy and safety with Restylane Perlane Lidocaine for correction of moderate to severe nasolabial folds.


Assuntos
Técnicas Cosméticas , Envelhecimento da Pele , Técnicas Cosméticas/efeitos adversos , Método Duplo-Cego , Humanos , Ácido Hialurônico/efeitos adversos , Sulco Nasogeniano , Resultado do Tratamento
19.
Skin Res Technol ; 27(3): 444-452, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33111421

RESUMO

BACKGROUND: Recently, the field of face and facial features has been progressively studied. The features of facial expression have gained increasing attention for related applications. The wrinkle is the most representative feature, and its research and applications have been topics of high interest. Wrinkles play an important role in face feature analysis. They have been widely used in applications, such as age estimation, skin texture classification, expression recognition, and simulation. PURPOSE: Existing approaches to the image-based analysis of wrinkles as texture not as curvilinear discontinuity and wrinkle detection mainly have focused on detecting wrinkles on forehead position, which is usually horizontal linear shapes, while the detection of the nasolabial wrinkle is not well understood due to their variety of shapes and complexity. METHOD: In this paper, we present a nasolabial wrinkle line detecting effective algorithm based on the Active appearance model and Hessian filter to improve localization results by creating unique initial shapes of the wrinkle lines for each input face image. RESULTS: Experimental results show that the proposed method is capable of tracking curve wrinkle lines, thus allowing to detect complexly structured wrinkle lines. This work demonstrates results illustrated the competitiveness of the proposed method in detecting nasolabial wrinkle lines. CONCLUSION: In our study, this was introduced the effectiveness of changing the structure of AAM and successfully applied in wrinkle line localizing, although competitive results are achieved by the proposed wrinkle detection method.


Assuntos
Envelhecimento da Pele , Testa , Humanos , Processamento de Imagem Assistida por Computador , Sulco Nasogeniano
20.
J Cosmet Dermatol ; 20(7): 2247-2258, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33171021

RESUMO

BACKGROUND: As deep nasolabial folds (NLF) are associated with facial aging, there is an increasing demand for esthetic correction with filler injections. Understanding the anatomy of the angular artery (AA) and facial artery (FA) around the NLF region is essential for ensuring the safety of dermal filler injections into the NLF. The purpose of this study was to provide detailed vascular anatomical information on the course and depth of AA and FA around NLF using Doppler ultrasound on live cases. METHODS: FA was observed from the origin level adjacent to the mandible corpus to the end of its terminal branch AA in 168 hemifaces of 84 cases with Doppler ultrasonography. RESULTS: We made a classification of the FA course based on the NLF. The minimum and maximum depths of the FA along its course were measured in 84 cases. The results showed that its course may be highly superficial (2.5 mm at the mandibular origin, 3.7 mm at the cheilion, 3.7 mm at the nasal ala) or it may follow a very deep course near the periosteum (15.0 mm at the mandibular origin, 18.7 mm at the cheilion, 23.5 mm at the nasal ala). FA depth was varied between 5.98 mm and 6.62 mm at the mandibular origin, between 8.36 mm and 9.20 mm at the cheilion, between 9.52 mm and 10.51 mm at the nasal ala at a 95% confidence interval. CONCLUSIONS: This study suggests that there is no absolutely safe depth or region for nasolabial fold filler injections.


Assuntos
Técnicas Cosméticas , Artérias/diagnóstico por imagem , Técnicas Cosméticas/efeitos adversos , Humanos , Sulco Nasogeniano , Nariz , Ultrassonografia Doppler
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