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Pryor S, Semersky A, Sabev T, Few J. Stackable Medical-Grade Skincare for the Cosmetic Medicine Patient: A Long-Term Pilot Assessment. Aesthet Surg J Open Forum 2024; 6:ojae037. [PMID: 38841211 PMCID: PMC11150041 DOI: 10.1093/asjof/ojae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
Background Multiple intrinsic and extrinsic factors influence aging and lead to visible changes in the skin, including dryness, fine lines and wrinkles, loss of elasticity, surface roughness, uneven pigmentation, and loss of luminosity. Although it is well established that a single combination of topicals can address multiple signs of skin aging, it is common for patients' at-home skin treatment routines to include multiple different topicals with different active ingredients. The layering of active ingredients can cause skin irritation, and lead to noncompliance with a consistent routine. Further, multiple active ingredients may exacerbate irritation from in-office aesthetic treatments. Objectives To assess the long-term efficacy, safety, tolerability, and patient adherence to a Stackable Treatment topical routine consisting of 4 complementary topical formulations. Methods This study examined a daily topical routine (Stackable Treatment routine) consisting of 4 topical formulas with different active ingredients, and evaluated the routine's safety, tolerability, and efficacy in a composite of in-office treatment patients who applied the routine for a minimum of 1 year. Results Of the 14 patients, 0 experienced adverse reactions. Improvements to multiple skin parameters were observed, including improvements to skin hydration, surface texture, pigmentation, vasculature, and the appearance of scars. The majority of patients continue to use the Stackable Treatment routine after the study's conclusion. Conclusions The combination of low incidence of irritation, high patient satisfaction, and overall efficacy of the routine indicates the Stackable Treatment routine may be well suited as a foundational skin care regimen that can complement in-office aesthetic treatments. Level of Evidence 4
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Affiliation(s)
| | - Alec Semersky
- Corresponding Author: Mr Alec Semersky, 409 Lena Circle, Chapel Hill, NC 27516, USA. E-mail:
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Liu Q, Guo L, Zhu Y, Song B, Zeng X, Liang Z, Liu J, Song B. Prospective comparative clinical study: Efficacy evaluation of collagen combined with hyaluronic acid injections for tear trough deformity. J Cosmet Dermatol 2024; 23:1613-1619. [PMID: 38299745 DOI: 10.1111/jocd.16211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Tear trough filling is a popular facial rejuvenation procedure, and hyaluronic acid is typically used as the filler of choice. However, Tyndall's phenomenon, a common complication following hyaluronic acid injection, can occur, leading to skin discoloration of the lower eyelid. AIMS This single-center, prospective, comparative clinical study aimed to evaluate the efficacy of collagen and hyaluronic acid injections in treating tear trough deformity. METHODS Sixty patients were enrolled between June 2022 and January 2023. Patients were randomly allocated into three groups: Group A received hyaluronic acid, Group B received hyaluronic acid combined with collagen, and Group C received collagen alone. Baseline characteristics, including age, sex, and tear trough deformity grade were considered before therapy. Changes in tear trough deformity scores, Global Aesthetic Improvement Scores, and the presence of the Tyndall effect were analyzed at 1 and 3 months postinjection to determine differences among the three groups. RESULTS Baseline profiles of the three groups were similar. In the first month postinjection, there was no difference in the Global Aesthetic Improvement Scores and tear trough deformity between the three groups. However, in the third-month postinjection, there was a significant difference in scores between patients in Group C and those in Groups A or B. The Tyndall effect manifested in three patients in Group A, which was significantly different from that in Groups B and C. CONCLUSION The combined use of hyaluronic acid with collagen in injectable fillers corrected tear trough deformities and reduced the occurrence of the Tyndall phenomenon, which can be problematic with hyaluronic acid alone. Additionally, this combination may help overcome the disadvantage of a shorter retention period when using collagen alone.
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Affiliation(s)
- Qing Liu
- Xian Bravou Medical Beauty Hospital, Xi'an, China
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Lei Guo
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yuhan Zhu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Binyu Song
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xianhui Zeng
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhen Liang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiaxi Liu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Baoqiang Song
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Lim TS, Liew S, Tee XJ, Chong I, Lo FJ, Ho MJ, Ong K, Cavallini M. Polynucleotides HPT for Asian Skin Regeneration and Rejuvenation. Clin Cosmet Investig Dermatol 2024; 17:417-431. [PMID: 38371328 PMCID: PMC10874187 DOI: 10.2147/ccid.s437942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024]
Abstract
Introduction Even lightly compromised skin may impact self-esteem and social behaviour. After intradermal infiltration, natural-origin Polynucleotides High Purification Technology (PN HPT) promote new collagen and extracellular matrix production, translating into a physiological correction of the ageing skin. The study aimed to explore the benefits of intradermal PN HPT on the four perceptual skin quality categories "Skin Tone Evenness", "Skin Surface Evenness", "Skin Firmness", and "Skin Glow" in a representative sample of 30 Asian subjects (mean age 40.2± 11.4 years old). Methods Study protocol: three intradermal injections of a PN HPT-based Class III CE-marked medical device at T0 (baseline assessment and first treatment session), T1 (four weeks after baseline), and T2 (eight weeks after baseline), with efficacy and safety evaluations at T1, T2, T3 (four months after baseline) and T4 (six months after baseline). Quantitative and qualitative assessments: 3D skin analysis system QuantifiCare and Global Aesthetic Improvement Scale (GAIS, Investigator and Patient subscales). Results PN HPT treatment led to a meaningful and statistically significant improvement of the skin surface, firmness, pigmentation, and radiance, with no early- or late-onset adverse events and benefits persisting up to the sixth-month visit in all subjects. At T4, 33% and 43% of treated subjects felt "Much Improved" and "Very Much Improved" (optimal result); 56% and 44% of treated subjects felt "Satisfied" or "Very Satisfied". At T4, the mean Investigator GAIS scores were 3.33 out of 5.0 for the "Skin Tone Evenness" skin quality perceptual category, 3.46 for the "Skin Surface Evenness" category, 3.61 for "Skin Firmness", and 3.45 per for the radiance determinant of the "Skin Glow" category. Conclusion Intradermal treatment with the PN HPT-based medical device led to a meaningful improvement of the skin surface, firmness, pigmentation, and radiance with complete safety. The aesthetic benefits persisted up to the sixth-month visit in all subjects.
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Affiliation(s)
| | | | | | - Ian Chong
- Clique Clinic, Petaling Jaya, Selangor, Malaysia
| | - Fui Jun Lo
- Clique Clinic, Petaling Jaya, Selangor, Malaysia
| | - Meng Jun Ho
- Clique Clinic, Petaling Jaya, Selangor, Malaysia
| | - KuokTjun Ong
- Clique Clinic, Petaling Jaya, Selangor, Malaysia
| | - Maurizio Cavallini
- Dermatology and Dermatosurgery Department, CDI Centro Diagnostico Italiano, Milan, Italy
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Trindade de Almeida AR, Marques ERMC, Contin LA, Trindade de Almeida C, Muniz M. Efficacy and Tolerability of Hyperdiluted Calcium Hydroxylapatite (Radiesse) for Neck Rejuvenation: Clinical and Ultrasonographic Assessment. Clin Cosmet Investig Dermatol 2023; 16:1341-1349. [PMID: 37255625 PMCID: PMC10226485 DOI: 10.2147/ccid.s407561] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/13/2023] [Indexed: 06/01/2023]
Abstract
Background The subdermal injection of calcium hydroxylapatite (CaHA) can improve the mechanical properties of the skin, providing immediate correction and stimulating the endogenous production of collagen, elastin, angiogenesis, and dermal cell proliferation; however, few studies have examined the neck region. Purpose This study assessed the clinical and ultrasonographic improvement induced by two sessions of subdermal injection of hyperdiluted (1:4) CaHA for neck rejuvenation in 22 women. Patients and Methods A quasi-experimental longitudinal trial (before and after) was performed by enrolling 22 adult women with mild and moderate neck aging (grades 1 and 2) on Merz Neck Volume Scale at rest (laxity) and Neck Horizontal Lines. They were submitted to two sessions of subdermal hyperdiluted CaHA (D0 and D45) treatments and assessed clinically and ultrasonographically at D0, D45, and D120. The main outcomes were the blinded photographic assessment (Merz scales of neck laxity and horizontal lines), dermal thickness (at three points), and the GAIS (Global Aesthetic Improvement Scale) score. Results The mean (SD) age was 43.5 (5.6) years. At the inclusion, the Merz scores for neck laxity were mild for 27% and moderate for 73% of participants, and the Merz scores for necklines were mild for 32% and moderate for 68%. At D120, scores decreased in 86% (95% CI 68-99%) of the participants by at least one degree on the necklines scale and in 82% (95% CI 73-90%) for neck laxity. According to the GAIS, 91% (95% CI 77-99%) of the participants evidenced improvement at D120. The mean dermal thickness increased by 15% (95% CI 8-21%) at D120. No severe adverse effects were recorded, and high satisfaction was reported by 82% of the participants. Conclusion Two sessions of subdermal hyperdiluted CaHA were well-tolerated and improved necklines, neck laxity, and dermal thickness in adult women with mild and moderate cervical aging.
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Affiliation(s)
| | | | - Letícia Arsie Contin
- Hospital do Servidor Público Municipal, São Paulo, SP, Brazil
- For Trials Pesquisa Clínica, São Paulo, SP, Brazil
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Pruksapong C, Buarabporn N, Junkajorn S. Efficacy of Cold Tumescent for Prevention of Intraoperative Bleeding in Patients Undergoing Liposuction: A Double-Blind Randomized Controlled Trial-Half-Side Comparison. Aesthet Surg J 2023; 43:NP258-NP267. [PMID: 36495216 DOI: 10.1093/asj/sjac331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bleeding, a common intraoperative complication of liposuction, often causes pain and discomfort during recovery. Because of the vasoconstrictive effect of adrenaline in the tumescent solution, bleeding can be reduced; however, reports of postoperative bleeding persist. Cold temperatures also have a vasoconstrictive effect. OBJECTIVES This study aimed to determine the efficacy of cold tumescent solution in preventing and reducing intraoperative bleeding. METHODS This prospective randomized controlled trial was conducted between June 2018 and June 2019. The liposuction areas in each participant were divided into left and right sides; one side received operative room temperature tumescent solution (25 °C), and the other side received low-temperature tumescent solution (4 °C). The areas of ecchymosis, pain scores, and patient and surgeon satisfaction scores were compared and analyzed. RESULTS Ten patients with 36 pairs of liposuction areas were enrolled in the study. Cold tumescent liposuction resulted in a significantly lower lipocrit than was obtained on the standard tumescent side (1.56 ± 0.69 vs 2.92 ± 0.94; P < .001). The ecchymosis area and pain score were significantly lower in the cold tumescent group on days 2, 4, 7, and 14. The satisfaction evaluation scores did not differ between patients and surgeons at 12 months postoperatively. CONCLUSIONS The use of cold tumescent anesthesia significantly improved liposuction outcomes by reducing the intraoperative blood loss and the postoperative ecchymosis and pain, with no immediate or short-term complications in low-volume liposuction (<1000 mL) procedures. Furthermore, it generated a standard outcome and good patient satisfaction scores. LEVEL OF EVIDENCE: 2
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Torre E, Vetrano S, Vertué S, Zazzaron M, Russo R. Satisfaction outcomes for patients and physicians following use of a new hyaluronic acid fillers. J Cosmet Dermatol 2023. [PMID: 36866821 DOI: 10.1111/jocd.15694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND The aesthetic appearance of the skin, with the emergence of wrinkles, blemishes, and infraorbital hollowing, can be a cause of social distress and is a process exacerbated by aging. The presence of skin imperfections and aging is partly due to a loss of hyaluronic acid (HA), which normally contributes to a maintain a healthy and voluminous skin. Attempts to restore volume and revert the signs of aging have therefore focused on the use of dermatologic fillers based on HA. AIM Here, we tested the safety and efficacy of MelHA®-Monophasic Elastic Hyaluronic Acid (Concilium FEEL® filler products) containing HA at different concentrations and injected at different sites according to recommendations. METHODS Five different physicians assessed 42 patients across five different medical facilities in Italy, where they performed the treatment and assessed the patients after a follow-up visit. Safety and efficacy of the treatment and change in quality of life after treatment were evaluated with two surveys, one directed to medical personnel, and one directed to patients. RESULTS Our results show that, across all products and personalized treatments, patients', physicians' and "independent photography reviewer" satisfaction was very high and that the treatment show a favorable safety profile. CONCLUSION These results are promising and suggest the use of Concilium Feel® filler products can contribute to an increased self-esteem and quality of life in aging patients.
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Shin DS, Son KM, Cheon JS, Choi WY, Choi MH. Clinical characteristics of and therapeutic approach to complications due to the injection of foreign material in the face: a retrospective study. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2022. [DOI: 10.14730/aaps.2021.00255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Soft tissue fillers are increasingly used to rejuvenate and beautify the body and face. Unknown foreign materials that have not always been proven to be safe for human use have been used for injections in the past. Various commercial injectable materials have since been developed and are used; however, the number of complications has increased as soft tissue fillers have increased in use.Methods A retrospective study of 39 patients with facial foreign body complications who underwent surgical treatment between March 2012 and February 2021 was conducted. Patient information was analyzed, and patient satisfaction was evaluated using a questionnaire after surgical treatment. A comparative statistical analysis was undertaken.Results Patients who underwent procedures performed by unlicensed practitioners tended to be older at the time of presenting to the hospital (P=0.004). The degree of satisfaction after surgical repair was significantly lower following the direct approach than after the indirect approach using a bypass incision (P=0.044). The degree of satisfaction significantly decreased (P=0.001) as the number of operations the patient received increased.Conclusions When treating complications caused by foreign material injections, surgical removal is a more reliable method than treatment with medication or further injections; however, treatment decisions should be made thoughtfully, and many factors must be considered. Patient satisfaction can be improved by reducing the number of operations and making the appropriate corresponding incisions or excisions to treat the full range of symptoms caused by foreign substances and by indirectly using bypass incisions to mitigate post-surgery scars.
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Tam C, Khong J, Tam K, Vasilev R, Wu W, Hazany S. A Comprehensive Review of Non-Energy-Based Treatments for Atrophic Acne Scarring. Clin Cosmet Investig Dermatol 2022; 15:455-469. [PMID: 35359828 PMCID: PMC8963193 DOI: 10.2147/ccid.s350040] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/12/2022] [Indexed: 11/24/2022]
Abstract
Scarring is a dire consequence of acne vulgaris. Particularly, atrophic acne scarring is highly prevalent among young adults, and its physical and psychological effects can persist throughout their lives if left untreated. This literature review will analyze various non-energy-based approaches to treating atrophic acne scarring, emphasizing recent advances within the last 5 to 10 years. To accomplish this, we performed a PubMed search for various acne scar treatments such as chemical peels, dermabrasion, microdermabrasion, subcision, microneedling, punch techniques, dermal fillers, and thread lifting. Our findings and analysis show that there is no panacean solution to treating atrophic acne scars, which explains the evolving trend towards developing unique combinatorial treatments. Although a fair comparison of each treatment approach is difficult to achieve due to the studies’ varying sample sizes, strength of evidence, treatment execution, etc, there still remains a level of consensus on what treatments are well suited for particular scar types.
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Affiliation(s)
- Curtis Tam
- Salar Hazany M.D. Inc, Beverly Hills, CA, USA
| | | | - Kevin Tam
- Salar Hazany M.D. Inc, Beverly Hills, CA, USA
| | | | - Wesley Wu
- Department of Dermatology, Veterans Affairs Medical Center, Seattle, WA, USA
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Xie Y, Wu S, Li S, Li Q, Zhao H. An evaluation of the long-term safety and biodegradability of hyaluronic acid dermal fillers (YVOIRE ® ) for the correction of nasolabial folds: Two multicenter, prospective, observational cohort studies. J Cosmet Dermatol 2022; 21:2387-2397. [PMID: 35357748 DOI: 10.1111/jocd.14952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 02/20/2022] [Accepted: 03/28/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The therapeutic effects of hyaluronic acid dermal fillers to correct facial wrinkles and folds usually last up to 6-12 months. Few studies have evaluated their long-term safety. AIMS To evaluate the long-term safety and biodegradability of two hyaluronic acid dermal fillers (YVOIRE® classic s and YVOIRE® volume s) for the correction of nasolabial folds (NLFs) in two prospective, observational studies. METHODS Subjects scheduled to receive the injections of YVOIRE® classic s (N = 503) or YVOIRE® volume s (N = 503) at NLFs were followed up until complete clinical biodegradation, defined as a change in Wrinkle Severity Rating Scale (WSRS) score of ≥0 from baseline. The primary biodegradation endpoint was the proportion of subjects with complete clinical biodegradation during or after the 104-week post-treatment period. RESULTS Complete clinical biodegradation was observed in 93.5% [95% CI 91.0-95.5%] of 494 assessable YVOIRE® classic s recipients and 98.5% [95% CI 97.0-99.4%] of 469 YVOIRE® volume s recipients during the 104-week post-treatment period. In most subjects, complete clinical biodegradation was observed within 52 weeks of the last treatment. Treatment-related adverse events (AEs) (mostly mild local injection-site reactions) occurred within 52 weeks post-treatment, in 68.2% and 75.0% of YVOIRE® classic s and YVOIRE® volume s recipients, respectively. During the 12- to 18-months after YVOIRE® volume s injection, 0.6% of subjects had treatment-related AEs (local injection-site reactions). No treatment-related AEs occurred 12- to 24-months after YVOIRE® classic s injection. CONCLUSIONS YVOIRE® classic s and YVOIRE® volume s can be safely used to correct NLFs. Total clinical biodegradation tends to occur within 12 months of injection.
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Affiliation(s)
- Yun Xie
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sufan Wu
- Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Shirong Li
- Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Qingfeng Li
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyi Zhao
- Beijing Hospital, Ministry of Health, Beijing, China
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Fusano M, Bencini PL. Microneedle fractional radiofrequency for atrophic acne scars: in vivo evaluation of results by 3D analysis and reflectance confocal microscopy. Dermatol Ther 2022; 35:e15454. [PMID: 35297143 DOI: 10.1111/dth.15454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The efficacy of microneedle fractional radiofrequency (MFR) for the treatment of atrophic acne scars has been recently described, but accurate in vivo microscopic documentation of the processes occurring has never been reported. AIMS The aim of this study is to describe in vivo morphological atrophic acne scars' variations after treatment with MFR by means reflectance confocal microscopy (RCM) and three-dimensional (3D) imaging. PATIENTS/METHODS A total of 11 patients requiring treatment for atrophic facial acne scars were treated with four monthly sessions of MFR. 3D imaging and RCM were assessed at baseline and 1 months after last session. Clinical improvement, according to Global Assessment Improvement Scale (GAIS), and patients' satisfaction were evaluated. RESULTS Clinical improvement was observed in all the treated patients, although better results were obtained for boxcar scars (p= 0.043). 3D imaging revealed a significant improvement in terms of mean scars' depth (p<0.001). Otherwise, RCM highlighted collagen remodeling with restoration of a reticular structure. CONCLUSIONS Our study confirms the efficacy and safety of MFR in acne scars' treatment and provides the microscopic description of the results using RCM. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Marta Fusano
- Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Via della Moscova 42, Milan, Italy
| | - Pier Luca Bencini
- Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Via della Moscova 42, Milan, Italy
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Using New Autologous Tissue Filler Improved Nasolabial Folds-Single-Armed Pilot Study. Aesthetic Plast Surg 2021; 45:2920-2927. [PMID: 34595598 DOI: 10.1007/s00266-021-02608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the clinical efficacy and safety of the new autologous tissue filler derived from autologous skin and hairs for correction of nasolabial folds. MATERIALS AND METHODS The new injectable soft tissue filler is prepared from autologous fibroblasts and keratin gel. A total of 40 patients were enrolled in this single-armed pilot study, all of them received the new filler injection treatment for correction nasolabial folds. Following up with the patients, collection of their clinical features, including photographs, satisfaction, and information on adverse events at the 1st, 3rd, 6th, 12th, and 24th months after injection. The clinical efficacy of each patient was evaluated by masked evaluators and independent expert panels, based on the Wrinkle Severity Rating Scale (WSRS) at different time points after the injection. RESULTS Thirty-two patients completed the 24-months follow-up, obtaining at least 93.8% improvement, and 75% of them had significantly improved. Base on the self-satisfaction assessment (SSA) indicated that all of them were satisfied with the results. No adverse effects of filler injection treatment were observed during the follow-up. CONCLUSIONS The combination of autologous keratin and fibroblasts as a new tissue engineering soft tissue filler has shown safety and long-term efficiency in correcting nasolabial folds, with high satisfaction and desirable result. 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 .
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Ghaddaf AA, Aljefri YE, Alharbi FA, Sharif RK, Alnahdi WA, Baaqeel R. Monophasic versus biphasic hyaluronic acid filler for correcting nasolabial folds: a systematic review and meta-analysis. J Cosmet Dermatol 2021; 21:627-635. [PMID: 34817919 DOI: 10.1111/jocd.14632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) fillers are the most popular dermal fillers for wrinkle correction and facial rejuvenation. Recently, there has been an interest toward classifying HA fillers based on the cross-linking properties into monophasic (MHA) and biphasic (BHA) fillers. We aimed to compare the efficacy and safety outcomes between MHA and BHA fillers for the correction of nasolabial folds (NLFs). METHODS We searched Medline, Embase, and CENTRAL for randomized controlled trials (RCTs) that compared MHA filler to BHA filler for individuals with moderate-to-severe bilateral NLFs. We sought to evaluate the following outcomes: Wrinkle severity rating scale (WSRS), pain on visual analog scale (VAS), global aesthetic improvement scale (GAIS), and adverse events. The standardized mean difference (SMD) was used to represent continuous outcomes while risk ratio (RR) was used to represent dichotomous outcomes. RESULTS A total of 11 RCTs that enrolled 935 participants deemed eligible. MHA filler revealed a significant improvement in the overall WSRS score and GAIS score compared to BHA filler (SMD = -0.38, 95% CI -0.49 to -0.27 and SMD = 0.34, 95% CI 0.24-0.45, respectively). No significant difference was noted between MHA and BHA fillers in terms of pain score or adverse events (SMD = -0.39, 95% CI -0.81-0.03 and RR = 1.00, 95% CI 0.89-1.12, respectively). CONCLUSIONS MHA filler showed discernable cosmetic results and comparable effective and tolerability to BHA filler.
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Affiliation(s)
- Abdullah A Ghaddaf
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Yara E Aljefri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Fahad A Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rahaf K Sharif
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Wejdan A Alnahdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rasha Baaqeel
- Department of Surgery/Plastic section, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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13
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Owczarczyk-Saczonek A, Zdanowska N, Wygonowska E, Placek W. The Immunogenicity of Hyaluronic Fillers and Its Consequences. Clin Cosmet Investig Dermatol 2021; 14:921-934. [PMID: 34295171 PMCID: PMC8291382 DOI: 10.2147/ccid.s316352] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/03/2021] [Indexed: 12/24/2022]
Abstract
Hyaluronic acid (HA) is a glycosaminoglycan, a natural component of the extracellular matrix. The identical structure of the molecule in all living organisms is its main advantage, as it translates into the minimal probability of immunogenicity. Therefore, it is the closest to the ideal preparation used as a filler, due to its biocompatibility and stability at the site of implantation. This paper includes the discussion of the potential mechanisms of adverse immune reactions to HA along with the mechanisms of reaction following vaccinations against SARS-CoV-2. Based on the literature, we tried to systematize adverse immune reactions with systemic manifestations to HA. The occurrence of unpredictable reactions to hyaluronic acid indicates that they may not be treated as neutral or non-allergenic. The modifications of the chemical structure of HA, additives and individual tendencies in a patient may be the cause of unpredictable reactions, leading to serious health consequences. Preparations of unknown origin, poorly purified, or including bacterial DNA are particularly dangerous. Therefore, long-lasting follow-up of the patient and the selection of a preparation approved by the FDA or EMA are of high importance. Patients are often unaware of the consequences of cheaper procedures performed by persons without suitable knowledge with the use of unregistered products, so the public should be educated and legal regulations should be introduced.
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Affiliation(s)
- Agnieszka Owczarczyk-Saczonek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Natalia Zdanowska
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Ewa Wygonowska
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Waldemar Placek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Michon A. Hyaluronic acid soft tissue filler delayed inflammatory reaction following COVID-19 vaccination - A case report. J Cosmet Dermatol 2021; 20:2684-2690. [PMID: 34174156 PMCID: PMC8447415 DOI: 10.1111/jocd.14312] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/02/2021] [Accepted: 06/16/2021] [Indexed: 12/02/2022]
Abstract
Background The use of hyaluronic acid soft tissue fillers in aesthetic medicine exploded in recent years for many reasons, including being relatively safe. Incidence of delayed inflammatory reactions (DIRs) to hyaluronic acid soft tissue fillers range between 0.3% and 4.25%. These reactions are mediated by T‐lymphocytes and can be triggered by flu‐like illnesses, including SARS‐CoV‐2 infection. Vaccination may also induce hypersensitivity. Aim In this case report, we present two cases of delayed reaction after hyaluronic acid soft tissue filler treatment of the tear trough area and following mRNA vaccination against SARS‐Cov‐2, also known as COVID‐19, months later. Patients A 39‐year old female who previously had her tear trough area treated with hyaluronic acid soft tissue filler developed swelling days after getting the mRNA Pfizer‐BioNTech COVID‐19 vaccine. Another patient, a 61‐year‐olf female, developed intermittent facial swelling in areas previously treated with hyaluronic acid soft tissue fillers days after receiving her first dose of the mRNA Pfizer‐BioNTech COVID‐19 vaccine. Results As demonstrated in our case report, vaccination against COVID‐19 may induce DIRs in patients who previously had hyaluronic soft tissue fillers. Conclusion Delayed inflammatory reactions to hyaluronic acid soft tissue fillers are uncommon and usually self‐limited, with frequent spontaneous resolution. However, considering the ongoing pandemic and the worldwide demand for vaccines against COVID‐19, the aesthetic providers should be conscious of the risks posed by the interaction of such vaccines in patients who previously had or seeking hyaluronic acid soft tissue filler injections.
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Affiliation(s)
- Alain Michon
- The Ottawa Skin Clinic, Ottawa, ON, Canada.,Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON, Canada.,Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
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15
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Shome D, Shah RA, Gowda D, Vadera S, Kumar V, Raj M, Atif A, Doshi K, Vekaria M, Pathak M, Kapoor R. A prospective, open-label, multicentric, single-arm, post-marketing clinical study to evaluate effectiveness and safety of Cross-Linked Sodium Hyaluronate 24mg with Lidocaine 3mg Injection in subjects undergoing treatment for facial wrinkles and lip augmentation. J Cosmet Dermatol 2021; 20:2472-2479. [PMID: 34021962 DOI: 10.1111/jocd.14249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Debraj Shome
- Department of Facial Plastic Surgery & Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | | | - Dinesh Gowda
- Hairline Diagnostics & Healthcare Pvt Ltd, Bengaluru, India
| | - Sapna Vadera
- Department of Facial Plastic Surgery & Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | - Vaibhav Kumar
- Clinical Research Coordinator, The Esthetic Clinics, Mumbai, India.,Faculty, TPCT's Terna Dental College, India
| | - Manish Raj
- Smile Designers Multispeciality Dental Hospital, Prayagraj, India
| | - Ali Atif
- Department of Oral and Maxillofacial Surgery, King George Medical College, Lucknow, India
| | - Komal Doshi
- Department of Facial Plastic Surgery & Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, India
| | | | | | - Rinky Kapoor
- Department of Dermatology, Cosmetic Dermatology & Dermato-Surgery, The Esthetic Clinics, Mumbai, India
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16
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Abstract
Cellulite is characterized by dimpled contour alterations of the skin and is present in approximately 85% to 90% of postpubertal females. Although the pathophysiology of cellulite remains to be fully elucidated, experimental evidence indicates a multifactorial process involving the number and types of fibrous septae, microvascular dysfunction, subcutaneous inflammation, decreased dermal thickness with age, and fat deposition. Cellulite is a major cosmetic concern for many women, and a number of both noninvasive (eg, massage, cosmeceuticals, laser therapy) and minimally invasive techniques (eg, subcision, collagenase injection) have been evaluated to improve the appearance of the affected skin. However, evidence for many of these treatments is limited, largely due to the lack of a validated, convenient tool for the standardized evaluation of cellulite severity. Various imaging modalities have been employed to characterize cellulite severity and the impact of treatment, but only 2-dimensional and 3-dimensional digital photography have been adequately validated. However, in many cases, imaging findings do not correlate with subjective measures of cellulite severity. A number of cellulite rating scales have been developed; some provide only a qualitative measure, whereas others do not fully capture all clinically relevant aspects of cellulite, including the perspective of the patient. There remains an unmet need for global adoption of a validated scale that can be utilized easily by clinicians and patients in clinical and research settings. We propose features that should be included in an ideal rating scale for assessment of cellulite severity.
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Affiliation(s)
- V Leroy Young
- Corresponding Author: Dr V. Leroy Young, Mercy Research, 901 Patients First Drive, Washington, MO 63090, USA. E-mail:
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17
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Santorelli A, Cerullo F, Cirillo P, Cavallini M, Avvedimento S. Mid-face reshaping using threads with bidirectional convergent barbs: A retrospective study. J Cosmet Dermatol 2021; 20:1591-1597. [PMID: 33641227 PMCID: PMC9292157 DOI: 10.1111/jocd.14038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 12/02/2022]
Abstract
Background Minimally invasive procedures, such as thread suspension techniques, are a growing trend for facial rejuvenation. However, not enough data are available on the efficacy, outcomes, and morbidity of suture suspension techniques in mid‐face reshaping. Aims Our goal was to assess treatment outcomes and patient satisfaction following mid‐face reshaping using threads with bidirectional convergent barbs (DefinisseTM free floating threads). Patients/Methods We performed a retrospective analysis of 60 patients who underwent treatment for mid‐face reshaping using DefinisseTM free floating threads. Response to treatment was assessed at 6 months using the mid‐face‐specific Mid‐Face Volume Deficit scale (Allergan®), Global Aesthetic Improvement and FACE‐QTM scales. Results Sixty patients underwent mid‐face treatment with the suspension thread technique (mean age 51.3, 90% female). No concomitant procedures were done. A reduction by one point or more in the Mid‐Face Volume Deficit Scale (MDFVS) score treatment was seen in all patients after 6 months. Mean overall MFVDS and FACE‐QTM scores were significantly improved. On the GAIS, most patients were rated as improved or better both by the evaluating investigators and during self‐assessment. No major complications were observed, and none of the patients requested the removal of the threads (mean follow‐up 9.8 months, range 6–14 months). Conclusion Our results suggest that mid‐face reshaping with DefinisseTM free floating threads is a safe and reliable procedure characterized by low complication rates and good esthetic results. This minimally invasive procedure is a good alternative for normal or combination skin patients who refuse or want to delay the need for traditional rhytidectomy.
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Affiliation(s)
| | | | - Pierfrancesco Cirillo
- Italian Association of Aesthetic Plastic Surgery, Rome, Italy.,Day Clinic EUR, Rome, Italy
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18
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Birajdar MS, Joo H, Koh WG, Park H. Natural bio-based monomers for biomedical applications: a review. Biomater Res 2021; 25:8. [PMID: 33795019 PMCID: PMC8015023 DOI: 10.1186/s40824-021-00208-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
In recent years, synthetic and semi-synthetic polymer materials have been widely used in various applications. Especially concerning biomedical applications, their biocompatibility, biodegradability, and non-toxicity have increased the interest of researchers to discover and develop new products for the well-being of humanity. Among the synthetic and semi-synthetic materials, the use of natural bio-based monomeric materials presents a possible novel avenue for the development of new biocompatible, biodegradable, and non-toxic products. The purpose of this article is to review the information on the role of natural bio-based monomers in biomedical applications. Increased eco-friendliness, biocompatibility, biodegradability, non-toxicity, and intrinsic biological activity are some of the attributes which make itaconic, succinic, citric, hyaluronic, and glutamic acids suitable potential materials for biomedical applications. Herein, we summarize the most recent advances in the field over the past ten years and specifically highlight new and interesting discoveries in biomedical applications. Natural origin acid-based bio-monomers for biomedical applications.
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Affiliation(s)
- Mallinath S Birajdar
- Department of Integrative Engineering, Chung-Ang University, Seoul, Republic of Korea
| | - Haejin Joo
- Department of Integrative Engineering, Chung-Ang University, Seoul, Republic of Korea
| | - Won-Gun Koh
- Department of Chemical and Biomolecular Engineering, Yonsei University, Seoul, Republic of Korea
| | - Hansoo Park
- Department of Integrative Engineering, Chung-Ang University, Seoul, Republic of Korea.
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19
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Fusano M, Galimberti MG, Bencini M, Guida S, Bencini PL. Picosecond Laser treatment of Striae Distensae: In vivo Evaluation of Results by 3D Analysis, Reflectance Confocal Microscopy, and Patient's Satisfaction. Lasers Surg Med 2021; 53:1180-1185. [PMID: 33764570 DOI: 10.1002/lsm.23401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/27/2021] [Accepted: 03/14/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVES The efficacy of picosecond laser (PSL) in the treatment of striae distensae (SD) has been recently reported; otherwise, the base for this improvement has not been clarified yet. The aim of this study is to treat long-lasting SD with PLS and to describe their in vivo morphological variations after treatment using three-dimensional (3D) imaging and reflectance confocal microscopy (RCM). STUDY DESIGN/MATERIALS AND METHODS A total of 27 patients asking for treatment for SD were treated with four monthly sessions of PLS. Clinical improvement was estimated through a blinded evaluation performed by two independent dermatologists, Global Assessment Improvement Scale (GAIS), patients' satisfaction, 3D imaging, and RCM assessments at baseline and 6 months after the last laser session. RESULTS Although a clinical improvement of SD was observed in 81.4% of patients according to physicians' GAIS, only 66.6% of patients reported subjective improvement and satisfaction after treatment (P = 0.04). 3D imaging revealed a significant improvement in terms of skin texture (P < 0.001) and mean SD depth (P < 0.001). Otherwise, RCM highlighted collagen remodeling and the appearance of new dermal papillae in all the treated SD compared with baseline. CONCLUSIONS The present study confirms that PLS represents a safe treatment option for SD; herein, we report morphological documentation of skin variations after PLS treatment. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Marta Fusano
- Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Via della Moscova 42, 20121, Milan, Italy
| | - Michela G Galimberti
- Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Via della Moscova 42, 20121, Milan, Italy
| | - Matelda Bencini
- Department of General Surgery, Università Degli Studi di Milano, 20157, Milan, Italy
| | - Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Science with Interest transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, via del Pozzo 71, 41125, Modena, Italy
| | - Pier Luca Bencini
- Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Via della Moscova 42, 20121, Milan, Italy
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20
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Mahajan S, Kalaivani M, Sethuraman G, Khaitan BK, Verma KK, Gupta S. A retrospective comparative study of outcome with surgical excision and repair versus nonsurgical and ablative treatments for basal cell carcinoma. Indian J Dermatol Venereol Leprol 2021; 87:348-356. [PMID: 33666033 DOI: 10.25259/ijdvl_170_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 01/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are few studies on basal cell carcinoma (BCC) from India. Long-term follow-up is available in only one study and the aesthetic outcome of treatment has not been evaluated in Indian patients. AIMS In this retrospective study on BCC, we compared treatment failure, recurrence rates and aesthetic outcomes on long-term follow-up between surgical excision and repair, and nonsurgical and ablative treatments. METHODS Records of patients with BCC treated in the dermatologic surgery clinic over the past 10 years were analyzed. Patients with histopathologically confirmed BCC who could be contacted were evaluated for recurrence, treatment failure, overall satisfaction and aesthetic outcomes by global aesthetic improvement scale. RESULTS Out of 98 patients, 72 were contactable. Four patients received both nonsurgical and ablative treatments and surgical excision and repair sequentially and were excluded. The mean age of patients was 57.9 ± 15.8 years (24-90 years) and the male: female ratio was 1.6:1. The most common site involved was the face (72.1%) followed by trunk and scalp, and the most common type of BCC was the pigmented superficial type (33.8%), followed by the pigmented noduloulcerative type (16.2%). There was no significant difference between the groups in the number of high-risk cases. The mean follow-up period was 37.1 ± 31.4 (range, 4-120) months. Fifty one patients were treated with surgical excision and repair, and 17 with nonsurgical and ablative treatments (9-imiquimod, 5-cryotherapy, 4-radiotherapy). Treatment failure was seen in 5 (7.4%) patients, all in the nonsurgical and ablative treatments group (P = 0.0006). Recurrence was seen in 2 (2.9%) patients, both in the surgical excision and repair group (P > 0.05). Mean patient satisfaction was significantly higher with surgical excision and repair, though there was no significant difference in the Global Aesthetic Improvement Scale between the groups. LIMITATIONS The sample size was low. Only telephonic and pictorial assessments were done where the patient could not come for follow-up. CONCLUSIONS Surgical excision and repair was associated with better outcomes than nonsurgical and ablative treatments. Treatment failures and adverse events were high with nonsurgical and ablative treatments. The recurrence rate was low.
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Affiliation(s)
- Soniya Mahajan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Gomathy Sethuraman
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Binod Kumar Khaitan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Kaushal Kumar Verma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Wege J, Anabtawi M, Blackwell MA, Patterson A. Lymphangioma Formation Following Hyaluronic Acid Injection for Lip Augmentation. Cureus 2021; 13:e12929. [PMID: 33654610 PMCID: PMC7910224 DOI: 10.7759/cureus.12929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Administration of hyaluronic acid (HA) filler for aesthetic lip augmentation is a routine and common procedure with a low rate of adverse reactions. This case report documents an extremely rare complication of lip augmentation with HA leading to the development of lymphangiomas. Lymphangiomas are uncommon hamartomas of the lymphatic system. Although usually congenital, they can be acquired due to trauma, inflammation, or lymphatic blockage. They may be in the deep or superficial tissues, with superficial forms being either lymphangioma circumscriptum or acquired lymphangioma, also referred to as lymphangiectasia. Acquired lymphangiomas are typically formed by blockage of lymphatic drainage leading to dilation of the lymphatic channels. The diagnosis in our case report is acquired lymphangioma. A 27-year-old female presented with a two-year history of linear swellings in her upper lip. These lumps followed the line where HA filler had been injected four years earlier. Hyaluronidase had previously been used unsuccessfully to remove these lumps. The patient was treated with surgery to excise the lesions. Five masses were excised, and histopathological analysis displayed the presence of variably ectatic lacunae, lined by cells with CD34 expression, a lymph-vascular-endothelial marker. There were also scattered macrophages with CD68 expression in the interstices. These are typical features of a lymphangioma. The patient was satisfied with the excellent aesthetic and functional outcome. To our knowledge this is the first case of a lymphangioma following HA lip augmentation. Although rare, this complication can have aesthetic implications for the patient which may require further treatment or surgery to correct.
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Affiliation(s)
- James Wege
- Oral and Maxillofacial Surgery, Castle Hill Hospital, Hull, GBR
| | - Mohammed Anabtawi
- Oral and Maxillofacial Surgery, Chesterfield Royal Hospital, Chesterfield, GBR
| | - Mike A Blackwell
- Oral and Maxillofacial Surgery, Leeds General Infirmary, Leeds, GBR
| | - Alan Patterson
- Oral and Maxillofacial Surgery, Rotherham National Health Service Foundation Trust, Rotherham, GBR
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22
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Two Randomized Controlled Trials of Hyaluronic Acid Fillers for the Correction of Nasolabial Folds. Plast Reconstr Surg Glob Open 2020; 8:e2975. [PMID: 32802667 PMCID: PMC7413804 DOI: 10.1097/gox.0000000000002975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/22/2020] [Indexed: 11/27/2022]
Abstract
YVOIRE Classic s (YC) and Restylane (RES) have similar rheological properties, which suit mid-dermis injection, while the rheological properties of YVOIRE Volume s (YV) are comparable to those of Perlane (PER), which suit deep dermis injection to treat deep wrinkles. Two similarly designed studies aimed to evaluate the performance and safety of YC and YV injected into the nasolabial folds (NLFs). METHODS These were split-face designed, evaluator-blind, noninferiority studies. Fifty-eight subjects with moderate-to-severe NLFs were enrolled in the first study and treated with YC and RES, and 57 subjects were enrolled in the second study and treated with YV and PER. The Wrinkle Severity Rating Scale ranged from 1 (no visible fold) to 5 (extremely deep and long folds), and subject satisfaction was evaluated. RESULTS The least squares mean Wrinkle Severity Rating Scale scores (standard error) at week 26 were 2.56 (0.09) for both YC- and RES-treated NLFs and 2.89 (0.08) and 2.91 (0.08) for YV- and PER-treated NLFs, respectively. The difference between the groups was 0 and 0.02, and the lower limit of its 95% confidence interval was -0.0725 and -0.0125, which was greater than the predefined margin (-0.29), proving the noninferiority of YC and YV to RES and PER, respectively. The safety profiles and subject satisfaction of YC and YV were similar to those of RES and PER, respectively. CONCLUSION YC is comparable to RES and YV is comparable to PER in terms of performance and safety profiles, with NLF-correcting effects lasting for up to 26 weeks.
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A Randomized, Active-Controlled, 52-Week Study of Hyaluronic Acid Fillers for Anteromedial Malar Region Augmentation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2648. [PMID: 32309093 PMCID: PMC7159933 DOI: 10.1097/gox.0000000000002648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Hyaluronic acid (HA) fillers for volume augmentation in the anteromedial malar region of Asians have been popular for many years. However, studies on their long-term effectiveness are lacking. This study aimed to evaluate the effectiveness and safety of HA fillers injected into the anteromedial malar region for volume augmentation for up to 52 weeks. Methods: Each anteromedial malar region of the subjects was treated with YVOIRE Contour (YVOC) in one side and Restylane Sub-Q (RESS) in the other and followed up at weeks 2, 14, 26, and 52. The volume using the mid-face aesthetic scale (MFAS) ranging from 0 (full) to 4 (very severely sunken) and the subject’s satisfaction and adverse events were evaluated. Results: Total 83 subjects were randomized and treated with YVOC and RESS. The LS means (standard error) of MFAS score in the YVOC and RESS groups were both 2.56 (0.05) at baseline, 1.32 (0.07) and 1.39 (0.07) at week 26, and 1.84 (0.10) and 1.89 (0.10) at week 52, respectively. The difference in the LS mean of MFAS score between the groups at week 26 was 0.07 (95% confidence interval, 0.01–0.12), showing the non-inferiority of YVOC to RESS. About 70% of subjects were still satisfied with the results at week 52. No specific safety concern was detected. Conclusions: The HA fillers injected for the anteromedial malar augmentation maintained the volume well for up to 52 weeks. Additionally, both YVOC and RESS show similar effectiveness and safety profiles.
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Shtraks JP, Fundakowski C, Yu D, Hartstein ME, Sarcu D, Lu X, Wulc AE. Investigation of the Longevity of the Endoscopic Midface Lift. JAMA FACIAL PLAST SU 2019; 21:535-541. [PMID: 31621793 DOI: 10.1001/jamafacial.2019.1015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance To our knowledge, until now, the efficacy and durability of the transtemporal endoscopic preperiosteal midface lift has not been reported in the literature. Objective To determine the efficacy and longevity of the endoscopic preperiosteal midface lift using objective measurements and validated aesthetic scales. Design, Setting, and Participants This retrospective review included patients 18 years or older who were treated for aging midface by endoscopic midface lift by the senior author (A.E.W.) between June 2000 and August 2016. Patients were categorized based on length of follow-up into 3 groups: (1) short-term (1-3 years), (2) intermediate-term (3-5 years), and (3) long-term (>5 years). Interventions or Exposures Endoscopic preperiosteal midface lift. Main Outcomes and Measures (1) Objective measurements of midfacial height (the width of the interzygomatic distance of the midface to the medial canthus [WIZDOM-MC]), (2) validated regional aesthetic scales, and (3) global aesthetic scoring systems measured preoperatively, 3 to 6 months postoperatively, and at the most recent follow-up visit. Results Adult patients 18 years or older (median [range] age, 59 [31-79] years) who were treated for aging midface by undergoing an endoscopic midface lift were included in this study. The medical records of 143 patients were reviewed (135 women and 8 men). The endoscopic midface lift resulted in objective improvement in midfacial height. The median WIZDOM-MC decreased by 3.4 mm after the endoscopic midface lift (interquartile range [IQR], 2.3-4.4 mm; P < .001), thus shortening the elongated lower eyelid. At 5 to 15 years after surgery, there was a sustained decrease in median WIZDOM-MC of 2.1 mm (IQR, 0.8-3.1 mm; P < .001). Improvement in the infraorbital hollow was also sustained in patients at more than 5 years' follow-up (IQR, 0-1.0; P < .001). Improvements in upper cheek fullness and lower cheek fullness were maintained at 3 to 5 years and tended to be at baseline at more than 5 years. Global aesthetic improvement scores remained significantly improved at 5 to 15 years' follow-up. Conclusions and Relevance There is a significant, objective improvement in midfacial height after the endoscopic midface lift that persists for up to 15 years. Validated midfacial scales and global aesthetic scoring systems demonstrate sustained improvement in midface appearance over time. Surgery that minimally disrupts the zygomatic and orbicularis retaining ligaments can provide long-lasting aesthetic improvements. Level of Evidence 4.
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Affiliation(s)
- Julie P Shtraks
- Lewis Katz School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania
| | - Christopher Fundakowski
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Daohai Yu
- Lewis Katz School of Medicine, Department of Clinical Sciences, Temple University, Philadelphia, Pennsylvania
| | - Morris E Hartstein
- Department of Ophthalmology, Assaf Harofeh Medical Center, Be'er Ya'akov, Israel
| | - David Sarcu
- Facial Plastic and Reconstructive Surgery, Aurora, Illinois
| | - Xiaoning Lu
- Lewis Katz School of Medicine, Department of Clinical Sciences, Temple University, Philadelphia, Pennsylvania
| | - Allan E Wulc
- Lewis Katz School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania.,Scheie Eye Institute, Perelman School of Medicine, Department of Ophthalmology, University of Pennsylvania, Philadelphia
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Philipp‐Dormston WG, Schuster B, Podda M. Perceived naturalness of facial expression after hyaluronic acid filler injection in nasolabial folds and lower face. J Cosmet Dermatol 2019; 19:1600-1606. [DOI: 10.1111/jocd.13205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Wolfgang G. Philipp‐Dormston
- Faculty of Health University Witten/Herdecke Witten Germany
- Hautzentrum Koeln Klinik Links vom Rhein Cologne Germany
| | - Bernd Schuster
- Private Clinic for ENT and Facial Plastic Surgery Munich Germany
| | - Maurizio Podda
- Department of Dermatology Klinikum Darmstadt Darmstadt Germany
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Kaufman‐Janette J, Taylor SC, Cox SE, Weinkle SH, Smith S, Kinney BM. Efficacy and safety of a new resilient hyaluronic acid dermal filler, in the correction of moderate-to-severe nasolabial folds: A 64-week, prospective, multicenter, controlled, randomized, double-blind and within-subject study. J Cosmet Dermatol 2019; 18:1244-1253. [PMID: 31444861 PMCID: PMC7384057 DOI: 10.1111/jocd.13100] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 07/24/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Injectables that behave similarly to native tissue and preserve facial expressiveness represent a new frontier in aesthetic medicine. A range of fillers made of high molecular weight hyaluronic acid (HA) chains with low crosslinking have been specifically developed to complement facial dynamics. AIMS The efficacy and safety of one of these resilient HA fillers, and its noninferiority to an effective comparator available in the US, were tested in the treatment of dynamic wrinkles. METHODS A 15-month, prospective, multicenter, controlled, randomized, double-blind, within-subject (split-face) clinical trial was conducted on 140 subjects with moderate-to-severe nasolabial folds (NLF). Study endpoints included improvement on a proprietary Wrinkle Severity Rating Scale (WSRS) and Global Aesthetic Improvement Scale, according to Blind Live Evaluators (BLE), subjects, and treating investigators (TI). Subject perception was evaluated with FACE-Q and satisfaction scales. RESULTS The per-protocol population included 88 subjects (92% women) of all Fitzpatrick phototypes, with a mean age of 57 years. WSRS improvement was significantly greater with the resilient HA than its comparator over 15 months, including at week 24 (primary endpoint), as rated by BLE and TI. Results demonstrated the noninferiority of the resilient HA filler to its comparator. Aesthetic improvement and subject satisfaction were durably high, with an overall trend toward higher scores for the resilient HA filler. Both treatments were safe and well tolerated. CONCLUSION The resilient HA filler made of long chains lightly crosslinked is at least equivalent to a well-established comparator for the correction of NLF in subjects of diverse skin phototypes.
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Affiliation(s)
| | - Susan C. Taylor
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | | | | | - Stacy Smith
- California Dermatology & Clinical Research InstituteEncinitasCAUSA
| | - Brian M. Kinney
- Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
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Treatment of Horizontal Neck Wrinkles with Hyaluronic Acid Filler: A Retrospective Case Series. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2366. [PMID: 31592383 PMCID: PMC6756638 DOI: 10.1097/gox.0000000000002366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 06/07/2019] [Indexed: 11/30/2022]
Abstract
Supplemental Digital Content is available in the text. Horizontal neck wrinkles are a common aesthetic deficiency but limited treatment options exist and none have been studied with follow-ups of over 2 months.
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Practical Approach and Safety of Hyaluronic Acid Fillers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2172. [PMID: 31624663 PMCID: PMC6635180 DOI: 10.1097/gox.0000000000002172] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/08/2019] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. Soft-tissue filler use has grown considerably related to the increasing popularity of minimally invasive cosmetic procedures. Hyaluronic acid products are currently the most utilized soft-tissue fillers. Proper working knowledge of individual products, limitations to use, and anatomic principles can improve outcomes. Prevention is key to minimize complications; however, when present, complications must be managed methodically. Complications are categorized based on the timing of presentation and include early, late, and delayed. Vascular compromise and tissue necrosis are among the most devastating complications seen with filler use. Nodules can be related to an inflammatory or infectious etiology but should be distinguished as treatment varies. Hyaluronidase is mandatory to have available as a reversal agent for hyaluronic acid products and can be used in treatment for many complications and untoward sequela.
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Li D, Sun J, Wu S. A multi‐center comparative efficacy and safety study of two different hyaluronic acid fillers for treatment of nasolabial folds in a Chinese population. J Cosmet Dermatol 2019; 18:755-761. [PMID: 31074161 DOI: 10.1111/jocd.12916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Dong Li
- Peking University Third Hospital Beijing China
| | - Jiaming Sun
- Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Sufan Wu
- Zhejiang Provincial People’s Hospital Hangzhou China
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Solish N, Bertucci V, Percec I, Wagner T, Nogueira A, Mashburn J. Dynamics of hyaluronic acid fillers formulated to maintain natural facial expression. J Cosmet Dermatol 2019; 18:738-746. [PMID: 31033110 PMCID: PMC6850461 DOI: 10.1111/jocd.12961] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 03/26/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Subjects seeking facial rejuvenation want the results to appear natural. Currently, however, there is no consensus definition of, or assessment scale for, "naturalness." AIMS This open-label pilot study explored evaluation techniques and criteria to assess naturalness of facial movement and expression following optimal bilateral correction of moderate-to-severe nasolabial folds and marionette lines with soft-tissue hyaluronic acid fillers formulated with XpresHAn Technology™. METHODS Primary efficacy was investigator assessed naturalness of dynamic expressions using baseline and Day 42 posttreatment 2D video. Other evaluations included investigator assessed naturalness using static images, wrinkle severity, investigator and subject Global Aesthetic Improvement Scale assessments, and subject satisfaction. RESULTS Thirty Caucasian females (41-65 years) received either Restylane® Refyne, Restylane® Defyne or both. Naturalness of dynamic expressions was at least maintained in all subjects. Naturalness of static expressions was not negatively affected in most subjects (96.7%). For dynamic expressions, 83.3% of subjects showed enhanced attractiveness, younger appearance and maintained naturalness. CONCLUSIONS Overall, nasolabial folds and marionette lines improved significantly based on severity and Global Aesthetic Improvement Scale scores, with high subject satisfaction and favorable safety profile. Based on subject satisfaction and investigator assessments, using highly flexible hyaluronic acid dermal fillers did not compromise naturalness of lower facial expressions while achieving the desired improvements in attractiveness and youthfulness. The preliminary results obtained in this pilot study suggest that dynamic and static assessments of facial animation may aid the evaluation of natural outcomes in facial rejuvenation procedures.
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Affiliation(s)
- Nowell Solish
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Cosmetic Dermatology, Yorkville, Ontario, Canada
| | - Vince Bertucci
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada.,Private Practice, Woodbridge, Ontario, Canada
| | - Ivona Percec
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ted Wagner
- Galderma Laboratories, L.P., Fort Worth, Texas
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Dai X, Li L, Peterson W, Baumgartner RR, Huang J, Baer-Zwick A, Hoeller S, Ivezic-Schoenfeld Z, Prinz M. Safety and effectiveness of hyaluronic acid dermal filler in correction of moderate-to-severe nasolabial folds in Chinese subjects. Clin Cosmet Investig Dermatol 2019; 12:57-62. [PMID: 30666143 PMCID: PMC6336025 DOI: 10.2147/ccid.s187079] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Modified sodium hyaluronate gel for injection, Princess® VOLUME (PV), has been on the European market since 2009 to correct deeper wrinkles and folds, increasing or restoring volume of the face, and remodeling facial contours. Objective To evaluate the safety and effectiveness of PV in correction of moderate-to-severe nasolabial folds (NLF) in Chinese subjects. Methods In this prospective, split-face, randomized, evaluator and subject-blinded, multicenter, noninferiority trial, 120 subjects were randomized to bilateral NLF treatment with PV administered in one NLF and Restylane® (RL) administered in the other NLF. NLFs were evaluated using the validated 5-point Wrinkle Severity Rating Scale with scores ranging from 1= none (no visible NLF) to 5= very severe (extremely deep and long NLF). Response was defined as ≥1 point improvement at Week 24 assessed by the blinded independent review committee (IRC) and the reduction of NLF severity, assessed by subjects and IRC based on the Global Aesthetic Improvement Scale. Results Among the 115 subjects who completed the study, median initial and touch-up volumes (mL) were 1.00 for both groups with a maximum dosage per NLF of 2.00 and a minimum of 0.30 for PV and 0.60 for RL. At week 24, the Wrinkle Severity Rating Scale improvement rate, as assessed by the IRC, reached 68.70% for PV and 52.17% for RL. The results indicate that PV is noninferior to RL (p<0.001). Most frequently reported adverse events for both devices were injection site swelling and procedural pain. The severity of the majority of the adverse events was mild. Conclusion This study confirms that PV is a safe and effective treatment for the correction of moderate-to-severe NLFs in Chinese subjects.
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Affiliation(s)
- Xia Dai
- Department of Plastic and Reconstructive Surgery, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Li Li
- Department of Dermatology, West China Hospital, Sichuan University, Sichuan, China
| | - Ward Peterson
- Clinical Development, CROMA-PHARMA GmbH, Leobendorf, Austria, .,Ward Peterson Consulting, Limited Liability Company, Morrisville, NC 27560, USA
| | | | | | | | - Sonja Hoeller
- Clinical Development, CROMA-PHARMA GmbH, Leobendorf, Austria,
| | | | - Martin Prinz
- Clinical Development, CROMA-PHARMA GmbH, Leobendorf, Austria,
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Fedyakova E, Pino A, Kogan L, Eganova C, Troya M, Anitua E. An autologous protein gel for soft tissue augmentation: in vitro characterization and clinical evaluation. J Cosmet Dermatol 2018; 18:762-772. [DOI: 10.1111/jocd.12771] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/17/2018] [Accepted: 07/30/2018] [Indexed: 12/21/2022]
Affiliation(s)
| | - Ander Pino
- BTI – Biotechnology Institute Vitoria Spain
| | | | | | | | - Eduardo Anitua
- BTI – Biotechnology Institute Vitoria Spain
- Eduardo Anitua Foundation Vitoria Spain
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Effectiveness and Safety of an Overnight Patch Containing Allium cepa Extract and Allantoin for Post-Dermatologic Surgery Scars. Aesthetic Plast Surg 2018; 42:1144-1150. [PMID: 29948103 PMCID: PMC6097777 DOI: 10.1007/s00266-018-1172-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/01/2018] [Indexed: 12/14/2022]
Abstract
Background An occlusive overnight intensive patch medical device (OIP) containing onion extract and allantoin has been developed for preventing and treating dermatologic scars and keloids. Here, we examined the efficacy and safety of the OIP for post-dermatologic surgery scars. Methods This was an intra-individual randomized, observer-blind, controlled study in adults with post-dermatologic surgery scars. Two scars per subject were randomized to no treatment or overnight treatment with the OIP for 12–24 weeks. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and a Global Aesthetic Improvement Scale. Results A total of 125 subjects were included. The decrease in observer-assessed POSAS from baseline was significantly greater for treated than untreated scars at week 6 (p < 0.001) and 24 (p = 0.001). The decrease in patient-assessed POSAS was significantly greater for the treated scar than the untreated scar at week 12 (p = 0.017) and 24 (p = 0.014). Subject- and investigator-evaluated Global Aesthetic Improvement Scale scores were higher for the treated than the untreated scar at all visits. All subjects considered the global comfort of the OIP to be good or very good, and no safety concerns were identified. Conclusions This study confirmed that the OIP safely promotes scar healing after minor dermatologic surgery. 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.
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Evaluating Perceived Naturalness of Facial Expression After Fillers to the Nasolabial Folds and Lower Face With Standardized Video and Photography. Dermatol Surg 2018; 44:826-832. [PMID: 29799826 PMCID: PMC5976216 DOI: 10.1097/dss.0000000000001419] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is Available in the Text. BACKGROUND Hyaluronic acid (HA) fillers are commonly used in treating facial wrinkles and folds but have not been studied with standardized methodology to include assessment of standard facial expressions. OBJECTIVE To assess perceived naturalness of facial expression after treatment with 2 HA fillers manufactured with XpresHAn Technology (also known as Optimal Balance Technology). MATERIALS AND METHODS Treatment was directed to the nasolabial folds (NLFs) and at least 1 additional lower face wrinkle or fold. Maintenance of naturalness, attractiveness, and age at 1 month after optimal treatment were assessed using video recordings and photographs capturing different facial animations. Global aesthetic improvement, subjects' satisfaction, and safety were also evaluated. RESULTS The treatment was well tolerated. Naturalness of facial expression in motion was determined to be at least maintained in 95% of subjects. Attractiveness was enhanced in 89% of subjects and 79% of subjects were considered to look younger. Most subjects assessed their aesthetic appearance as improved and were satisfied with their treatment. CONCLUSION Naturalness and attractiveness can be assessed using video recordings and photographs capturing different facial animations. XpresHAn Technology HA filler treatments create natural-looking results with high subject satisfaction.
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Padulla GA, Bagatin E, Hirata SH, Yarak S. Effect of botulinum toxin type A on the healing of facial skin biopsies - series of cases. An Bras Dermatol 2018; 93:610-611. [PMID: 30066781 PMCID: PMC6063123 DOI: 10.1590/abd1806-4841.20187425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/03/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
- Geórgia Andrade Padulla
- Student of the Post-Graduation Program in Dermoscopy, Universidade
Federal de São Paulo, São Paulo (SP), Brazil
- Department of Dermatology, Universidade Federal de São
Paulo, São Paulo (SP), Brazil
| | - Ediléia Bagatin
- Department of Dermatology, Universidade Federal de São
Paulo, São Paulo (SP), Brazil
| | | | - Samira Yarak
- Department of Dermatology, Universidade Federal de São
Paulo, São Paulo (SP), Brazil
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Baek ES, Hwang S, Choi YJ, Roh MR, Nguyen T, Kim KH, Chung CJ. Quantitative and perceived visual changes of the nasolabial fold following orthodontic retraction of lip protrusion. Angle Orthod 2018; 88:465-473. [PMID: 29561659 DOI: 10.2319/100317-665.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The objectives of this study were to evaluate the quantitative and perceived visual changes of the nasolabial fold (NLF) after maximum retraction in adults and to determine its contributing factors. MATERIALS AND METHODS A total of 39 adult women's cone-beam computed tomography images were collected retrospectively and divided into the retraction group (age 26.9 ± 8.80) that underwent maximum retraction following 4 premolar extraction and the control group (age 24.6 ± 5.36) with minor changes of the incisors. Three-dimensional morphologic changes of hard and soft tissue including NLF were measured by pre- and posttreatment cone-beam computed tomography. In addition, perceived visual change of the NLF was monitored using the modified Global Aesthetic Improvement Scale. The influence of age, initial severity of NLF, and initial soft tissue thickness was evaluated. RESULTS Anterior retraction induced significant changes of the facial soft tissue including the lips, perioral, and the NLF when compared with the controls ( P < .01). Perceived visual changes of the NLF was noted only in women younger than age 30 ( P < .05), with the odds ratio (95% confidence interval) of 2.44 (1.3461-4.4226), indicating greater possibility for improvement of NLF esthetics in young women of the retraction group when compared with the controls. CONCLUSIONS Orthodontic retraction induced quantitative and perceived visual changes of the NLF. For adult women younger than age 30, the appearance of the NLF improved after maximum retraction despite the greater posterior change of the NLF.
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Clinical Applications of Injectable Biomaterials. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1077:163-182. [DOI: 10.1007/978-981-13-0947-2_10] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Prager W, Agsten K, Kerscher M. Patient-Reported Outcomes following Split-Face Injection of 2 Volumizing Fillers in the Upper Cheeks. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1412. [PMID: 29184723 PMCID: PMC5682159 DOI: 10.1097/gox.0000000000001412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 05/24/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient-reported outcomes are important measures when assessing the efficacy of aesthetic procedures. OBJECTIVE To compare outcomes between 2 volumizing hyaluronic acid fillers. MATERIALS AND METHODS Subjects with moderate-to-severe volume loss in the cheeks were randomized in a split-face design to malar enhancement with Cohesive Polydensified Matrix 26 mg/ml HA (CPM-26) and Vycross 20 mg/ml HA (VYC-20). The same injection technique and injection volume were applied for both sides of the face. Anesthetics, overcorrection, and touch-ups were not permitted. Blinded subjects assessed aesthetic improvements using the Global Aesthetic Improvement Scale and treatment satisfaction by confirming their willingness to repeat treatment or recommend it to friends. Follow-up was 18 months. RESULTS A total of 45 subjects received a single 2 mL injection of CPM-26 on one side and VYC-20 on the contralateral side of the face. The proportion of subjects reporting improvement on the Global Aesthetic Improvement Scale compared with baseline for CPM-26 and VYC-20 was 97.7% and 88.6%, respectively, at 3 months, 73.8% and 71.1% at 12 months, and 61.0% and 56.7% at 18 months. Treatment satisfaction was high, with the majority of subjects stating that they would repeat treatment and recommend it to friends, but at each time point, a higher proportion of subjects was more satisfied with the CPM-26-treated side of the face. CONCLUSIONS In this first direct comparison of CPM-26 and VYC-20, the majority of subjects were satisfied with both treatments throughout the study. Patient-reported outcome measures identified a trend in favor of CPM-26.
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Affiliation(s)
- Welf Prager
- From the Prager & Partner Dermatologische Praxis, Hamburg, Germany; SCIderm GmbH, Hamburg, Germany; and Department of Cosmetic Science University of Hamburg, Hamburg, Germany
| | - Karla Agsten
- From the Prager & Partner Dermatologische Praxis, Hamburg, Germany; SCIderm GmbH, Hamburg, Germany; and Department of Cosmetic Science University of Hamburg, Hamburg, Germany
| | - Martina Kerscher
- From the Prager & Partner Dermatologische Praxis, Hamburg, Germany; SCIderm GmbH, Hamburg, Germany; and Department of Cosmetic Science University of Hamburg, Hamburg, Germany
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Yun Y, Choi I. Effect of thread embedding acupuncture for facial wrinkles and laxity: a single-arm, prospective, open-label study. Integr Med Res 2017; 6:418-426. [PMID: 29296569 PMCID: PMC5741386 DOI: 10.1016/j.imr.2017.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 11/02/2022] Open
Abstract
Background There is a growing trend for patients to seek the least invasive treatments with less risk of complications and downtime for facial rejuvenation. Thread embedding acupuncture has become popular as a minimally invasive treatment. However, there is little clinical evidence in the literature regarding its effects. Methods This single-arm, prospective, open-label study recruited participants who were women aged 40-59 years, with Glogau photoaging scale III-IV. Fourteen participants received thread embedding acupuncture one time and were measured before and after 1 week from the procedure. The primary outcome was a jowl to subnasale vertical distance. The secondary outcomes were facial wrinkle distances, global esthetic improvement scale, Alexiades-Armenakas laxity scale, and patient-oriented self-assessment scale. Results Fourteen participants underwent thread embedding acupuncture alone, and 12 participants revisited for follow-up outcome measures. For the primary outcome measure, both jowls were elevated in vertical height by 1.87 mm (left) and 1.43 mm (right). Distances of both melolabial and nasolabial folds showed significant improvement. In the Alexiades-Armenakas laxity scale, each evaluator evaluated for four and nine participants by 0.5 grades improved. In the global aesthetic improvement scale, improvement was graded as 1 and 2 in nine and five cases, respectively. The most common adverse events were mild bruising, swelling, and pain. However, adverse events occurred, although mostly minor and of short duration. Conclusion In this study, thread embedding acupuncture showed clinical potential for facial wrinkles and laxity. However, further large-scale trials with a controlled design and objective measurements are needed.
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Affiliation(s)
- Younghee Yun
- Chung-Yeon Medical Institute, CY Co. Ltd, Seoul, Korea
| | - Inhwa Choi
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, Kyung Hee University, Seoul, Korea
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40
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Wollina U, Goldman A, Tchernev G. Fillers and Facial Fat Pads. Open Access Maced J Med Sci 2017; 5:403-408. [PMID: 28785319 PMCID: PMC5535644 DOI: 10.3889/oamjms.2017.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 12/11/2022] Open
Abstract
Fillers are used for facial sculpturing and anti-ageing treatments with increasing popularity. The optimal outcome of any filler treatment depends upon different factors: exact indication, known limitations, filler product, and filler placement. For volumizing effect and longevity of procedures, however, the interaction of fillers and facial fat pads seems to be crucial. Here, we will review the optimum filler injections for facial applications in relationship to new data and concepts concerning facial fat pads anatomy and physiology. Such a view will us enable to provide optimum results in aesthetic procedures.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany
| | | | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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Kerscher M, Agsten K, Kravtsov M, Prager W. Effectiveness evaluation of two volumizing hyaluronic acid dermal fillers in a controlled, randomized, double-blind, split-face clinical study. Clin Cosmet Investig Dermatol 2017; 10:239-247. [PMID: 28721082 PMCID: PMC5498678 DOI: 10.2147/ccid.s135441] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Enhancement of the midface can be achieved with volumizing hyaluronic acid (HA) fillers. Objective The objective of this study was to compare the safety and effectiveness of Cohesive Polydensified Matrix® 26 mg/mL HA gel (CPM-26) and Vycross® 20 mg/ml HA gel (VYC-20) in a controlled, randomized, evaluator-blind, split-face clinical study. Patients and methods Subjects with moderate-to-severe malar volume loss on the Merz Aesthetics Scale (MAS) received CPM-26 on one side and VYC-20 on the contralateral side of the face. Effectiveness assessments were performed by blinded evaluators including photographic and live MAS ratings and live Global Aesthetic Improvement Scale (GAIS) ratings. Calculations of anatomical volume variations at month 3 (M3), month 6 (M6), month 12 (M12) and month 18 (M18) were also performed. Results Non-inferiority of CPM-26 versus VYC-20 was demonstrated at M3 (primary end point) based on MAS. GAIS rating showed that significantly more subjects had better improvement with CPM-26 than with VYC-20 at month 1, M3, M12 and M18 (p=0.0032, p=0.0074, p=0.0384 and p=0.0110, respectively). Standardized evaluation of volume variations from baseline to M3, M12 and M18 showed that CPM-26 created more volume augmentation at all time points, and the difference was significant at M3. Conclusion CPM-26 was non-inferior to VYC-20 based on MAS ratings at M3 and demonstrated a favorable safety and effectiveness profile for midfacial volume enhancement with results lasting up to M18.
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Affiliation(s)
| | | | | | - Welf Prager
- Prager & Partner Dermatologische Praxis, Hamburg, Germany
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42
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Swift A, von Grote E, Jonas B, Nogueira A. Minimal recovery time needed to return to social engagement following nasolabial fold correction with hyaluronic acid fillers produced with XpresHAn technology. Clin Cosmet Investig Dermatol 2017; 10:229-238. [PMID: 28652795 PMCID: PMC5476436 DOI: 10.2147/ccid.s138155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The appeal of hyaluronic acid fillers for facial soft tissue augmentation is attributable to both an immediate aesthetic effect and relatively short recovery time. Although recovery time is an important posttreatment variable, as it impacts comfort with appearance and perceived treatment benefit, it is not routinely evaluated. Natural-looking aesthetic outcomes are also a primary concern for many patients. MATERIALS AND METHODS A single-center, noncomparative study evaluated the time (in hours) until subjects return to social engagement (RtSE) following correction of moderate and severe nasolabial folds (NLFs) with RR (Restylane® Refyne)® and RD (Restylane Defyne), respectively. Twenty subjects (aged 35-57 years) who received bilateral NLF correction documented their RtSE and injection-related events posttreatment. Treatment efficacy was evaluated by improvements in Wrinkle Severity Rating Scale (WSRS) and subject satisfaction questionnaire at days 14 and 30, and by Global Aesthetic Improvement Scale (GAIS) at day 30. Safety was evaluated by injection-related events and treatment-emergent adverse events. RESULTS Fifty percent of subjects reported RtSE within 2 hours posttreatment. WSRS for the RR group improved significantly from baseline at day 14 (-1.45±0.42) and day 30 (-1.68±0.46) (P<0.001), respectively. WSRS for the RD group improved significantly from baseline at day 14 (-2.22±0.44) and day 30 (-2.50±0.50) (P<0.004), respectively. All GAIS improvements were clinically significant at day 30. The majority of injection-related events were mild or moderate. Two subjects experienced 3 related treatment-emergent adverse events; 1 RR subject experienced severe bruising, and 1 RD subject experienced severe erythema and mild telangiectasia. Subject satisfaction was high regarding aesthetic outcomes and natural-looking results. CONCLUSION Optimal correction of moderate NLFs with RR and severe NLFs with RD involved minimal time to RtSE for most subjects. Treatments that significantly improved WSRS and GAIS, were generally well-tolerated, and provided natural-looking aesthetic outcomes.
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Affiliation(s)
- Arthur Swift
- Arthur Swift Research Inc., Montreal, QC, Canada
| | - Erika von Grote
- Medical Affairs, Galderma Laboratories, L.P., Fort Worth, TX, USA
| | - Brandie Jonas
- Medical Affairs, Galderma Laboratories, L.P., Fort Worth, TX, USA
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Yazdanparast T, Samadi A, Hasanzadeh H, Nasrollahi SA, Firooz A, Kashani MN. Assessment of the Efficacy and Safety of Hyaluronic Acid Gel Injection in the Restoration of Fullness of the Upper Lips. J Cutan Aesthet Surg 2017; 10:101-105. [PMID: 28852297 PMCID: PMC5561704 DOI: 10.4103/jcas.jcas_115_16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND AIM Lips have a significant role in face aesthetic perception, and lip augmentation is one of the most commonly requested aesthetic procedures. Non-permanent dermal fillers, such as hyaluronic acid (HA), are used for augmenting the lips. This article presents the results of Phase II, before - after designed study, assessing the safety and efficacy of a soft tissue HA filler, for upper lip augmentation. MATERIALS AND METHODS Investigators treated 10 healthy adult women 28-45 years old, using a single injection of Hyamax Kiss soft tissue HA filler (a product from Hyamed Laboratories, Switzerland) for upper lip augmentation. The primary efficacy endpoint was an increase in lip fullness at least one grade on Medicis Lip Fullness Scale at 2, 12 and 24 weeks post-treatment. Furthermore, the effectiveness and durability of filler were assessed using a 5-point Investigator's Global Assessment (IGA). Adverse events and volunteers' satisfaction were reported using visual analog scale. RESULTS Response to treatment (as defined above) after 2, 12 and 24 weeks were observed in 80%, 70% and 80% of patients, respectively. No statistical difference was found in response to treatment rate between follow-up visits (P = 0.83). The mean value of IGA score in weeks 2, 12 and 24 were 3.4 ± 0.96, 3.3 ± 0.67 and 3.3 ± 0.67, respectively. The study subjects were almost all satisfied with their lip improvement. Reported adverse effects were temporary and mostly mild in severity. CONCLUSION Soft tissue HA filler tested in this study was well tolerated, efficient and durable when used for upper lip augmentation.
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Affiliation(s)
- Taraneh Yazdanparast
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.,Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Air Pollution, Health and Occupational Diseases Research Unit, Tehran, Iran
| | - Aniseh Samadi
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hournaz Hasanzadeh
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Ahmad Nasrollahi
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Nassiri Kashani
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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Technical Considerations for Filler and Neuromodulator Refinements. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1178. [PMID: 28018778 PMCID: PMC5172486 DOI: 10.1097/gox.0000000000001178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/24/2016] [Indexed: 11/27/2022]
Abstract
Supplemental Digital Content is available in the text. Background: The toolbox for cosmetic practitioners is growing at an unprecedented rate. There are novel products every year and expanding off-label indications for neurotoxin and soft-tissue filler applications. Consequently, aesthetic physicians are increasingly challenged by the task of selecting the most appropriate products and techniques to achieve optimal patient outcomes. Methods: We employed a PubMed literature search of facial injectables from the past 10 years (2005–2015), with emphasis on those articles embracing evidence-based medicine. We evaluated the scientific background of every product and the physicochemical properties that make each one ideal for specific indications. The 2 senior authors provide commentary regarding their clinical experience with specific technical refinements of neuromodulators and soft-tissue fillers. Results: Neurotoxins and fillers are characterized by unique physical characteristics that distinguish each product. This results in subtle but important differences in their clinical applications. Specific indications and recommendations for the use of the various neurotoxins and soft-tissue fillers are reviewed. The discussion highlights refinements in combination treatments and product physical modifications, according to specific treatment zones. Conclusions: The field of facial aesthetics has evolved dramatically, mostly secondary to our increased understanding of 3-dimensional structural volume restoration. Our work reviews Food and Drug Administration–approved injectables. In addition, we describe how to modify products to fulfill specific indications such as treatment of the mid face, décolletage, hands, and periorbital regions. Although we cannot directly evaluate the duration or exact physical properties of blended products, we argue that “product customization” is safe and provides natural results with excellent patient outcomes.
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Perpendicular Strut Injection of Hyaluronic Acid Filler for Deep Wrinkles. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 3:e567. [PMID: 26893992 PMCID: PMC4727719 DOI: 10.1097/gox.0000000000000552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 10/06/2015] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. Although various injection techniques of hyaluronic acid (HA) filler for facial rejuvenation have been developed, correction of deep wrinkles/grooves, such as the nasolabial fold (NLF), with intradermal or subdermal injections remains difficult. We tested the intradermal HA injection method to place multiple HA struts by (1) inserting a small needle perpendicularly to the wrinkle and (2) injecting HA as intradermal struts with the skin fully stretched by the practitioner’s fingers. The results of both NLFs in 10 patients suggest that this technique improves NLFs and maintain the effects more consistently than conventional techniques, although the effects of both methods were almost lost after 6 months. Selective and/or combined application of this technique may enhance the current approach to facial rejuvenation with dermal fillers.
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Gubanova EI, Starovatova PA. A Prospective, Comparative, Evaluator-blind Clinical Study Investigating Efficacy and Safety of Two Injection Techniques with Radiesse(®) for the Correction of Skin Changes in Aging Hands. J Cutan Aesthet Surg 2015; 8:147-52. [PMID: 26644738 PMCID: PMC4645144 DOI: 10.4103/0974-2077.167271] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Dermal fillers are used to correct age-related changes in hands. Aims: Assess efficacy and safety of two injection techniques to treat age-related changes in the hands using calcium hydroxylapatite filler, Radiesse®. Settings and Design: This was a prospective, comparative, evaluator-blind, single-center study. Materials and Methods: Radiesse® (0.8 mL/0.2 mL 2% lidocaine) was injected subdermally on Day (D)01, using a needle multipoint technique in one hand (N) and a fan-like cannula technique in the other (C). Assessments were made pre-injection, on D14, Month (M)02, M03 and M05 using the Merz Aesthetics Hand Grading Scale (MAS) and Global Aesthetic Improvement Scale (GAIS). Participants completed questionnaires on satisfaction, pain and adverse events (AEs). Statistical Analysis Used: Data distribution was tested with the Shapiro-Wilk and Levene's tests. The Wilcoxon signed-rank and Chi-square tests were employed to evaluate quantitative and qualitative data, respectively. Results: All 10 participants completed the study, four opted for a M03 touch-up (0.8 mL Radiesse®). Evaluator-assessed mean GAIS scores were between 2 (significant improvement but not complete correction) and 3 (optimal cosmetic result) at each time point. The MAS score improved from D01 to M05 (N: 2.60 to 1.40; C: 2.20 to 1.30). Following treatment, participants reported skin was softer, more elastic, more youthful and less wrinkled. Other than less noticeable veins and tendons on the C hand, no differences in participant satisfaction were noted. All AEs were mild, with no serious AEs reported. Conclusions: Both injection techniques (needle and cannula) demonstrated equivalent clinical efficacy with a comparable safety profile for the correction of age-related changes in hands with Radiesse®.
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Affiliation(s)
- Elena I Gubanova
- Vallex M Clinic of Preventive Medicine, Moscow National University of Food Production, Moscow, Russia ; Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, Russia
| | - Polina A Starovatova
- Vallex M Clinic of Preventive Medicine, Moscow National University of Food Production, Moscow, Russia ; Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, Russia
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A Phase III, Randomized, Multi-Center, Double-Masked, Matched-Pairs, Active-Controlled Trial to Compare the Efficacy and Safety between Neuramis Deep and Restylane in the Correction of Nasolabial Folds. Arch Plast Surg 2015; 42:721-8. [PMID: 26618119 PMCID: PMC4659985 DOI: 10.5999/aps.2015.42.6.721] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND We conducted this clinical study to compare the efficacy and safety between Neuramis Deep and Restylane in the correction of nasolabial folds. METHODS In this phase III, randomized, multi-center, double-masked, matched-pairs, active-controlled trial (ClinicalTrials.gov Identifier: NCT01585220), we evaluated a total of 67 subjects (n=67). All the subjects underwent Neuramis Deep treatment on one side and Restylane on the contralateral side of the bilateral nasolabial folds at a ratio of 1:1. To compare the efficacy of Neuramis Deep and Restylane, we evaluated the Wrinkle Severity Rating Scale scores and those of the Global Aesthetic Improvement Scale. In addition, we compared the safety of Neuramis Deep and Restylane based on adverse events, physical examination, and clinical laboratory tests. RESULTS Neuramis Deep was not inferior in improving the nasolabial folds as compared with Restylane. In addition, there was no significant difference in the efficacy between Neuramis Deep and Restylane. There were no significant differences in safety parameters between Neuramis Deep and Restylane. CONCLUSIONS In conclusion, our results indicate that Neuramis Deep may be a safe, effective material for improving the nasolabial folds. However, further studies are warranted to compare the tolerability of Neuramis Deep and Restylane based on histopathologic findings.
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Abstract
In our contemporary postmodern society, a modified perception of the human body is accompanied by an increasing demand for body shaping procedures. The treatment needs to be effective but it is just as important that they are safe and can be easily integrated into the daily working and routine schedule. While the options for minimally invasive volume addition are largely limited to injectable implants based on hyaluronic acid or autologous fat, a multitude of options are available for volume reduction. Before deciding on the method of choice, the following needs to be considered: which indications need to be treated, the extent of the reduction in volume and how much pain and possible undesired reactions the patient is prepared to accept.
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Affiliation(s)
- N Krüger
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Deutschland.
| | - S Lübberding
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Deutschland
| | - G Sattler
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Deutschland
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Biology and biotechnology of hyaluronan. Glycoconj J 2015; 32:93-103. [PMID: 25971701 DOI: 10.1007/s10719-015-9586-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/13/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
The hyaluronan (HA) polymer is a critical component of extracellular matrix with a remarkable structure: is a linear and unbranched polymer without sulphate or phosphate groups. It is ubiquitous in mammals showing several biological functions, ranging from cell proliferation and migration to angiogenesis and inflammation. For its critical biological functions the amount of HA in tissues is carefully controlled by different mechanisms including covalent modification of the synthetic enzymes and epigenetic control of their gene expression. The concentration of HA is also critical in several pathologies including cancer, diabetes and inflammation. Beside these biological roles, the structural properties of HA allow it to take advantage of its capacity to form gels even at concentration of 1 % producing scaffolds with very promising applications in regenerative medicine as biocompatible material for advanced therapeutic uses. In this review we highlight the biological aspects of HA addressing the mechanisms controlling the HA content in tissues as well as its role in important human pathologies. In the second part of the review we highlight the different use of HA polymers in the modern biotechnology.
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Becker M, Balagué N, Montet X, Calmy A, Salomon D, Toutous-Trellu L. Hyaluronic Acid Filler in HIV-Associated Facial Lipoatrophy: Evaluation of Tissue Distribution and Morphology with MRI. Dermatology 2015; 230:367-74. [PMID: 25870932 DOI: 10.1159/000379747] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/02/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This prospective observational study evaluated magnetic resonance imaging (MRI) findings of hyaluronic acid (HA) injections used for the correction of HIV-associated facial lipoatrophy. METHODS Ten consecutive males underwent subdermal HA injection (mean 1.3 ± 0.6 ml per side) and MRI examinations prior to and then 1, 6 and 12 months after injection. Two radiologists blinded to the clinical data assessed morphologic and quantitative changes. RESULTS MRI revealed HA deposition in the subdermal and deep fat compartments. A significant HA volume increase was observed 1 month after injection (mean increase 331%, p < 0.0001) as compared to the injected amount. No volume reduction occurred at 12 months (p = 0.9961). The measured bound water content did not change (p > 0.9991), whereas skin thickness and tissue vascularization increased during the first 6 months (p = 0.01). CONCLUSION Our data show that the cosmetic results of HA injections are caused by water binding in the deep facial fat and by a transient increase in vascularization and skin thickness.
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Affiliation(s)
- Minerva Becker
- Department of Radiology, Geneva University Hospitals, Geneva, Switzerland
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