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Giang NN, Kim HJ, Chien PN, Kwon HJ, Ham JR, Lee WK, Gu YJ, Zhou SY, Zhang XR, Nam SY, Heo CY. An evaluation of the effectiveness of 'ULTRACOL 200' in enhancing nasolabial fold wrinkles through cutaneous repair. Skin Res Technol 2024; 30:e13679. [PMID: 38616503 PMCID: PMC11016812 DOI: 10.1111/srt.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/16/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Injectable filler, a nonsurgical beauty method, has gained popularity in rejuvenating sagging skin. In this study, polydioxanone (PDO) was utilized as the main component of the ULTRACOL200 filler that helps stimulate collagenesis and provide skin radiant effects. The study aimed to evaluate and compare the effectiveness of ULTRACOL200 with other commercialized products in visually improving dermatological problems. METHODS Herein, 31 participants aged between 20 and 59 years were enrolled in the study. 1 mL of the testing product, as well as the quantity for the compared groups was injected into each participants face side individually. Subsequently, skin texture and sunken volume of skin were measured using ANTERA 3D CS imaging technology at three periods: before the application, 4 weeks after the initial application, and 4 weeks after the 2nd application of ULTRACOL200. RESULTS The final results of skin texture and wrinkle volume evaluation consistently demonstrated significant enhancement. Consequently, subjective questionnaires were provided to the participants to evaluate the efficacy of the testing product, illustrating satisfactory responses after the twice applications. CONCLUSION The investigation has contributed substantially to the comprehension of a PDO-based filler (ULTRACOL200) for skin enhancement and provided profound insight for future clinical trials.
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Affiliation(s)
- Nguyen Ngan Giang
- Department of Medical Device DevelopmentCollege of MedicineSeoul National UniversitySeoulRepublic of Korea
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Hyun Ji Kim
- Korea Institute of Nonclinical StudyH&Bio. co. Ltd.SeongnamRepublic of Korea
| | - Pham Ngoc Chien
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Korea Institute of Nonclinical StudyH&Bio. co. Ltd.SeongnamRepublic of Korea
| | | | | | - Won Ku Lee
- UltraV Co., Ltd. R&D CenterSeoulSouth Korea
| | - Yeon Ju Gu
- UltraV Co., Ltd. R&D CenterSeoulSouth Korea
| | - Shou Yi Zhou
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Xin Rui Zhang
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Sun Young Nam
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Chan Yeong Heo
- Department of Medical Device DevelopmentCollege of MedicineSeoul National UniversitySeoulRepublic of Korea
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamSouth Korea
- Korea Institute of Nonclinical StudyH&Bio. co. Ltd.SeongnamRepublic of Korea
- Department of MedicineCollege of MedicineSeoul National UniversitySeoulRepublic of Korea
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Taylor S, Weinkle S, Kaufman-Janette J, Gallagher CJ, Kooken K, Brown J. Effectiveness and Safety of Resilient Hyaluronic Acid (RHA) Dermal Fillers for the Correction of Moderate-to-Severe Nasolabial Folds in People of Color: Post Hoc Subgroup Analyses of US Pivotal Clinical Data. Aesthet Surg J 2024; 44:412-420. [PMID: 37556827 PMCID: PMC10942799 DOI: 10.1093/asj/sjad251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND People of color (POC) are often underrepresented in clinical studies evaluating the safety and effectiveness of aesthetic products, including hyaluronic acid (HA) fillers, for which there is to date limited clinical data in POC. OBJECTIVES The aim of this study was to assess the safety and effectiveness of a new line of dynamic resilient HA fillers (RHA; Revance, Nashville, TN) for treating moderate-to-severe nasolabial folds (NLFs) in POC vs non-POC. METHODS Post hoc subgroup analyses compared the efficacy and safety of POC vs non-POC subjects treated with RHA2, RHA3, or RHA4 for correction of moderate-to-severe NLFs in the pooled per-protocol population (N = 217) in 2 clinical trials. Evaluated population cohorts were classified by Fitzpatrick skin type (FST) (high FST [IV-VI] vs low FST [I-III]) and by subject-reported race (non-White vs White) relative to baseline at 6, 9, 12, and 15 months. RESULTS POC consistently showed greater improvement in wrinkle severity and higher responder rates compared with non-POC, which reached statistical significance at several measured time points. Global Aesthetic Improvement Scale scores and subject satisfaction ratings were similar for POC and non-POC and remained high throughout the course of the study. Treatment-related adverse event rates were generally lower for high FSTs vs low FSTs, with no reported cases of keloidal scarring. CONCLUSION The RHA line of dynamic fillers is well tolerated and effective for the correction of moderate-to-severe NLFs in POC and can be confidently used in this important and growing patient population.See the abstract translated into Hindi, Portuguese, Korean, German, Italian, Arabic, Chinese, and Taiwanese online here: https://doi.org/10.1093/asj/sjad251. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Susan Taylor
- Corresponding Author: Dr Susan Taylor, 3400 Civic Center Blvd, South Tower 7-768, Philadelphia, PA 19104, USA. E-mail:
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Quereshy FA, Schieder GF. Perioral Filler Augmentation. Atlas Oral Maxillofac Surg Clin North Am 2024; 32:23-33. [PMID: 38307632 DOI: 10.1016/j.cxom.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
Perioral tissues are among the first areas to show signs of facial aging, leading many patients to seek perioral fillers as their initial cosmetic treatment. These fillers offer a temporary solution by enhancing volume and reducing common facial lines. Various regions within the perioral area can be targeted, including the lips, nasolabial folds, philtral columns, vertical lip rhytids, oral commissures, melomental folds, mentolabial folds, and nasolabial folds. The technique for injecting perioral fillers depends on the specific region, chosen product, and the desired outcome of augmentation.
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Affiliation(s)
- Faisal A Quereshy
- Department of Oral & Maxillofacial Surgery, Case Western Reserve University, 9601 Chester Avenue, Cleveland, OH 44106, USA
| | - George F Schieder
- Department of Oral & Maxillofacial Surgery, Case Western Reserve University, 9601 Chester Avenue, Cleveland, OH 44106, USA.
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Mataro I, La Padula S. A Two-Center, Prospective, Randomized Controlled Trial to Evaluate the Efficacy and Safety of and Satisfaction with Different Methods of ART FILLER® UNIVERSAL Injection for Correcting Moderate to Severe Nasolabial Folds in Chinese Individuals. Aesthetic Plast Surg 2024; 48:1027-1029. [PMID: 37798494 DOI: 10.1007/s00266-023-03703-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
The article titled "A Two-Center, Prospective, Randomized Controlled Trial to Evaluate the Efficacy and Safety of and Satisfaction with Different Methods of ART FILLER® UNIVERSAL Injection for Correcting Moderate to Severe Nasolabial Folds in Chinese Individuals," authored by Feng et al. in Aesthetic Plastic Surgery, aims to compare two hyaluronic acid (HA) injection techniques for enhancing nasolabial folds: the conventional injection method and the ligament injection method. However, concerns have arisen regarding the methodology employed in this study. Having a precise understanding of the properties of the active substance is crucial for treatment standardization. It is imperative to comprehensively grasp the key characteristics of the employed HAs to determine any potential correlation between these properties, outcomes, and the likelihood of complications. Understanding HA's rheological properties, including viscosity, elasticity, and cohesiveness, is essential for selecting the most appropriate facial filler. While recognizing the authors' contributions, we firmly believe that further analysis should encompass these factors.Level of Evidence V 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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Affiliation(s)
- Ilaria Mataro
- Department of Plastic Reconstructive Surgery and BURNS, AORN A. Cardarelli, Via Antonio Cardarelli, 9, 80131, Napoli, NA, Italy.
| | - Simone La Padula
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
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Ma Y, Yang E, Lin W. Using the depth deviation based on three-dimensional images to evaluate the correction of nasolabial folds: A prospective and quantitative analysis. J Cosmet Dermatol 2024; 23:607-613. [PMID: 37752833 DOI: 10.1111/jocd.16011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/06/2023] [Accepted: 09/17/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND AND OBJECTIVE The deepening of the nasolabial fold (NLF) is a common occurrence during the aging process, necessitating the development of an objective method to evaluate changes in NLFs. The objective of our study was to introduce a method of depth deviation based on three-dimensional (3D) image for evaluating the efficacy of hyaluronic acid (HA) injection in correcting NLFs. METHODS Between May 2019 and November 2019, we recruited 56 Chinese volunteers with moderate to severe NLFs for this study. The participants received HA injections and were followed up for a period of 12 months. Pre and posttreatment, we collected the Wrinkle Severity Rating Scale (WSRS) scores and 3D images. To assess the efficacy of NLF correction, we used the maximum value of depth deviation (MVD) based on 3D images and the Global Aesthetic Improvement Scale (GAIS) score. Additionally, we compared the relationship between MVD and other clinical parameters. RESULTS Fifty-four female participants completed the study and were included in the analysis. The HA injection resulted in a significant decrease in NLF severity (p < 0.05). One month after the injection, the average GAIS score was 4.72 ± 0.45, and the average MVD was 2.10 ± 0.56 mm. Both the GAIS score and the average MVD exhibited a decline over time during the follow-up period, with the average MVD showing a significant correlation with the GAIS score at all time points (p < 0.05). CONCLUSIONS Using 3D technology, we demonstrated that the quantitative data provided by MVD can serve as an objective method for evaluating the correction of NLFs.
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Affiliation(s)
- Yucheng Ma
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - E Yang
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wentao Lin
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Lorenc ZP, Smith S, Bass LS, Bank D, Weiss R, Canfield D, D'Alessandro BM, Cramer LM. Validating the Reliability and Clinical Relevance of a Nasolabial Fold Photonumeric Scale. J Drugs Dermatol 2024; 23:1319-1324. [PMID: 38206141 DOI: 10.36849/jdd.7316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND The use of tissue fillers to treat age-related deepening of the nasolabial fold (NLF) has increased and become the standard clinical approach, creating a need for evidence-based, objective evaluation for pre- and post-procedure assessment of the NLF. METHODS A 5-point rating scale was developed to assess the NLF, specifically the presence of depression and shadowing. Live validation of the scale was performed with a total of 73 participants representing the full range of NLF severities. Physicians board-certified in a core aesthetic specialty (3 trained raters) performed the scale validation over 2 rounds, 2 weeks apart. Training was carried out, and test-retest reliability was quantitated through the determination of intra- and inter-rater reliability by percentage of agreement, weighted kappa statistic with 95% confidence interval (CI), and intraclass correlation coefficient with 95% CI. To evaluate the clinical relevance of a 1-grade difference, rater assessments of 90 photo pairs were compared with previous designations of clinically different or not clinically different. RESULTS The NLF scale achieved near-perfect intra- and inter-rater reliability when utilized by trained raters to assess a diverse group of live participants. Furthermore, clinically relevant differences between grades were established, and a 1-point difference was detectable by trained evaluators using the NLF scale. CONCLUSION The clinically relevant and highly reliable validated NLF scale provides a standardized grading system with a user-friendly design for objectively assessing NLF in clinical practice and as a research tool for clinical approval studies of new aesthetic products and technologies. J Drugs Dermatol. 2024;23(1):1284-1291. doi:10.36849/JDD.7316.
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Alcotzer I, Liassidou A, Hexsel D, Tsur Shenhav L, Artzi O. Optimal Changes Seen in Patients After Treatment With Poly- l -Lactic Acid: A Retrospective Descriptive Study. Dermatol Surg 2024; 50:69-74. [PMID: 37910604 DOI: 10.1097/dss.0000000000003993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Poly- l -lactic acid (PLLA) is a biostimulator that enhances collagen production and leads to volume restoration. It became popular because of its improvement of facial wrinkles and long-lasting effect, although the specific visible changes it causes in the facial area are not fully described. OBJECTIVE To identify and characterize the visible changes resulting from injecting PLLA into the facial area. METHODS A list of 678 patients who underwent 2 to 3 treatments with PLLA injections in this center between 2021 and 2022 were retrieved. After 2 rounds of evaluations, 31 independent international evaluators described the 3 main changes they observed in the before-and-after images (taken approximately 7 months after the last injection session) of the 12 patients with the most significant improvement. RESULTS A total of 1,015 descriptions were received. They were divided into categories based upon similarity. The main detected changes were better contouring and enhancement of the lateral face, a lifting effect and secondary impact on the nasolabial fold, and improvement of skin texture and skin firmness. CONCLUSION Poly- l -lactic acid injections were judged to be effective for contouring, lifting, and improving skin texture in the facial area. Further research is needed to validate these results and create an assessment scale for PLLA injections.
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Affiliation(s)
- Inbar Alcotzer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aspasia Liassidou
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Doris Hexsel
- Hexsel Dermatologic Clinic and Research Center, Porto Alegre, RS, Brazil
| | - Leah Tsur Shenhav
- Department of Military Medicine and "Tzameret", Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Medical Corps, Israel Defense Forces, Israel
| | - Ofir Artzi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Guo Y, Wei W, Wang H, Li Q, Wei C, Zhang J, Jin P. Effect of a New Hyaluronic Acid Hydrogel Dermal Filler Cross-Linked With Lysine Amino Acid for Skin Augmentation and Rejuvenation. Aesthet Surg J 2023; 44:NP87-NP97. [PMID: 37265096 DOI: 10.1093/asj/sjad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Hyaluronic acid (HA) fillers are the most popular filler agents for skin rejuvenation. Although 1,4-butanediol diglycidyl ether is regarded as a relatively safe cross-linker, it still exhibits certain cytotoxicity. OBJECTIVES We presented here an amino acid-cross-linked HA (ACHA) which was obtained by an amidation reaction with lysine and HA. This study aimed to investigate ACHA's efficacy and safety for skin augmentation and rejuvenation. METHODS Rheology, compressive tests, and swelling experiments were conducted to investigate ACHA's mechanical and viscoelastic properties. The effects of ACHA on the human keratinocytes (HaCaT) cells and the human dermal fibroblast (HDF) were investigated by Transwell and wound healing assays. Its impacts on the epithelial thickness and collagen synthesis were further examined in a mouse experimental model. We recruited 50 patients with moderate to severe nasolabial folds (NLFs). The patients were randomly allocated to receive ACHA or Restylane injections. The resulting retention rates of HA and the Wrinkle Severity Rating Scale and Global Aesthetic Improvement Scale outcomes were evaluated and compared. RESULTS ACHA exhibited good viscoelasticity. It not only promoted migration and proliferation of HaCat and HDF and secretion of various growth factors but also increased skin thickness and promoted the generation of collagen. Patients who received ACHA had more residual volume 12 months after treatment. ACHA exhibited a promising augmentation effect in NLF correction with few adverse reactions. CONCLUSIONS ACHA has shown promise as a biomaterial with excellent biocompatibility and viscoelastic characteristics in both research and the clinic.See the abstract translated into Hindi, Portuguese, Korean, German, Italian, Arabic, Chinese, and Taiwanese online here: https://doi.org/10.1093/asj/sjad169. LEVEL OF EVIDENCE: 2
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Li XZ, Chiang CF, Lin YH, Chen TM, Wang CH, Tzeng YS, Cui HY. Safety and efficacy of hyaluronic acid injectable filler in the treatment of nasolabial fold wrinkle: a randomized, double-blind, self-controlled clinical trial. J DERMATOL TREAT 2023; 34:2190829. [PMID: 37694979 DOI: 10.1080/09546634.2023.2190829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/09/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION The injectable skin fillers available for soft tissue augmentation are constantly growing, providing esthetic surgeons with more options in the treatment of scars, lines, and wrinkles. Hyaluronic acid (HA)-derived injectable fillers are ideal to reduce the appearance of nasolabial folding. This study investigated the efficacy and safety of the commercially available HA filler from Maxigen Biotech Inc. (MBI-FD) in the treatment of nasolabial folds (NLFs). METHODS We analyzed 1,4-butanediol diglycidyl ether (BDDE) residues and injection force test and observed the protein content in MBI-FD, and then was cultured in fibroblast L929 cells and examined for cytotoxicity. Finally, 95 healthy participants underwent dermal filler injection therapy to evaluate the efficacy and safety for 24 and 52 weeks, respectively. RESULTS BDDE residues in MBI-FD was <0.125 µg/mL. MBI-FD was fitted using 27- and 30-G injection needles with an average pushing force of 14.30 ± 2.07 and 36.43 ± 3.11 N, respectively. Sodium hyaluronate protein in MBI-FD was 7.19 µg/g. The cell viabilities of 1× and 0.5× MBI-FD were 83.25% ± 3.58% and 82.23% ± 1.85%, respectively, indicating MBI-FD had no cytotoxicity, and decreased NLF wrinkles with no serious adverse events. CONCLUSION MBI-FD is an effective filler for tissue augmentation of the NLFs and may be a suitable candidate as an injectable dermal filler for tissue augmentation in humans in the future.
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Affiliation(s)
- Xing-Zhou Li
- Department of Plastic Surgery, Hainan Women and Children's Medical Center, Hainan Province, China
| | - Chi-Fu Chiang
- Research & Design Center, TCI CO., Ltd, Taipei, Taiwan
| | | | - Tim-Mo Chen
- Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Hsing Wang
- Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Sheng Tzeng
- Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hai-Yan Cui
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Han WY, Kim HJ, Kwon R, Kang SM, Yon DK. Safety and Efficacy of Poly-L-Lactic Acid Filler (Gana V vs. Sculptra) Injection for Correction of the Nasolabial Fold: A Double-Blind, Non-Inferiority, Randomized, Split-Face Controlled Trial. Aesthetic Plast Surg 2023; 47:1796-1805. [PMID: 37626137 DOI: 10.1007/s00266-023-03600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Poly-L-lactic acid (PLLA) fillers have shown excellent results as soft tissue fillers for progressive midface volume enhancement, with long-lasting results and high patient satisfaction. OBJECTIVE Herein, we investigated the safety and effectiveness of a new PLLA filler (Gana V) in comparison with those of the widely used Sculptra. METHODS This double-blind, non-inferiority, randomized, split-face controlled trial was performed in France to evaluate the safety and effectiveness of injectable Gana V compared with those of Sculptra for correction of nasolabial fold (NLF) depression. The primary outcome was improvement in NLFs, as determined using the Wrinkle Severity Rating Scale (WSRS). This trial is an interim report of the results at 6 months. The trial was registered at ClinicalTrials. gov, number NCT05215054. RESULTS Fifty-five participants with moderate-to-severe NLFs (mean age 53.8 [standard deviation 8.7] years; 48 [87.3%]) female) were enrolled. After 6 months, Gana V showed improved WSRS score (mean difference - 0.25; 95% confidence interval [CI] - 0.49 to - 0.01) in intention-to-treat analysis, while Sculptra did not (mean difference - 0.20; 95% CI - 0.42 to 0.03). Furthermore, Gana V showed an acceptable 6-month effectiveness compared with Sculptra, within our defined non-inferiority margin (pnon-inferiority = 0.1787). The immediate results by the investigator after the initial injection showed higher satisfaction in the Gana V than in the Sculptra group. Gana V and Sculptra showed no difference in adverse reactions. Similar patterns were observed in per-protocol analyses. CONCLUSIONS Gana V is non-inferior to Sculptra with respect to the correction of NLFs and has higher investigator satisfaction. Further research is required to ensure long-term safety. LEVEL OF EVIDENCE I 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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Affiliation(s)
- Woo Yeon Han
- Department of Plastic and Reconstructive Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seoul, 16995, South Korea.
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea
- Department of Regulatory Science, Kyung Hee University , Seoul, South Korea
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea
- Department of Regulatory Science, Kyung Hee University , Seoul, South Korea
| | - So Min Kang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea.
- KBI Korea Biomedical research Institute, Seongnam, South Korea.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea.
- Department of Regulatory Science, Kyung Hee University , Seoul, South Korea.
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Shen WW, Jiao CB, Ma JX, Xia YC, Cui LG. Evaluation of facial artery course variations, diameters, and depth by Doppler ultrasonography. J Plast Reconstr Aesthet Surg 2023; 84:79-86. [PMID: 37327736 DOI: 10.1016/j.bjps.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The facial artery (FA) is the main blood vessel supplying blood to the face. It is essential to understand the anatomy of FA around the nasolabial fold (NLF). This study aimed to provide the detailed anatomy and relative positioning of FA to help avoid unexpected complications in plastic surgery. METHODS FA was observed from the inferior border of the mandible to the end of its terminal branch in 66 hemifaces of 33 patients with Doppler ultrasonography. The evaluation parameters were: (1) location, (2) diameter, (3) FA-skin depth, (4) relationship between the NLF and FA, (5) distance between the FA and significant surgical landmarks, and (6) the running layer. The FA course is classified based on the terminal branch. RESULTS The most common FA course was Type 1, which had an angular branch as the final branch (59.1%). The most common FA-NLF relationship was that the FA was situated inferior to the NLF (50.0%). The mean FA diameter was 1.56 ± 0.36 mm at the mandibular origin, 1.40 ± 0.37 mm at the cheilion, and 1.32 ± 0.34 mm at the nasal ala. The FA diameter on the right hemiface was thicker than that on the left hemiface (p < 0.05). CONCLUSION The FA mainly terminates in the angular branch, running in the medial NLF and in dermis and subcutaneous tissue, with a blood supply advantage in the right hemisphere. We suppose that a deep injection into periosteum around the NLF may be safer than an injection into the superficial musculoaponeurotic system (SMAS) layer.
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Affiliation(s)
- Wei-Wei Shen
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Chen-Bo Jiao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Jian-Xun Ma
- Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China.
| | - You-Chen Xia
- Department of Plastic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Li-Gang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
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Byun JW, Kang YR, Park S, Hong W. Efficacy of radiofrequency combined with single-dot ultrasound efficacy for skin rejuvenation: A non-randomized split-face trial with blinded response evaluation. Skin Res Technol 2023; 29:e13452. [PMID: 37753689 PMCID: PMC10496459 DOI: 10.1111/srt.13452] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) and radiofrequency (RF) are non-invasive modalities for skin rejuvenation, but their combined effects have not been evaluated. OBJECTIVE We evaluated and compared the efficacy of HIFU alone and combined HIFU and bipolar RF using a newly designed probe. METHODS Twenty-two Korean adults with facial wrinkles and aging underwent treatment on both sides of their face: HIFU-only on the left and HIFU combined with RF on the right. Skin parameters were measured at different time points to evaluate the improvement in skin rejuvenation. RESULTS HIFU treatment significantly improved skin parameters, including pore volume and number, skin elasticity, depth of eye wrinkles, degree of sagging in the eye area, nasolabial folds and cheeks, volume of the jawline, skin density, and permittivity. Furthermore, combining bipolar RF with HIFU treatment enhanced efficacy in reducing pore number, improving skin elasticity, diminishing eye wrinkle depth, and increasing skin moisturization. These findings indicate that bipolar RF can synergically improve skin rejuvenation by providing a thermal effect to the upper papillary dermis, which is more superficial than the target area of HIFU. CONCLUSION Combining HIFU with bipolar RF synergistically improves skin rejuvenation, including pore reduction, periorbital wrinkle improvement, skin elasticity, and skin moisturization.
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Affiliation(s)
- Ji Won Byun
- Department of DermatologyINHA University School of MedicineIncheonSouth Korea
| | - Yoo Ri Kang
- Clinical Trial DivisionHuman Co., Ltd. Skin Clinical Trial CenterSeoulSouth Korea
| | - Soojung Park
- Department of DermatologyHuman Dermatology ClinicGangseoSeoulSouth Korea
| | - Wonkyu Hong
- Department of DermatologyHuman Dermatology ClinicCheong‐laIncheonSouth Korea
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13
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Ein L, Trzcinski L, Perry L, Bark KY, Hadlock T, Guarin DL. Embellishing Emotrics for a More Complete Emotion Analysis: Addition of the Nasolabial Fold. Facial Plast Surg Aesthet Med 2023; 25:409-414. [PMID: 36857744 DOI: 10.1089/fpsam.2022.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Background: The nasolabial fold (NLF) greatly contributes to facial aesthetics; changes to NLF depth and vector are disfiguring in patients with facial paralysis (FP). NLF parameters are integral to clinician-graded outcomes, but automated programs currently lack NLF identification capabilities. Objective: To incorporate an automated NLF identification and quantification function into the facial landmark program, Emotrics, and to compare new Emotrics-derived NLF data to clinician-graded electronic facial paralysis assessment (eFACE) data for accuracy. Methods: Photographs of 135 patients with FP were marked bilaterally, using identification markers manually placed on each NLF. A machine learning model was trained to automatically localize the markers using these data. Once Emotrics accurately identified the NLF and its corresponding vector, photographs of 20 additional patients who underwent facial reanimation procedures were assessed by the algorithm. Results: The enhanced Emotrics algorithm successfully identified the NLF, and measured the vector from midline, in a series of patients with FP. NLF vector data closely matched corresponding eFACE parameters. Furthermore, changes in NLF presence and vector were detected following facial reanimation procedures. Conclusion: The Emotrics program now provides critical NLF data, providing objective parameters for clinicians interested in changing NLF dynamics after FP.
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Affiliation(s)
- Liliana Ein
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lauren Trzcinski
- Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Luke Perry
- Florida Insititute of Technology, Department of Biomedical and Chemical Engineering, Melbourne, Florida, USA
| | - Kee Yoon Bark
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Tessa Hadlock
- Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Diego L Guarin
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
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14
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Wang X, Chen X, Zhao Q, Zhou Z, Wu S, Chen Y, Wang X, Huang X, Long X. Patient-Specific Implants for Correction of Midfacial Aging. J Craniofac Surg 2023; 34:1784-1788. [PMID: 36991544 DOI: 10.1097/scs.0000000000009269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/03/2022] [Indexed: 03/31/2023] Open
Abstract
The nasolabial folds (NLFs) may be shallowed with the use of nostril base augmentation. This study aimed to design and customize patient-specific implants (PSIs) with computer-aided design/computer-aided manufacturing (CAD/CAM) to correct NLF deepening caused by midfacial aging. The patient's head computed tomography data obtained and were used for reconstruction. The PSIs were customized by CAD/CAM techniques, which were implanted into a nasal base for shallow NLFs caused by midfacial aging. Preoperative and postoperative photos and a wrinkle severity rating scale were used to evaluate the changes in NLFs. Also, the global esthetic improvement scale was used to investigate the surgical satisfaction of patients. Eleven patients (22 NLFs) received PSIs in the nasal base (22 implants). The customized PSI matched well with premaxilla, reducing the difficulty of operation. After 3 to 12 months of follow-up, PSI was stable without foreign body reaction or inflammatory reaction. Postoperative wrinkle severity rating scale scores showed that NLF severity was reduced in all patients, with a significant esthetic improvement compared with preoperatively ( P < 0.01). The global esthetic improvement scale showed an extremely satisfied improved NLF in 27.27% of patients, much improved in 63.63%, and improved in 9.90% (2/22), and none reported change or poor NLF. Patient satisfaction with their midface appearance differed significantly before and after surgery ( P < 0.01). Individualized PSI designed with high precision and matching degree by CAD and prepared using CAM could be applied to overcome the limitations of noncustomized implants.
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Affiliation(s)
- Xin Wang
- Department of Plastic Surgery, Zhejiang Hospital Affiliated to the Zhejiang University School of Medicine
| | - Xiaoping Chen
- Department of Plastic Surgery, Hangzhou Time Medical Cosmetic Surgery Hospital, Hangzhou, Zhejiang, China
| | - Qiming Zhao
- Department of Plastic Surgery, Zhejiang Hospital Affiliated to the Zhejiang University School of Medicine
| | - Zhuying Zhou
- Department of Plastic Surgery, Hangzhou Time Medical Cosmetic Surgery Hospital, Hangzhou, Zhejiang, China
| | - Sihan Wu
- Department of Plastic Surgery, Hangzhou Time Medical Cosmetic Surgery Hospital, Hangzhou, Zhejiang, China
| | - Yue Chen
- Department of Plastic Surgery, Zhejiang Hospital Affiliated to the Zhejiang University School of Medicine
| | - Xiaowei Wang
- Department of Plastic Surgery, Zhejiang Hospital Affiliated to the Zhejiang University School of Medicine
| | - Xiaoxiang Huang
- Department of Plastic Surgery, Zhejiang Hospital Affiliated to the Zhejiang University School of Medicine
| | - Xiaohui Long
- Department of Plastic Surgery, Zhejiang Hospital Affiliated to the Zhejiang University School of Medicine
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15
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Jeong KM, Seo JY, Kim A, Kim YC, Baek YS, Oh CH, Jeon J. Ultrasonographic analysis of facial skin thickness in relation to age, site, sex, and body mass index. Skin Res Technol 2023; 29:e13426. [PMID: 37632182 PMCID: PMC10370326 DOI: 10.1111/srt.13426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Numerous nonsurgical but invasive cosmetic procedures are performed blindly in the dermis or subcutaneous fat layer of the facial skin. OBJECTIVES To measure the numerical skin thickness of the facial areas where dermatological procedures are performed by applying ultrasound techniques, and to make it possible to estimate the skin thickness by investigating the influence of several individual constitutional factors such as age, sex, and body mass index (BMI), so that these variables can be applied to estimate skin thickness. MATERIALS AND METHODS Skin thickness was measured at eight different facial points using an ultrasound machine (Affiniti 50; Philips Inc.). Demographic data were gathered using questionnaires. Manual BMI was calculated from the weight and height of each participant, and individual BMI measurements were performed using a body composition analyzer. RESULTS In terms of whole skin thickness, the thickest point was the mouth corner, and the thinnest point was the lateral forehead. The thickest point in the epidermis was the chin, and the thinnest point was the nasolabial fold. The thickest point in the dermis was the corner of the mouth, and the thinnest was the lateral forehead. Full skin thickness and dermal thickness were mostly lower in females. Skin thickness was not significantly correlated with BMI. CONCLUSION The skin thickness at different points on the face was variable, and realistic data about skin thickness can be obtained by in vivo ultrasonographic analysis of the skin.
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Affiliation(s)
- Kyung Muk Jeong
- Department of Dermatology, Korea University College of MedicineKorea University Guro HospitalSeoulRepublic of Korea
| | - Ji Yun Seo
- Department of Dermatology, Korea University College of MedicineKorea University Guro HospitalSeoulRepublic of Korea
| | - Anna Kim
- Department of Dermatology, Korea University College of MedicineKorea University Guro HospitalSeoulRepublic of Korea
| | - Young Chan Kim
- Department of Dermatology, Korea University College of MedicineKorea University Guro HospitalSeoulRepublic of Korea
| | - Yoo Sang Baek
- Department of Dermatology, Korea University College of MedicineKorea University Guro HospitalSeoulRepublic of Korea
| | - Chil Hwan Oh
- Department of DermatologyWonkwang University HospitalWonkwang University School of MedicineIksanRepublic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Korea University College of MedicineKorea University Guro HospitalSeoulRepublic of Korea
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16
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Moorefield AK, Rose-Reneau Z, Wright BW, Surek CC. Venous Tributaries of the Lip: Implications for Lip Filler Injection. Plast Reconstr Surg 2023; 152:257e-263e. [PMID: 36728199 DOI: 10.1097/prs.0000000000010212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Demand for lip filler injection continues to increase. Despite the current literature's acknowledgement of the role both venous and arterial vasculature play in minor and major side effects, research addressing the venous vasculature of the lower one-third of the face is scarce. METHODS A photographic analysis of the venous vasculature of 26 participants was performed using a vein transilluminator to display the venous flow around the perioral region. The data were analyzed for commonalities among participants and then compared with common lip filler injection techniques and locations. RESULTS Venous tributaries were identified in all patients, with slight variation in pattern, superior to the upper vermilion border between the nasolabial fold and philtral column on each side of the mouth. Venous tributaries were noted approximately 1 to 1.5 cm lateral to the oral commissures extending inferiorly to the chin and along the labiomental crease. Four areas of venous pooling were deemed significant: a small area approximately 2 mm superior to the Cupid's bow, along the middle tubercle of the upper lip, along the wet-dry line of the lower lip; and centrally along the vermilion border between the lower lip tubercles. CONCLUSIONS Perioral venous mapping provides a guide for injectors performing lip enhancement procedures in identifying areas at risk for injury because of venous pooling. Avoiding these anatomically vulnerable regions can minimize the potential for inflammation and ecchymosis associated with intravenous injection and prevent dissatisfactory aesthetic results because of lumps, excessive bruising, swelling, or asymmetry.
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Affiliation(s)
| | - Zak Rose-Reneau
- From the Division of Clinical Anatomy, Kansas City University
| | - Barth W Wright
- From the Division of Clinical Anatomy, Kansas City University
| | - Christopher C Surek
- From the Division of Clinical Anatomy, Kansas City University
- Surek Plastic Surgery
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17
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Southwick G, Dewael S. Commentary on "Nasolabial Sulcus Rejuvenation: Paranasal Augmentation Using a Folded Dermal Graft". Aesthetic Plast Surg 2023; 47:192-193. [PMID: 36510018 DOI: 10.1007/s00266-022-03169-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/14/2022]
Affiliation(s)
| | - Sophie Dewael
- Melbourne Institute of Plastic Surgery, Melbourne, Australia
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18
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Marin Q, Honda T, Okano Y, Cherel M, Prestat‐Marquis E. Comparative analysis of original face and skin-warped average face images for the scoring of skin attributes. Skin Res Technol 2023; 29:e13324. [PMID: 37113094 PMCID: PMC10234171 DOI: 10.1111/srt.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES Representative of a panel, an average face image could be used to analyse/display skin changes while alleviating image rights constraints. Therefore, we used landmark-based deformation (warping) of individual skin images onto their panel's average face, evaluating this approach's relevance and possible limits. METHODS An average front face image was constructed from images of 71 Japanese women (50-60 years old). After warping individual skin images onto this average face, the resulting skin-warped average faces were presented to three experts who graded: forehead wrinkles, nasolabial fold, wrinkle of the corner of the lips, pore visibility and skin pigmentation homogeneity. Two experts estimated subjects' age. Results were compared to gradings performed on original images. RESULTS Inter-expert grading shows excellent to good correlation whatever image type: from 0.918 (forehead wrinkles) to 0.693 (visibility of pores). Correlations between scoring of both image types are almost always higher than inter-expert correlations (maximum: 0.939 for forehead wrinkles-minimum: 0.677 for pore visibility). Frequencies of grades/ages are similar when scoring original and skin-warped average face images. Experts scores are similar in 90.6%-99.3% of the cases. Average deviations upon scoring both image types are smaller than average inter-expert deviations on original images. CONCLUSIONS Scoring facial characteristics in original images and skin-warped average face images show an excellent agreement, even for perceived age, a complex feature. This opens the possibility of using this approach to grade facial skin features, monitor changes over time, and to valorise results on a face deprived of image rights.
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19
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Huang Y, Zhang Y, Fei X, Fan Q, Mao J. Monophasic and Biphasic Hyaluronic Acid Fillers for Esthetic Correction of Nasolabial Folds: A Meta-Analysis of Randomized Controlled Trials. Aesthetic Plast Surg 2022; 46:1407-1422. [PMID: 35066619 DOI: 10.1007/s00266-021-02729-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/12/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) fillers have become the most popular dermal fillers for esthetic nasolabial folds (NLFs) correction. Based on the cross-linking method, they can be classified as monophasic or biphasic types. OBJECTIVES The aim of this meta-analysis is to compare the efficacy and safety of monophasic HA fillers with that of biphasic HA fillers for treatment of NLFs. PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and Chinese databases were searched from inception to January 2021. METHODS Randomized controlled trials (RCTs) that compared treatment outcomes of a monophasic HA filler with a biphasic HA filler for esthetic NLF correction were selected. Twenty-two RCTs with totally 1848 subjects were included to this meta-analysis. A significantly higher improvement of NLF severity score was seen for monophasic fillers than biphasic fillers at 2 (p = 0.005), 8 (p <0.0001), 12 (p = 0.03), 16 (p = 0.005), 24 (p <0.00001), 36 (p = 0.007), and 52 week (p <0.0001) after treatment. RESULTS The effect was retained regardless of ethnicity, total injection volume, and baseline NLF severity. More subjects preferred monophasic fillers over biphasic ones (≤7 months: RR = 3.45, 95% CI 1.17 to 10.11; >7 months: RR = 2.37, 95% CI 1.45 to 3.86). Rate of post-injection pain was significantly lower for monophasic fillers (RR = 0.85, 95% CI 0.78 to 0.92, p <0.0001), but no statistical difference was observed for other post-injection adverse events. Compared to biphasic HA fillers, monophasic HA fillers were associated with a greater and more durable esthetic NLFs improvement, a lower rate of post-injection pain, and were favored by more patients. 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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Affiliation(s)
- Yiwen Huang
- Medical Affairs Department, Tigermed-Jyton, Shanghai, People's Republic of China
| | - Yibin Zhang
- Medical Affairs Department, Tigermed-Jyton, Shanghai, People's Republic of China
| | - Xiaojing Fei
- Medical Affairs Department, Tigermed-Jyton, Shanghai, People's Republic of China
| | - Qi Fan
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
| | - Jie Mao
- Medical Affairs Department, Tigermed-Jyton, Shanghai, People's Republic of China.
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20
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Bertucci V, Nikolis A, Solish N, Lane V, Hicks J. Efficacy and Safety of Flexible Hyaluronic Acid Fillers in Lip and Perioral Enhancement. J Drugs Dermatol 2021; 20:402-408. [PMID: 33852235 DOI: 10.36849/jdd.2021.5525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Since lips have a significant role in facial aesthetic perception, lip augmentation is an increasingly popular aesthetic procedure. OBJECTIVE To evaluate aesthetic improvement and facial dynamics with hyaluronic acid (HA) fillers in the lips and perioral region at 8 weeks after the last treatment compared to pre-treatment. METHODS AND MATERIALS In this open-label study, all subjects received HARK in the lips, and an additional group also received HARR and/or HARD in nasolabial folds (NLFs) and marionette lines (MLs). Assessments included aesthetic improvement, naturalness of facial expressions, perception of age, and lip texture. RESULTS Nineteen subjects received HARK only; 40 received HARK and HARR and/or HARD. The primary objective was met. All subjects experienced aesthetic improvement in lip fullness at week 8. The investigators also reported aesthetic improvement in all subjects. For the majority of subjects, aesthetic improvement was associated with maintenance of natural and youthful facial expressions, and improved lip texture. Most treatment-emergent adverse events were mild; none were serious. CONCLUSION HARK is a well-tolerated and effective treatment for enhancing lip fullness, maintaining naturalness and youthfulness of facial expressions, and smoothing lip texture, whether used alone or in combination with HARR/ HARD in the NLFs and/or MLs. J Drugs Dermatol. 20(4): 402-408. doi:10.36849/JDD.2021.5525.
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21
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Palm M, Weinkle S, Cho Y, LaTowsky B, Prather H. A Randomized Study on PLLA Using Higher Dilution Volume and Immediate Use Following Reconstitution. J Drugs Dermatol 2021; 20:760-766. [PMID: 34232000 DOI: 10.36849/jdd.6034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The reconstitution volume of a PLLA-containing injectable device has gradually increased in clinical practice, often in combination with adding lidocaine to the solution. OBJECTIVE This study, SCRIPT (Sculptra Contemporary Reconstitution & Injection Procedure Trial) evaluated PLLA for correction of nasolabial folds after changes in reconstitution and injection procedures. Primary endpoint for effectiveness was change from baseline of nasolabial folds, assessed by blinded evaluation using a validated wrinkle assessment scale (WAS), at week 48. METHODS Subjects were treated to optimal correction of nasolabial folds at a single treatment regimen consisting of ≤4 injection sessions, with PLLA reconstituted with 8 mL or 5 mL sterile water for injection (SWFI), randomized 2:1. The 8 mL product included an additional 1 mL 2%-lidocaine and was injected immediately following reconstitution. Assessments included wrinkle severity, aesthetic improvement and safety. RESULTS A total of 80 subjects were included in the study. Most subjects were female (95%), mean age was 51.5 years. Primary endpoint was met and subjects from both study groups demonstrated high WAS responder rates (≥1-grade improvement from baseline) at week 24 (≥75%) and week 48 (≥67%). Aesthetic improvement was high (≥86%) throughout the study. Adverse events related to study product or injection procedure were mostly mild and transient. CONCLUSION PLLA reconstituted with 8 mL SWFI demonstrated a comparable treatment effect to that of the reference group in reducing wrinkle severity of nasolabial folds. Safety was not compromised using a higher reconstitution volume including lidocaine, injected immediately after reconstitution.
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22
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Moers-Carpi M, Christen MO, Delmar H, Brun P, Bodokh I, Kestemont P. European Multicenter Prospective Study Evaluating Long-Term Safety and Efficacy of the Polycaprolactone-Based Dermal Filler in Nasolabial Fold Correction. Dermatol Surg 2021; 47:960-965. [PMID: 33731572 DOI: 10.1097/dss.0000000000002978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Age-related changes affecting facial areas can be corrected using minimally invasive dermal fillers. The use of polycaprolactone-dermal filler (PCL-filler) in aesthetics is increasing. OBJECTIVE To evaluate the long-term safety and efficacy of the PCL-filler, in a European, multicenter, prospective study. MATERIALS AND METHODS Subjects (n = 90) with moderate/severe nasolabial folds (Wrinkle Severity Rating Scale [WSRS]: 3 to 4) were treated on Day 0 with a single injection of similar volume on each side; safety and efficacy assessments were performed over an 18-month period. In 1 of the 3 study centers, safety was evaluated at 30 months. RESULTS At Month 12 (M12; primary endpoint), 84% of subjects showed a ≥1-point improvement on the WSRS (M6: 92%; M18: 64%). From the investigator/subject's evaluation, from Day 7 to M12, Global Aesthetic Improvement was reported for >90% of subjects, with the effect maintained for up to 18 months in >80% of patients. Subjects/investigators reported high satisfaction and skin quality improvement. Most of the immediate injection-site reactions disappeared after 2 to 4 days. No severe or unexpected adverse events were reported. CONCLUSION This study demonstrated the long-term safety and efficacy of the PCL-filler, with safety confirmed for up to 30 months.
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Affiliation(s)
| | | | - Henry Delmar
- Mediti-Clinique Science et Beauté, Juan-les-Pins, France
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23
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Abramo AC, Sgarbi R, Kim CY, Bastos PA. Effectiveness and Long-Acting of the Hyaluronic Acid Injected into the Nasolabial Fold Measured Through Magnetic Resonance Imaging. Aesthetic Plast Surg 2021; 45:1221-1230. [PMID: 33230693 DOI: 10.1007/s00266-020-02050-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND MRI analyzed quantitatively the HA injected into the NLF subcutaneous fat to correlate the gel diffusion and degradation with the morphological changes of the NLF appearance for twelve months. Measurements of the gel diffusion and degradation were taken by MRI as parameters to assess the clinical efficacy and long-acting of the HA in NLF rejuvenation. METHOD HA was applied into the superficial compartment of the subcutaneous fat of twenty NLFs. Each NLF received three injection points, from the nasal ala toward the oral commissure, 1.0-1.5 cm distant from each other, according to the NLF length. A bolus injection technique without retrograde backflow applied per injection point 0.15-0.20 ml of HA for moderate. NLF and 0.20-0.25 ml for severe NLF. Patients were evaluated through MRI and clinically twenty-four hours, one month and twelve months after the HA application. RESULTS MRI, in T2-weighted, displayed the gel as a dense, spindle-shaped nodule as pattern of the gel diffusion, measuring its largest longitudinal and transverse axes. Twenty-four hours after HA application the longitudinal axis measured 1.79 cm, after one month 2.33 cm and at month twelve 0.91 cm. The transverse axis measured 0.92 cm at 24 hours, 1.13 cm after one month and 0.47 cm at month twelve. CONCLUSION Despite reduction in size and denseness of the spindle-shaped nodule, the small amount of gel presenting into the subcutaneous fat after twelve months of the application evidenced the HA efficacy and long-acting in NLF rejuvenation. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors - www.springer.com/00266 .
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Affiliation(s)
- Antonio Carlos Abramo
- Post-Graduate Course of the ACA-Institute of Assistance in Plastic Surgery of São Paulo, Division of Plastic Surgery, General Hospital São Rafael, endorsed by the Brazilian Society of Plastic Surgery and Brazilian Medical Association, Rua Afonso de Freitas, 641, São Paulo, SP, 04006-052, Brazil.
| | - Romulo Sgarbi
- Post-Graduate Course of the ACA-Institute of Assistance in Plastic Surgery of São Paulo, Division of Plastic Surgery, General Hospital São Rafael, endorsed by the Brazilian Society of Plastic Surgery and Brazilian Medical Association, Rua Afonso de Freitas, 641, São Paulo, SP, 04006-052, Brazil
| | - Clara Young Kim
- Post-Graduate Course of the ACA-Institute of Assistance in Plastic Surgery of São Paulo, Division of Plastic Surgery, General Hospital São Rafael, endorsed by the Brazilian Society of Plastic Surgery and Brazilian Medical Association, Rua Afonso de Freitas, 641, São Paulo, SP, 04006-052, Brazil
| | - Paulo Armon Bastos
- Post-Graduate Course of the ACA-Institute of Assistance in Plastic Surgery of São Paulo, Division of Plastic Surgery, General Hospital São Rafael, endorsed by the Brazilian Society of Plastic Surgery and Brazilian Medical Association, Rua Afonso de Freitas, 641, São Paulo, SP, 04006-052, Brazil
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24
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Lukavsky R, Trussler A, Barton FE, Lee M. Identifying Regional Viscoelastic Properties of the Superficial Muscular Aponeurotic System. Aesthet Surg J 2021; 41:277-283. [PMID: 32463437 DOI: 10.1093/asj/sjaa140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Suspension of the superficial muscular aponeurotic system (SMAS) is generally believed to be necessary in facelift surgery. Although many techniques have been suggested, all rely on the viscoelastic properties of the SMAS. OBJECTIVES The aim of this study was to determine the viscoelastic properties of bursting strength, stress relaxation, and creep in the lateral, mid-cheek, and medial regions of the SMAS. METHODS The viscoelastic properties of the SMAS were determined in 12 cadaveric hemifaces. Lateral SMAS was classified as the SMAS overlying the parotid gland; mid-cheek SMAS as anterior to the parotid and overlying the masseter muscle; and medial SMAS as including tissue extending medial from the lateral canthus and ending at the nasolabial fold. RESULTS The 3 SMAS regions showed significantly different bursting strengths: 38.9 N for the lateral SMAS, 26.7 N for the mid-cheek SMAS, and 11.9 N for the medial SMAS (P < 0.0001). Stress relaxation was similar in all vertical regions with measurements of 54% in the lateral, 48% in the mid-cheek, and 59% in the medial SMAS. Creep was found to be similar in the lateral and mid-cheek SMAS with values of 18% and 19%, respectively. The medial SMAS was noted to have a higher creep at 22%. CONCLUSIONS The lateral SMAS has a stronger bursting strength than the mid-cheek and medial SMAS. Creep appears to be lower in the lateral and mid-cheek SMAS. Stress relaxation appears to be similar in all 3 vertical regions.
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Affiliation(s)
- Robert Lukavsky
- Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX
| | - Andrew Trussler
- Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX
| | - Fritz E Barton
- Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX
| | - Michael Lee
- Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX
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Othman S, Cohn JE, Daggumati S, Bloom JD. The Impact of Dermal Fillers on Perceived Personality Traits and Attractiveness. Aesthetic Plast Surg 2021; 45:273-280. [PMID: 32696160 DOI: 10.1007/s00266-020-01888-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dermal fillers are increasingly popular for facial rejuvenation and enhancement, including effacement of nasolabial folds (NLFs) and marionette lines and lip augmentation. This study aimed to evaluate casual observer perception of physical and interpersonal traits of subjects who receive filler treatment. METHODS An anonymous survey of 8 before/after treatment photographical sets was administered in Likert scale format (1-7) using online crowdsourcing. Three sets of photographs were before/after NLF/ marionette line treatment, three of lip augmentation, and two internal controls. Respondents were surveyed on personal demographics, as well as perceptions of subject photographs across nine domains (facial symmetry, confidence, likeability, youthfulness, trustworthiness, attractiveness, intelligence, approachability, happiness). RESULTS In total, 260 respondents completed the survey. The majority were male (63.1%), Caucasian (58.1%), 18-34 years old (58.1%), and college graduates (66.2%). Respondents rated photographs with line filler treatment and lip filler treatment as significantly improved compared to the pre-treatment photographs across all nine trait domains [p < 0.001, for all]. No differences were found between the control photosets [p > 0.05, for all]. Middle-aged respondents (35-55 years) were more likely to perceive treated filler photographs as more youthful than younger respondents (18-34 years) [p < 0.006] Additionally, respondents with lower educational attainment (high-school graduate or less) were more likely to perceive treated patients as less intelligent compared to higher-educated respondents (college/postgraduates) [p < 0.05, for both]. CONCLUSION The use of dermal fillers for treatment of NLF/marionette lines and lip augmentation have significant associations with the perception of improved attractiveness and several personality traits. Additionally, casual observer demographic subgroups may influence perceptions. 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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Affiliation(s)
- Sammy Othman
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Jason E Cohn
- Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic, Philadelphia, PA, USA
| | - Srihari Daggumati
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Jason D Bloom
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.
- Bloom Facial Plastic Surgery, Two Town Place, Suite 110, Bryn Mawr, PA, 19010, USA.
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Abstract
To document the amount and rate of re-absorption of fatty tissue transplanted using the author's technique, the author initiated controlled studies in 1987. A selected crease was infiltrated with autologous fatty tissue using a nearby crease as control. At specific time intervals the infiltrated crease was compared to the nearby control crease to evaluate percentage of recurrence. Photographs were taken in the first week, then at least yearly over six years. All views, all positions of the mouth, and all lighting situations demonstrated the continued absence of any crease in the area of infiltration. In contrast, the nearby control crease remained unchanged or deepened from its preoperative condition, giving every indication of a permanent correction. This experiment demonstrates the potential lasting nature of corrections performed with the transplantation of fatty tissue and is supported by over 400 infiltrations into the nasolabial folds in the author's practice.
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Dayan S, Maas CS, Grimes PE, Beer K, Monheit G, Snow S, Murphy DK, Lin V. Safety and Effectiveness of VYC-17.5L for Long-Term Correction of Nasolabial Folds. Aesthet Surg J 2020; 40:767-777. [PMID: 31346621 DOI: 10.1093/asj/sjz200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Juvéderm Vollure XC (VYC-17.5L; Allergan plc, Dublin, Ireland) belongs to a family of hyaluronic acid gels based on the Vycross technology platform. OBJECTIVES The authors sought to evaluate the safety and effectiveness of Vollure for correction of moderate to severe nasolabial folds (NLFs) over 18 months and after repeat treatment. METHODS In this prospective, randomized study, patients (N = 123) received initial/touch-up treatment with Vollure in 1 NLF and control filler in the contralateral NLF. Patients received optional repeat treatment with Vollure after month 12, 15, or 18. Assessments included investigator-rated NLF Severity Scale responder rates (≥1-point improvement vs baseline), patient-assessed Appraisal of Nasolabial Folds scale of the FACE-Q questionnaire, and patient satisfaction (11-point scale). RESULTS Median volume of Vollure injected was 1.7 mL for initial/touch-up treatment combined and 0.6 mL for repeat treatment. The NLF Severity Scale responder rates were 93%, 85%, and 59% at months 6, 9, and 18 after initial/touch-up treatment and increased to 94% at 1 month after repeat treatment. Mean patient-reported FACE-Q scores significantly improved from baseline at all timepoints. Most patients were very satisfied with treatment at all timepoints from day 3 (75%) through month 18 (68%) and at 1 month after repeat treatment (94%). Common injection site responses after initial/touch-up and repeat treatment were firmness, swelling, and tenderness to touch; most were mild/moderate. CONCLUSIONS Vollure was safe and effective for correction of moderate to severe NLFs, with results lasting 18 months in 59% of NLFs. Repeat treatment required one-third of the injection volume to achieve similar improvement in NLF severity as initial/touch-up treatment. LEVEL OF EVIDENCE: 2
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Sobral MA, Runa D, Julião M. Letter to the Editor: Clinical Signs of Impending Death, A Retrospective Descriptive Analysis. ACTA MEDICA PORT 2019; 32:789. [PMID: 31851890 DOI: 10.20344/amp.12737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/22/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Maria Ana Sobral
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
| | - Daniela Runa
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra. Sintra. Portugal
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Sharma PP, Sharma DK, Carr A. Comparative Study of UMA Jeunesse Classic ® and UMA Jeunesse Ultra ®. Aesthetic Plast Surg 2018; 42:1111-1118. [PMID: 29761211 DOI: 10.1007/s00266-018-1144-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/29/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The emergence of hyaluronic acid dermal fillers with lidocaine has transformed the minimally invasive treatment of wrinkles, lines and folds of the face. Patients can be treated quickly, painlessly and without the need for large doses of lidocaine. Therefore, it is important to scientifically evaluate the merits of lidocaine-containing products over those without. METHODS The two products, with (UJU) and without lidocaine (UJ), were randomly injected into nasolabial folds of 75 healthy volunteers with varying skin types in a split face study, age ranging 26-60 years. Only 73 subjects completed the follow-up. There were 68 females and 5 males with medium-to-deep nasolabial folds. All subjects were randomly injected with the two products on one or the other side of the face. Patients were followed up for 9 months. RESULTS Both products achieved significant improvement in the wrinkle severity score. Overall results were slightly better with UJU due to ease of injection, lack of pain and avoidance of topical or parenteral anaesthetic. In all other respects, differences in clinical data were not statistically significant. UJU® was preferred by patients and injectors due to less pain during and after injection as compared to UJ® (P < 0.0001). The overall rate of early and late complications with the two products was similar. Duration of maintenance of aesthetic effect between products also showed similarity. Optimum aesthetic effect was maintained in most cases for over 9 months with both products but patients in the 30-50-year age group did better. The patient acceptability rate was much higher with UJU. CONCLUSION Clinical data from this study suggest that performance and outcomes of treatment of medium-to-deep nasolabial folds with UJ and UJU are quite similar. However, treatment with UJU offers enhanced patient comfort and is preferred by patients and injectors. LEVEL OF EVIDENCE I 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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Affiliation(s)
- Peeyush P Sharma
- William Harvey Hospital, Ashford, Kent, England, UK.
- , 28-29 Maxwell Road, Peterborough, Cambridgeshire, UK.
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Moon KC, Lee HS, Han SK, Chung HY. Correcting Nasojugal Groove with Autologous Cultured Fibroblast Injection: A Pilot Study. Aesthetic Plast Surg 2018; 42:815-824. [PMID: 29273929 DOI: 10.1007/s00266-017-1044-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 11/26/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND A new commercial drug that contains autologous cultured fibroblasts has been developed and approved by the United States Food and Drug Administration for improving the appearance of nasolabial folds. However, the treatment requires three sessions every 3-6 weeks. It is known that the skin overlying the nasojugal groove is thinner, and the wrinkle is generally shallower than nasolabial folds. Therefore, we hypothesized that the nasojugal groove could be improved by just one treatment session. Therefore, the purpose of this study was to evaluate the efficacy and safety of autologous cultured fibroblast injection to correct nasojugal grooves. METHODS Forty-six subjects with nasojugal grooves were enrolled in this study. They were injected with autologous cultured fibroblasts or placebo in one session. Blinded evaluators and subjects assessed the efficacy using a validated wrinkle assessment scale at 4, 12, and 24 weeks after the injection. Information of adverse events was collected at each visit. RESULTS Based on the evaluators' assessment at 24 weeks after the injection, 76% of subjects treated with autologous cultured fibroblasts showed improvement whereas 0% of subjects treated with placebo showed improvement (P < 0.0001). Based on self-assessment at 24 weeks after the injection, 72% of subjects treated with autologous cultured fibroblasts and 45% of subjects treated with placebo showed improvement (P = 0.0662). There were no serious adverse events related to autologous cultured fibroblast injection. CONCLUSIONS Autologous cultured fibroblast injection might be effective and safe to correct nasojugal grooves. LEVEL OF EVIDENCE I 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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Affiliation(s)
- Kyung-Chul Moon
- Department of Plastic Surgery, Korea University Guro Hospital, 148 Guro-Dong, Guro-Ku, Seoul, 152-703, South Korea
| | - Hyun-Su Lee
- Department of Plastic Surgery, Korea University Guro Hospital, 148 Guro-Dong, Guro-Ku, Seoul, 152-703, South Korea
| | - Seung-Kyu Han
- Department of Plastic Surgery, Korea University Guro Hospital, 148 Guro-Dong, Guro-Ku, Seoul, 152-703, South Korea.
| | - Ho-Yun Chung
- Department of Plastic Surgery, Kyungpook National University School of Medicine, 130 Dongduck-Ro, Jung-Ku, Daegu, South Korea
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Liu D, Chow P, Strawn S, Rajpara A, Wang T, Aires D. Chronic Nasolabial Fold Seborrheic Dermatitis Successfully Controlled With Crisaborole. J Drugs Dermatol 2018; 17:577-578. [PMID: 29742192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Gold MH, Baumann LS, Clark CP, Schlessinger J. A Multicenter, Double-Blinded, Randomized, Split-Face Study of the Safety and Efficacy of a Novel Hyaluronic Acid Gel for the Correction of Nasolabial Folds. J Drugs Dermatol 2018; 17:66-73. [PMID: 29320589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Injectable hyaluronic acid is frequently used to correct volume loss in nasolabial folds. OBJECTIVE To compare the safety and efficacy of a novel hyaluronic acid gel to a non-animal stabilized hyaluronic acid (Comparator) gel for the correction of nasolabial folds (NLF). METHODS Qualified subjects had NLF with a Wrinkle Severity Rating Scale (WSRS) score of 3 or 4 (moderate or severe). NLFs were treated with Test Product on one side of the face and Comparator on the other side of the face (facial side randomly assigned). Improvement from baseline was evaluated at weeks 1, 2, 4, 12, and 24 weeks. The primary study endpoint was the mean change in WSRS score from baseline to week 24. RESULTS The mean changes in WSRS score from baseline were 1.02 ±0.689 for Test Product and 0.91±0.762 for Comparator. The mean difference in change from baseline in WSRS scoring (Comparator minus Test Product) at week 24 was -0.11 (-0.225-0.001, 95% confidence interval [CI]). The upper boundary (0.001) of the 95% CI was less than the prespecified non-inferiority limit of 0.50, indicating that the Test Product was non-inferior to the Comparator. No subject discontinued the study due to adverse events. CONCLUSION The Test Product is safe and non-inferior to the Comparator for the correction of nasolabial folds. The Test Product was associated with less swelling, pain, and overall severity of treatment-emergent adverse events than the Comparator. <p><em>J Drugs Dermatol. 2018;17(1):66-73.</em></p>.
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Gosain AK, Sweeney WM. New Insights into the Anatomy of the Midface Musculature and its Implications on the Nasolabial Fold (Discussion). Aesthetic Plast Surg 2017; 41:1091-1092. [PMID: 28698938 DOI: 10.1007/s00266-017-0939-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 06/28/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Arun K Gosain
- Division of Plastic Surgery, Anne & Robert H. Lurie Children's Hospital Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Division of Pediatric Plastic Surgery, Anne & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 93, Chicago, IL, 60611, USA.
| | - Walter M Sweeney
- Division of Plastic Surgery, Anne & Robert H. Lurie Children's Hospital Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Savvateeva DM, Svistushkin VM, Godzhyan ZT. [The nasolabial cyst]. Vestn Otorinolaringol 2017; 82:65-67. [PMID: 28252595 DOI: 10.17116/otorino201782165-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The authors present the clinical observation of the nasolabial cyst together with the concise overview of the relevant literature and terminology, etiology and pathogenesis of this condition.
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Affiliation(s)
- D M Savvateeva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia, 119991
| | - V M Svistushkin
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia, 119991
| | - Zh T Godzhyan
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia, 119991
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Cameli N, Mariano M, Serio M, Berardesca E. Clinical and instrumental evaluation of a cross-linked hyaluronic acid filler dermal injection: effects on nasolabial folds skin biophysical parameters and augmentation from a single-dose, monocentric, open-label trial. GIORN ITAL DERMAT V 2016; 151:507-514. [PMID: 27139014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND When a hyaluronic acid dermal device to fill soft tissues is chosen, efficacy, safety and durability are key concerns. This is an open-label prospective study to instrumentally evaluate the effects of HA filler dermal injection on nasolabial folds skin biophysical parameters and augmentation. METHODS A single Italian site treated female subjects aged 40-55, for nasolabial folds, with a single standardized injection. The outcome was evaluated with objective quantitative measurements after 90 (T1) and 180 days (T2) from the injection comparing to baseline (T0) by means of Corneometer (skin hydration measurement), Cutometer (skin elasticity measurement), and Visioface devices for digital and UV computerized image analysis. Secondary endpoints were safety assessment, subject investigator satisfaction with the intervention. Assessment of aesthetic results included photographic documentation. RESULTS The computerized image analysis confirmed the clinical assessment showing statistically significant reduction in nasolabial folds both at T1 and T2. Visioface® indexes showed a marked and statistical significant response. An excellent profile of satisfaction of the product at T2 from investigators and patients was recorded. Skin hydration and elasticity did not show significant changes. CONCLUSIONS In our study, a standardized HA filler dermal injection on nasolabial folds did not influence skin biophysical parameters such as skin hydration and elasticity. Nasolabial folds showed a persistent and significative response at T2 confirmed by instrumental evaluation. The tolerability and safety profile of the product was excellent.
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Affiliation(s)
- Norma Cameli
- Department of Dermatology, San Gallicano Institute IRCCS, Rome, Italy -
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Shi XH, Zhou X, Zhang YM, Lei ZY, Liu T, Fan DL. Complications from Nasolabial Fold Injection of Calcium Hydroxylapatite for Facial Soft-Tissue Augmentation: A Systematic Review and Meta-Analysis. Aesthet Surg J 2016; 36:712-7. [PMID: 27178901 DOI: 10.1093/asj/sjv206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite its increasing usage of facial applications, there is a paucity of objective data regarding calcium hydroxylapatite (CaHA). OBJECTIVES To systematically evaluate the complications from CaHA injection for facial soft tissue augmentation. METHODS Published studies on CaHA injection for facial soft tissue enhancement were identified through searches of the PubMed, EMBASE, and Cochrane Controlled Trial databases. Only randomized, controlled trials comparing CaHA injection to either placebo or an active comparator for facial cosmetic use were included. The outcome measures were the count (n) and frequency (%) of each complication, including edema (swelling), erythema (redness), ecchymosis (bruising), pain, pruritus (itching), hematomas, nodules, and extrusions. RESULTS Four studies on nasolabial fold (NLF) injection of CaHA consisting of two subgroups were included: (i) a CaHA-lidocaine vs CaHA subgroup and (ii) a CaHA vs hyaluronic acid (HA) subgroup. The addition of lidocaine to CaHA therapy displayed no significant effect on edema (RR (95% CI): 1.07 (0.94-1.21), P = .311), erythema (RR (95% CI): 0.91 (0.66-1.24), P = .544), ecchymosis (RR (95% CI): 1.04 (0.71-1.52), P = .843), pain (RR (95% CI): 0.88 (0.58-1.33), P = .553), or pruritus (RR (95% CI): 0.82 (0.45-1.50), P = .515). There was no significant difference between CaHA vs HA for hematomas (RR (95% CI): 0.24 (0.01-4.31), P = .332) or nodules (RR (95% CI): 0.18 (0.01-6.62), P = .353). There was no significant publication bias detected in either subgroup (Begg's test P > 0.05). CONCLUSIONS These findings support the addition of lidocaine to NLF injection of CaHA and suggest an equivalence between CaHA and HA with respect to hematoma and nodule formation. LEVEL OF EVIDENCE 2: Risk.
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Affiliation(s)
- Xiao-Hua Shi
- From the Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Xin Zhou
- From the Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Yi-Ming Zhang
- From the Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Ze-Yuan Lei
- From the Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Ting Liu
- From the Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Dong-Li Fan
- From the Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
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Wu Y, Sun N, Xu Y, Liu H, Zhong S, Chen L, Li D. Clinical comparison between two hyaluronic acid-derived fillers in the treatment of nasolabial folds in Chinese subjects: BioHyalux versus Restylane. Arch Dermatol Res 2016; 308:145-51. [PMID: 26924549 DOI: 10.1007/s00403-016-1630-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 01/15/2016] [Accepted: 02/09/2016] [Indexed: 11/27/2022]
Abstract
Hyaluronic acid fillers are used to improve the appearance of nasolabial folds (NLF). This study aimed to compare the efficacy, safety, and durability of a new hyaluronic acid gel (BioHyalux) versus Restylane for the correction of NLF. This was a multicenter, double-blinded, randomized, controlled, non-inferiority clinical trial involving 88 subjects with moderate to severe NLF. Subjects were randomized to BioHyalux and Restylane on either sides of the NLF. NLF was assessed before and right after injection, and at 1 week, 1, 3, and 6 months. Patients were followed up for 13-15 months to evaluate the durability and long-term safety. A clinically meaningful response was predefined as at least one-point improvement on the Wrinkle Severity Rating Scale, which is a five-point scale. At 6 months, the response rate of BioHyalux was not inferior to that of Restylane (P < 0.05). At the 13-15 months follow-up, the response rate by investigators was 58.0 % on the BioHyalux side versus 63.8 % on the Restylane side. The response rate by subjects showed similar results, which was 56.5 % on the BioHyalux side versus 60.9 % on the Restylane side at 13-15 months. The subjects' Global Aesthetic Improvement Scale (GAIS) showed that most subjects felt improvements on both sides of NLF (P > 0.05) at all time points. At 6 months, 100 % reported improvements on both side; at 13-15 months, 60 % of subjects reported improvements with BioHyalux versus 64 % with Restylane. Adverse events were transient and predominantly mild or moderate in severity including injection site swelling, pain, itching, bruising, and tenderness. BioHyalux had reliable safety and tolerance, and could be an effective injectable filler for correcting NLF.
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Affiliation(s)
- Yan Wu
- Department of Dermatology, Peking University First Hospital, Beijing, 100034, China
| | - Nan Sun
- Department of Dermatology, Peking University First Hospital, Beijing, 100034, China
| | - Yue Xu
- Department of Dermatology, Peking University First Hospital, Beijing, 100034, China
| | - Huixian Liu
- Department of Dermatology, Peking University First Hospital, Beijing, 100034, China
| | - Shaomin Zhong
- Department of Dermatology, Peking University First Hospital, Beijing, 100034, China
| | - Liyang Chen
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Dong Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, 100191, China.
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Wu Y, Xu J, Jia Y, Murphy DK. Safety and Effectiveness of Hyaluronic Acid Injectable Gel in Correcting Moderate Nasolabial Folds in Chinese Subjects. J Drugs Dermatol 2016; 15:70-76. [PMID: 26741384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The hyaluronic acid (HA) dermal filler, Juvéderm® Ultra, which employs Hylacross® technology, produces a gel with a smooth consistency and has demonstrated effectiveness in correcting nasolabial folds (NLFs) in Caucasian populations. OBJECTIVE To evaluate the safety and effectiveness of Juvéderm Ultra vs Restylane® for the correction of moderate NLFs in Chinese subjects. METHODS In this double-blind randomized study, adult Chinese subjects with moderate NLFs received Juvéderm Ultra (24 mg/mL) in 1 NLF and Restylane injectable gel (20 mg/mL) in the other NLF. NLFs were evaluated using the validated 5-point photonumeric Allergan NLF Severity Scale (NLFSS); scores ranged from 0 ("no wrinkle") to 4 ("very deep wrinkle"). Response was defined as ≥1-point improvement at 6 months. Investigator-assessed responder rate (primary outcome), NLF mean improvement, and subject-assessed responder rate and preference were assessed. RESULTS Among the 104 subjects who completed the study, median initial volumes (mL) were 0.8 (range, 0.2-1.4) for Juvéderm Ultra and 0.8 (0.3-1.5) for Restylane; median touch-up volumes were 0.3 (0.1-0.5) and 0.3 (0.1-0.5), respectively. At 6 months, investigator-assessed responder rates were 87.3% for both products, indicating that Juvéderm Ultra was noninferior to Restylane; mean improvement in NLFSS scores from baseline was 1.0 for both products. At 6 months, Juvéderm Ultra and Restylane subject-assessed responder rates were 86.3% and 79.4%, respectively, and mean improvement in NLFSS scores from baseline was 1.2 and 1.0, respectively. Among subjects who expressed a preference, 57.9% preferred Juvéderm Ultra. For both products, the most commonly reported treatment site responses were swelling, firmness, and tenderness; treatment site responses were generally mild or moderate in severity. Juvéderm Ultra had fewer severe responses than Restylane. CONCLUSIONS Juvéderm Ultra is noninferior to Restylane and is a safe and effective treatment for correcting moderate NLFs in Chinese subjects.
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Choi WJ, Han SW, Kim JE, Kim HW, Kim MB, Kang H. The Efficacy and Safety of Lidocaine-Containing Hyaluronic Acid Dermal Filler for Treatment of Nasolabial Folds: A Multicenter, Randomized Clinical Study. Aesthetic Plast Surg 2015; 39:953-62. [PMID: 26493557 DOI: 10.1007/s00266-015-0571-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 10/01/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of injectable hyaluronic acid-based gel is well established in aesthetic facial procedures especially on the nasolabial fold (NLF). OBJECTIVE To compare the efficacy and safety of PP-501-A-Lidocaine dermal filler with RestylaneLidocaine(®) when administered to the NLF. METHODS Sixty-six subjects seeking correction of NLFs, with moderate or severe wrinkle severity, were recruited for this multicenter, randomized, patient and evaluator-blind, matched pairs, and active-controlled design clinical study. PP-501-A-Lidocaine and RestylaneLidocaine(®) were injected into the deep layer of the dermis and/or subcutis of the NLF. The first validity evaluation variable was the average wrinkle severity rating scale (WSRS), as scored by independent blinded evaluators at week 24. The second validity evaluation variable including the global aesthetic improvement scale (GAIS), the WSRS, and adverse event reporting at weeks 8, 16, and 24 were also performed. RESULTS The mean improvement in the WSRS from baseline was 1.58 ± 0.68 for the PP-501-A-Lidocaine and 1.51 ± 0.66 for the RestylaneLidocaine(®) at week 24. The average value at week 8 after the final application was 1.62 ± 0.78 and 1.60 ± 0.75 in parts subject to PP-501-A-Lidocaine and RestylaneLidocaine(®), respectively, and 1.58 ± 0.70 and 1.57 ± 0.68 at week 16, respectively. Both improvement and duration of the treatment effect were similar between the two groups. GAIS data rated by the treating investigator and participants showed no statistically significant differences. Both fillers were well tolerated and adverse reactions were mild and transient in most cases. CONCLUSION PP-501-A-Lidocaine showed an equivalent efficacy and safety observed after 6 months of follow-up compared to RestylaneLidocaine(®). LEVEL OF EVIDENCE I 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 Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Won Joon Choi
- Department of Dermatology, St. Paul Hospital, College of Medicine, The Catholic University of Korea, 180 Wangsan-ro Dongdaemun-gu, 130-709, Seoul, Korea
| | - Seung Won Han
- Department of Dermatology, St. Paul Hospital, College of Medicine, The Catholic University of Korea, 180 Wangsan-ro Dongdaemun-gu, 130-709, Seoul, Korea
| | - Jung Eun Kim
- Department of Dermatology, St. Paul Hospital, College of Medicine, The Catholic University of Korea, 180 Wangsan-ro Dongdaemun-gu, 130-709, Seoul, Korea
| | - Hye Won Kim
- Department of Dermatology, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University of Korea, Seoul, Korea
| | - Moon Beom Kim
- Department of Dermatology, Pusan National University Hospital, College of Medicine, Pusan National University, Pusan, Korea
| | - Hoon Kang
- Department of Dermatology, St. Paul Hospital, College of Medicine, The Catholic University of Korea, 180 Wangsan-ro Dongdaemun-gu, 130-709, Seoul, Korea.
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Biesman BS, Bowe WP. Effect of Midfacial Volume Augmentation With Non Animal Stabilized Hyaluronic Acid on the Nasolabial Fold and Global Aethestic Appearance. J Drugs Dermatol 2015; 14:943-947. [PMID: 26355611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Non animal stabilized hyaluronic acid (Perlane, Galderma, SA) was FDA approved in 2007 for the treatment of facial wrinkles and folds. Off-label use led to the observation that injection of Perlane in the midface improved both global aesthetic appearance and reduced the depth of nasolabial folds. A proof-of-concept trial was undertaken to explore this clinical observation further. METHODS Twenty subjects with moderate midfacial volume loss and prominence of nasolabial folds underwent injection of the midface with Perlane between May and July, 2009. The average volume administered was 3.68 +/- 0.55 ml. Assessments were performed by the injecting physician and subject self-assessment for 6 months following treatment. RESULTS 17 of 20 subjects completed all study visits. At the 6-month follow up visit 16 of 17 subjects were found to have clinically significant improvement of the midface and 14 of 17 subjects were found to have clinically significant improvement of the nasolabial folds. No serious adverse events occurred. CONCLUSION In this early stage, proof-of-concept trial, the majority of patients treated demonstrated clinically significant, aesthetically pleasing improvement 6 months after injection of Perlane in the midface.
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Sagiroglu SG, Guler SA. Giant nasolabial cyst. J PAK MED ASSOC 2014; 64:1320-1321. [PMID: 25831657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Nasolabial (nasoalveolar) cysts are nonodontogenic soft tissue lesions derived from epithelial remanant of the nasolacrimal duct. These are generally slow-growing painless lesions. Additionally, they can cause obstruction, facial deformity and pain. This case report evaluates the facial deformity and boat-shaped resorption demonstrated on computerized tomography (CT) in a 28 years-old patient presenting with facial swelling and pain as a result of a nasolabial cyst. Nasolabial cysts must be kept in mind in patients suffering from facial deformity and infection as an underlying predisposing factor. Recurrences may be seen in cases not amenable to treatment by surgical excision.
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Mally P, Czyz CN, Chan NJ, Wulc AE. Vibration anesthesia for the reduction of pain with facial dermal filler injections. Aesthetic Plast Surg 2014; 38:413-8. [PMID: 24464122 DOI: 10.1007/s00266-013-0264-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 12/09/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Vibration anesthesia is an effective pain-reduction technique for facial cosmetic injections. The analgesic effect of this method was tested in this study during facial dermal filler injections. The study aimed to evaluate the safety and efficacy of vibration anesthesia for these facial injections. METHODS This prospective study analyzed 41 patients who received dermal filler injections to the nasolabial folds, tear troughs, cheeks, and other facial sites. The injections were administered in a randomly assigned split-face design. One side of the patient's face received vibration together with dermal filler injections, whereas the other side received dermal filler injections alone. The patients completed a posttreatment questionnaire pertaining to injection pain, adverse effects, and preference for vibration with future dermal filler injections. RESULTS The patients experienced both clinically and statistically significant pain reduction when a vibration stimulus was co-administered with the dermal filler injections. No adverse events were reported. The majority of the patients (95 %) reported a preference for vibration anesthesia with subsequent dermal filler injections. CONCLUSIONS Vibration is a safe and effective method of achieving anesthesia during facial dermal filler injections. 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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Affiliation(s)
- Pooja Mally
- Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, PA, USA
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Lee SK, Kim HS. Recent trend in the choice of fillers and injection techniques in Asia: a questionnaire study based on expert opinion. J Drugs Dermatol 2014; 13:24-31. [PMID: 24385116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND With recognition of the value of volume enhancement in achieving a more youthful appearance, there has been concomitant explosion in the soft tissue filler market. Given the vast array of filler products and techniques currently available, choosing the right product and technique can be overwhelming to those with little experience. OBJECTIVE To evaluate the recent trend in the choice of fillers and injection techniques among leading dermatologists in Asia and offer guidance to those who practice facial fillers. METHODS A panel of dermatologists, who are recognized as filler experts and key speakers in Korea were asked to fill out an in-depth questionnaire on fillers in 2012. The results of the 2012 questionnaire are presented and compared with the questionnaire results of the exact same group of doctors in 2011. RESULTS Those who participated in the questionnaire study practiced fillers for an average of 10.6 years with an average of 32.8 filler cases per week. Common indications for filler injection were midface augmentation and nose augmentation. Indications that most drastically increased between 2011 and 2012 were midface and forehead augmentation. For the nasolabial folds, the most preferred choice of filler product, needle, injection technique and injection depth was Radiesse®, 27G short needle, Layering technique and the Upper subcutaneous fat layer. For filler rhinoplasty, the preferred choices were Radiesse®, 27G short needle, Linear threading technique and the Mid-deep fatty layer. For dark circles, the favored choices were Esthelis Basic®, 30G short needle, Vertical technique and the SOOF (suborbicularis oculi fat) layer. For forehead augmentation, the most favored choices were Juvederm Voluma®, 23G cannula, Linear threading technique and Fanning and the Supraperiosteal layer. The physicians' satisfaction score for the nasolabial folds, filler rhinoplasty, dark circles and forehead augmentation was 71.5, 90, 84.5 and 87 respectively. CONCLUSION On general, filler experts preferred fillers with relatively high visco-elasticity for the nasolabial folds, nose augmentation and forehead augmentation but chose fillers with low visco-elasticity for dark circles. Linear treading technique (with or without fanning) was universally popular but Vertical injection was considered more useful for dark circles and the nasal tip.
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Farris PK, Edison BL, Weinkauf RL, Green BA. A novel, volumizing cosmetic formulation significantly improves the appearance of target Glabellar lines, nasolabial folds, and crow's feet in a double-blind, vehicle-controlled clinical trial. J Drugs Dermatol 2014; 13:41-46. [PMID: 24385118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Facial lines and wrinkles are caused by many factors including constant exposure to external elements, such as UV rays, as well as the dynamic nature of facial expression. Many cosmetic products and procedures provide global improvement to aging skin, whereas injectable therapies are frequently utilized to diminish specific, target wrinkles. Despite their broad availability, some patients are unwilling to undergo injectables and would benefit from an effective topical option. A noninvasive option to volumize target wrinkle areas could also extend benefits of commonly used cosmetic anti-aging products. To this end, a two-step formulation containing the novel, cosmetic anti-aging ingredient, N-acetyl tyrosinamide, was developed for use on targeted wrinkle areas. The tolerability and efficacy of the serum plus cream were tested for 16 weeks in women with moderate facial photodamage on predetermined wrinkle areas (glabellar lines, nasolabial folds, under eye lines, and lateral canthal (crow's feet) wrinkles) in a single-center, randomized, double-blind, vehicle-controlled, clinical trial. Seventy women (47 Active group, 23 Vehicle group) completed the study. Digital photography, clinical grading, ultrasound and self-assessment scores confirmed improvement to wrinkle areas. The topical cosmetic formulation was statistically superior (P<0.05) to its vehicle in visually improving nasolabial folds, glabellar lines, crow's feet, and under eye wrinkles and in reducing pinch recoil time. Both the test formulation and its vehicle were tolerated well. The novel, two-step cosmetic formulation reduced the appearance of wrinkles and increased skin elasticity thus providing an effective anti-aging option for target wrinkle areas. This study suggests that in addition to its use as monotherapy for reducing targeted lines and wrinkles this cosmetic formulation may be also serve as an adjuvant to injectable therapies.
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McGuire LK, Hale EK, Godwin LS. Post-filler vascular occlusion: a cautionary tale and emphasis for early intervention. J Drugs Dermatol 2013; 12:1181-1183. [PMID: 24085057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We report a case of a 36-year-old female who experienced significant vascular occlusion after injection with hyaluronic acid into the nasolabial folds. The patient experienced immediate pain after the injection, however, the vascular compromise was not diagnosed and treated until 48 hours later. The patient suffered tissue damage despite treatment with hyaluronidase, hyperbaric oxygen, nitropaste, and aspirin. The case highlights the importance of proper injection technique by a qualified physician, as well as the need for immediate recognition and treatment of vascular occlusion should it occur.
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Abstract
BACKGROUND A device to assist in the delivery of dermal filler may achieve reductions in patient discomfort and adverse events, as well physician fatigue. It may also increase the accuracy of material placement. OBJECTIVES The authors assess the safety and performance of the Artiste Assisted Injection System (Nordson Micromedics, St Paul, Minnesota) in normal therapeutic use compared with the standard manual administration of dermal fillers. METHODS At 3 study sites, a total of 52 patients (48 women and 4 men) received bilateral full-correction injections of dermal fillers into randomized nasolabial folds (NLF). Injection into 1 NLF was made via Artiste, and injection into the other NLF was made via manual delivery. Immediately posttreatment and through 29 days, physician investigators, patients, and blinded evaluators recorded treatment durations and volumes, evaluated designated posttreatment characteristics using questionnaires, and documented adverse events (AE) and differences in cosmetic effects. RESULTS Mean filler volume was 1.25 mL for the Artiste-treated NLF and 1.29 mL for manually treated NLF. One investigator used significantly less volume with Artiste than with manual injection (0.95 mL vs 1.12 mL; P = .001). Blinded evaluators rated Wrinkle Severity Rating Scale (WSRS) results as "identical" in 81% of patients. Investigator questionnaires showed a clear and statistically significant preference for Artiste over manual injection in all parameters (P < .001). CONCLUSIONS The Artiste device is a viable option for physicians seeking a continuous-flow, injection-assisted device for ease of treatment, better accuracy, and improved results.
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Affiliation(s)
- Z Paul Lorenc
- Lorenc Aesthetic Plastic Surgery Center, 983 Park Ave, New York, NY 10028, USA.
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Royo de la Torre J, Moreno-Moraga J, Isarría MJ, Muñoz E, Cruz I, Pérez G, Cornejo P. The evaluation of hyaluronic acid, with and without lidocaine, in the filling of nasolabial folds as measured by ultrastructural changes and pain management. J Drugs Dermatol 2013; 12:e46-e52. [PMID: 23545926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Pain management is an important objective in procedures involving dermal fillers composed of hyaluronic acid (HA). OBJECTIVE To compare the 1-year clinical results of filling the nasolabial fold with 2 types of filler: large-gel particle HA and large-gel particle HA plus 0.3% lidocaine (HA+L). We compared the level of pain during treatment and 10 minutes after treatment and assessed the safety and efficacy profile, satisfaction, and histological findings (using reflectance confocal microscopy [RCM]). MATERIALS AND METHODS We performed a comparative, parallel-group, double-blind trial with an external observer (blinded to the type of treatment administered). The filler was applied to the nasolabial fold in 119 patients (HA in 62 patients and HA+L in 57). Patients were followed at months 3, 9, and 12. Pain was evaluated using a visual analog scale. Efficacy and satisfaction were evaluated using the Wrinkle Severity Rating Scale and the Global Aesthetic Improvement Scale. RCM images (n=32) were taken at baseline and at months 3 and 12. RESULTS Pain: The severity of pain was decreased in patients treated with HA+L on application (P <.001) and 10 minutes later ( P=.008). Efficacy and satisfaction: No significant differences existed between the 2 groups at months 3, 9, and 12. RCM: Skin rejuvenation occurred with a 32% increase in the height of the dermoepidermal junction at month 12 (P <.001), which was similar in both groups. Adverse events: At month 3, the most common adverse events (AEs) were erythema (68%) and hematoma (11%). No AEs were recorded at months 9 or 12. CONCLUSION The use of HA+L provides pain relief without affecting efficacy, satisfaction, safety, or the duration of results. RCM showed that the changes in the dermoepidermal junction represented a histological improvement in the skin with similar results in both groups.
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Hallam MJ, Nduka C. The modified scar approach for young patients undergoing lengthening temporalis myoplasty. J Plast Reconstr Aesthet Surg 2012; 65:1752-3. [PMID: 22884680 DOI: 10.1016/j.bjps.2012.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 07/27/2012] [Indexed: 11/17/2022]
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KAUFMAN WH. Dermatitis of the nasolabial folds, an unusual skin disorder. Va Med Mon (1918) 1963; 90:275-6. [PMID: 14031393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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LEIMSNER K. [Carcinoma in the region of the nasolabial fold in an infant]. HNO 1953; 4:49-51. [PMID: 13128496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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