Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

Background: Often ignored, hands are one of the most telltale signs of aging. This prospective study was initiated to evaluate the effect of subcutaneous hyaluronic acid (HA) injections in aging hands, with special attention to complications and long-term outcomes. Methods: Between January 2010 and December 2010, a total of 38 patients with skin phototypes II-IV and between 58 and 76years old were treated with HA injection for aging hands. The quantity of injection never exceeded 1.0-1.5ml HA per hand. A clinical follow-up was performed at 2weeks, 4weeks, 3months, and 6months after injection. Complications were reviewed for the whole series. At the first follow-up, 2weeks after the procedure, ultrasound was carried out to determine if additional filling material was required. At each follow-up, patients were asked to fill out a satisfaction questionnaire. Results: Nine patients developed slight ecchymosis that disappeared after 1week. No other complications were seen in the series. Pain during the injection and discomfort after the procedure were minimal. At the 2-week follow-up, after ultrasound control, nine patients received a complementary injection. At each follow-up, overall patient satisfaction was high and was validated by clearance of rhytids, veins, bony prominences, and dermal and subcutaneous atrophy. Conclusion: Skin revitalization with injectable HA can improve the clinical appearance of the back of the hands. However, this therapy requires knowledge of the possible complications and their remediation as well as knowledge and respect of injected doses. Moreover, despite excellent results at each follow-up, the results of our series are not as good after 6months, and a longer follow-up would be needed to determine if this procedure provides long-lasting benefit. Level of Evidence III: 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/0026

Lipólisis láser y liposucción en ginecomastia: retracción cutánea eficaz y segura Laser-assisted lipolysis for gynecomastia: safe and effective skin retraction

OBJETIVO: Valorar la eficacia de la lipólisis-láser para corregir el volumen, flacidez y excedente cutáneo sin escisión. MÉTODOS: Prospectivamente, en 32 pacientes con ginecomastia, bajo anestesia tumescente y sedación se realizó lipólisis con láser de diodo 980nm, 15W en emisión continua, 8kJ a 12kJ de energía por mama. Externamente se utilizó aire frío para protección de la piel. Después se utilizó lipoaspiración convencional. No se emplearon drenajes pero si vendaje compresivo. Los pacientes evaluaron los resultados en una escala visual analógica. Dos médicos evaluaron los resultados por fotografías de antes y seis meses después, y midieron las areolas y contorno torácico. RESULTADOS: Veintitrés pacientes consideraron los resultados como Muy Bueno, siete Bueno y dos Regular. La retracción cutánea en la areola fue notable un mes después de la intervención y fue máxima a los seis meses. La valoración de los médicos fue 26 Muy Bueno, cinco Bueno y un Regular. No existieron quemaduras, isquemia, ni lesiones en areolas o pezón. CONCLUSIÓN: La liposucción asistida por láser es eficaz y de ejecución sencilla, poco traumática y permite una temprana reintegración a las actividades.OBJECTIVES: To evaluate efficacy of laser lipolysis in the treatment of gynecomastia to correct breast volume, flaccidity and excess skin without its excision. METHODS: Prospectively, 32 patients with gynecomastia under tumescent anaesthesia and sedation underwent laser lipolysis with 980nm diode laser, 15W continuous emission and 8 to 12 kJ energy per breast. Externally cold air was used to protect the skin. No drainages were used but a compressive bandage. Patients evaluated results on a VAS scale. Two doctors evaluated results comparing before and 6 month after photographs and also measured the areola and chest diameter. RESULTS: Twenty three patients considered results as Very Good, 7 Good and 2 Fair Cutaneous retraction of the areola was noticeable one month after the surgery and was maximum 6 months after. Evaluation by doctors was 26 Very Good, 5 Good and 1 Fair. There were no burns, ischemia or lesions in areolas or nipples. CONCLUSION: Laser assisted liposuction is a simple and efficacious technique, barely traumatic and permits a rapid reincorporation to normal activitie

Valoración clínica e histológica de resultados de una tecnología innovadora de láser Erbio: YAG para rejuvenecimiento facial

Resumen Introducción y Objetivo En los últimos años existe un creciente interés en el empleo de tecnología láser parcialmente ablativa en el rejuvenecimiento facial. Entre los láseres desarrollados con esta finalidad, el de Erbio:YAG acoplado a un sistema de ablación espacial modulada (RecoSMA®, Linline, Minsk, Bielorrusia) merece atención porque cambia el tradicional depósito térmico del láser por un fenómeno de empuje mecánico. Nuestro objetivo fue determinar la eficacia y seguridad de un nuevo método de rejuvenecimiento facial que emplea un láser de Erbio:YAG acoplado al sistema RecoSMA®. Material y Método Estudiamos 26 mujeres, con fototipos II a V y signos de envejecimiento facial entre moderados y severos en relación con su edad cronológica. Todas se sometieron a 2 sesiones de tratamiento separadas por 3 semanas. En cada sesión tratamos la totalidad de la cara. Tomamos fotografías y biopsias antes del primer tratamiento y 3 y 6 meses después del segundo. Evaluamos la eficacia clínica, tolerancia, efectos adversos, complicaciones y cambios clínicos e histológicos. Resultados Las líneas finas, arrugas y las características del envejecimiento facial global mejoraron de forma significativa (p< 0.0001). La media de mejoría de líneas finas y arugas en ambos grupos fue de 66,4 ± 9,4 (r= 45-85). La media de mejoría del envejecimiento global en ambos grupos (A+B) fue de 76.2% ± 6.2 (r = 60 - 85%) a los 3 meses, y de 59.4% ± 9.6 (r= 40 -75%) a los 6 meses. Mostramos a todas las pacientes fotografías comparativas de antes y después del tratamiento, y el 85% manifestaron estar satisfechas o muy satisfechas con los resultados. Vimos también que los resultados obtenidos a los 3 meses disminuían en la evaluación a los 6 meses, con un 62% de pacientes satisfechos. Conclusiones El perfil eficacia-seguridad fue muy satisfactorio con ventajas adicionales respecto a otros láseres empleados para el rejuvenecimiento facial. Hay que tener en cuenta la disminución de resultados a los 6 meses para indicar sesiones adicionales, aunque debe advertirse previamente a los pacientes

Nonanimal stabilized hyaluronic acid for tissue augmentation of the dorsal hands: a prospective study on 38 patients

BACKGROUND Often ignored, hands are one of the most telltale signs of aging. This prospective study was initiated to evaluate the effect of subcutaneous hyaluronic acid (HA) injections in aging hands, with special attention to complications and long-term outcomes. METHODS Between January 2010 and December 2010, a total of 38 patients with skin phototypes II-IV and between 58 and 76 years old were treated with HA injection for aging hands. The quantity of injection never exceeded 1.0-1.5 ml HA per hand. A clinical follow-up was performed at 2 weeks, 4 weeks, 3 months, and 6 months after injection. Complications were reviewed for the whole series. At the first follow-up, 2 weeks after the procedure, ultrasound was carried out to determine if additional filling material was required. At each follow-up, patients were asked to fill out a satisfaction questionnaire. RESULTS Nine patients developed slight ecchymosis that disappeared after 1 week. No other complications were seen in the series. Pain during the injection and discomfort after the procedure were minimal. At the 2-week follow-up, after ultrasound control, nine patients received a complementary injection. At each follow-up, overall patient satisfaction was high and was validated by clearance of rhytids, veins, bony prominences, and dermal and subcutaneous atrophy. CONCLUSION Skin revitalization with injectable HA can improve the clinical appearance of the back of the hands. However, this therapy requires knowledge of the possible complications and their remediation as well as knowledge and respect of injected doses. Moreover, despite excellent results at each follow-up, the results of our series are not as good after 6 months, and a longer follow-up would be needed to determine if this procedure provides long-lasting benefit. LEVEL OF EVIDENCE III 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