Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

Background: The eyebrow area is a clinically critical district due to the anatomical complexity and the propensity to aging-related atrophy. Hyaluronic acid fillers have been proposed to recover the dermal volume of the facial and lips regions. Aim: The aim of the present investigation was to evaluate hyaluronic acid fillers enriched with glycine and proline for the treatment of eyebrow augmentation. Methods: A total of 15 healthy patients were treated with eyebrow augmentation procedure. The distance between mid-bipupil to lateral eyebrow and mid-eyebrow to the medial eyebrow was measured before, immediately after treatment and at follow-up of 6 months. Results: The healing period was uneventful, and no evidence of inflammation or swelling associated with the treatment was reported. No macroscopical alteration was reported in the surrounding tissues with no evidences of visible wheals or lumps in the treated sites at the follow-up. Before treatment, the angle was equal to 9.32 ± 0.2°, while after treatment it was 11.21 ± 0.4° (p < 0.01); after three and 6 weeks, it was, respectively, 10.66 ± 0.2° (p<0.05) and 10.02 ± 0.3°(p > 0.05). Conclusions: The study results suggest that the hyaluronic acid fillers enriched with glycine and proline treatment resulted as being a useful procedure for augmentation, contour and volume definition and elevation of the eyebrow region with a high-level aesthetic result

Static Crow’s Feet Treated with Voltaic Arc Dermabrasion (Atmospheric Plasma): Post-Operative Pain Assessment by Thermal Infrared Imaging

Background: In the literature, several strategies have been described for the treatment of unaesthetic marks on the face resulting from the aging processes. The atmospheric plasma procedure is a non-invasive, inexpensive technique proposed for the rejuvenation of facial tissues. The aim of this study was to evaluate the performance of voltaic arc dermabrasion (VAD) for the treatment of static crow’s feet of the periorbital area. Methods: The crow’s feet of 135 patients (127 female and 8 male) were treated using the VAD technique. The perioperative skin temperature measurement was assessed using an Infrared Temperature sensor. The pain was measured using the Visual Analogic Score (VAS) at 1 week, 1 month and 1 year. The patient’s and surgeon’s satisfaction were assessed using the Global Aesthetic Improvement Scale (GAIS) at 1 month and 1 year from the procedure. The severity of the crow’s feet was rated using the Crow’s Feet Grading Scale (CFGS). Results: A complete epidermal healing of all the subjects treated was evident at 7 days. The atmospheric plasma technique showed an efficient treatment for the removal of the crow’s feet, with a good aesthetic outcome, high surgeon and patient satisfaction, without clinical complications. Conclusions: The atmospheric plasma technique can be a useful modality in the cosmetic as well as therapeutic treatment of crow’s feet

Pilot study of histology aspect of cellulite in seventy patients who differ in BMI and cellulite grading

Cellulite is a topographic alteration of the skin with unknown etiology and is characterized by the presence of a dimpled or puckered aspect, as resembling an orange peel and cottage cheese or as having mattress-like appearance

A new technique for the treatment of nasal telangiectasia using atmospheric plasma (voltaic arc dermabrasion): Postoperative pain assessment by thermal infrared imaging

Nasal telangiectasias are superficial, small vessels in the ala nasi and nasolabial crease with a varying origin. They represent an unaesthetic condition, frustrating patients who frequently request their removal. Microsclerotherapy, electrosurgery, different types of laser therapy, needle-assisted electrocoagulation, and TRASER therapy have been described for treating this condition

Facial anti-aging treatments with soft peeling and microneedling technique

Background: The interest in maintaining a young and attractive appearance in an era with increasingly hectic rhythms has generated a pressing demand for effective aesthetic procedures with the shortest possible recovery period, stimulating the search for non-invasive, yet successful, solutions. The aim of this study was to evaluate the effectiveness of the combined soft peeling and MN technique on the various imperfections typical of facial aging. Methods: This multicentric uncontrolled experimental study recruited a population of healthy subjects of both sexes with advanced signs of photo- and chrono-aging. These subjects were provided with a single session of microneedling and peeling at the same time. Recruited subjects were re-evaluated 30 (\ub14) and 60 (\ub14) days after treatment by photographic comparison before and after treatment. The physicians evaluated the improvement of facial wrinkles according to the Wrinkle Assessment Scale of Lemperle. Forty-nine subjects completed the study and showed a significant improvement in wrinkles in all areas of the face. Results: There were no significant differences in the different subpopulations compared: males\u2013females, Glogau 3\u2013Glogau 4, smokers\u2013non-smokers, phototypes 1\u20134, and check up at 30 days\u2013control at 60 days. The adverse events manifested were localized edema in four cases (8.2%) lasting an average of 3\u20134 days, very fine crustiness in four cases (8.2%), transient post inflammatory dyschromia in two cases (4.1%) lasting 2\u20133 weeks, and herpetic reactivation in one case (2.0%). Conclusions: The study demonstrates the therapeutic efficacy of the combined needling-peeling treatment in different types of wrinkles

A New Treatment for Local Adiposity with Ascorbic Acid and Ascorbyl-Palmitate Solution: Clinical and Histological Study

Background: Localized adiposity (AL) is the accumulation of subcutaneous adipose tissue, placed in definite anatomic areas, building up an alteration of the body silhouette. The aim of the present clinical and histological study is to assess the effectiveness of an injectable solution containing sodium salt of ascorbic acid 0.24% and surfactant agent at 0.020% ascorbyl-palmitate (SAP) for treating local adiposity. Methods: Eighty healthy female adult patients were selected, suffering from local adiposity in the abdominal region. The patients underwent a cycle of 6 sessions, with biweekly treatments, without the addition of any active ingredient. Direct infiltration of pharmacologically active SAP solutions into the adipose tissue with a long needle, very similar to the needles used for spinal anesthesia, was performed. This procedure is quick and painless (does not require any anesthesia) with moderate infiltration speed. Results: All the patients treated showed good results with good satisfaction of the circumferential reductions. Before treatment: Waist (cm) 78.8 \ub1 10.6 and hip 93.6 \ub1 9.0 with WHR 0.84 \ub1 0.07. After treatment: Waist (cm) 70.8 \ub1 9.6 and hip 92.6 \ub1 8.0 with WHR 0.76 \ub1 0.06. Indeed, signs of adipocyte apoptosis were observed in subcutaneous skin after injection of SAP. Conclusion: The results showed in the present study suggest that the SAP utilized induces apoptosis of adipocytes and could be of use as a safe and effective method with which to eliminate subcutaneous abdominal fat. 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

A new treatment for stretch marks and skin ptosis with electromagnetic fields and negative pressure: a clinical and histological study

Stretch marks (SM) are nowadays the most common aesthetic pathology of the body; in the XX century, it mainly affected pregnant women, while today it also affects teenagers during puberty, boys and girls without distinction. The aim of this study was to evaluate possible variations in the histological structure of the skin-in terms of quality/quantity of the extracellular matrix and of the collagen and elastic fibers-following the electromagnetic fields and negative pressure (V-EMF) treatment as regards hypotonia and SMs

Dermal Cosmetic Migration after Lip Augmentation Procedure: Clinical Management and Histological Analysis in a Case Report with Review of the Literature

Lip augmentation procedures have become gradually more popular and common due to cultural tendencies and an increasing association of the appearance of the lips with both beauty and youth. Different dermal fillers have been proposed for lip augmentation—such as collagen, calcium hydroxylapatite, hyaluronic acid, and polylactic acid—which are used as temporary fillers. The present case report describes the histopathologic and clinical management of one case of HA filler migrating into the intraoral cheek, which caused discomfort by intraoral swelling. There is also a review of the relevant literature. A female patient, V.A., 34 years old, smoker, no allergies to drug and food substances, came to our attention. The patient was referred to the Department of Innovative Technology in Medicine and Dentistry of the University “G. D’Annunzio” of Chieti-Pescara in Italy by her dentist for the removal of a mass present in the right cheek. The clinical examination of the patient revealed a single mobile mass mimicking a soft tissue tumor in the right anterior cheek. The mass was palpable and approximately 2 cm long and was causing pain and swelling. The mucosa appeared healthy without ulcers. The filler, which had migrated into the cheek, was removed by reaching it with a scalped blade. The material was stored immediately in 10% buffered formalin and processed for histological analysis. The literature search was carried out in accordance with the criteria of the PICO guidelines. Observed histologically, the filler was surrounded by fibroblasts and a few inflammatory cells and giant cells without granuloma formation. The clinical diagnosis was swelling and discomfort caused by chewing trauma, while the histological examination excluded discomfort due to a foreign body reaction caused by the HA used for a lip augmentation procedure. In conclusion, the high-pressure and high-volume filler injections probably caused a detachment of the tissues, with the orbicularis oris muscle concurrently acting as a pump and moving the HA implant, causing migration to the area with low-density tissue such as the cheek

Morphological description of hypothetical cellulite starting unit. The first step to explain cellulite development

Introduction: Cellulite is a complex pathology that affects about 85% of women. The origin of cellulite is poorly understood, even if some studies describe different hypotheses based on the observation of subcutaneous architecture, vascular and lymphatic patterns. Material and methods: in this work an ultra-structural description of cellulite specimens, harvested from fifteen healthy women affected by first degree cellulite, was provided. Specimens were harvested from trochanter, after local anaesthesia using punch biopsy. Samples were fixated, immediately after biopsy, in glutaraldehyde 2% and processed for electron microscopy. Results: with scanning and transmission electron microscopy it was possible to describe the hypothetical cellulite starting unit, consisting of mature unilocular adipocytes strictly connected with sweat glands. The peculiar structure of this complex was not described in other adipose depots, even if this formations resembled the mammary glands during the pubertal phase in which there is a hormonal influence, leading to breast augmentation. With the ultra-structural and morphological analysis of cellulite specimens it was possible to define the possible role of sweat glands associated with mature adipocytes in the dermis of patients. Sweat glands probably stimulate mature adipocytes and mesenchymal stem cells to cause an increase in adipose tissue. In the case of cellulite the increase in adipose tissue was associated also with the stimulation of fibroblasts with the effect of collagen fibres deposition and with the consequent formation of the typical cellulite morphology. Discussion: understanding cellulite origin might be conducive to developing more specific and accurate treatments and to hypothesize novel prevention strategies

Evaluation of Safe and Effectiveness of an Injectable Solution Acid Deoxycholic Based for Reduction of Localized Adiposities

Background:. The use of deoxycholic acid to reduce localized fat deposits is a procedure that has been in use for about 30 years. Its effectiveness as treatment is due to emulsification of phospholipids and therefore, solubilization of the biological membranes with resulting fat necrosis. The purpose of the study was to assess the effectiveness and the safety of an injectable solution containing sodium deoxycholtate 1.25% (DB125), used as intralipotherapy. Methods:. The effectiveness and safety of DB125 solution have been assessed with a multicentre observational prospective study carried out between February and October 2017. The 221 selected patients presented with various forms and degrees of localized fat in several areas. Intralipotherapy treatments were performed 6 weeks apart and until the clinical result was obtained. Aesthetic outcomes were evaluated by the authors using preoperative and postoperative photographic documentation and by the patients with their level of satisfaction by filling out an anonymous form. Major adverse events were reported by each doctor who performed the treatment. Results:. Two hundred twenty-one patients treated in 273 cases of different localized fat deposits. One hundred eighty-five patients who could be assessed for final results gave the effectiveness of the treatment an average score of 7.4. The failure percentage of the treatment was 3.8%. The medical evaluation showed treatment success in 93.5% of cases. Adverse events can be divided into 2 groups: minor adverse events, which are very frequent and major ones, which are extremely rare. For both groups, the adverse events can be ascribed to localized problems in the treatment area. Conclusion:. Studies have shown that the second-generation solution containing sodium deoxycholate 1.25% is effective and safe to treat different localized fat deposits. The high degree of effectiveness shown in the study was not associated with a lesser degree of handling because, at the doses indicated and with the use of intralipotherapy, the occurrence of adverse events was minimal