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Tettamanzi M, Muratore G, Arrica G, Cuomo R, Beatrici E, Ginatempo I, Trignano C, Rubino C, Trignano E. Advancements in Face and Neck Contouring: Integrating Radiofrequency-Assisted Liposuction with FaceTite and Buccal Fat Pad Excision for Facial Slimming. Aesthetic Plast Surg 2024:10.1007/s00266-024-04245-1. [PMID: 39078425 DOI: 10.1007/s00266-024-04245-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND The integration of neck liposuction with FaceTite Manipulus Radiofrequency (RF) technology and buccal fat pad excision for enhanced neck rejuvenation promise heightened precision and efficacy in sculpting the neck and jawline. Neck liposuction, coupled with RF technology, provides controlled thermal energy for adipose tissue treatment and collagen remodeling, while buccal fat pad excision offers refined contouring of the lower face and neck. This integrated approach aims to optimize patient outcomes and advance the field of esthetic plastic surgery. METHODS A prospective study was conducted from 2016 to 2023 on 80 consecutive patients who presented to the author's private clinic and required neck remodeling surgery for esthetic purposes. Patients were monitored and clinic appointments were scheduled at intervals of 0, 1, 3, 6 and 12 months post-treatment for evaluation. A tape measure recorded submental length at 1 and 6 months, and a satisfaction survey was administered one week before surgery and after six months. Physicians assessed improvement using a five-point scale for patient satisfaction and a four-point scale for overall improvement. RESULTS All patients underwent successful RFAL treatment, consistently achieving satisfaction with the outcomes. The average reduction in submental length measured 23 mm during the 6-month follow-up period. Additionally, the removal of buccal fat pads played a pivotal role in facial slimming and enhancing the esthetics of the upper cheek region. CONCLUSIONS The integration of neck liposuction with FaceTite RF technology and buccal fat pad excision offers a promising approach for enhanced neck rejuvenation and facial contouring. This combined method demonstrates heightened precision and efficacy in sculpting the neck and jawline, aiming to optimize patient outcomes and advance the field of esthetic plastic surgery. 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)
- Matilde Tettamanzi
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy.
| | - Giovanni Muratore
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Giovanni Arrica
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Roberto Cuomo
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Edoardo Beatrici
- Department of Urology, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Ilaria Ginatempo
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Claudia Trignano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Corrado Rubino
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
| | - Emilio Trignano
- Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Sassari, Italy
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Al-Jumaily AM, Liaquat H, Paul S. Focused Ultrasound for Dermal Applications. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:8-17. [PMID: 37806924 DOI: 10.1016/j.ultrasmedbio.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Abstract
Focused ultrasound (FUS) is emerging as one of the most promising, non-invasive treatment techniques. The advancement of transducer technology has paved the way for dermatological applications. A comprehensive review is presented for healthcare practitioners and researchers, summarizing the effect of various operational parameters on the injury zone produced by ultrasound beams for various dermatological applications, which include skin tightening, fat reduction, hyperpigmentation and cancer treatment. In this article, we aim to highlight the efficient operational parameters of FUS to enhance pain relief during surgery and its affordability for skin treatment. Finally, a prospective future technique for efficient FUS is discussed.
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Affiliation(s)
- Ahmed M Al-Jumaily
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand.
| | - Hassan Liaquat
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Sharad Paul
- University of Auckland, Auckland, New Zealand
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Zhu J, Han Y, Liu Y, Chang R, Gao W, Gong X, Zhu Y, Shang Y, Shen L, Yu W, Lyu D, Lin X. Evaluation of a Novel Microfocused Ultrasound with Three-Dimensional Digital Imaging for Facial Tightening: A Prospective, Randomized, Controlled Trial. Dermatol Ther (Heidelb) 2024; 14:233-249. [PMID: 38100073 DOI: 10.1007/s13555-023-01078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/24/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The excellent efficacy is mitigated by the limited safety profile of microfocused ultrasound procedures. OBJECTIVE We sought to assess the safety and tightening efficacy of a novel microfocused ultrasound. METHODS The randomized middle and lower face and submental region of the participants were treated with the novel device using the following transducers: M4.5, D4.5, M3.0, and D3.0. Improvement in paired comparison of pretreatment and posttreatment photographs, three-dimensional (3D) volumetric assessments, skin thickness measured by B-ultrasonography, and skin photoaging parameters were evaluated. Adverse events and patient satisfaction were also recorded. RESULTS A total of 20 participants (20 female) were enrolled. Fourteen of 20 participants (70%) were judged to show clinically significant facial tightening during 3-month follow-up (P < 0.05). The mean volumetric change in the lower face, as quantitatively assessed after 3 months was -0.29 mL compared with +0.42 mL on the control side (P < 0.05). The VAS pain score was 3.00 ± 1.19 without any oral or intramuscular anesthesia. CONCLUSIONS A small sample size, lack of clinical scales, and impersonalized treatment parameters. The novel microfocused ultrasound appears to be a safe and effective modality for lower-face tightening. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR 2200064666.
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Affiliation(s)
- Jiafang Zhu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yue Han
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Rui Chang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wei Gao
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xia Gong
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yijia Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lingyue Shen
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Dongze Lyu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Peng JH, Peng HLP. Treating the double chin with hyaluronic acid injection. J Cosmet Dermatol 2024; 23:79-83. [PMID: 37997546 DOI: 10.1111/jocd.16100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/25/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION Submental fullness (SMF), or the double chin, is a condition regarded as undesirable. Many treatment modalities are available for SMF reduction, such as energy-based devices, injection lipolysis, or surgery. However, of minimal invasive modalities, hyaluronic acid (HA) injection has not been explored for possible SMF treatment. CASE REPORT A 52-year-old East Asian female patient with prominent SMF underwent HA filler injection. Aside from marked reduction of SMF prominence, an improvement of sagging over her cheeks and jawline, and a general improvement to facial aging signs was noted. CONCLUSION HA filler injections for SMF offer an instant, zero downtime, and safe alternative, and can be considered in patients who wish to simultaneously achieve improvement in other facial areas.
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Affiliation(s)
- Jui-Hui Peng
- Department of Dermatology, Hualien Tzu-Chi Hospital, Hualien, Taiwan
| | - Hsien-Li Peter Peng
- P-Skin Professional Clinic, Kaohsiung, Taiwan
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Coiante E, Pensato R, Hadji I, Lo Giudice G, Pizza C, SidAhmed-Mezi M, D'Andrea F, Meningaud JP, Hersant B, La Padula S. Assessment of the Efficacy of Cryolipolysis on Abdominal Fat Deposits: A Prospective Study. Aesthetic Plast Surg 2023; 47:2679-2686. [PMID: 37138191 DOI: 10.1007/s00266-023-03369-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Cryolipolysis is a non-invasive and efficacious procedure for body contouring. The effectiveness of cryolipolysis has been demonstrated on multiple areas of the body, but on a limited number of subjects. The aim of this study is to demonstrate the effectiveness and the safety of cryolipolysis in the lower abdomen adipose tissue thickness reduction. METHODS A prospective study on 60 healthy women was carried out using CryoSlim Hybrid device. Each patient underwent two cryolipolysis sessions centered on the abdominal area. The primary endpoint was to decrease the thickness of the abdominal fat deposits. The change in the abdominal circumference and the thickness of the subcutaneous fat layer were assessed. Patient satisfaction and tolerance of the procedure were also taken into account. RESULTS A significant reduction of the abdominal circumference and subcutaneous fat layer thickness was observed. The mean decrease in abdominal circumference was 2.10 cm (3.1%) 3 months after the procedure and 4.03 cm (5.8%) 6 months after the procedure. The mean decrease in fat layer thickness was 1.25 cm (43.81%) 3 months after the procedure and 1.61 cm (41.73%) 6 months after the procedure. No major adverse events were noted. All patients were very satisfied, and minimal pain was reported. CONCLUSIONS Cryolipolysis is an effective technique to treat abdominal localized fat deposits. No major adverse events have been described for this procedure. Our promising results should encourage further studies aimed at optimizing the efficacy of the procedure without a considerable increase in the risks. 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 http://www.springer.com/00266 .
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Affiliation(s)
- Edoardo Coiante
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Ilyes Hadji
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Giorgio Lo Giudice
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Chiara Pizza
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Mounia SidAhmed-Mezi
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Francesco D'Andrea
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Simone La Padula
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy.
- , 50 rue Saint, 75011 PARIS, Sébastien, France.
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La Padula S, Ponzo M, Lombardi M, Iazzetta V, Errico C, Polverino G, Russo F, D'Andrea L, Hersant B, Meningaud JP, Salzano G, Pensato R. Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications. J Clin Med 2023; 12:4351. [PMID: 37445386 DOI: 10.3390/jcm12134351] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/19/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Nanofat is a relatively novel technique in fat grafting that has gained significant interest in the fields of regenerative medicine, aesthetic and translational research. It involves the extraction of autologous fat from a patient, which is then transformed into "nanofat", consisting of small fat particles with a diameter of less than 0.1 mm and containing high concentrations of stem cells and growth factors. This article focuses on the use of nanofat in facial rejuvenation and its potential for lipomodelling. Fat tissue is a "stem cell depot" and nanofat contains many stem cells that can differentiate into various cell types. The Lipogem technology, developed in 2013, enables the isolation of nanofat with an intact perivascular structure, utilizing the high concentration of mesenchymal stromal cells near the pericytes of the adipose vascular system. Nowadays nanofat is used primarily for cosmetic purposes particularly in rejuvenating and improving the appearance of the skin, especially the face. Indeed, it has wide applicability; it can be used to treat fine lines, wrinkles, acne scars, sun-damaged skin, scar repair, and as an alopecia treatment. However, further studies are needed to assess the long-term efficacy and safety of this technique. In conclusion, nanofat is a safe and minimally invasive option for tissue regeneration with considerable therapeutic potential. This study reviews the application and effects of nanofat in regenerative medicine and facial cosmetic surgery.
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Affiliation(s)
- Simone La Padula
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Martina Ponzo
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Mariagiovanna Lombardi
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Vincenzo Iazzetta
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Concetta Errico
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Gianmarco Polverino
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Francesca Russo
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Luca D'Andrea
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Barbara Hersant
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Henri Mondor Hospital, University Paris, XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Federico II University of Naples, 80131 Naples, Italy
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy
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Li Y, Liao M, Zhu Y, Gao J, Song Y, Zhai Y, Zhu M, He Y, Dong W. Hyaluronic Acid Compound Filling Plus Mesotherapy vs Botulinum Toxin A for the Treatment of Horizontal Neck Lines: A Multicenter, Randomized, Evaluator-Blinded, Prospective Study in Chinese Subjects. Aesthet Surg J 2022; 42:NP230-NP241. [PMID: 34758056 PMCID: PMC8972830 DOI: 10.1093/asj/sjab387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Although energy devices and botulinum toxin A (BTX-A) can alleviate age-related laxity, ptosis, and platysmal bands, they have limited efficacy on horizontal neck lines. Objectives The purpose of this study was to investigate the efficacy, safety, and subject satisfaction of a combined treatment of non–cross-linked hyaluronic acid (HA) compound filling plus mesotherapy for the correction of horizontal neck lines, in comparison with BTX-A. Methods This multicenter, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to-severe horizontal neck lines corrected with either 2 or 3 sessions of of non–cross-linked HA compound filling plus mesotherapy or 1 session of BTX-A injection. Improvement of the neck lines grades, Global Aesthetic Improvement Scale (GAIS), patient satisfaction, and adverse events (AEs) were evaluated and compared at 1, 3, 6, and 10 months after the final treatment. Results Twenty-five patients received HA filling plus mesotherapy and 23 received BTX-A injection. Compared with BTX-A, the HA compound filling plus mesotherapy significantly improved the horizontal neck lines grades on all follow-up visits (P = 0.000). Cases of different baseline grades (2, 2.5, and 3) demonstrated similar outcomes. The GAIS and patients’ satisfaction ratings were significantly higher for the HA filling plus mesotherapy treatment group (P = 0.000). Significantly higher pain ratings, higher incidence, and longer recovery of AEs (erythema, edema, and ecchymosis) were noticed in the combined treatment group (P < 0.001). No serious AEs occurred. Conclusions Compared with BTX-A, combined treatment with HA compound filling plus mesotherapy significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patient satisfaction. Level of Evidence: 4
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Affiliation(s)
- Yiming Li
- Department of Dermatology and Venerology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Meirong Liao
- Department of Dermatology, Sichuan FreSkin Hospital, Chengdu, Sichuan, China
| | - Yijin Zhu
- Department of Dermatology, Sichuan FreSkin Hospital, Chengdu, Sichuan, China
| | - Jie Gao
- Department of Dermatology, Sichuan FreSkin Hospital, Chengdu, Sichuan, China
| | - Yang Song
- Department of Dermatology, Xian FreSkin Hospital, Xian, Shanxi, China
| | - Yang Zhai
- Department of Dermatology, Xian FreSkin Hospital, Xian, Shanxi, China
| | - Miao Zhu
- Department of Dermatology, Changsha FreSkin Hospital, Changsha, Hunan, China
| | - Yan He
- Department of Dermatology, Chongqing FreSkin Hospital, Chongqing, China
| | - Weiwei Dong
- Department of Plastic Surgery, Sichuan FreSkin Hospital, Chengdu, Sichuan, China
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Renga M, Ryder TJ. Treatment of Horizontal Wrinkles of the Neck Using a Hyaluronic Acid Filler: Results From a Prospective Study. Dermatol Surg 2022; 48:322-326. [PMID: 35093965 DOI: 10.1097/dss.0000000000003310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND VYC-12 is a hyaluronic acid filler with low cohesivity. OBJECTIVE To evaluate the safety and effectiveness of VYC-12 for aesthetic improvement of horizontal neck lines. METHODS This was a prospective study of consecutive women undergoing neck treatment using VYC-12. All had a baseline score of 1 to 4 on the Allergan Transverse Neck Lines Scale (ATNLS). Individuals with an ATNLS score of 1 to 3 were treated with VYC-12 alone; those with a score of 4 received filler combined with high-intensity focused ultrasound (HIFU). Total VYC-12 volumes were ∼1 mL per patient. Follow-up lasted ≤30 months. RESULTS Fifty women were enrolled (mean age: 55.0 ± 5.7 years; n = 42 VYC-12 alone, n = 8 VYC-12 + HIFU). Forty-six patients (92%) achieved a ≥ 1-grade improvement on ATNLS 1 month post-treatment; the mean ATNLS score decreased from 2.64 ± 0.83 to 1.44 ± 0.81 (p < .0001). Rasch-transformed scores on the FACE-Q "Appraisal of the Neck" questionnaire improved from 31.0 ± 14.2 at baseline to 49.7 ± 14.4 at 1 month (p < .0001). Repeat injections at 9- to 12-month intervals led to progressive improvements. There were no treatment-related adverse events. CONCLUSION Treatment of the neck using VYC-12 was safe and effective in reducing the appearance of horizontal lines.
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Abi-Rafeh J, Mojtahed Jaberi M, Kazan R, Alabdulkarim A, Boily M, Thibaudeau S. Utility of Ultrasonography and Significance of Surgical Anatomy in the Management of de Quervain Disease: A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2022; 149:420-434. [PMID: 35077418 DOI: 10.1097/prs.0000000000008792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The role of ultrasound in plastic surgery practice has grown significantly over the past decade, with notable applications for conditions of the upper extremity. Its utility for the management of de Quervain disease, however, remains to be established, and the prevalence of first dorsal compartment anatomical variations needs to be adequately assessed. METHODS A systematic review was performed to evaluate the role of ultrasound in the diagnosis, anatomical characterization, and clinical management of de Quervain disease. A meta-analysis was conducted to establish the prevalence of first dorsal compartment anatomical variations in the de Quervain disease and general population, along with the diagnostic accuracy of ultrasound for their detection. Outcomes were documented and compared to alternative treatment options. RESULTS Extensor retinaculum thickening, tendon sheath swelling, peritendinous edema, and tendon enlargement were the most common sonographic features of de Quervain disease. The prevalence of an intercompartmental septum in the de Quervain disease surgical population was shown to be significantly greater than in the general cadaveric population (67 percent versus 35 percent, respectively). Although the efficacy of energy-based therapeutic ultrasound remains elusive, ultrasound-guided corticosteroid injections were shown to be more accurate than manual injections (90 to 100 percent versus 40 to 100 percent), and to confer significantly better treatment outcomes (73 to 100 percent versus 59 to 83 percent success rates, respectively). CONCLUSIONS Ultrasound use is essential to achieve the best evidence-based outcomes in the management of de Quervain disease. The varied prevalence of first dorsal compartment anatomical variations and high accuracy of ultrasound for their detection carry significant prognostic implications.
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Affiliation(s)
- Jad Abi-Rafeh
- From the Departments of Medicine and Diagnostic Radiology and Divisions of Plastic and Reconstructive Surgery and Experimental Surgery, McGill University
| | - Mehrad Mojtahed Jaberi
- From the Departments of Medicine and Diagnostic Radiology and Divisions of Plastic and Reconstructive Surgery and Experimental Surgery, McGill University
| | - Roy Kazan
- From the Departments of Medicine and Diagnostic Radiology and Divisions of Plastic and Reconstructive Surgery and Experimental Surgery, McGill University
| | - Abdulaziz Alabdulkarim
- From the Departments of Medicine and Diagnostic Radiology and Divisions of Plastic and Reconstructive Surgery and Experimental Surgery, McGill University
| | - Mathieu Boily
- From the Departments of Medicine and Diagnostic Radiology and Divisions of Plastic and Reconstructive Surgery and Experimental Surgery, McGill University
| | - Stephanie Thibaudeau
- From the Departments of Medicine and Diagnostic Radiology and Divisions of Plastic and Reconstructive Surgery and Experimental Surgery, McGill University
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de Melo F, Carrijo A, Hong K, Trumbic B, Vercesi F, Waldorf HA, Zenker S. Minimally Invasive Aesthetic Treatment of the Face and Neck Using Combinations of a PCL-Based Collagen Stimulator, PLLA/PLGA Suspension Sutures, and Cross-Linked Hyaluronic Acid. Clin Cosmet Investig Dermatol 2020; 13:333-344. [PMID: 32440186 PMCID: PMC7211299 DOI: 10.2147/ccid.s248280] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/09/2020] [Indexed: 12/31/2022]
Abstract
Background Combinations of minimally invasive procedures (MIPs) are often used in aesthetic treatments and are increasingly considered as the new standard of care. Three agents with specific properties are available in this perspective: a polycaprolactone (PCL)-based collagen stimulator, a poly-L-lactic acid (PLLA)- and a poly-glycolic acid (PLGA)-based resorbable suspension suture with a 3D-cone technology, and a cross-linked hyaluronic acid (HA). Objective To develop the first practice guidelines on rejuvenation treatment of the face and the neck using combinations of these agents, whether associated or not with other widely used MIPs such as botulinum neurotoxins or energy-based devices. Methods A multi-disciplinary, multi-national board of plastic surgeons and dermatologists convened to develop guidelines using a predefined consensus method. The consensus was defined as ≥83% agreement rate between participants. Results Practice guidelines and algorithms, describing optimal procedure sequence and spacing, are proposed for the treatment of upper-, mid-, lower-face and neck, combining the PCL collagen stimulator, the PLLA/PLGA suspension sutures, and the cross-linked HA, whether associated or not with other MIPs. Conclusion These new guidelines provide general support to optimal management strategies. Individual treatment plans should be adapted according to the physician’s individual competence and the patient’s preferences.
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