1
|
Dilber M, Bayar Muluk N, Cingi C. A narrative-style review of non-surgical rhinoplasty: Indications, outcomes, and limitations. J Craniomaxillofac Surg 2024; 52:1012-1018. [PMID: 38876955 DOI: 10.1016/j.jcms.2024.06.014] [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: 01/17/2024] [Revised: 02/13/2024] [Accepted: 06/08/2024] [Indexed: 06/16/2024] Open
Abstract
The aim of this narrative-style review was to evaluate non-surgical rhinoplasty in terms of indications, outcomes, and limitations. Both 'PubMed' and 'Science Direct' were reviewed by all authors, in order to reach consensus with regard to the chosen studies. Studies published from 1980 to 2023 were searched using the key terms "non-surgical rhinoplasty", "dermal filler", "thread lifting", and "botulinum toxin", and relevant papers were selected. Non-surgical rhinoplasty refers to the use of injectable temporary fillers to augment selected areas of the nose, in order to achieve improved appearance or function in select patients. It includes the use of dermal fillers, thread lifting, and botulinum toxin injections. The perfect dermal filler would be inexpensive, safe, painless to inject, hypoallergenic, and long lasting. In addition, it should produce consistent and predictable results, feel natural under the skin, take little time to inject, be ready to use, exert no downtime on the patient, and have a low risk of complications. Regions of the nose treated with filler injections include the frontonasal angle, dorsum, nasolabial angle, and columella. Thread lifting and botulinum toxin injection are the other methods of non-surgical rhinoplasty. Dermal fillers, thread lifting, and botulinum toxin injections can be used as non-surgical rhinoplasty. Dermal fillers and botulinum neurotoxin can be used alongside each other to allow minimally invasive resculpting of the nasal region and midface, compensating for a reduction in tissue volume and the formation of rhytides.
Collapse
Affiliation(s)
- Muhammet Dilber
- Dilber Ear, Nose, and Throat Diseases and Surgery Clinic, İstanbul, Turkey
| | - Nuray Bayar Muluk
- Department of Otorhinolaryngology, Medical Faculty, Kirikkale University, Kirikkale, Turkey.
| | - Cemal Cingi
- Department of Otorhinolaryngology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| |
Collapse
|
2
|
Hsieh CH, Liu YX, Chen PY, Fang HW. Zigzag Barbed Polydioxanone Thread Implantation and Evaluation Using Polydimethylsiloxane Model to Simulate Thread Migration in Tissue. Polymers (Basel) 2024; 16:1785. [PMID: 39000641 PMCID: PMC11244147 DOI: 10.3390/polym16131785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 07/17/2024] Open
Abstract
Facial lifting with polydioxanone barbed threads has been widely used in aesthetic treatment for years. However, gravity resists the thread and continuously pulls the face downward. This study aims to determine methods to lift the skin more efficiently with longer longevity. The quality of the thread is important and is defined by the pulling and pullout strengths. Moreover, the method of using threads is also important. We compared five thread-implantation techniques and six angles for the V-shaped implantation methods using a polydimethylsiloxane model to simulate thread migration in tissues. The results of the simulated thread-lift techniques can provide valuable information for physicians, enabling a more precise design of facelift surgery techniques.
Collapse
Affiliation(s)
- Chia-Hsien Hsieh
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (C.-H.H.); (Y.-X.L.); (P.-Y.C.)
| | - Yi-Xin Liu
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (C.-H.H.); (Y.-X.L.); (P.-Y.C.)
- High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
| | - Pei-Yu Chen
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (C.-H.H.); (Y.-X.L.); (P.-Y.C.)
- High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (C.-H.H.); (Y.-X.L.); (P.-Y.C.)
- High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town 35053, Miaoli County, Taiwan
| |
Collapse
|
3
|
Park JH, Jeong JW, Park JU. Advanced Facial Rejuvenation: Synergistic Effects of Lower Blepharoplasty and Ultrasound Guided Mid-Face Lift Using Polydioxanone (PDO) Threads. Aesthetic Plast Surg 2024; 48:1706-1714. [PMID: 38519570 PMCID: PMC11093801 DOI: 10.1007/s00266-024-03975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Traditional facial aging surgeries have risks and extended recovery times, leading to a demand for minimally invasive alternatives. PDO (polydioxanone) threads, which are absorbable sutures that stimulate collagen production and tissue contraction, offer improved aesthetic outcomes. This paper evaluates the combined use of PDO thread mid-cheek lift and lower blepharoplasty for facial rejuvenation. METHODS This retrospective study compared outcomes in patients undergoing lower blepharoplasty combined with a mid-face lift using PDO threads versus those undergoing only lower blepharoplasty. Focused on individuals with baggy lower eyelids and pronounced nasolabial folds, outcome measures included the Modified Fitzpatrick wrinkle scale, Allergan® midface volume deficit scale, Width of inter zygomatic distance, Patient and Observer Scar Assessment Scale, and patient satisfaction questionnaires, assessed at baseline, 3 months, and 1 year postoperatively. RESULTS The combined procedure demonstrated superior aesthetic outcomes and higher patient satisfaction compared to lower blepharoplasty alone. Improvements were more significant in wrinkle reduction, midface volume, and inter-zygomatic distance in the combined procedure group. Although the combined procedure had a longer mean operation time, scar assessment scores were similar between both groups, with no complications reported. CONCLUSION The combination of lower blepharoplasty and mid-face lift using PDO threads is a comprehensive and effective approach for facial rejuvenation. It significantly enhances wrinkle reduction, mid-face lifting, and patient satisfaction. Ultrasound-guided thread lifting, a method of assessing and performing mid-face lifting, proves to be safe and efficient. This approach holds promise as a future option in cosmetic anti-aging surgery, presenting a minimally invasive alternative with natural-looking results and reduced downtime. 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 https://link.springer.com/journal/00266 .
Collapse
Affiliation(s)
- Jun Ho Park
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea
| | - Ji Won Jeong
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea
| | - Ji-Ung Park
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea.
| |
Collapse
|
4
|
Hong GW, Song S, Park SY, Lee SB, Wan J, Hu KS, Yi KH. Why Do Nasolabial Folds Appear? Exploring the Anatomical Perspectives and the Role of Thread-Based Interventions. Diagnostics (Basel) 2024; 14:716. [PMID: 38611629 PMCID: PMC11011544 DOI: 10.3390/diagnostics14070716] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/09/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
The classification of nasolabial folds into three types, each with distinct causative factors and mechanisms, is explored. Age-related changes in facial skin and connective tissues are examined in detail, revealing variations across different facial regions due to variances in tissue firmness and thickness. The innovative 'Reverse Technique,' involving cog threads to enhance tissue traction and effectiveness in thread-lifting procedures, is introduced. Detailed technical guidelines, anatomical considerations, and safety measures are provided, emphasizing the importance of identifying optimal vectors and fixing points to achieve maximum lifting effects while minimizing potential risks, particularly those associated with vascular structures. Additionally, the 'Cross Technique using volumizing thread' is discussed, designed to smooth tissue boundaries and rejuvenate sagging areas. Facial anatomy, including the positioning of arteries and ligaments, is underscored as essential for ensuring the safety and efficacy of procedures. In conclusion, this review stands as a comprehensive guide for practitioners, offering insights into innovative thread-lifting methods and their applications in addressing nasolabial folds. The primary focus is on achieving optimal aesthetic results while prioritizing patient safety.
Collapse
Affiliation(s)
- Gi-Woong Hong
- Samskin Plastic Surgery Clinic, Seoul 06577, Republic of Korea;
| | - Sehyun Song
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
| | - Soo Yeon Park
- Made-Young Plastic Surgery Clinic, Seoul 06615, Republic of Korea;
| | | | - Jovian Wan
- Asia Pacific Aesthetic Academy, Hong Kong, China;
| | - Kyung-Seok Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
| | - Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
- Maylin Clinic (Apgujeong), Seoul 06001, Republic of Korea
| |
Collapse
|
5
|
Yi K, Kim S, Chua D, Stefanelli MB, Alfertshofer M, Vachiramon V. Horizontal necklines correction with absorbable braided polydioxanone threads: Case series. Skin Res Technol 2024; 30:e13617. [PMID: 38444188 PMCID: PMC10915367 DOI: 10.1111/srt.13617] [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: 01/27/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION The prevalence of horizontal neck lines as a cosmetic concern is widely acknowledged, yet the available treatment options are limited, and no studies have investigated the use of polydioxanone-barbed threads. These threads, characterized by a finely braided structure, function as a scaffold to attract regenerative factors and facilitate the migration and proliferation of cells. This study aims to evaluate the outcomes of concurrent application of braided polydioxanone-barbed threads for addressing horizontal neck wrinkles. METHODOLOGY A retrospective case series involving four female participants (aged 41, 43, 45, and 46) treated with polydioxanone-barbed threads for horizontal neck wrinkles between January 2023 and July 2023 was conducted. Adult patients were assessed at an 8-week follow-up, revealing a significant reduction in wrinkle intensity based on the Horizontal Neck Wrinkle Severity Scale. RESULTS The analysis of horizontal neck lines demonstrated a notable decrease in wrinkle intensity according to the Horizontal Neck Wrinkle Severity Scale at the 8-week mark, and this improvement maintained statistical significance. Both patient Global Aesthetic Improvement Scale (GAIS) scores (90%-100%) and physician GAIS scores (100%) were rated as excellent. CONCLUSION The subdermal application of polydioxanone-barbed threads for horizontal neck lines proves to be a secure and efficacious approach for treating horizontal neck wrinkles, with no observed Tyndall effect. This technique shows promise for rejuvenating the skin in the horizontal neckline region.
Collapse
Affiliation(s)
- Kyu‐Ho Yi
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research InstituteBK21 FOUR ProjectYonsei University College of DentistrySeodaemun‐guSeoulSouth Korea
- Maylin Clinic (Apgujeong)Gangnam‐guSeoulSouth Korea
| | - Soo‐Bin Kim
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research InstituteBK21 FOUR ProjectYonsei University College of DentistrySeodaemun‐guSeoulSouth Korea
| | | | | | - Michael Alfertshofer
- Department of Plastic and Aesthetic SurgeryTechnical University MunichMunichGermany
| | - Vasanop Vachiramon
- Department of Internal MedicineFaculty of MedicineRamathibodi HospitalMahidol UniversityBangkokThailand
| |
Collapse
|
6
|
Yi K. What are filling (volumizing) threads? Skin Res Technol 2024; 30:e13658. [PMID: 38514895 PMCID: PMC10957715 DOI: 10.1111/srt.13658] [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: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Facial aging prompts a shift in the demands for lifting procedures, transitioning from targeted improvements in younger individuals to overall facial contour enhancements as skin elasticity declines in later years. This paper examines the evolution of PDO volumizing threads, delineating their development from initial limitations to contemporary innovations aimed at addressing tissue deformation and maintaining thread integrity post-insertion. Categorizing these threads based on elasticity, shape, and functionality underscores their versatility and application nuances, catering to specific wrinkle correction, contour sculpting, and facial volume restoration. The discussion emphasizes the pivotal role of thread characteristics in achieving optimal outcomes while minimizing potential complications. By delving into historical contexts, mechanisms, effectiveness, and thread classification, this paper equips practitioners with a comprehensive understanding to make informed decisions in selecting threads for volumizing thread procedures. Recommendations for future research directions, including long-term safety assessments and patient-specific outcomes, seek to enhance the clinical utility and applicability of this analysis.
Collapse
Affiliation(s)
- Kyu‐Ho Yi
- Division in Anatomy and Developmental BiologyDepartment of Oral BiologyHuman Identification Research InstituteBK21 FOUR ProjectYonsei University College of DentistrySeoulSouth Korea
- Maylin Clinic (Apgujeong)SeoulSouth Korea
| |
Collapse
|
7
|
Su D, Wang S, He T, Wang J. Experimental investigation of biostimulatory effects after polydioxanone thread insertion in a pig model. J Cosmet Dermatol 2024; 23:658-665. [PMID: 37644781 DOI: 10.1111/jocd.15966] [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: 05/21/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Polydioxanone (PDO) threads have been widely used to tighten and lift the facial soft tissue. OBJECTIVE This research aims to determine the collagenation and inflammation changes that occur in the adipose tissue over time when different types of threads are implanted. METHODS & MATERIALS Three threads types, PDO, poly glycolic-co-lactic acid (PGLA), and nylon, were inserted in the subcutaneous fat of 12-month-old Bama miniature pigs. Collagen production and inflammatory response were evaluated by hematoxylin and eosin and Masson trichrome staining at 1, 4, 12, 24, and 48 weeks. RESULTS The integrity of the PDO thread lasted up to 24 weeks with mild inflammation and collagen production. The PGLA thread integrity lasted until 12 weeks and had a strong inflammatory response. The nylon thread's integrity was maintained for 48 weeks and showed minor inflammation and collagen production. CONCLUSION Our data suggest that PDO thread is the best choice for clinicians, as it has a mild action process with minimal irritation, moderate collagen production, a reasonable explanation time, with obvious bridging fibrous tissue, and thickening action for the superficial fascia.
Collapse
Affiliation(s)
- Diya Su
- Department of Plastic Surgery, Xinhua Hospital Affiliated to Dalian University, Dalian, China
| | - Shiwei Wang
- Medical Department, Imeik Technology Development Co., Ltd., Beijing, China
| | - Tong He
- Medical Department, Imeik Technology Development Co., Ltd., Beijing, China
| | - Jieqing Wang
- Department of Plastic Surgery, Xinhua Hospital Affiliated to Dalian University, Dalian, China
| |
Collapse
|
8
|
Verma KK, Friedmann DP. Retained Periorbital Subdermal Polydioxanone Threads. Dermatol Surg 2024; 50:206-207. [PMID: 37815504 DOI: 10.1097/dss.0000000000003975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Kritin K Verma
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas
| | - Daniel P Friedmann
- Westlake Dermatology Clinical Research Center, Westlake Dermatology & Cosmetic Surgery, Austin, Texas
| |
Collapse
|
9
|
Kim JH, Han MW, Lee MH, Kweon DK, Park YJ, Heo CY. Comparative In Vivo Study of Solid-Type Pure Hyaluronic Acid in Thread Form: Safety and Efficacy Compared to Hyaluronic Acid Filler and Polydioxanone Threads. Aesthetic Plast Surg 2024; 48:221-227. [PMID: 37644191 PMCID: PMC10912330 DOI: 10.1007/s00266-023-03614-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Although various products are commonly used for skin rejuvenation, solid-type hyaluronic acid (HA) as an injectable form has not been researched or utilized. This study aimed to demonstrate the safety and efficacy of solid-type HA in thread form, which differs from the conventional gel-type HA commonly used. METHOD Solid-type HA threads, conventional HA fillers, and polydioxanone (PDO) threads were inserted into the dorsal subcutaneous layer of mice. Photographs were taken on days 0, 1, 3, and 7, and on day 7, the samples were harvested for histological analysis. Inflammatory reactions and detection of collagen were confirmed through tissue staining, and real-time PCR was conducted to quantify collagen synthesis. RESULTS In the histological analysis, the PDO threads exhibited a greater inflammatory response compared to the HA threads. Masson's trichrome staining revealed a higher degree of collagen synthesis in the HA thread group compared to the HA filler group. While collagen type 1 expression was significantly higher in the PDO thread group than in the HA thread group, the HA thread group showed higher expression levels of collagen type 3. Furthermore, the PDO thread group demonstrated a statistically significant increase in TGF-β1 compared to the HA group. CONCLUSION This in vivo study demonstrated the stable application of solid-type pure HA threads and their potential for inducing collagen production, while also yielding a low inflammatory response. The findings highlight the promising applications of solid-type HA in the field of cosmetic dermatology. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .
Collapse
Affiliation(s)
- Jong-Ho Kim
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 463-707, Korea
| | - Man Wong Han
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 463-707, Korea
| | | | | | | | - Chan Yeong Heo
- Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 463-707, Korea.
| |
Collapse
|
10
|
Barbosa ADP, Espasandin I, Pinheiro de Lima L, de Souza Ribeiro C, Raquel Silva L, Faria Quintal T, Nascimento Lima E, Catarina Duarte Vieira L, Soares TR, Autran Colaço AR. Body Harmonization: The Definition of a New Concept. Clin Cosmet Investig Dermatol 2023; 16:3753-3766. [PMID: 38170132 PMCID: PMC10759920 DOI: 10.2147/ccid.s426813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/05/2023] [Indexed: 01/05/2024]
Abstract
Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions.
Collapse
Affiliation(s)
- Antony de Paula Barbosa
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Isabela Espasandin
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Lucas Pinheiro de Lima
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Caroline de Souza Ribeiro
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Lara Raquel Silva
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Thalita Faria Quintal
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Evenny Nascimento Lima
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Láila Catarina Duarte Vieira
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Thaina Ribeiro Soares
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Anna Raphaella Autran Colaço
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| |
Collapse
|
11
|
de Sousa AMS, Duarte AC, Decnop M, Guimarães DDF, Coelho Neto CAF, Sarpi MDO, Duarte LGP, Souza SA, Segato LF, Zavariz JD, Mukherji SK, Garcia MRT. Imaging Features and Complications of Facial Cosmetic Procedures. Radiographics 2023; 43:e230060. [PMID: 37943699 DOI: 10.1148/rg.230060] [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: 11/12/2023]
Abstract
Facial aesthetic procedures have become increasingly popular and complex, making knowledge of facial anatomy crucial for achieving desired outcomes without complications. Some of the most common procedures include blepharoplasty, bichectomy, face-lifts, facial implants, thread lifting, and fillers. Blepharoplasty and bichectomy are surgical procedures that respectively aim to restore youthful contours to the periorbita and create a slimmer lower face by removing Bichat fat from the maxillofacial region. Facial implants are used for aesthetic augmentation of the skeletal structure and restoration of facial contour by using biomaterials or autogenous bone grafts. Face-lift surgeries involve incisions and removal of excess skin, and thread lifts involve less invasive procedures performed by inserting threads beneath the skin, with the aim to lift the skin and thus reduce wrinkles and sagging. Fillers improve wrinkles and loss of facial volume, with biologic types made from animal, human, or bacterial sources (such as hyaluronic acid), while synthetic fillers include substances such as paraffin, silicone, calcium hydroxyapatite, polymethylmethacrylate microspheres, polyacrylamide hydrogel, hydroxyethyl-ethyl methacrylate, and poly-l-lactic acid. Synthetic fillers can be classified as rapidly resorbable (<12 months), slowly resorbable (<24 months), or permanent. Imaging modalities such as US, CT, and MRI can help identify and analyze each type of facial aesthetic procedure or filler, as well as their possible complications such as foreign-body granuloma, noninflammatory nodule, late intermittent persistent edema, filler migration, infection, or complications after removal of the buccal fat pad. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center The online slide presentation from the RSNA Annual Meeting is available for this article.
Collapse
Affiliation(s)
- Andrea Meneses Soares de Sousa
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Angelo Chelotti Duarte
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Marcos Decnop
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Daniel de Faria Guimarães
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Carlos Alberto Ferreira Coelho Neto
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Maíra de Oliveira Sarpi
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Luis Gustavo Palhiari Duarte
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Soraia Ale Souza
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Larissa Freire Segato
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Julia Diva Zavariz
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Suresh K Mukherji
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| | - Márcio Ricardo Taveira Garcia
- From the Department of Radiology, Head and Neck Section (A.M.S.d.S., M.D., C.A.F.C.N., M.d.O.S., L.G.P.D., S.A.S., J.D.Z., M.R.T.G.) and Neuroradiology Section (A.M.S.d.S.), Dasa/Alta Excelência Diagnóstica, Av Juruá 548, Alphaville, Barueri, São Paulo 06455-010 SP, Brazil; Department of Radiology, Neuroradiology Section, Irmandade da Santa Casa de Misericordia de Sao Paulo, São Paulo, Brazil (A.C.D., D.d.F.G.); Division of Head and Neck Imaging, Instituto Nacional do Cancer, Rio de Janeiro, Brazil (M.D.); Head and Neck Radiology Section, Universidade Federal de São Paulo, São Paulo, Brazil (S.A.S.); Head and Neck Radiology Section (S.A.S.) and Ultrasound Section (J.D.Z.), Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Universidade de Brasília, Brasília, Brazil (L.F.S.); and Department of Radiology, ProScan Imaging, Cincinnati, Ohio (S.K.M.)
| |
Collapse
|
12
|
Beiu C, Popa LG, Bălăceanu-Gurău B, Iliescu CA, Racoviță A, Popescu MN, Mihai MM. Personalization of Minimally-Invasive Aesthetic Procedures with the Use of Ultrasound Compared to Alternative Imaging Modalities. Diagnostics (Basel) 2023; 13:3512. [PMID: 38066753 PMCID: PMC10705986 DOI: 10.3390/diagnostics13233512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 04/12/2024] Open
Abstract
Ultrasonography is a well-tolerated procedure that aids in the targeted esthetic therapies of special cutaneous regions, as well as in the prevention (vascular mapping, identification of previous filler, and others) and management of potential complications (vascular occlusion, external vascular compression, product misplacement or migration, inflammatory reactions, and others). It has lately been promoted as the first-line imaging tool to address injectables. In this article, we aim to review the evolving role of ultrasonography in cosmetic filler procedures, from the fundamental ultrasound characterization of cosmetic fillers to the ultrasound-enhanced detection and management of cosmetic filler complications, including ultrasound's role in hyaluronidase-guided injections for cosmetic filler dissolution. Furthermore, the paper explores the integral role played by ultrasound in enhancing the precision, efficacy, and safety of additional minimally invasive aesthetic techniques such as mesotherapy, radiofrequency, cryolipolysis, and polydioxanone procedures.
Collapse
Affiliation(s)
- Cristina Beiu
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.B.); (L.G.P.); (M.M.M.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.B.); (L.G.P.); (M.M.M.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | | | - Carmen Andrada Iliescu
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Andreea Racoviță
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Marius Nicolae Popescu
- Department of Physical and Rehabilitation Medicine, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Clinic of Physical and Rehabilitation Medicine, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Mara Mădălina Mihai
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.B.); (L.G.P.); (M.M.M.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| |
Collapse
|
13
|
Carrasco GV, Hiramatsu Azevedo L, da Silva AC, Lobo MM, Kirschner R, Moreira de Freitas P. Antimicrobial Photodynamic Therapy in the Approach of Complication After Implantation of Spiculated Polydioxanone Threads. Cureus 2023; 15:e42418. [PMID: 37637524 PMCID: PMC10448437 DOI: 10.7759/cureus.42418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
The present manuscript is a clinical case report in which antimicrobial photodynamic therapy (aPDT) - using a low-power laser (660 nm) associated with methylene blue photosensitizer (0.01%) - was considered for treating a case of complication after implantation of spiculated polydioxanone (PDO) threads, an aesthetic procedure worldwide performed in facial cosmetic non-surgical procedures. A 72-year-old female patient presented an infection in the face region where the PDO thread was implanted (mandible angle). After divulsion and local drainage, it was decided to associate aPDT using a low-level laser associated with a 0.01% methylene blue photosensitizer. Two sessions of aPDT were performed - on sequential days - and within 48 hours the region was dry and without signs of secretion. The use of aPDT seems to be a promising and effective option in cases of infections after implantation of PDO threads, consisting of a safe technique, of low execution complexity and without adverse effects.
Collapse
Affiliation(s)
- Gabriela V Carrasco
- Restorative Dentistry, School of Dentistry/University of São Paulo, São Paulo, BRA
| | | | | | - Maristela M Lobo
- Especial Master's Degree Course in Facial Esthetics, São Leopoldo Mandic, São Paulo, BRA
| | - Roger Kirschner
- Especial Master's Degree Course in Facial Esthetics, São Leopoldo Mandic, São Paulo, BRA
| | - Patrícia Moreira de Freitas
- Restorative Dentistry, School of Dentistry/University of São Paulo, São Paulo, BRA
- Faculdade de Odontologia, Universidade de São Paulo, São Paulo, BRA
| |
Collapse
|
14
|
Şahan A, Yeniay Y. Brow gliding: A new non-surgical concept for almond upturned eyes. J Cosmet Dermatol 2022; 21:5957-5962. [PMID: 35880467 DOI: 10.1111/jocd.15275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/15/2022] [Accepted: 07/22/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND The eyes are one of the most prominent features of the face. To date, a vast majority of procedures have been described for periorbital rejuvenation. Among them, non-surgical threading is an alternative and minimally invasive technique. OBJECTIVE We developed a new non-surgical threading technique to achieve long-lasting almond-shaped upturned eyes with brow lifting that we call "brow gliding". We developed a new non-surgical threading technique to achieve long-lasting almond-shaped upturned eyes with brow lifting that we call "brow gliding". Here, we present details of our procedure and the clinical experience of our patients who have at least a 6-month follow-up period. METHODS AND MATERIALS We used polydioxanone cog threads in combination with knots to lift the lateral sides of the brows and eyes. By burying these knots in the subcutaneous tissue and extending the threads to the scalp fascia, we were able to spread the load of the threads over multiple stable structures in order to achieve an effective lifting impact. RESULTS According to the subjective assessment scale, all patients described the improvements as very good or beyond expectations after the procedure. During the follow-up period, 4 of 34 (11.8%) patients stated it was very good and 19 of 34 (55.9%) patients stated that it was still beyond expectations. CONCLUSION The Brow Gliding technique is a promising office-based cosmetic procedure for periorbital aesthetics with a prominent outcome and minimally invasive fashion.
Collapse
Affiliation(s)
- Ali Şahan
- Doctor Al-Sa Aesthetic, Cosmetic and Dermatology Clinic, Ankara, Turkey
| | - Yıldıray Yeniay
- Department of Dermatology, Golcuk Public Hospital, Kocaeli, Turkey
| |
Collapse
|
15
|
Khan G, Kim BJ, Kim DG, Park E. Retrospective study of the absorbable braided polydioxanone threads' usefulness in the aged lower eyelids' rejuvenation. J Cosmet Dermatol 2022; 21:5952-5956. [PMID: 35866335 DOI: 10.1111/jocd.15257] [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: 02/03/2022] [Revised: 06/20/2022] [Accepted: 07/14/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Tear trough deformity, hyperpigmentation, and skin laxity of the lower eyelid make individuals appear fatigued and elderly. Many patients prefer less invasive, cosmetic correction of the aged lower eyelid. Polydioxanone (PDO)-barbed threads introduced braided fine threads design, which works as a template for attraction of the regenerative factors and for cells' migration and proliferation. The purpose of this study was to estimate the outcomes of simultaneous additional application of braided type PDO threads (N-scaffold) for aged lower eyelids' rejuvenation in patients, who underwent the midface PDO thread lifting. MATERIALS AND METHODS A total of 30 patients with mildly loose skin in the facial area, who underwent the thread lifting using PDO threads, were included in this study. Patients were divided into two groups, 15 patients per group. The first group underwent the midface thread lifting using PDO threads ("non-SCA" group). The second group underwent midface thread lifting in combination with braided PDO threads for tear trough deformity improvement ("N-scaffold" group). The results were evaluated subjectively, based on the patients' satisfaction rates, and objectively, by evaluating photographs. RESULTS According to Barton's grading system, 7 months after the treatment, there was a statistically significant difference between the two groups: 1.733 ± 0.74 in the non-SCA group and 0.733 ± 0.83 in the N-scaffold group (p < 0.05). Based on patients' self-assessment, there was a significant difference at 7 months after the treatment: 2.86 ± 0.84 in "non-SCA" group and 3.76 ± 0.90 in "N-scaffold" group, p < 0.05. Complications such as persistent swelling, hematoma, skin irregularity, and infection were not observed during follow-up assessments. CONCLUSION The application of braided type PDO threads (N-scaffold) as part of the midface thread lifting, for aged lower eyelids rejuvenation appears to be effective and safe within a period. This study suggests that PDO threads insertion may be a useful, additional, and non-invasive tool for the aged lower eyelids rejuvenation.
Collapse
Affiliation(s)
- Galina Khan
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Beom Jun Kim
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Dong Gyu Kim
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - EunSoo Park
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| |
Collapse
|
16
|
van der Sluis N, Gülbitti HA, van Dongen JA, van der Lei B. Lifting the Mouth Corner: A Systematic Review of Techniques, Clinical Outcomes, and Patient Satisfaction. Aesthet Surg J 2022; 42:833-841. [PMID: 35373812 PMCID: PMC9342679 DOI: 10.1093/asj/sjac077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mouth corners are an essential part of the centrofacial area for perception of attractiveness and emotions. Downturned mouth corners are a result of aging or have a congenital origin. Different mouth corner lifting techniques are described in the literature. OBJECTIVES This review was performed to systematically assess and compare invasive and noninvasive mouth corner lifting techniques and their effectiveness, patient satisfaction, and adverse effects. METHODS MEDLINE (via PubMed), EMBASE (OvidSP), and the Cochrane Central Register of controlled trials databases were searched for clinical and observational studies published in peer-reviewed academic journals with abstracts available (searched from May 18, 2019, to December 18, 2021). Outcomes of interest were aesthetic mouth corner lifting techniques, the degree of lift as well as the longevity of the lifting effect, patient satisfaction, and adverse effects. Techniques were subdivided in invasive techniques and noninvasive techniques. RESULTS Out of 968 studies found from the search, 11 were included in the qualitative analysis. In general, surgical techniques seem to have a better mouth corner lifting effect than nonsurgical techniques; however, objective evidence is weak, and surgery inevitably results in a scar. Reported patient satisfaction was good for both surgical and nonsurgical techniques and no severe complications have been described. CONCLUSIONS Surgical techniques seem to have a better lifting effect on mouth corners than nonsurgical techniques. Nevertheless, objective evidence is weak, and a scar is inevitable. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Nanouk van der Sluis
- Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Haydar A Gülbitti
- Department of Dentistry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Joris A van Dongen
- Department of Plastic, Reconstructive, and Hand Surgery, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands
| | - Berend van der Lei
- Department of Plastic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
17
|
Hong W, Chen IC, Su CY, Perng CK, Ma H, Fang HW. Evaluating Pull-Out Strength of Barbed Suture In Vitro by Using Porcine Tissue and Polydimethylsiloxane (PDMS). Polymers (Basel) 2022; 14:polym14112170. [PMID: 35683843 PMCID: PMC9183050 DOI: 10.3390/polym14112170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
Using barbed thread lifting for facial rejuvenation has become popular these days due to its minimally invasive procedures with reduced complications. However, only limited studies regarding its mechanical properties for face suspension were published. The aim of this study was to evaluate suture-holding ability regarding its facelift property, and different specimens were tested in order to establish an in vitro model. Fresh porcine tissue and the synthetic material polydimethylsiloxane (PDMS) were selected to simulate human skin for evaluating barbed suture pull-out strength by the universal material testing machine. The results showed that the pull-out strength of barbs between different porcine tissues varied without consistency. By contrast, PDMS (30:1) showed more consistent pull-out strength in each testing, and the average maximum load force was close to porcine tissue. Furthermore, after submerging barbed sutures in PBS for 0 days (T0), 7 days (T7) and 14 days (T14), a trend of decreased average maximum load force, displacement and force of 1.5 mm/2 mm/3 mm displacement could be detected by in vitro testing with PDMS (30:1). These results provide support for using PDMS (30:1) to evaluate suture pull-out strength and holding/lifting capacities in vitro to obtain consistent and objective information for evaluating substantial equivalence of devices. The established in vitro method could be used for the future development of barbed thread lifting technology.
Collapse
Affiliation(s)
- Wei Hong
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (W.H.); (I.-C.C.); (C.-Y.S.)
| | - I-Cheng Chen
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (W.H.); (I.-C.C.); (C.-Y.S.)
- Accelerator for Happiness and Health Industry, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
| | - Chen-Ying Su
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (W.H.); (I.-C.C.); (C.-Y.S.)
| | - Cherng-Kang Perng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, 19F, No. 201, Sec. 2, Shi-Pei Street, Beitou Dist, Taipei 11217, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou District, Taipei City 11221, Taiwan
| | - Hsu Ma
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, 19F, No. 201, Sec. 2, Shi-Pei Street, Beitou Dist, Taipei 11217, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou District, Taipei City 11221, Taiwan
- Department of Surgery, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City 11490, Taiwan
- Correspondence: (H.M.); (H.-W.F.); Tel.: +886-2-2771-2171 (ext. 2521) (H.-W.F.)
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; (W.H.); (I.-C.C.); (C.-Y.S.)
- Accelerator for Happiness and Health Industry, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan
- Correspondence: (H.M.); (H.-W.F.); Tel.: +886-2-2771-2171 (ext. 2521) (H.-W.F.)
| |
Collapse
|
18
|
Zhukova O, Dydykin S, Kubíková E, Markova N, Vasil'ev Y, Kapitonova M. A New Complex Minimally Invasive Thread Lift Method for One-Time Three-Step Fixation of the Face and Neck Soft Tissues. Arch Plast Surg 2022; 49:296-303. [PMID: 35832146 PMCID: PMC9142270 DOI: 10.1055/s-0042-1748641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Abstract
Background In recent years thread lift has become widespread; however, existing methods need to improve their long-term outcome, which requires considering topographic anatomy of face and neck, especially the ligamentous apparatus. This study aims to assess the effectiveness and safety of an innovative method of one-time three-step thread facelift, which provides an additional support to the ligamentous structures of the upper, middle, and lower thirds of the face and neck.
Methods The study included 357 patients aged 32 to 67 years with various morphotypes of aging. The original method of thread lift was applied, and its effectiveness was followed up for to 2 years. The Wrinkle Severity Rating Score (WSRS) and Global Aesthetic Improvement Scale (GAIS) scores were used for assessment by investigators, independent observers, and patients. Statistical significance was determined using paired t-test and chi-square test.
Results The mean WSRS score was 3.88 ± 0.88 before the thread lift, 1.93 ± 0.81 one month after the procedure, and 2.36 ± 0.85 after 2 years of follow-up. The mean GAIS was 4.80 ± 0.04 one month after thread lift, and 4.01 ± 0.04 after 2 years, while in the patients' assessment Global Satisfaction Scale was 4.86 ± 0.02 and 4.10 ± 0.02, respectively. There were no clinically significant complications throughout the observation period.
Conclusion The new method of one-time three-step thread fixation of the soft tissues of the face and neck demonstrated a high degree of satisfaction by both experts and patients after 2 years of follow-up. It showed high efficacy and safety, including in the group of patients with pronounced age-related changes of the skin of face and neck.
Collapse
Affiliation(s)
- Olga Zhukova
- Department of Dermatology and STD, RUDN Peoples' Friendship University of Russia, Moscow, Russia
| | - Sergey Dydykin
- Department of Topographical Anatomy and Operative Surgery, Sechenov University, Moscow, Russia
| | - Eliska Kubíková
- Anatomical Institute, Comenius University, Bratislava, Slovakia
| | | | - Yuriy Vasil'ev
- Department of Topographical Anatomy and Operative Surgery, Sechenov University, Moscow, Russia
| | - Marina Kapitonova
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| |
Collapse
|
19
|
Usages of thread lifts on nasolabial folds for facial rejuvenating effects. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.1007/s00238-022-01961-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
20
|
Rezaee Khiabanloo S, Nabie R, Aalipour E. Effectiveness of Jawline, Jaw angle, and Marionette Lines Correction in Combination with APTOS Threads and ELLANSE; An Innovative Technique. J Cosmet Dermatol 2022; 21:4727-4734. [PMID: 35506203 DOI: 10.1111/jocd.15042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Facial aging is a multifactorial process in which considerable changes occur in different face structures. Thread lifting is one of the most common minimally invasive treatments related to facial rejuvenation. This study aimed to evaluate the efficacy and safety of jawline, jaw angle, and marionette lines correction in combination with APTOS threads and ELLANSE M types through an innovative technique. MATERIALS AND METHODS In this prospective chart review study, 50 patients with ptosis candidates for lower face correction were included between October 2019 to February 2020. To perform correction of the jawline, jaw angle, and marionette lines, APTOS thread (LLN2GS) and ELLANSE M type were used through an innovative technique. The efficacy (six and twelve months after the surgery) and safety (one, six, and eight weeks after the surgery) were assessed by two surgeons independently. Data were analyzed by SPSS ver. 22 for windows (IBM Inc, NY). RESULTS In this study, 50 patients (4 male, 46 female) with Mean±SD age of 53.84±10.79 years old (Range: 42 years) were included. Regarding the results, patients' level of satisfaction (improved to excellent levels) increased from 74% six months after the surgery to 86% twelve months after the surgery. Moreover, the level of satisfaction obtained from surgeons (improved to excellent levels) decreased from 96% to 86% at six months and twelve months after the surgery, respectively. Based on the results, there were substantial and perfect agreements between the surgeon and the independent surgeon to evaluate the surgery efficacy of facial rejuvenation six and twelve months after the surgery. No side effects were reported after 6 and 8 weeks after surgery. CONCLUSION Regarding the results, due to rare complications, deep satisfaction, and short downtime, the correction of the lower face in combination with APTOS thread (LLN2G) and ELLANSE M type through our innovative technique be considered an efficient and safe treatment.
Collapse
Affiliation(s)
- S Rezaee Khiabanloo
- Dermatologist, Novin Didegan Subspecialty Complex Clinic, Medico Derma Eexir Skin and beauty Clinic, Tehran, Iran
| | - Reza Nabie
- Professor of Ophthalmology, Oculoplastic and Strabismus Surgeon, Mehr Eye Hospital, Tabriz, East Azarbaijan, Iran
| | | |
Collapse
|
21
|
Contact Dermatitis in the Surgical Patient: A Focus on Wound Closure Materials. Dermatitis 2022; 34:191-200. [PMID: 35481860 DOI: 10.1097/der.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing compounds, or the material itself, have been implicated as contact allergens. This article provides the latest overview of the components of 3 major forms of wound closure materials-sutures, staples, and tissue adhesives-associated with contact dermatitis, discusses their cross-reactivity, and provides diagnostic and treatment guidelines.
Collapse
|
22
|
Combined Dermis Spacer Graft, Lateral Canthopexy and Subperiosteal Midface Lifting in the Management of Lower Eyelid Retraction Secondary to Chronic Facial Nerve Palsy. J Maxillofac Oral Surg 2022. [DOI: 10.1007/s12663-022-01688-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
23
|
Abstract
ABSTRACT Skin changes that accompany aging lead many to seek treatments that restore a more youthful appearance. Common issues of concern include skin tone, wrinkles, skin thinning, sagging, laxity and decreased elasticity, and hollowing of the face. This work discusses these concerns and their anatomic bases and highlights evidence for a causal role played by menopause-associated hormonal changes where such evidence exists. In addition, treatment options are discussed, with an emphasis on minimally invasive approaches. A variety of modalities are discussed, including botulinum toxins, fillers, multiple types of lasers, radiofrequency devices, focused ultrasound, chemical peels, and thread lifts. These interventions, often in combination, can achieve goals of patients seeking aesthetic rejuvenation.
Collapse
Affiliation(s)
- Yakir S Levin
- Harvard Medical School, Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114
| |
Collapse
|
24
|
Preibisz L, Boulmé F, Paul Lorenc Z. Barbed Polydioxanone Sutures for Face Recontouring: Six-Month Safety and Effectiveness Data Supported by Objective Markerless Tracking Analysis. Aesthet Surg J 2022; 42:NP41-NP54. [PMID: 34626467 DOI: 10.1093/asj/sjab359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Barbed polydioxanone (PDO) sutures allowing for minimally invasive skin lifting are broadly and increasingly used in aesthetic dermatology. OBJECTIVES To describe utilization of diverse barbed PDO sutures for aesthetic facial corrections in Caucasian patients, to evaluate long-term safety and to demonstrate effectiveness in skin tightening, redefinition of facial contours, and tissue elevation. METHODS A retrospective chart review of patients routinely treated with barbed PDO sutures on face was performed. Aesthetic improvement was evaluated at 6-, 12- and 24-week posttreatment by the treating physician, patients, and an independent photographic reviewer. Patient's satisfaction with treatment outcome was evaluated. Procedure effects were also objectively measured by markerless tracking analysis. RESULTS Sixty patients were treated with a total of 388 barbed sutures in various anatomical areas and followed-up for 24 weeks. At Week 24, the aesthetic improvement rate was 80% to 100% (depending on the evaluator), skin movements related to pre-treatment photographs showed significant changes across several different anatomical regions, and 97% of patients were satisfied with the overall treatment outcome. Transient, mild, and short-lasting adverse events, mostly pain and hematoma, occurred in 15% of patients. CONCLUSIONS Barbed PDO sutures are safe and highly effective for aesthetic corrections, with results lasting for at least 24 weeks. LEVEL OF EVIDENCE: 4
Collapse
|
25
|
Li K, Zhang X, Guo W, Wang L, Wang G, Gao L. Polydioxanone thread insertion in combination with radio frequency treatment does not exhibit synergistic efficacy: Animal study with pigs. J Cosmet Dermatol 2021; 21:3479-3485. [DOI: 10.1111/jocd.14651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/16/2021] [Accepted: 11/10/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Kai Li
- Department of Dermatology Xijing Hospitial Fourth Military Medical University Xi’an China
| | - Xiao Zhang
- Department of Dermatology Xijing Hospitial Fourth Military Medical University Xi’an China
| | - Wei Guo
- Department of Dermatology Xijing Hospitial Fourth Military Medical University Xi’an China
| | - Li Wang
- Department of Dermatology Xijing Hospitial Fourth Military Medical University Xi’an China
| | - Gang Wang
- Department of Dermatology Xijing Hospitial Fourth Military Medical University Xi’an China
| | - Lin Gao
- Department of Dermatology Xijing Hospitial Fourth Military Medical University Xi’an China
| |
Collapse
|
26
|
Donnarumma M, Vastarella M, Ferrillo M, Cantelli M, D'Andrea M, Fabbrocini G. An innovative treatment for acne scars with thread-lift technique: our experience. Ital J Dermatol Venerol 2021; 156:40-41. [PMID: 31525839 DOI: 10.23736/s2784-8671.19.06313-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marianna Donnarumma
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy -
| | - Maria Vastarella
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria Ferrillo
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Mariateresa Cantelli
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Mirella D'Andrea
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| |
Collapse
|
27
|
Safety Profile of Thread Lifts on the Face and Neck: An Evidence-Based Systematic Review. Dermatol Surg 2021; 47:1460-1465. [PMID: 34699439 DOI: 10.1097/dss.0000000000003189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND "Thread lifting" has quickly gained popularity as a minimally invasive treatment for facial rejuvenation. However, the effectiveness is questionable, and the safety and adverse effects are often not discussed. OBJECTIVE To identify and discuss the adverse effects associated with various types of threads. MATERIALS AND METHODS Studies describing the use of thread lifts were identified using a PubMed search. Inclusion criteria included studies in which barbed and nonbarbed threads were used for the face and neck. RESULTS Fifty-nine articles consisting of 14,222 patients (14,134 barbed, 81 nonbarbed, and 7 combined cases) were included. The most common side effects overall were facial asymmetry (n = 6,143), edema/tumefaction (n = 453), and ecchymosis (n = 407). Serious adverse effects were rare and consisted of paresthesias, alopecia, and injuries to vessels/glands. Most adverse effects were transient and self-resolving, with the exception of contour irregularities, injuries to vessels/glands, infections, and inflammatory reactions. CONCLUSION Most side effects associated with threads were self-resolving, whereas more serious cases subsided with treatment. Future studies are critical to further determine whether thread lifting provides long-lasting, safe, and satisfying results.
Collapse
|
28
|
Botti C, Botti G, Pascali M. Facial Aging Surgery: Healing Time, Duration Over the Years, and the Right Time to Perform a Facelift. Aesthet Surg J 2021; 41:NP1408-NP1420. [PMID: 34337655 DOI: 10.1093/asj/sjab304] [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: 11/14/2022] Open
Abstract
BACKGROUND The "time variable" assumes paramount importance, especially regarding facial rejuvenation procedures. Questions regarding the length of recovery time before returning to work, how long the results will last, and the ideal time (age) to undergo this particular type of surgery are the most commonly asked by patients during the initial consultation. OBJECTIVES The authors endeavored to determine the healing time, optimal age to perform the surgery, and duration of the results after cosmetic face surgery. METHODS A 35-year observational study of 9313 patients who underwent facial surgeries was analyzed. The principal facial rejuvenation interventions were divided into 2 subgroups: (1) eyelid and periorbital surgery, including eyebrow lift, blepharoplasty, and its variants and midface lift; and (2) face and neck lift. Significant follow-ups were conducted after 5, 10, and 20 years. To evaluate the course of convalescence, the degree of satisfaction with the intervention, and the stability of the results, a questionnaire survey was administered to a sample of 200 patients who underwent face and neck lifts. RESULTS The answers given indicated that surgery performed according to rigorous standards allowed for a relatively rapid recovery, and the positive results were stable up to 10 years after surgery. The level of patient satisfaction also remained high even after 20 years. CONCLUSIONS The "right time" for a facelift, taking into account age, recovery time, and the longevity of the results, is an important consideration for both the patient and the cosmetic surgeon. LEVEL OF EVIDENCE: 4
Collapse
|
29
|
Niu Z, Zhang K, Yao W, Li Y, Jiang W, Zhang Q, Troulis MJ, August M, Chen Y, Han Y. A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting. Aesthetic Plast Surg 2021; 45:2148-2158. [PMID: 33821308 DOI: 10.1007/s00266-021-02256-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/16/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Facial thread-lifting (FTL) has gained more popularity, but the incidences of complications following FTL remain controversial. We aimed to perform a meta-analysis and systematic review to estimate the incidences of complications and to compare the short- and long-term satisfaction rates following FTL. METHODS We searched PubMed, Web of Science, Embase and Cochrane library for eligible studies. The primary outcome was the incidences of complications following FTL. The secondary outcome was the satisfaction rate immediately and 6-month after FTL. The pooled incidences of complications and 95% confidence intervals were estimated using random-effects models. RESULTS A total of 26 studies were included in this meta-analysis. Swelling was the most commonly reported complication with a pooled incidence of 35%, followed by skin dimpling (10%), paresthesia (6%), thread visibility/palpability (4%), infection (2%), and thread extrusion (2%). Absorbable threads were associated with a significantly lower risk of paresthesia (3.1% vs. 11.7%) and thread extrusion (1.6% vs. 7.6%) than non-absorbable threads. Patients older than 50 years had a significantly higher risk of dimpling (16% vs. 5.6%) and infection (5.9% vs. 0.7%) than their younger counterparts. In addition, the pooled long-term satisfaction rate was significantly decreased compared to it immediately after FTL (88% vs. 98%). CONCLUSION Non-absorbable threads and older age of patients are associated with higher risks of complications. Therefore, we recommend a judicious use of non-absorbable threads and FLT in older patients. Furthermore, it should be discussed with patients preoperatively that the rejuvenation effect of FTL may not maintain in the long-term. 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 .
Collapse
Affiliation(s)
- Zehao Niu
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Kexue Zhang
- Department of Pediatric Orthopedic, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wende Yao
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Yan Li
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Weiqian Jiang
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China
| | - Qixu Zhang
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030, USA
| | - Maria J Troulis
- Harvard School of Dental Medicine, Boston, Massachusetts, 02115, USA
| | - Meredith August
- Harvard School of Dental Medicine, Boston, Massachusetts, 02115, USA
| | - Youbai Chen
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China.
| | - Yan Han
- Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China.
| |
Collapse
|
30
|
Facial Thread Lifting Complications in China: Analysis and Treatment. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3820. [PMID: 34549008 PMCID: PMC8447984 DOI: 10.1097/gox.0000000000003820] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 07/26/2021] [Indexed: 11/25/2022]
Abstract
Background: Facial thread lifting technology has been applied for more than 30 years, with relatively few complications. In 2014, China approved polydioxanone thread (an absorbable barbed thread) for large-scale nonsurgical facial lifting. However, due to surgeons’ lack of overall experience, the complications of polydioxanone thread facelift have been relatively high. Methods: From April 2014 to January 2020, a total of 190 patients with postoperative complications of facelifts were treated after they underwent thread lifting in other hospitals. Of these, 189 patients were women and one was a man; the age of patients ranged from 28 to 62 years, with an average age of 37.4 years. Results: Patients were mainly treated in our outpatient clinic for the following complications: skin dimpling (77 cases, 40.5%); contour irregularity (32 cases, 16.8%); visible threads (31 cases, 16.3%); thread extrusion (10 cases, 5.3%); infection (17 cases, 8.9%); swelling (nine cases, 4.7%); incomplete facial paralysis (five cases, 2.6%); hyperpigmentation (four cases, 2.1%); hematoma (four cases, 2.1%); allergy (one case, 0.05%). Follow-up was scheduled 1–24 weeks after treatment. Conclusions: The most common complications of facial thread lifting are, in the following order, skin dimpling, contour irregularity, visible threads, and thread extrusion. The reasons for complications are mainly unfamiliarity with facial anatomy, unskilled surgical operation, and misunderstanding of the facial aesthetics of Asian women.
Collapse
|
31
|
Cho SW, Shin BH, Heo CY, Shim JH. Efficacy study of the new polycaprolactone thread compared with other commercialized threads in a murine model. J Cosmet Dermatol 2021; 20:2743-2749. [PMID: 33421303 PMCID: PMC8451902 DOI: 10.1111/jocd.13883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/15/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Polydioxanone (PDO) threads, poly-L-lactic acid (PLLA) threads, and polycaprolactone (PCL) threads have been used for lifting and antiaging purposes. The new PCL threads that have less residual monomer compared to the previous PCL are developed. AIMS The efficacy of threads regarding collagen synthesis and wrinkle improvement was evaluated in vivo model. METHODS In this study, threads were inserted into 30 six-week-old male SKH-1 hairless mice. One of four threads was implanted at either side of the spine of each mouse. Biopsy specimens obtained at 1, 4, and 8 weeks were examined using hematoxylin and eosin (H&E) and Herovici's stain. Additionally, immunoblot analysis was performed using primary antibody for collagen type III and transforming growth factor-β (TGF-β) and visualized by chemiluminescence and densitometric quantification. Finally, skin replicas were used to calculate total wrinkle area (mm2 ). RESULTS Neocollagenesis was significantly increased by 50% in the new PCL and pre-existing PCL groups at 8 weeks (p value < 0.001). Additionally, new-PCL-implanted mice showed a significant increase in collagen type III and TGF-β expressions at 8 weeks (p value < 0.001). The number of inflammatory cells was also increased in the skin of PCL-implanted mice at 8 weeks. Finally, wrinkles were reduced about 20% in the new PCL group at 8 weeks. CONCLUSIONS The new PCL thread exhibited a superior skin rejuvenation effect. This suggests that the material processing technology can be applied not only to the thread but also to various products such as dermal filler and cosmetics.
Collapse
Affiliation(s)
- Seung Woo Cho
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
| | - Byung Ho Shin
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
| | - Chan Yeong Heo
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
- Department of Plastic and Reconstructive SurgerySeoul National University College of MedicineSeoulKorea
| | - Jung Hee Shim
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
- Department of Research Administration TeamSeoul National University Bundang HospitalSeongnamKorea
| |
Collapse
|
32
|
Percutaneous Thread Lift Facial Rejuvenation: Literature Review and Evidence-Based Analysis. Aesthetic Plast Surg 2021; 45:1540-1550. [PMID: 33471152 DOI: 10.1007/s00266-020-02095-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Interest in noninvasive facial rejuvenation procedures continues to grow. With the advent of the so-called lunch-time face-lift, suture suspension facial rejuvenation has gained prominence and much popularity largely patient driven rather than data driven. We have published a decade ago a review about this rejuvenation technique. Despite its popularity at that time, serious long-term studies and peer-reviewed data about longevity and patient satisfaction were lacking to our surprise. As 10 years have passed, we have conducted a new systematic PubMed database search limited to the last 10 years interval. METHODS The search identified 192 publications. After screening the titles and abstracts, 20 clinical and 2 experimental studies met the inclusion criteria and were selected for this review. RESULTS Though thread lift facial rejuvenation is considered to be a promising modality, no new evidence has been added to the literature to support its use. CONCLUSION Until evidence-based efficacy and robust data are objectively documented, patients requesting percutaneous facial rejuvenation must be well informed about adverse events, longevity of effect, and limited available data on efficacy. 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 .
Collapse
|
33
|
Absorbable Barbed Threads for Lower Facial Soft-Tissue Repositioning in Asians. Dermatol Ther (Heidelb) 2021; 11:1395-1408. [PMID: 34218425 PMCID: PMC8322220 DOI: 10.1007/s13555-021-00569-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/16/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Asian patients often seek to address lower facial aging through clinical interventions that increase anterior projection and jawline contouring. The Definisse™ (also known as Happy Lift™) thread lift treatment uses barbed absorbable threads to suspend tissues and induce biostimulation. We evaluated the efficacy and safety of absorbable barbed threads for lower facial reshaping in Thai patients. Methods This prospective, evaluator-blinded study enrolled 27 Thai patients diagnosed with mild to moderate facial laxity. Patients underwent thread implantation along the mandibular angle with one of two double needle thread lengths (12 and 23 cm) to create a “J stitch”. Primary outcome was the clinical improvement in facial laxity as graded by two blinded dermatologists at baseline, immediately after treatment, and at 1 week and 1, 2, 3, 6, and 12 months follow-up. Objective measurements included volume in the jawline, nasolabial folds, and submental area. Patients’ self-assessment scores and adverse reactions were recorded. Results Of the 27 patients recruited to the study, 25 (92.6%) attended all follow-up visits. Clinical improvement of facial laxity was observed immediately after thread implantation. There was significant volume improvement in the jawline, nasolabial folds and submental area at almost all follow-up visits (p < 0.007), with most patients (51.9%) reporting excellent lifting effect as early as the 1 week follow-up visit. All adverse reactions were mild and resolved spontaneously without any medical intervention. Conclusion Implantation of absorbable barbed threads is a safe and effective treatment for facial rejuvenation in Thai patients. Long threads (23 cm) showed a slight superiority to short threads (12 cm) in terms of face-lifting efficacy, which suggests the benefit of additional barbs in tissue suspension and biostimulation. The disadvantage of absorbable threads is that their visible lifting effects are not as long-lasting as those of non-absorbable ones, since they are reabsorbed from 6 months onwards. Trial registration ClinicalTrials.gov identifier: TCTR20210415001. This clinical trial was retrospectively registered 12 April 2021.
Collapse
|
34
|
Kim TS, Kim SS, Jeong C, Song YK. Expert consensus on the facial rejuvenation using the Mint Lift ® in Koreans: Perspectives of plastic surgeons. J Cosmet Dermatol 2021; 20:2224-2231. [PMID: 33721393 DOI: 10.1111/jocd.14072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND It would be mandatory for plastic surgeons to consider anthropometric and anatomical differences between Asians and Caucasians in performing facial rejuvenation procedures using absorbable threadlifts in Asians. METHODS A consensus meeting was convened to discuss indications, treatment procedures, possible combination treatments, clinical outcomes, and safety of an absorbable polydioxanone (PDO) monofilament threadlift (Mint Lift® ; HansBiomed Co. Ltd., Seoul, Korea), for which the "Mint Aesthetics Expert Group" was organized with four Korean board-certified specialists in plastic and reconstructive surgery. RESULTS Our recommendations are as follows: First, the entry and exit points should be determined considering anatomical characteristics of the face (Level of evidence III). Second, treatment procedures may vary depending on indications (Level of evidence III). Third, short-term efficacy and safety of facial rejuvenation using the Mint Lift® have been well documented (Level of evidence I and III). Third, facial rejuvenation using the Mint Lift® may be combined with a liposuction (Level of evidence III). CONCLUSIONS Here, we propose expert consensus on facial rejuvenation using a novel absorbable PDO monofilament threadlift in Koreans. Of note, this is the only expert consensus prepared by board-certified specialists in plastic surgery in Korea. But more evidence-based efforts should be made to update and to expand the current recommendations.
Collapse
Affiliation(s)
| | | | - Cheol Jeong
- Gangnam JC Plastic Surgery Clinic, Jinju, Korea
| | | |
Collapse
|
35
|
Polydioxanone Threads for Atrophic Neck Scars. Dermatol Surg 2021; 47:751-753. [PMID: 32769520 DOI: 10.1097/dss.0000000000002535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Khan G, Ahn KH, Kim SY, Park E. Combined press cog type and cog PDO threads in comparison with the cog PDO threads in facial rejuvenation. J Cosmet Dermatol 2021; 20:3294-3298. [PMID: 33904637 DOI: 10.1111/jocd.14092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thread lifting is one of the most common minimally invasive options in facial rejuvenation procedures. The application of polydioxanone (PDO) showed good results and fewer complications. PDO threads effectively strengthen the contour of the face, reduce roundness, and lift sagging skin due to collagen-stimulating properties. OBJECTIVE The purpose of this study was an evaluation of the efficacy of the PDO threads: the combination of the cog type and press cog type threads (Ncog and Nfix) and cog type thread (Ncog) alone. And this study was conducted to define complications related to thread inserting during the follow-up period. MATERIALS AND METHODS Thirty patients who underwent PDO thread treatment for facial rejuvenation and tightening sagging skin tissues were evaluated. The follow-up period was seven months. Photographic objective and subjective evaluations were performed during this period. RESULTS Thirty patients were included in this study. The mean age of participants was 51.8 years (range 65 to 34). There was a statistically significant difference between pre and 1-month post-operative results in both groups with a mean score of 1.94 ± 0.43 (p < 0.05). Furthermore, the combination of Ncog and N fix showed slightly better results than Ncog alone. According to patient satisfaction, all patients were satisfied with the clinical outcomes. CONCLUSIONS Our results revealed PDO threads are effective in aged skin rejuvenation, soft tissue retraction, and support, showing fewer complications. In addition, it could be assumed that treatment with thicker thread could be a more efficacious procedure. However, this statement requires further researches.
Collapse
Affiliation(s)
- Galina Khan
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Kwang Hyeon Ahn
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Se Young Kim
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - EunSoo Park
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| |
Collapse
|
37
|
Lee KW, Yoon JH, Kim JS, Hu KS, Kim HJ. Three-dimensional topography of facial soft tissues for the safer and effective threading procedures. Clin Anat 2021; 34:1050-1058. [PMID: 33583088 DOI: 10.1002/ca.23726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/24/2021] [Accepted: 02/05/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION To reduce complications caused by the procedure, the target layer for thread lifting should be the superficial fat or superficial musculoaponeurotic system of the face. The aim of this study was to establish the thicknesses of the facial skin and superficial fat using a 3D scanning system to provide basic clinical data for thread lifting. MATERIAL AND METHODS Thirty fixed Korean and Thai cadavers (male: 17, female: 13) were used. The depths of the skin and superficial fat were measured using a three dimensional (3D) structured-light scanner. Facial images of both undissected and removed skin and superficial fat were taken with the 3D scanner. The paths from the temple and the front of the tragus to the infraorbital, perioral, cheek, and mental areas were displayed on the 3D image. The thickness along the path was measured by calculating the difference between the undissected and dissected 3D images. RESULTS The means and standard deviations of thicknesses of the skin and superficial fat were 2.1 ± 0.4 mm and 5.2 ± 1.9 mm in the 11 pathways. The facial skin became thicker going toward the lower aspect of the face from temple to infraorbtial and perioral regions. The thickness of the superficial fat around the marionette line showed the biggest change. CONCLUSIONS The present findings indicate that a 3D scanning system can yield crucial anatomical information about the thickness of the facial skin and superficial fat for use in various minimally invasive clinical procedures including thread lifting.
Collapse
Affiliation(s)
- Kang-Woo Lee
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea
| | | | - Ji-Soo Kim
- YSBio Co. Ltd., Seoul, South Korea.,Dr Youth Clinic, Seoul, South Korea
| | - Kyung-Seok Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea.,Department of Materials Science & Engineering, College of Engineering, Yonsei University, Seoul, South Korea
| |
Collapse
|
38
|
Chang DY, Kim HM, Ahn TH, Lee SB, Moon HJ. Proposed Treatment Protocols for Facial Rejuvenation Using a Novel Absorbable Polydioxanone Monofilament Threadlift in Koreans: Empirical Perspectives of Aesthetic Physicians and Surgeons. Aesthet Surg J Open Forum 2020; 3:ojaa049. [PMID: 33791670 PMCID: PMC7954395 DOI: 10.1093/asjof/ojaa049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 01/19/2023] Open
Abstract
Background Aesthetic physicians and surgeons should consider differences in anthropometric and anatomical characteristics between Asians and Caucasians in performing facial rejuvenation procedures using absorbable threadlifts in Koreans. Objectives This paper was prepared to propose empirical treatment protocols for Korean aesthetic physicians and surgeons. Methods A panel of 5 Korean experts on the aesthetic uses of an absorbable polydioxanone (PDO) monofilament threadlift (Mint Lift; HansBiomed Co. Ltd., Seoul, Korea), thus termed as “the Mint Consensus Group,” was convened to recommend practical guidelines for empirical treatment with the Mint Lift. Results To summarize, our recommendations are as follows: First, the entry and exit points should be determined considering the anatomical characteristics of the face (level of evidence III). Second, treatment procedures may vary depending on indications (level of evidence III). Conclusions Here, the authors propose empirical treatment protocols for facial rejuvenation using a novel absorbable PDO monofilament threadlift in Koreans. But more evidence-based efforts should be made to update the current treatment protocols. Level of Evidence: 4
Collapse
Affiliation(s)
| | | | | | | | - Hyoung-Jin Moon
- Corresponding Author:Hyoung-Jin Moon, MD, BeUp Aesthetic Plastic Surgery Clinic, 3Fl Shinwoong Tower, 216 Teheran-ro, Gangnam-gu, Seoul 06221, Korea. E-mail:
| |
Collapse
|
39
|
Abstract
BACKGROUND Absorbable wedge-shaped polydioxanone (PDO) sutures are currently available for facial rejuvenation, and they are extremely popular in the aesthetic clinics in Korea. Other than face lifting, threads also can be used for nonsurgical rhinoplasty. The Asian nose is typified by a flat nasal bridge, indistinct nasal dorsum, underprojected and broad nasal tip, and a short columella. In the past, Asian rhinoplasty mainly focused on dorsal augmentation. At present, augmentation of the nasal tip is very popular and is considered an important aspect of achieving a natural and balanced nose. OBJECTIVE To describe a novel technique with PDO threads in nonsurgical rhinoplasty. In addition, the authors aimed to assess the overall safety and efficacy of nonsurgical rhinoplasty combining both fillers and threads. METHODS A retrospective analysis was performed on Korean patients who received rhinoplasty with PDO threads and fillers. All participants underwent a single treatment session. The results were assessed objectively by 2 independent dermatologists using serial photography and subjectively based on the patients' satisfaction scores at 6-month follow-up. RESULTS A total of 31 patients were evaluated, and 93.5% considered the results satisfactory. Consensus ratings at the 6-month follow-up were largely categorized as very much improved (38.7%), much improved (35.5%), and improved (25.8%). An average increase of 6.3° (percentage increase by 7.6) in the nasolabial angle (p < .05) was measured at follow-up. The incidence of the complications was low, and the ones reported were minor. CONCLUSION Nonsurgical rhinoplasty combining PDO threads and fillers can be safe and effective, maintaining good results at 6 months after the procedure. Threads are especially useful for lifting-up the nasal tip, contributing to a more harmonious and pleasing nasal appearance by modifying the columella-labial angle.
Collapse
|
40
|
Kim SM, Won YS, Kim SK. Gold Thread Implantation for Female Sexual Dysfunction and Vaginal Laxity: A Preliminary Investigation. J Menopausal Med 2020; 26:130-134. [PMID: 32893514 PMCID: PMC7475290 DOI: 10.6118/jmm.19024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 07/03/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives We evaluated the efficacy of gold thread implantation (GTI) in the vulva and vagina to improve female sexual dysfunction (FSD) and vaginal laxity. Methods A retrospective chart review was conducted on 46 women who underwent GTI between 2017 and 2018 at our institution. Physicians interviewed patients using questionnaires at baseline and 1–3 months post-treatment. The questionnaires consisted of eight questions: vaginal laxity, vaginal dryness, pain during intercourse, sexual satisfaction during intercourse, sexual arousal confidence, sexual satisfaction of partner, frequency, and maintaining lubrication. Results Overall, participants experienced significant improvement after GTI treatment (P < 0.0001). The median score of vaginal laxity was 3 (slightly loose) at baseline and 5 (slightly tight) at post-treatment. Vaginal dryness also improved from 4 (moderate) at baseline to 2 (little) at post-treatment. The degree of pain during intercourse decreased from 3 to 1. The sexual satisfaction score was 3 (moderately dissatisfied) at baseline and 4 (about equally satisfied and dissatisfied) at post-treatment. Sexual confidence of arousal increased from a score of 3 (low confidence) at baseline to 4 (moderate confidence) at post-treatment. They perceived greater partner sexual satisfaction, moving from a score of 2 to 4. Participants reported lubrication was more frequent during sexual activity, which was maintained until completion of sexual activity. Both scores regarding lubrication increased from 3.5 at baseline to 5 at post-treatment. Conclusions GTI may be an option for FSD and vaginal laxity.
Collapse
Affiliation(s)
- Su Mi Kim
- Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju, Korea
| | | | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
41
|
Cobo R. Use of Polydioxanone Threads as an Alternative in Nonsurgical Procedures in Facial Rejuvenation. Facial Plast Surg 2020; 36:447-452. [DOI: 10.1055/s-0040-1714266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractMinimally invasive cosmetic procedures are in increasing demand worldwide. Patients are constantly searching for office-based techniques that can help improve the signs of aging but without the morbidity of a surgical procedure. Thread lifting with polydioxanone (PDO) sutures is a cosmetic procedure where lax tissue is lifted and repositioned trying to create a more youthful looking facial contour. The threads are absorbable and come in different shapes and lengths. The rate of complications and the downtime of the procedure are low, which are something patients are looking for. Ideally, these procedures should be performed by trained specialists who have complete knowledge of the facial anatomy, thus enhancing and improving results. Thread lifting with PDO absorbable threads has become an excellent option for minimally invasive facial rejuvenation procedures with a high satisfaction among patients and very few complications. It is a new tool that can be introduced in the armamentarium of specialists who work in the field of facial plastic surgery and who can offer this option to their patients with improved outcomes.
Collapse
Affiliation(s)
- Roxana Cobo
- Department of Otolaryngology,Centro Médico Imbanaco, Cali, Colombia
| |
Collapse
|
42
|
Clinical effectiveness of thread-embedding acupuncture in the treatment of Bell's palsy sequelae: A randomized, patient-assessor-blinded, controlled, clinical trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
43
|
Mini-midface Lift Using Polydioxanone Cog Threads. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2920. [PMID: 32766067 PMCID: PMC7339253 DOI: 10.1097/gox.0000000000002920] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/23/2020] [Indexed: 11/26/2022]
Abstract
Background: Deepening of the nasolabial fold with reduced malar highlight caused by sagging of the midface is one of the most important characteristics of facial aging. This report describes the use of 18-G polydioxanone (PDO) cog threads to improve midface soft tissue sagging and achieve satisfactory results through a minimally invasive procedure. Methods: In total, 64 patients (all women; age, 33–60 years) underwent a midface thread lift from January 2017 to January 2018. After a stab incision was made through an 18-G needle over the lateral orbital rim, three 18-G precannulated PDO cog threads were inserted, targeting the deep medial fat pad and inner layer of the superficial muscular aponeurotic system. The threads were anchored to the periosteum of the lateral orbit, suspending the soft tissue to a more superior direction. Surgical results were evaluated subjectively (patient satisfaction ratings) and objectively (blinded physician ratings based on changes in the vertical position of the malar highlight). Results: No major complications (postoperative hematoma, infection, or temporary sensory/motor decreases) were observed. The mean procedural time was 15 minutes, and all patients underwent local anesthesia. Patient satisfaction was the highest at 1 month postoperatively (mean, 4.7/5.0), decreasing at 1 year postoperatively (2.8/5.0). The scores on the objective assessment followed the same trend (4.5/5.0 at 1 month; 3.1/5.0 at 1 year). Conclusion: Using PDO cog threads for midface lifting is simpler, quicker, and less invasive than using conventional surgical methods, and this method simultaneously achieves satisfactory results for at least 6 months.
Collapse
|
44
|
Halepas S, Chen XJ, Ferneini EM. Thread-Lift Sutures: Anatomy, Technique, and Review of Current Literature. J Oral Maxillofac Surg 2020; 78:813-820. [DOI: 10.1016/j.joms.2019.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/27/2022]
|
45
|
Choi MS, Byeon HS, Moon HJ. Short-term safety of facial rejuvenation using an absorbable polydioxanone monofilament thread in patients with mild-to-moderate facial skin sagging. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2020. [DOI: 10.14730/aaps.2019.01928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
|
46
|
Short-term Treatment Outcomes of Facial Rejuvenation Using the Mint Lift Fine. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2775. [PMID: 32440439 PMCID: PMC7209836 DOI: 10.1097/gox.0000000000002775] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/24/2020] [Indexed: 12/26/2022]
Abstract
Background Threadlifts are classified as absorbable or nonabsorbable, natural or synthetic, and multifilament or monofilament ones, each of which has its own merits and demerits. We placed a novel absorbable polydioxanone monofilament threadlift (Mint Lift Fine; HansBiomed Co. Ltd., Seoul, Korea) in the subcutaneous fat compartment for facial rejuvenation in patients with nasolabial folds, nasojugal groove, marionette lines, or sagging jowl. Here, we describe its short-term treatment outcomes in a retrospective consecutive series of 21 patients. Methods A total of 21 patients (n = 21) were evaluated; their treatment outcomes were described based on a comparison between preoperative and postoperative findings and Global Aesthetic Improvement Scale (GAIS) scores were assessed at 6 months. This is accompanied by analysis of the incidence of postoperative complications. Results The patients had a mean GAIS score of 3.62 ± 0.84 points, which corresponds to "Much improved" or "Very much improved." Moreover, there were no significant differences in the GAIS scores between the target sites (midface and lower face: 3.78 ± 1.13; lower face: 3.43 ± 0.50; and midface: 3.60 ± 0.49; P > 0.05). Furthermore, there were a total of 4 cases (19.0%) of postoperative complications, all of which were spontaneously resolved within a maximum period of 4 months. Conclusions We describe short-term treatment outcomes of facial rejuvenation using the Mint Lift Fine in patients with nasolabial folds, nasojugal groove, marionette lines, or sagging jowl. But further large-scale, prospective, multicenter studies with long periods of follow-up are, therefore, warranted to establish our results.
Collapse
|
47
|
Rezaee Khiabanloo S, Nabie R, Aalipour E. Outcomes in thread lift for face, neck, and nose; A prospective chart review study with APTOS. J Cosmet Dermatol 2020; 19:2867-2876. [PMID: 32267994 DOI: 10.1111/jocd.13397] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 03/13/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION To evaluate the surgical efficacy and outcomes related to midface, mandible, neck (and double chin), and nose lifting with APTOS thread lift. METHODS In this prospective review chart study, a total of 58 patients were included (from July 2018 to July 2019). All participants underwent facial thread lifting using APTOS. The patients were followed up first week, third, and sixth month after lifting surgery. Outcomes were assessed by two surgeons and patients based on the GAIS score. All data were analyzed by SPSS-17 software with chi-square test. RESULTS A total of 58 patients (Mean ± SD: 52.52 ± 10.58) (F: 45, Mean ± SD:53.13 ± 11.27 years, M:13, Mean ± SD: 50.38 ± 9.43 years) were included in the study. The most common sites for the face-lifting surgery were midface and mandibular (N = 45, 77.5%), neck (N = 10, 17.3%), and nose (N = 3, 5.2%), respectively. The level of satisfaction remained unchanged (after 6 months), about 80%, for the patients, increased from 90.7% (first week) to 94.8% (sixth month) after surgery, and increased from 93.1% (first week) to 94.8% (sixth month after surgery). The highest rate of potential complications after the surgery was related to ecchymosis (17 cases, 30%), followed by complications of pain (N = 10, 17.2%), tumefaction (N = 4, 6.9%), and dimple (N = 1, 1.7%) were reported. CONCLUSION The results showed that satisfaction in patients and surgeons increased over time (after 6 months). Postoperative (minor) complications were also assessed and ecchymosis was found to be the most common complication. However, the proportion of postoperative complications was relatively low.
Collapse
Affiliation(s)
- Samad Rezaee Khiabanloo
- Novin Didehgan Skin and Laser Clinic, Tehran, Iran.,Medico Derma Eexir Skin and beauty Clinic, Tehran, Iran
| | | | - Ezatollah Aalipour
- Research and Development Center, Medico Derma Eexir Skin and beauty Clinic, Tehran, Iran
| |
Collapse
|
48
|
Abstract
BACKGROUND Treatment of the aging midface is increasingly deemed a key part of facial and periorbital rejuvenation. Compared with Westerners, Asians tend to have a relatively prominent zygoma and mandibular angle, thicker dermis, and greater propensity for scar formation. OBJECTIVE This study was performed to review our surgical method of vertical midface lifting in Asian patients and evaluate the clinical outcomes. METHODS AND MATERIALS This retrospective observational study involved 116 Asian women who complained of an aged midface. All patients underwent midface rejuvenation surgery with one lower eyelid incision and 2 small frontal-temporal incisions. Clinical results were assessed objectively using photographs and subjectively by a patient satisfaction survey. RESULTS All patients recovered well without major complications. High patient satisfaction (94%) was attained. The improvement scores as evaluated by the panel demonstrated a higher level of improvement for the malar eminence (8.3 ± 0.6), nasojugal groove (8.0 ± 0.8), and nasolabial fold (7.9 ± 0.7) than for the lower face (6.2 ± 1.0). CONCLUSION Our vertical midface lift technique is safe and effective for older Asian patients with a midface aging appearance. LEVEL OF EVIDENCE Therapeutic IV.
Collapse
|
49
|
Abstract
BACKGROUND In the past 5 years, several absorbable sutures for use in minimally invasive suture lifts have appeared on the market. These newer sutures were preceded by several iterations of nonabsorbable counterparts, all of which were eventually removed from the market because of complications. OBJECTIVE This review will provide a history of suture lift experience, review the published evidence on the safety and efficacy of currently available absorbable suture lift materials, and detail the clinical experience of the authors using these products. MATERIALS AND METHODS A review of relevant clinical terms was performed on PUBMED and MEDLINE databases. All articles were reviewed, and further studies examined from citations of selected articles. Articles that focused on suture lifting using extensive dissection were excluded. RESULTS Twelve studies detailed the results of absorbable suture lifting largely through patient satisfaction surveys or retrospective chart review of cases. No randomized controlled studies were available. CONCLUSION Data on suture lifting are limited, with largely descriptive and retrospective case reports available in the literature entailed Oxford Centre evidence-based medicine Levels 2a to 5. Based on the available data, suture lifting appears to be safe and well tolerated, with patient satisfaction similar to or above that reported for other noninvasive lifting and tightening procedures. However, due to the lack of randomized controlled trials, the authors give the suture lifting Strength of Recommendation Level C. Further controlled studies are necessary to determine efficacy, longevity, and safety of this technology.
Collapse
|
50
|
Lee W, Oh W, Kim HM, Chan BL, Yang EJ. Novel technique for infraorbital groove correction using multiple twisted polydioxanone thread. J Cosmet Dermatol 2020; 19:1928-1935. [PMID: 31900989 DOI: 10.1111/jocd.13269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/27/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The infraorbital groove can be corrected by lower blepharoplasty, microfat grafting, and soft tissue filler injection. Recently, multiple twisted polydioxanone threads were developed for facial rejuvenation. OBJECTIVE This study aimed to examine the efficacy and associated risks of the use of new synthetic threads for infraorbital groove correction. METHODS From March 2018 to June 2019, 40 patients (mean age: 43.4 years; range: 25-56 years) underwent transcutaneous multiple twisted thread insertion to correct the infraorbital groove. Three threads were inserted along the infraorbital groove on each side. The outcomes were assessed based on a comparison between preprocedure and postprocedure findings. Barton's grading and Global Aesthetic Improvement Scale scores were assessed by two physicians. Patient satisfaction with the aesthetic outcome of the procedure was evaluated at the end of the procedure and after 3 months. Ultrasonographic evaluation was performed to confirm that the threads had been properly placed. The anatomical layer in which the threads were placed was evaluated in a cadaveric study. RESULTS The mean Barton grade improved significantly (P < .001) without decline throughout the 12-week period. Improvement was found in all patients who were designated with a score >2 ("improved"). More than 77.5% of the patients were satisfied with the outcomes, and the rest of the patients reported some extent of correction with little satisfaction. CONCLUSIONS The findings indicate the benefits of the multiple twisted polydioxanone thread insertion in the treatment of patients with infraorbital groove without septal protrusion. This evaluation raised no major safety concerns.
Collapse
Affiliation(s)
- Won Lee
- Yonsei E1 Plastic Surgery Clinic, Anyang, South Korea
| | - Wook Oh
- Samsung Feel Clinic, Seoul, South Korea
| | | | | | - Eun-Jung Yang
- Dept. of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Hanyang University, Seoul, South Korea
| |
Collapse
|