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Sparavigna A, Grimolizzi F, Cigni C, Lualdi R, Bellia G. Efficacy and tolerability of Profhilo® Structura intended to restore lateral cheek fat compartment: An observational pilot study. Health Sci Rep 2024; 7:e1743. [PMID: 38260185 PMCID: PMC10801275 DOI: 10.1002/hsr2.1743] [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: 08/11/2023] [Revised: 09/29/2023] [Accepted: 11/13/2023] [Indexed: 01/24/2024] Open
Abstract
Background and Aims Hyaluronic acid (HA)-based injections are used worldwide to improve skin defects associated with aging and ultraviolet light/environmental exposure. HA formulations developed according to molecular weight or with additional components, for example, cross-linking reagents, are limited by their low biological activity and concentration limit. NAHYCO™ technology has enabled the production of hybrid cooperative complexes (HCCs) of low and high molecular weight HA. Developed for injection into the fat compartments of the face and previously demonstrating potential benefits for adipose tissue restoration, Profhilo Structura® is a new 2 mL HCC formulation comprising low molecular weight HA (45 mg/mL) and high molecular weight HA (45 mg/mL). To evaluate the efficacy and tolerability of Profhilo Structura® to restore adipose tissue compartments in the lateral cheek fat compartment. Methods Fifty healthy enrolled subjects received two injections, 1 month apart, and were evaluated 3 months posttreatment. Investigators performed clinical evaluations (Facial Volume Loss Scale [FVLS] and Wrinkle Severity Rating Scale [WSRS]) at different time points. Subjects also completed self-evaluation assessments following treatment. Results A significant improvement in FVLS and WSRS clinical scores after the first treatment was observed; treatment benefit was maintained 3 months after treatment completion and confirmed by subject self-assessment. Most participants reported an improvement, particularly a marked reduction of wrinkles and increased skin firmness. No serious adverse events were reported, confirming the excellent safety profile of HCC injectable devices. Conclusions Overall, the study highlighted the efficacy and tolerability of the studied medical device proving its effect on adipose tissue.
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de Maio M, Brenninkmeijer EEA, Nurlin I, Colucci L, Sanchez T. Applying the MD Codes™ to Treat Emotional and Social Attributes with HA Fillers: A Retrospective Serial Case Study. Clin Cosmet Investig Dermatol 2023; 16:3441-3453. [PMID: 38050477 PMCID: PMC10693774 DOI: 10.2147/ccid.s430747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/01/2023] [Indexed: 12/06/2023]
Abstract
Background Aesthetic treatment directed at improving facial emotional messages and social attributes may maximize patient satisfaction with treatment results. The MD Codes™ is an approach to facial aesthetic treatment that accounts for emotional messages and social attributes while minimizing variability in patient assessment, injection technique, injection sites, and treatment outcomes. Objective To assess the impact of the MD Codes systematic treatment approach on emotional and social attributes and natural appearance after facial aesthetic treatment with hyaluronic acid (HA) fillers. Methods A retrospective analysis was performed in patients treated with 12 mL of HA fillers (Juvéderm® Vycross™ products) per patient using the MD Codes. Study injectors, experienced clinician observers, clinical staff, laypeople, and patients evaluated impact of treatment on emotional and social attributes and natural appearance based on pre- and post-treatment photographs of patients. Results Twelve patients and 49 external observers, from 12 countries, evaluated the images. More than 90% of patients named "eye bags" as the facial area most in need of aesthetic treatment; >55% of external observers identified "cheeks." The top 3 facial emotional attributes noted by all evaluators after treatment were, in order, "less tired", "less saggy", and "younger." All patients reported a visible and positive change in emotional attributes except for "less sad." After 9 months, most patients reported looking "less tired" (n=11/12), "less saggy" (n=8/12), and "less sad" (n=6/12). At months 6 and 9, all patients rated their appearance as natural looking. At least 90% of external observers considered the frontal view results natural for all but 1 patient. Patients reported improved positive social attributes (eg, "looking friendlier") and improvements in well-being after treatment. No serious side effects were reported. Conclusion Implementing the MD Codes for facial aesthetic treatment may improve facial emotional attributes as well as enhance social attributes and well-being, with natural-looking results.
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Affiliation(s)
| | | | | | | | - Tania Sanchez
- Instituto Dermatológico de Jalisco, Zapopan, Jalisco, Mexico
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Fabi S, Zoumalan C, Fagien S, Downie J, Yoelin S, Sartor M, Chawla S. Effectiveness of Volbella (VYC-15L) for Infraorbital Hollowing: Patient-Reported Outcomes From a Prospective, Multicenter, Single-Blind, Randomized, Controlled Study. Aesthet Surg J 2023; 43:1357-1366. [PMID: 37066828 PMCID: PMC10575619 DOI: 10.1093/asj/sjad100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Infraorbital hollowing can be addressed with hyaluronic acid soft tissue fillers. A prospective, multicenter, evaluator-blinded, randomized, controlled study (NCT03418545) demonstrated the safety and effectiveness of Juvéderm Volbella XC (VYC-15L, Allergan Aesthetics, an AbbVie company, Irvine, CA) in adults seeking correction for infraorbital hollows. OBJECTIVE The objective of the current analysis was to examine patient-reported outcomes from the clinical study. METHODS Participants were randomly assigned 3:1 to the VYC-15L treatment group or the no-treatment control group. Outcome measurements included: evaluating investigator (EI)- and participant-assessed Global Aesthetic Improvement Scale (GAIS) scores, as well as participant responses to the FACE-Q Appraisal of Lower Eyelids, questions on treatment satisfaction, the extent to which patients were bothered by dark circles under their eyes, and willingness to recommend treatment to a friend. RESULTS The modified intent-to-treat population included 135 participants (median age, 47 years; 91.9% female). At Month 3, the majority of VYC-15L-treated participants showed improvements in the EI- and participant-assessed GAIS. The mean change from baseline to Month 3 score (32.7% increase) showed statistically significant improvement (mean [standard deviation], 17.8 [19.8], P < .0001). At Months 3 and 12 posttreatment, most VYC-15L-treated participants reported feeling satisfied with treatment and not feeling moderately or very bothered by dark circles under their eyes, and would recommend treatment to a friend. CONCLUSIONS The current analysis demonstrated the effectiveness of VYC-15L treatment to reduce infraorbital hollowing and to improve overall satisfaction based on validated patient-reported outcomes. Participant-assessed improvements aligned with EI-assessed outcomes and lasted for 1 year. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Sabrina Fabi
- Corresponding Author: Dr Sabrina Fabi, 9339 Genesee Avenue, Unit 300, San Diego, CA 92121, USA. E-mail:
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Chiu A, Montes JR, Munavalli G, Shamban A, Chawla S, Abrams S. Improved Patient Satisfaction With Skin After Treatment of Cheek Skin Roughness and Fine Lines With VYC-12L: Participant-Reported Outcomes From a Prospective, Randomized Study. Aesthet Surg J 2023; 43:1367-1375. [PMID: 37074002 PMCID: PMC10575618 DOI: 10.1093/asj/sjad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND VYC-12L is a hyaluronic acid filler to improve skin quality. A prospective study showed safety and effectiveness of VYC-12L for improving cheek skin smoothness and fine lines. OBJECTIVES To report participant-reported outcomes, subgroup analyses, and physician experience from the prospective study. METHODS Adults with moderate to severe Allergan Cheek Skin Smoothness (ACSS) scale scores were randomized 2:1 to VYC-12L or control (no treatment with optional treatment). Participant assessments included FACE-Q Satisfaction With Skin, FACE-Q Appraisal of Lines, natural look and feel, the Global Aesthetic Improvement Scale (GAIS), and safety. Subgroup analyses examined ACSS responder rate (≥1-grade improvement from baseline to 1 month). RESULTS FACE-Q Satisfaction With Skin overall mean scores improved from baseline to 1 month posttreatment by 32.0 and 1.4 in the VYC-12L and control groups, respectively. FACE-Q Appraisal of Lines overall mean scores improved from baseline to 1 month posttreatment by 23.3 and 0.4 in VYC-12L and control, respectively. Treated participants had high median scores (≥9.0) of natural look and feel of their cheek skin. GAIS responder rate was high at Month 1 (85.5%; 95% CI, 79.3%-91.7%) and through Month 6 (83.1%; 95% CI, 76.5%-89.7%). Mean participant-rated pain scores were low (<3). The most common injection site reactions were redness, swelling, and lumps/bumps; most resolved within 3 days. Subgroup analyses showed significant differences in ACSS responder rate between VYC-12L and control groups 1 month posttreatment. Physician injectors reported that VYC-12L was easily injected at the superficial skin and integrated quickly. CONCLUSIONS VYC-12L treatment produced significant improvements in satisfaction with skin and cheek skin smoothness, as measured by participant-reported outcome measures. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Annie Chiu
- Corresponding Author: Dr Annie Chiu, 1636 Aviation Blvd #201, Redondo Beach, CA 90278, USA. E-mail:
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Gallo L, Kim P, Yuan M, Gallo M, Thoma A, Voineskos SH, Cano SJ, Pusic AL, Klassen AF. Best Practices for FACE-Q Aesthetics Research: A Systematic Review of Study Methodology. Aesthet Surg J 2023; 43:NP674-NP686. [PMID: 37162009 DOI: 10.1093/asj/sjad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The FACE-Q Aesthetics module is a validated patient-reported outcome measure (PROM) that evaluates perspectives on facial aesthetic treatments. Improper administration and poor study methodology can compromise the validity and interpretation of this PROM. OBJECTIVES This systematic review sought to evaluate the administration and scoring of the FACE-Q Aesthetics scales within the literature. METHODS A search of Ovid Medline, Embase, Cochrane, and Web of Science was performed on December 20, 2022, with the assistance of a health-research librarian (CRD42022383676). Studies that examined facial aesthetic interventions using the FACE-Q Aesthetics module as a primary or secondary outcome measure were included for analysis. RESULTS There were 114 studies included. The Face Overall (n = 52, 45.6%), Psychological (n = 45, 39.4%), and Social (n = 43, 37.7%) scales were most frequently reported. Errors in FACE-Q administration were identified in 30 (26.3%) studies. The most common error was the presentation of raw ordinal scores rather than the converted Q score (n = 23). Most studies reported a time horizon for their primary analysis (n = 76, 66.7%); however, only 4 studies provided a rationale for this selection. Sample size calculations for the primary outcome were rarely performed (n = 9, 7.9%). CONCLUSIONS There continues to be limitations in PROM administration and the quality of articles that report FACE-Q Aesthetic scale data. The authors suggest that future investigators using the FACE-Q refer to the User's Guide regarding administration and scoring of this scale, report a rationale for the study time horizon, and provide an a priori sample size calculation for the primary outcome of interest.
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Alexiades M, Palm MD, Kaufman-Janette J, Papel I, Cross SJ, Abrams S, Chawla S. A Randomized, Multicenter, Evaluator-blind Study to Evaluate the Safety and Effectiveness of VYC-12L Treatment for Skin Quality Improvements. Dermatol Surg 2023; 49:682-688. [PMID: 37163665 PMCID: PMC10292578 DOI: 10.1097/dss.0000000000003802] [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: 05/12/2023]
Abstract
BACKGROUND Skin quality may be assessed by degrees of skin smoothness, fine lines, and hydration. VYC-12L is a recently developed hyaluronic acid filler to improve skin quality. OBJECTIVE This was a randomized, evaluator-blind study assessing safety and effectiveness of intradermal VYC-12L treatment for improving cheek skin smoothness, fine lines, and hydration. METHODS Participants (≥22 years) with moderate-to-severe investigator-assessed Allergan Cheek Smoothness Scale (ACSS) scores were randomized in 2:1 ratio to receive VYC-12L or control (no treatment with optional treatment). Effectiveness was assessed 1 month after last injection (initial or touch-up) by a responder rate (≥1-grade improvement from baseline on both cheeks) using investigator-rated ACSS and Allergan Fine Lines Scale (AFLS), and tissue dielectric constant probe-measured skin hydration. Safety was evaluated throughout. RESULTS Participants (VYC-12L, n = 131; control, n = 71) were 86.1% female with a median age of 58.0 years. At month 1, ACSS and AFLS responder rates were statistically significantly higher in the VYC-12L group (57.9%, 58.3%, respectively) than in the untreated controls (4.5%, 5.4%, respectively; p < .001). VYC-12L ACSS and AFLS responder rates remained consistent throughout the 6-month follow-up. Six participants reported treatment-related adverse events; none led to study discontinuation. CONCLUSION VYC-12L is an effective, well-tolerated treatment for lasting improvement of cheek skin smoothness, fine lines, and hydration.
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Affiliation(s)
- Macrene Alexiades
- Associate Clinical Professor, School of Medicine, Yale University, New Haven, Connecticut
- Dermatology & Laser Surgery Center of New York, New York
| | | | | | - Ira Papel
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
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Chiu A, Bertucci V, Coimbra DD, Li D. Assessment and Treatment Strategies for the Aesthetic Improvement of the Lower Face and Neck. Clin Cosmet Investig Dermatol 2023; 16:1521-1532. [PMID: 37337568 PMCID: PMC10276991 DOI: 10.2147/ccid.s405639] [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: 03/10/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Background Interest in aesthetic rejuvenation of the lower face and neck is growing, but published expert guidance is limited. Objective Review aesthetic concerns of the lower face and neck and provide expert guidance on evaluation and treatment. Methods Twelve international experts participated in an advisory board on lower face and neck aesthetic treatment. They completed a premeeting survey and met twice, reviewing responses and discussing patient evaluation and treatment strategies. They developed decision tree algorithms on patient assessment and treatment planning and sequencing, using clinical cases as a reference. Results Treatment concerns include neck and lower face skin laxity, structural bone deficiency, insufficient or excess volume, submental fat, jowls, platysma bands, and masseter muscle prominence. Advisors agreed that the lower face and neck may be the most challenging areas to assess and treat; treatment goals include lower facial contour and overall facial harmony/balance. Advisors recommended first ruling out a surgical approach, then determining whether midface treatment is needed to support the lower face, and lastly evaluating the lower face for significant submental fat, excess or insufficient volume, and structural bone deficiency. To treat the lower face and neck, an anatomical layer approach, moving from deep to superficial layers, beginning with structural support, was recommended. Assessment and treatment decision trees were based on this approach. Conclusion The lower face and neck are important but underrecognized areas of aesthetic concern. This article provides expert guidance and a suggested algorithm for assessment and treatment aimed at achieving satisfying and harmonious facial aesthetic results.
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Affiliation(s)
- Annie Chiu
- The Derm Institute, Redondo Beach, CA, USA
| | | | - Daniel Dal'Asta Coimbra
- Department of Cosmetic Dermatology at Santa Casa de Misericórdia, Rio de Janeiro, RJ, Brazil
| | - Dan Li
- Department of Plastic and Reconstructive Surgery, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
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Solomon MP. Commentary on: Men's Experiences and Psychological Outcomes of Nonsurgical Medical Penile Girth Augmentation: A Preliminary Prospective Study. Aesthet Surg J 2023; 43:192-194. [PMID: 36259333 DOI: 10.1093/asj/sjac269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/05/2022] [Accepted: 10/05/2022] [Indexed: 02/07/2023] Open
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Ottenhof MJ, Veldhuizen IJ, Hensbergen LJV, Blankensteijn LL, Bramer W, Lei BV, Hoogbergen MM, Hulst RRWJ, Sidey-Gibbons CJ. The Use of the FACE-Q Aesthetic: A Narrative Review. Aesthetic Plast Surg 2022; 46:2769-2780. [PMID: 35764813 PMCID: PMC9729314 DOI: 10.1007/s00266-022-02974-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/25/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In the past decade there has been an increasing interest in the field of patient-reported outcome measures (PROMs) which are now commonly used alongside traditional outcome measures, such as morbidity and mortality. Since the FACE-Q Aesthetic development in 2010, it has been widely used in clinical practice and research, measuring the quality of life and patient satisfaction. It quantifies the impact and change across different aspects of cosmetic facial surgery and minimally invasive treatments. We review how researchers have utilized the FACE-Q Aesthetic module to date, and aim to understand better whether and how it has enhanced our understanding and practice of aesthetic facial procedures. METHODS We performed a systematic search of the literature. Publications that used the FACE-Q Aesthetic module to evaluate patient outcomes were included. Publications about the development of PROMs or modifications of the FACE-Q Aesthetic, translation or validation studies of the FACE-Q Aesthetic scales, papers not published in English, reviews, comments/discussions, or letters to the editor were excluded. RESULTS Our search produced 1189 different articles; 70 remained after applying in- and exclusion criteria. Significant findings and associations were further explored. The need for evidence-based patient-reported outcome caused a growing uptake of the FACE-Q Aesthetic in cosmetic surgery and dermatology an increasing amount of evidence concerning facelift surgery, botulinum toxin, rhinoplasty, soft tissue fillers, scar treatments, and experimental areas. DISCUSSION The FACE-Q Aesthetic has been used to contribute substantial evidence about the outcome from the patient perspective in cosmetic facial surgery and minimally invasive treatments. The FACE-Q Aesthetic holds great potential to improve quality of care and may fundamentally change the way we measure success in plastic surgery and dermatology. 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 .
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Affiliation(s)
- Maarten J Ottenhof
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands.
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Inge J Veldhuizen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Lusanne J V Hensbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Louise L Blankensteijn
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Wichor Bramer
- Medical Library, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Berend Vd Lei
- Department of Plastic Surgery, University and University Medical School of Groningen and Bey Bergman Clinics, Groningen, The Netherlands
| | - Maarten M Hoogbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - René R W J Hulst
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Chris J Sidey-Gibbons
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
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Nanocarriers as Active Ingredients Enhancers in the Cosmetic Industry-The European and North America Regulation Challenges. Molecules 2022; 27:molecules27051669. [PMID: 35268769 PMCID: PMC8911847 DOI: 10.3390/molecules27051669] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/14/2022] [Accepted: 03/01/2022] [Indexed: 02/07/2023] Open
Abstract
“Flawless skin is the most universally desired human feature” is an iconic statement by Desmond Morris. Skin indicates one´s health and is so important that it affects a person’s emotional and psychological behavior, these facts having propelled the development of the cosmetics industry. It is estimated that in 2023, this industry will achieve more than 800 billion dollars. This boost is due to the development of new cosmetic formulations based on nanotechnology. Nanocarriers have been able to solve problems related to active ingredients regarding their solubility, poor stability, and release. Even though nanocarriers have evident benefits, they also present some problems related to the high cost, low shelf life, and toxicity. Regulation and legislation are two controversial topics regarding the use of nanotechnology in the field of cosmetics. In this area, the U.S. FDA has taken the lead and recommended several biosafety studies and post-market safety evaluations. The lack of a global definition that identifies nanomaterials as a cosmetic ingredient is a hindrance to the development of global legislation. In the EU, the legislation regarding the biosafety of nanomaterials in cosmetics is stricter. “The cost is not the only important issue, safety and the application of alternative testing methods for toxicity are of crucial importance as well”.
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Zarbafian M, Beleznay K, Carruthers JDA, Humphrey S. Safety of VYC-12 as a Combination Treatment for Skin Rejuvenation: A Retrospective Analysis of 1577 Treatments. Dermatol Surg 2022; 48:369-372. [PMID: 34923524 DOI: 10.1097/dss.0000000000003359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Misha Zarbafian
- Dermatology Resident, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katie Beleznay
- Clinical Instructor, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Shannon Humphrey
- Clinical Assistant Professor, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
- Clinical Professor, Department of Ophthalmology, University of British Columbia
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Safa M, Natalizio A, Hee CK. A Prospective, Open-Label Study to Evaluate the Impact of VYC-12L Injection on Skin Quality Attributes in Healthy Volunteers. Clin Cosmet Investig Dermatol 2022; 15:411-426. [PMID: 35300433 PMCID: PMC8921677 DOI: 10.2147/ccid.s352007] [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] [Received: 12/09/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022]
Abstract
Purpose Age-related changes in skin structure and function can negatively impact skin quality. VYC-12L is a crosslinked hyaluronic acid filler for treating fine lines and improving hydration and elasticity. The goal of this study was to understand skin quality, histologic, and genomic changes underlying long-term clinical benefits of VYC-12L treatment. Patients and Methods In this prospective, nonrandomized, open-label study, 11 healthy men (n = 2) and women (n = 9) received intradermal VYC-12L treatment on the volar forearm. Clinical probes assessed skin quality at baseline and months 1 and 3 post-treatment. Punch biopsies were collected 1 and 3 months post-treatment to evaluate histologic and genomic changes. Safety was evaluated throughout. Results Participants had a mean age of 41 years and Fitzpatrick skin phototypes II (54.5%) and III (45.5%). At months 1 and 3, VYC-12L-treated skin had higher hydration in the stratum corneum than untreated skin. Cutometer measurements indicated treated skin that was firmer and more resistant to deformation. Histology showed increased epidermal AQP3 and Ki67 expression 1 and 3 months post-treatment and a qualitative increase in papillary dermal collagen I at month 3. Genomic analyses demonstrated treatment-related upregulation of genes involved in adipocyte differentiation, lipid metabolism, keratinocyte renewal, and dermal extracellular matrix (ECM) maintenance. Injection site reactions were mild-to-moderate in severity and resolved by month 1. Five participants reported 19 adverse events; most (68.4%) were related to the biopsy and none to VYC-12L. Conclusion VYC-12L produced changes in hydration, firmness, and ECM density and composition consistent with improved skin properties, demonstrating that VYC-12L can act as a substrate for tissue repair.
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Affiliation(s)
- Marva Safa
- La Jouvence, Neuchâtel, Switzerland
- Correspondence: Marva Safa, La Jouvence, Rue de l’Hôpital 18, 2000 Neuchâtel, Switzerland, Tel +41 32 710 19 07, Email
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Renga M, Ryder TJ. Treatment of Horizontal Wrinkles of the Neck Using a Hyaluronic Acid Filler: Results From a Prospective Study. Dermatol Surg 2022; 48:322-326. [PMID: 35093965 DOI: 10.1097/dss.0000000000003310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND VYC-12 is a hyaluronic acid filler with low cohesivity. OBJECTIVE To evaluate the safety and effectiveness of VYC-12 for aesthetic improvement of horizontal neck lines. METHODS This was a prospective study of consecutive women undergoing neck treatment using VYC-12. All had a baseline score of 1 to 4 on the Allergan Transverse Neck Lines Scale (ATNLS). Individuals with an ATNLS score of 1 to 3 were treated with VYC-12 alone; those with a score of 4 received filler combined with high-intensity focused ultrasound (HIFU). Total VYC-12 volumes were ∼1 mL per patient. Follow-up lasted ≤30 months. RESULTS Fifty women were enrolled (mean age: 55.0 ± 5.7 years; n = 42 VYC-12 alone, n = 8 VYC-12 + HIFU). Forty-six patients (92%) achieved a ≥ 1-grade improvement on ATNLS 1 month post-treatment; the mean ATNLS score decreased from 2.64 ± 0.83 to 1.44 ± 0.81 (p < .0001). Rasch-transformed scores on the FACE-Q "Appraisal of the Neck" questionnaire improved from 31.0 ± 14.2 at baseline to 49.7 ± 14.4 at 1 month (p < .0001). Repeat injections at 9- to 12-month intervals led to progressive improvements. There were no treatment-related adverse events. CONCLUSION Treatment of the neck using VYC-12 was safe and effective in reducing the appearance of horizontal lines.
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Dal'Asta Coimbra D. Clinical experience with a new injectable hyaluronic acid designed to improve skin quality in a private clinic in Brazil: A retrospective cohort study. Health Sci Rep 2021; 4:e399. [PMID: 34632098 PMCID: PMC8493242 DOI: 10.1002/hsr2.399] [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: 03/10/2021] [Revised: 08/12/2021] [Accepted: 08/31/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Juvéderm Volite is a skin-conditioning hyaluronic acid (HA) gel for intradermal injection that provides longer-lasting effects with a lower concentration of hyaluronic acid. Few studies evaluating its use for aesthetic purposes are available. AIM To examine the use and safety of Juvéderm Volite in daily clinical practice. METHODS A retrospective cohort study of subjects treated with Juvéderm Volite for aesthetic purposes from May 2018 to October 2019 in Rio de Janeiro. Data were extracted from the attending physician's records obtained at each medical appointment. Subjects were assessed according to their age group and treatment characteristics, which include the use of cannulas vs needles and the effectiveness and safety of associated treatments in a single session. Need for subsequent treatment was stratified by touch-up treatment (<3-month period) and repeat treatment (≥3-month period). Safety assessment was based on the report of nodule formation and late hypersensitivity in patients. Appropriate statistical tests were used for data analysis. RESULTS One hundred and eight subjects were included in the study analysis. The total number of treatment sessions consisted of 159, with a mean follow-up time of 300.3 days. Of the total 108 subjects, 8.4% required touch-up treatment for optimum correction and repeat treatment occurred in 9.0%. No cases of adverse events were reported during the follow-up period. CONCLUSIONS This study has shown, based on clinical observation, that Juvéderm Volite is a useful tool to improve skin quality, requiring fewer and less frequent maintenance treatments. No serious adverse events were reported during the follow-up period.
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Affiliation(s)
- Daniel Dal'Asta Coimbra
- Instituto de Dermatologia Professor Rubem David AzulaySanta Casa de Misericórdia/IDPRDARio de JaneiroBrazil
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15
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Humphrey S, Manson Brown S, Cross SJ, Mehta R. Defining Skin Quality: Clinical Relevance, Terminology, and Assessment. Dermatol Surg 2021; 47:974-981. [PMID: 34148998 PMCID: PMC8231670 DOI: 10.1097/dss.0000000000003079] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Flawless skin is one of the most universally desired features, and demand for improvements in skin quality is growing rapidly. Skin quality has been shown to substantially impact emotional health, quality of life, self-perception, and interactions with others. Although skin quality improvements are a common end point in studies of cosmeceuticals, they are rarely assessed in clinical studies of other aesthetic treatments and products. Descriptive terminology for skin quality parameters also varies considerably within the aesthetic field, relying on a range of redundant and occasionally contradictory descriptors. In short, skin quality has not been clearly defined. OBJECTIVE The goal of this review is to highlight the importance of skin quality to patients and physicians, explore known and unknown factors comprising skin quality, and provide clarity regarding terminology, descriptors, and evaluation tools for assessing skin quality. MATERIALS AND METHODS A review of the literature on skin quality was performed without limitation on publication date. Relevant articles are presented. RESULTS AND CONCLUSION We propose a framework of attributes contributing to skin quality rooted in 3 fundamental categories-visible, mechanical, and topographical-with the aim to provide information to help guide clinicians and inform future clinical studies.
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Affiliation(s)
- Shannon Humphrey
- Humphrey Cosmetic Dermatology, Vancouver, British Columbia, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Rahul Mehta
- Allergan Aesthetics, an AbbVie Company, Irvine, California
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16
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de Maio M. MD Codes™: A Methodological Approach to Facial Aesthetic Treatment with Injectable Hyaluronic Acid Fillers. Aesthetic Plast Surg 2021; 45:690-709. [PMID: 32445044 PMCID: PMC8012343 DOI: 10.1007/s00266-020-01762-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/30/2020] [Indexed: 01/02/2023]
Abstract
Background Patients often seek aesthetic correction of facial deficiencies (e.g., lines and folds) that are rarely the underlying cause of dissatisfaction with their appearance. Use of a more holistic approach focused on improving the emotional messages of the face (e.g., looking less sad) may improve patient satisfaction with treatment outcomes. The MD Codes™ system was developed to increase clinician success rates by reducing variability in the technical aspects of hyaluronic acid (HA) filler treatment and focusing on addressing unfavorable emotional attributes of the face. Methods The MD Codes, or medical codes, represent specific anatomical subunits for injection of HA fillers. Each MD Code includes information regarding the target depth of injection, the proper delivery tool (needle or cannula) and delivery technique (e.g., aliquot, bolus, fanning), and the minimum product volume recommended to achieve visible, reproducible results (active number). During treatment planning, the appropriate MD Codes are selected using algorithms focused on lessening unfavorable facial attributes (a saggy, tired, sad, or angry look) and enhancing positive attributes (an attractive, younger, more contoured, or feminine [soft] or masculine look). Results Three case studies are presented to illustrate how the MD Codes and their algorithms were used to address sagginess, tiredness, and sadness in two women and one man. Conclusions MD Codes provide a universal symbolic language for reducing variability in injection technique. The platform provides user-friendly algorithms to help clinicians increase patient satisfaction by going beyond treatment of lines and folds and to focus on reducing unfavorable facial attributes. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Electronic supplementary material The online version of this article (10.1007/s00266-020-01762-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maurício de Maio
- MD Codes Institute, Rua Santa Justina, 660 - cjs 121 e 124, Via Olímpia, Sao Paulo, SP, Brazil.
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17
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Ogilvie P, Thulesen J, Leys C, Sykianakis D, Chantrey J, Safa M, Figueiredo V, Heydenrych I, Cavallini M, Langeland EK, Wetter A. Expert Consensus on Injection Technique and Area-Specific Recommendations for the Hyaluronic Acid Dermal Filler VYC-12L to Treat Fine Cutaneous Lines. Clin Cosmet Investig Dermatol 2020; 13:267-274. [PMID: 32308460 PMCID: PMC7152505 DOI: 10.2147/ccid.s239667] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/17/2020] [Indexed: 12/26/2022]
Abstract
Background VYC-12L is a hyaluronic acid (HA) injectable gel designed to treat fine cutaneous lines and improve skin quality attributes such as hydration and elasticity. Objective Expert consensus was sought on VYC-12L injection technique and primary treatment target areas. Methods A multinational group of aesthetic medicine clinicians (n = 128) attended product training and each identified ~10 patients for VYC-12L. After treating their first and last patients, the clinicians completed a survey on preferred injection methodology/technique, including injection angle, volume, and spacing. An expert panel (n = 12) discussed survey results and their clinical experiences to obtain consensus on VYC-12L technique and appropriate treatment areas. Results Recommendations included micro-depot injections of VYC-12L into the deep dermis with a 32G ½ inch needle inserted at <45º to the skin, spaced 0.5‒1.0 cm apart, with 0.01‒0.05 mL volume per injection (full-face total volume: ~2 mL). Recommended primary treatment areas were the malar, perioral, neck, and décolletage regions. Injection techniques for different treatment areas/demographic characteristics were similar, with some variability in treatment approach. Patient selection criteria, pre- and post-treatment guidelines, and managing patient expectations are important components of treatment. Conclusion These consensus recommendations may assist clinicians in optimizing the treatment of fine lines with VYC-12L.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Maurizio Cavallini
- Servizio di Chirurgia Plastica, Centro Diagnostico Italiano, Milan, Italy
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