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Al-Jumaily AM, Liaquat H, Paul S. Focused Ultrasound for Dermal Applications. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:8-17. [PMID: 37806924 DOI: 10.1016/j.ultrasmedbio.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Abstract
Focused ultrasound (FUS) is emerging as one of the most promising, non-invasive treatment techniques. The advancement of transducer technology has paved the way for dermatological applications. A comprehensive review is presented for healthcare practitioners and researchers, summarizing the effect of various operational parameters on the injury zone produced by ultrasound beams for various dermatological applications, which include skin tightening, fat reduction, hyperpigmentation and cancer treatment. In this article, we aim to highlight the efficient operational parameters of FUS to enhance pain relief during surgery and its affordability for skin treatment. Finally, a prospective future technique for efficient FUS is discussed.
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Affiliation(s)
- Ahmed M Al-Jumaily
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand.
| | - Hassan Liaquat
- Institute of Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand
| | - Sharad Paul
- University of Auckland, Auckland, New Zealand
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Zhu J, Han Y, Liu Y, Chang R, Gao W, Gong X, Zhu Y, Shang Y, Shen L, Yu W, Lyu D, Lin X. Evaluation of a Novel Microfocused Ultrasound with Three-Dimensional Digital Imaging for Facial Tightening: A Prospective, Randomized, Controlled Trial. Dermatol Ther (Heidelb) 2024; 14:233-249. [PMID: 38100073 DOI: 10.1007/s13555-023-01078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/24/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND The excellent efficacy is mitigated by the limited safety profile of microfocused ultrasound procedures. OBJECTIVE We sought to assess the safety and tightening efficacy of a novel microfocused ultrasound. METHODS The randomized middle and lower face and submental region of the participants were treated with the novel device using the following transducers: M4.5, D4.5, M3.0, and D3.0. Improvement in paired comparison of pretreatment and posttreatment photographs, three-dimensional (3D) volumetric assessments, skin thickness measured by B-ultrasonography, and skin photoaging parameters were evaluated. Adverse events and patient satisfaction were also recorded. RESULTS A total of 20 participants (20 female) were enrolled. Fourteen of 20 participants (70%) were judged to show clinically significant facial tightening during 3-month follow-up (P < 0.05). The mean volumetric change in the lower face, as quantitatively assessed after 3 months was -0.29 mL compared with +0.42 mL on the control side (P < 0.05). The VAS pain score was 3.00 ± 1.19 without any oral or intramuscular anesthesia. CONCLUSIONS A small sample size, lack of clinical scales, and impersonalized treatment parameters. The novel microfocused ultrasound appears to be a safe and effective modality for lower-face tightening. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR 2200064666.
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Affiliation(s)
- Jiafang Zhu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yue Han
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Liu
- Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Rui Chang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wei Gao
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xia Gong
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yijia Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lingyue Shen
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Dongze Lyu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Xiaoxi Lin
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Wong A, Lowery AS, Bloom JD. Ultrasound Therapy for the Skin. Facial Plast Surg Clin North Am 2023; 31:503-510. [PMID: 37806683 DOI: 10.1016/j.fsc.2023.05.008] [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] [Indexed: 10/10/2023]
Abstract
Ultrasound energy is delivered to the dermal and subdermal tissue to induce thermal injury, leading to collagen remodeling and resulting in lifting and tightening of the skin. Ulthera and Sofwave are two Food and Drug Administration-approved systems that have demonstrated clinically significant results in providing eyebrow, submental, and neck lift and minimizing facial fine lines and wrinkles. Patient selection and management of expectations are important components to a successful treatment process. Both devices boast high patient satisfaction rates, minimal recovery time, and excellent safety profile. Ultrasound technology is an effective, nonsurgical option for facial rejuvenation.
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Affiliation(s)
- Anni Wong
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 3737 Market Street, Suite 302, Philadelphia, PA 19104, USA
| | - Anne S Lowery
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Jason D Bloom
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Bloom Facial Plastic Surgery, Two Town Place, Suite 110, Bryn Mawr, PA 19010, USA.
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Al-Omair A, Bukhari A. Patient satisfaction of microfocused ultrasound treatments on the face and neck laxity: A narrative review. J Cosmet Dermatol 2023; 22:2671-2676. [PMID: 37128835 DOI: 10.1111/jocd.15766] [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: 06/28/2022] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Microfocused ultrasound with visualization (MFU-V) delivers focused ultrasound energy to heat tissue and has emerged as a fast and effective noninvasive method for treating skin laxity. After obtaining approval in 2009 by the Food and Drug Administration, satisfactory feedback was recorded using several scoring systems for MFU-V treatment for facial and neck laxity. AIM To evaluate the efficacy and satisfaction rates of MFU-V for facial and neck laxity treatment by providing a basis for developing a validated scoring system for MFU-V treatment. METHOD A constrictive survey was carried out by selecting relevant publications on MFU-V treatment of facial and neck laxity using PubMed, Medline, and Embase electronic databases from January 2017 to March 2022. RESULTS Of the 11 original articles used in this review, the majority of the scoring methods used were the subjective global aesthetic improvement scale and the 5-point scale rating global aesthetic improvement in appearance. Around half of the patients were described as much improved or very much improved on days 30 and 90, while most returned to baseline on Day 360. Most of the adverse events reported were mild bruising, redness, and pain. None of the patients reported serious adverse events. A burn occurred in one case because of improper application of the probe. CONCLUSION The MFU-V provides excellent and promising responses for treating facial and neck laxity. A few mild events were observed, such as erythema, pain, edema, and injection-site induration, all of which resolved within approximately 2-3 days.
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Affiliation(s)
- Abdullah Al-Omair
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abrar Bukhari
- Department of Dermatology, College of Medicine - Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
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Corduff N, Lowe S. Hi5 Protocol for the Use of Microfocused Ultrasound with Visualization. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5184. [PMID: 37583398 PMCID: PMC10424899 DOI: 10.1097/gox.0000000000005184] [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: 12/02/2022] [Accepted: 06/27/2023] [Indexed: 08/17/2023]
Abstract
Background Microfocused ultrasound with visualization (MFU-V) is used for lifting and tightening of facial tissues. Standard protocols are completed in a single session. Despite excellent outcomes, we identified several barriers of entry for a significant number of patients. Therefore, we devised an individualized pan-facial protocol that is delivered as a series of short, intense treatments to address these issues. Methods We enrolled 12 participants with mild-to-moderate skin and fibromuscular laxity to receive one superficial and one deep pass per visit (average 280 lines). Qualitative improvements were rated by both patients and physicians at 6 or 10 months due to COVID-19 delays. Changes in the submentum and eyebrow heights were quantified. Results Ten patients (age range: 31-61 years) underwent an average of four MFU-V treatments. Two patients were excluded after massive weight gain. Skin and fibromuscular ptosis and overall soft tissue laxity improved in all patients. Mean brow height increased by 1.7 mm, whereas the mean submental lift was 78.7 mm2. All patients and treating physicians rated an improvement in appearance, whereas independent physicians rated improvements in 87% of cases. Four patients self-rated as "markedly improved." Pain was rated at up to 6.2 (out of 10). Although mask-wearing was mandatory, loss of elasticity, wrinkles, and skin roughness all improved. Superficial welts (n = 5), erythema (n = 3), tenderness (n = 3), and mild bruising (n = 2) occurred, but all resolved within a few days and no severe or permanent adverse events occurred. Conclusion The Hi5 protocol was noninferior to standard single-session protocols and improved brow heights and submental lifting.
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Lim JTE. Safety and efficacy of superficial micro-focused ultrasound with visualization for melasma in Asians: An uncontrolled pilot study. J Cosmet Dermatol 2023; 22:1764-1773. [PMID: 36762392 DOI: 10.1111/jocd.15661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND The pathophysiology of melasma is multifactorial, resulting in treatment resistance and a high recurrence rate. Recent research suggests that focused ultrasound might treat melasma effectively. OBJECTIVES To investigate the efficacy and safety of superficial micro-focused ultrasound with visualization (MFU-V) for melasma in Asians. METHODS Patients (n = 20) with mixed melasma on both cheeks received 2 MFU-V treatments spaced 1 month apart. At monthly visits over 5 months, treatment efficacy and safety were evaluated. Standardized photographs were clinically assessed using the modified Melasma Area and Severity Index (mMASI), and 6-point grading scales for melasma lightening and area of involvement. Patients provided pain, global aesthetic improvement scale (GAIS), and satisfaction assessments. RESULTS In 40 cheeks, the mean mMASI score was significantly reduced from 13.2 at baseline to 2.4 at month 4, and 2.8 at month 5. Twenty-nine cheeks (72.5%) showed lightening of melasma at month 4 that persisted until month 5, with improvements up to 75% compared to baseline. Melasma area decreased overall, with sites containing >30% melasma involvement decreasing from 55% to 20% by month 5, and none with 70%-89% involvement. Melasma lightening and area improved visibly in 40% and 20% of cheeks, respectively, as early as 1 month after index MFU-V treatment. Improvements continued after the second treatment and persisted until study closure, correlating with patient GAIS and satisfaction scores. Procedure was well tolerated with only mild-to-moderate pain reported in 92.5% of treatments. CONCLUSION Superficial MFU-V is a safe and effective treatment for melasma.
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Hongcharu W, Boonchoo K, Gold MH. The efficacy and safety of the high-intensity parallel beam ultrasound device at the depth of 1.5 mm for skin tightening. J Cosmet Dermatol 2023; 22:1488-1494. [PMID: 36757157 DOI: 10.1111/jocd.15672] [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: 11/15/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND High-intensity parallel beam ultrasound (US) is a novel device equipped with Synchronous Ultrasound Parallel Beam (SUPERB) technology applied in anti-aging treatment. The system is aimed at pathways stimulating neocollagenesis and neoelastinogenesis in the dermis leading to skin tightening and rejuvenation. AIMS Evaluate the efficacy and safety of the high-intensity parallel beam US device at the depth of 1.5 mm for skin tightening treatment. METHODS Thirty-six participants were enrolled in the study. Digital photographs and Antera 3D photographs were taken at baseline, 1 and 3 months post-treatment. The depression volume of nasolabial folds (NLFs) and marionette lines (MLs) in each visit was evaluated using Antera 3D imaging program. Pain was evaluated by pain measurement scales immediately after treatment. Any procedure related side effects were documented and examined. RESULTS Post-treatment results were compared to the baseline; statistically significant mean depression volume (MDV) change of NLFs and MLs were found at 1 and 3 months post-treatment. No significant MDV change from 1 to 3 months post-treatment could be demonstrated. The mean pain score was 6.64 on a 0-10 scale. No adverse events were reported. CONCLUSIONS Our study demonstrates that the novel high-intensity parallel beam US device is clinically safe and effective for skin tightening in the lower face area. We noticed a reduction in NLFs and MLs in more than 60% of our participants already as early as 1 month post-treatment.
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Affiliation(s)
| | | | - Michael H Gold
- Gold Skin Care Center, Nashville, Tennessee, USA.,The Tennessee Clinical Research Center, Nashville, Tennessee, USA
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Park JY, Chen JF, Choi H, Ho WWS, Lesthari NNI, Lim JTE, Lim TS, Lowe S, Ong-Amoranto B, Vachiramon V, Wanitphakdeedecha R, Kerscher M. Insights on Skin Quality and Clinical Practice Trends in Asia Pacific and a Practical Guide to Good Skin Quality from the Inside Out. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:10-21. [PMID: 35783570 PMCID: PMC9239129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We sought to examine the current skin quality trends and gaps in clinical practice in the Asia Pacific region and develop a practical guide to improve skin quality. METHODS Medical practitioners from 11 countries in the Asia Pacific region completed an online survey on current trends in skin quality treatment. A panel of 12 leading experts convened for a virtual meeting to develop a practical guide for skin quality improvement. RESULTS A total of 153 practitioners completed the survey. The four most common skin quality issues were uneven skin tone, skin surface unevenness, skin laxity, and sebaceous gland hyperactivity and enlarged pores. Most practitioners reported using a combination of treatment modalities for each skin quality issue. It was also observed that each treatment modality could be used to treat several skin quality issues. A multimodal approach targeting different interrelated issues across the tissue planes was recommended for balanced results. The panel developed a practical guide for the appropriate combinations and sequence of treatments, and created treatment protocols for specific skin quality outcome goals. The guide employed an "inside-out" approach, treating the deeper tissue planes prior to the superficial layers to achieve harmonious results. LIMITATIONS Future studies are needed to support the recommended treatment protocols for skin quality improvement. CONCLUSION These findings provide valuable insights on current skin quality trends and gaps in clinical practice. The practical guide provides a framework for practitioners to customize their treatment plan according to each patient's needs.
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Affiliation(s)
- Je-Young Park
- Dr. Park is with the Apkoo-Jung Oracle Dermatology Clinic in Seoul, South Korea
| | - Jeng-Feng Chen
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
| | - Hosung Choi
- Dr. Choi is with the Piena Clinic in Seoul, South Korea
| | - Wilson W S Ho
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
| | | | - Joyce Teng Ee Lim
- Dr. Teng Ee Lim is with Joyce Lim Skin and Laser Clinic in Singapore
| | - Ting Song Lim
- Dr. Ting Song Lim is with the Clique Clinic in Kuala Lumpur, Malaysia
| | - Stephen Lowe
- Dr. Lowe is with MUSE Clinic in Sydney, Australia
| | - Beverly Ong-Amoranto
- Dr. Ong-Amoranto is with the Department of Dermatology at Asian Hospital and Medical Center in Metro Manila, Philippines
| | - Vasanop Vachiramon
- Dr. Vachiramon is with the Division of Dermatology, Faculty of Medicine Ramathibodi Hospital at Mahidol University in Bangkok, Thailand
| | - Rungsima Wanitphakdeedecha
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
| | - Martina Kerscher
- Dr. Kerscher is with the Division of Cosmetic Science and Aesthetics at the University of Hamburg in Hamburg, Germany
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Simon D, Capitán L, Bailón C, Bellinga RJ, Gutiérrez Santamaría J, Tenório T, Sánchez-García A, Capitán-Cañadas F. Facial Gender Confirmation Surgery: The Lower Jaw. Description of Surgical Techniques and Presentation of Results. Plast Reconstr Surg 2022; 149:755e-766e. [DOI: 10.1097/prs.0000000000008969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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New Technologies in Skin Tightening. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Goldie K, Kerscher M, Fabi SG, Hirano C, Landau M, Lim TS, Woolery-Lloyd H, Mariwalla K, Park JY, Yutskovskaya Y. Skin Quality - A Holistic 360° View: Consensus Results. Clin Cosmet Investig Dermatol 2021; 14:643-654. [PMID: 34163203 PMCID: PMC8214518 DOI: 10.2147/ccid.s309374] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/01/2021] [Indexed: 12/12/2022]
Abstract
Introduction Skin quality is an important component of human attractiveness. To date, there are no standardized criteria for good skin quality. To establish a consensus for good skin quality parameters and measurement and treatment options, a virtual skin quality advisory board consisting of a global panel of highly experienced aesthetic dermatologists/aesthetic physicians was convened. Methods A total of 10 dermatologists/aesthetic physicians served on the advisory board. A modified version of the Delphi method was used to arrive at consensus. Members accessed an online platform to review statements on skin quality criteria from their peers, including treatment and measurement options, and voted to indicate whether they agreed or disagreed. Statements that did not have agreement were modified and the members voted again. Consensus was defined as: strong consensus = greater than 95% agreement; consensus = 75% to 95% agreement; majority consent = 50% to 75% agreement; no consensus = less than 50% agreement. Results There was strong consensus that good skin quality is defined as healthy, youthful in appearance (appearing younger than a person's chronological age), undamaged skin and that skin quality can be described across all ethnicities by four emergent perceptual categories (EPCs): skin tone evenness, skin surface evenness, skin firmness, and skin glow. The EPCs can be affected by multiple tissue layers (ie, skin surface quality can stem from and be impacted by deep structures or tissues). This means that topical approaches may not be sufficient. Instead, improving skin quality EPCs can require a multilayer treatment strategy. Conclusion This global advisory board established strong consensus that skin quality can be described by four EPCs, which can help clinicians determine the appropriate treatment option(s) and the tissue or skin layer(s) to address. Skin quality is important to human health and wellbeing and patients' perception for the need for aesthetic treatment.
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Affiliation(s)
| | - Martina Kerscher
- Division of Cosmetic Science, Department of Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany
| | | | - Cyro Hirano
- Division of Dermatology General Polyclinic of Rio de Janeiro, Private Practice, CD Clinica Dermatologica, Rio de Janeiro, Brazil
| | - Marina Landau
- Dermatology Unit, Wolfson Medical Center, Holon, Israel
| | | | - Heather Woolery-Lloyd
- Department of Ethnic Skin Care, University of Miami Cosmetic Medicine and Research Institute, Miami Beach, FL, USA
| | | | - Je-Young Park
- Apkoo-Jung Department, Oracle Dermatology Center, Seoul, Republic of Korea
| | - Yana Yutskovskaya
- Dermatovenerology and Cosmetology Department, Pacific State Medical University of Health, Moscow, Russia
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Araco A, Araco F. Preliminary Prospective and Randomized Study of Highly Purified Polynucleotide vs Placebo in Treatment of Moderate to Severe Acne Scars. Aesthet Surg J 2021; 41:NP866-NP874. [PMID: 33755110 DOI: 10.1093/asj/sjab125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Managing acne scars is a challenge and therapies are divided into nonsurgical and surgical. Highly Purified Technology Polynucleotides (PN-HPT) is a compound that contains a mixture of DNA polymers of different lengths. Numerous studies have shown that PN-HPT also serves as an energy source, thus influencing cellular growth and cell vitality. OBJECTIVES The authors aimed to assess the improvement in dermal quality and acne scars after PN-HPT vs placebo according to Antera 3D and the patient responses to the patient satisfaction questionnaire after a comparison of pretreatment and posttreatment photographs at 1 and 3 months. METHODS Included were women aged 30 to 50 years with grade 3 to 4 moderate-to-severe atrophic scars according to the Goodman classification; nonsmokers; and had not had active acne during the past 5 years. Ten patients (PN-HPT group) were treated with 4.0 mL of PN-HPT, and 10 patients (control) were treated with 4.0 mL of normal saline. All medical treatments were performed in a double-blinded manner; neither the injection doctor nor the patient knew if the PN-HPT or the placebo was being administered. RESULTS Twenty women who fit the inclusion criteria were enrolled in this study. Only patients in the PN-HPT group improved significantly at 1 and 3 months after treatment compared with baseline. CONCLUSIONS This prospective and randomized study showed that PN-HPT in monotherapy was safe and effective treatment for atrophic scar acne compared with placebo. Prospective and randomized studies will be necessary to investigate the clinical effectiveness in a larger cohort of patients and for a longer follow-up. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Antonino Araco
- Department of Aesthetic Medicine, University Tor Vergata of Roma, Rome, Italy
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Effect of CO 2 Laser, Ultherapy, and Nanofat Graft Combination on Burn Scars: A New Approach. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3416. [PMID: 33680664 PMCID: PMC7929695 DOI: 10.1097/gox.0000000000003416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
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Araco A. Prospective Study on Clinical Efficacy and Safety of a Single Session of Microfocused Ultrasound With Visualization for Collagen Regeneration. Aesthet Surg J 2020; 40:1124-1132. [PMID: 32324851 DOI: 10.1093/asj/sjz363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recent studies have shown that transcutaneous microfocused ultrasound with visualization is beneficial for noninvasive skin tightening, collagen regeneration, and lower face contour improvement. OBJECTIVES The primary study endpoint was the improvement of the laxity and ptosis face skin; the secondary endpoint was the improvement of wrinkles, texture, and hemoglobin content; and the third endpoint was the patient's responses to a patient satisfaction questionnaire. METHODS Patients with soft to moderate skin laxity and ptosis of the face and neck were enrolled and their sex, ethnicity, age, Fitzpatrick skin type, and smoking habit recorded. Patient assessment was made by digital macro-photographs, Vectra H2, and Antera 3D, and strict exclusion criteria were set up. RESULTS From November 2017 to November 2018, 47 women and 3 men with a mean age of 52.8 ± 7.43 years and Araco's Ptosis Scale System 2.7 ± 0.46, which fit the inclusion criteria, were enrolled in the study. All patients signed a consent form and received 1200 spot-lines (400 lines from each transducer) of microfocused ultrasound with visualization. No major side effects were reported during the study and all patients completed the follow-up after 6 months. Wrinkles, texture, Surgeon Assessment Scoring System scores, and patient satisfaction questionnaire scores improved significantly. Patients found the treatment tolerable according to the patient pain scale rate. No statistically significative differences were found among homogenous groups of smokers and nonsmokers. CONCLUSIONS The study proves that microfocused ultrasound with visualization in a single session of treatment in monotherapy is safe and effective for the treatment of face laxity and ptosis when a proper number of energy spot-lines is delivered in the correct tissue layer. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Antonino Araco
- Department of Aesthetic Medicine, University Tor Vergata of Roma, Rome, Italy
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Wanitphakdeedecha R, Yan C, Ng JNC, Nokdhes Y, Tantrapornpong P, Techapichetvanich T, Eimpunth S, Manuskiatti W. The efficacy of macro‐focused ultrasound in the treatment of upper facial laxity: A pilot study. J Cosmet Dermatol 2020; 19:1955-1961. [DOI: 10.1111/jocd.13550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/22/2020] [Accepted: 06/08/2020] [Indexed: 01/20/2023]
Affiliation(s)
| | - Chadakan Yan
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Janice Natasha C. Ng
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Ya‐Nin Nokdhes
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | | | - Thanya Techapichetvanich
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Sasima Eimpunth
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
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Antonino A, Francesco A. Prospective and randomized comparative study of calcium hydroxylapatite vs calcium hydroxylapatite plus HIFU in treatment of moderate-to-severe acne scars. J Cosmet Dermatol 2020; 20:53-61. [PMID: 32385943 DOI: 10.1111/jocd.13472] [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: 04/13/2020] [Accepted: 04/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Acne scars are the most common sequelae of the severe inflammatory process of acne, and its managing is a challenge. Objective of this study was to assess safety and effectiveness of calcium hydroxylapatite monotherapy and its association with high-intensity microfocused ultrasound for treating moderate-to-severe atrophic acne scars. METHODS Women with moderate-to-severe atrophic scars of the face were enrolled on the study. Assessments were made by digital macrophotographs, Vectra H2, and Antera 3D. RESULTS From October to December 2019, twenty women which fitted the inclusion criteria signed a consent form and received 3.0 mL of calcium hydroxylapatite and after 4 weeks, 400 lines of HIFU. No major side effects were reported during the study, and all patients completed the follow-up after 6 months. At 1 month, patients treated with calcium hydroxylapatite (group 1) improved wrinkles and skin texture compared to placebo (group 2). At 3 and 6 months, all patients improved acne scars. CONCLUSION Our study showed that that both calcium hydroxylapatite and HIFU in monotherapy were safe and effective treatments for atrophic scar acne. Calcium hydroxylapatite was clinically effective when compared with placebo, though the combination of calcium hydroxylapatite and HIFU did not enhance the clinical efficacy compared to monotherapy.
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Affiliation(s)
- Araco Antonino
- Aesthetic Medicine Department, Cosmetic Surgeon at Univeristy Tor Vergata of Roma, Rome, Italy
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Vachiramon V, Triyangkulsri K, Iamsumang W, Chayavichitsilp P. Efficacy and Safety of Microfocused Ultrasound With Visualization in Abdominal Skin Laxity: A Randomized, Comparative Study. Lasers Surg Med 2020; 52:831-836. [PMID: 32173882 DOI: 10.1002/lsm.23234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Microfocused ultrasound with visualization (MFU-V) has been approved for the treatment of skin laxity on several areas including the eyebrows, neck, and submental area. This study aims to determine the efficacy of MFU-V for the treatment of abdominal skin laxity using two different treatment protocols. STUDY DESIGN/MATERIALS AND METHODS Thirty female patients with abdominal skin laxity were enrolled. Each side of the abdomen was randomly assigned to receive a single session of single-plane MFU-V treatment (4.5 mm) or dual-plane MFU-V treatment (4.5 and 3.0 mm). Improvement scores (0-10) were assigned by a blinded physician and patients at 1, 3, and 6 months after treatment. RESULTS Twenty-eight female patients completed the study. The physician-evaluated mean improvement scores in single-plane treatment were 3.03 (±1.26), 3.43 (±1.35), and 2.18 (±0.86) at 1-, 3-, and 6-month follow-up, respectively. For dual-plane treatment, the scores were 3.11 (±1.23), 3.39 (±1.34), and 2.02 (±0.79). There was no statistically significant difference between single- and dual-plane treatment at each time point. A similar pattern of improvement was observed in patient-rated mean improvement scores. Patients who had undergone childbirth had significantly higher physician and patient-rated mean improvement scores than those who had not in both single- and dual-plane treatments. In addition, a significant reduction of mean waist circumference was observed in patients who had undergone childbirth. The median pain scores were 5.25 for single-plane treatment and 4.29 for dual-plane treatment (P = 0.20). CONCLUSION Both single- and dual-plane MFU-V treatments showed comparable efficacies in treating abdominal skin laxity. The effect is more pronounced in patients who had undergone childbirth. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Bangkok, 10400, Thailand
| | - Korn Triyangkulsri
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Bangkok, 10400, Thailand
| | - Wimolsiri Iamsumang
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Bangkok, 10400, Thailand
| | - Pamela Chayavichitsilp
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Bangkok, 10400, Thailand
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