1
|
Sanyal RD, Fabi SG. Energy-Based Devices for the Treatment of Facial Skin Conditions in Skin of Color. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2024; 17:22-32. [PMID: 38912197 PMCID: PMC11189641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Background The development of microfocused ultrasound and fractional radiofrequency-based devices has expanded the range of cosmetic treatment options for patients with skin of color. Fractional non-ablative laser treatments can also be safely performed in skin types III-VI with appropriate settings and adjunctive topical treatments. Objective We sought to review the available literature on the use of energy-based devices for treatment of facial skin conditions in skin types III-VI. Methods A PubMed search was performed on studies from 2010-2021 assessing safety and efficacy of fractional ablative and non-ablative lasers, radiofrequency, and microfocused ultrasound-based treatments for conditions such as acne scars, melasma, benign pigmented lesions, rhytids, and skin laxity in skin types III-VI. Results Seven randomized trials, fourteen prospective cohort studies, and six retrospective reviews were included. Combination treatment with fractional radiofrequency and non-ablative laser has demonstrated efficacy in the treatment of acne scars in skin of color with minimal adverse effects. Laser-assisted drug delivery with low-density 1927-nm thulium or diode lasers has been shown to reduce the number of treatments required for significant clearance of melasma as compared with other modalities. Microfocused ultrasound has been shown to safely treat skin laxity in skin of color. Limitations There is a paucity of studies which include patients with skin type VI, limiting our overall understanding of the safety of these treatments in skin of color. Conclusion There are numerous available studies demonstrating safety and efficacy of energy-based devices for the treatment of facial skin conditions in skin types III-VI, but the significant variation among their designs, methods of assessment, and study populations highlights the need for larger meta-analyses to further interpret their results.
Collapse
Affiliation(s)
- Riana D. Sanyal
- Dr. Sanyal is with the Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California and the Metropolis Dermatology, Los Angeles, California
| | - Sabrina G. Fabi
- Dr. Fabi is with Cosmetic Laser Dermatology, San Diego, California and University of California, San Diego, California
| |
Collapse
|
2
|
Fatemi F, Najafian R, Sadri MA. New Ultherapy method: Utilizing novel surgical and anatomical concepts yields outstanding results. J Cosmet Dermatol 2024. [PMID: 38773827 DOI: 10.1111/jocd.16374] [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: 10/08/2023] [Revised: 04/19/2024] [Accepted: 05/03/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND Micro-focused ultrasound (MFU) is a technique for skin rejuvenation and lifting, targeting the facial SMAS-a fibrous network encompassing the platysma muscle and parotid fascia. OBJECTIVE This study aims to propose a novel and cost-effective method (suggested by Fatemi) for Ultherapy, comparing its effectiveness with the conventional approach. MATERIALS AND METHODS A prospective double-blind clinical trial was conducted with 30 female volunteers randomly assigned to two groups: The control group (conventional method) and the experimental group (new method). Ultherapy procedures utilized MFU technology with low energy and a higher frequency. RESULTS Statistically significant differences in lifting effects and improvement in skin laxity were observed between the two groups. The new method, with a focus on the parotideal area of the SMAS, demonstrated superior outcomes and higher patient satisfaction. CONCLUSION The parotideal region's accessibility, increased thickness, and safety profile make it an ideal target for Ultherapy. This not only reduces the risk of nerve injury but also yields effective collagen remodeling and skin-lifting results.
Collapse
Affiliation(s)
- Farahnaz Fatemi
- Dermatology, Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Romina Najafian
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
3
|
Scarano A, Amuso D, Amore R, Gehrke SA, Tari SR. Heating of metallic orthodontic devices during anti-aging treatment with vacuum and electromagnetic fields: In vitro study. Skin Res Technol 2024; 30:e13687. [PMID: 38566505 PMCID: PMC10988114 DOI: 10.1111/srt.13687] [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: 03/10/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The physical appearance of an individual plays a primary role as it influences the opinion of the viewer. For this reason, orthodontic therapy to improve perceived aesthetics is in high demand among patients. This factor, combined with the increase in the number of non-invasive facial aesthetic treatments, has led to the need to understand potential risk factors in the application of medical devices to the perioral skin in patients with fixed orthodontic appliances. The aim of this study was to evaluate in vitro heating of the orthodontic bracket following electromagnetic fields and negative pressure (V-EMF) used as an anti-aging treatment. METHODS Two different types of titanium alloy wires, one made of "beta-Titanium" alloy and the other "Ni-Ti" (DW Lingual Systems GmbH-Bad Essen-Germany) were used. The orthodontic wires and brackets mounted on a resin mouth were covered with porcine muscle tissue, then subjected to anti-aging therapy with a Bi-one LifeTouchTherapy medical device (Expo Italia Srl-Florence-Italy) which generates a combination of vacuum and electromagnetic fields (V-EMF) already adopted for antiaging therapy. During administration of the therapy, the orthodontic brackets and porcine tissue were thermally monitored using a Wavetek Materman TMD90 thermal probe (Willtek Communications GmbH-Germany). In total 20 orthodontic mouths were used, 10 with Beta Titanium wires and 10 with Nickel Titanium wires. RESULTS A temperature increase of about 1°C was recorded in each group. The outcome of the present research shows that the absolute temperatures measured on orthodontic appliances, which, despite having a slightly different curve, both show an increase in temperature of 1.1°C at the end of the session, thus falling well within the safety range of 2°C as specified by the standard CENELEC EN 45502-1. Therefore, V-EMF therapy can be considered safe for the entire dental system and for metal prostheses, which tend to heat up at most as much as biological tissue (+0.9°C/1.1°C vs. 1.1°C/1.1°C). CONCLUSION In conclusion, anti-aging therapy with V-EMF causes a thermal increase on orthodontic brackets that is not harmful to pulp health.
Collapse
Affiliation(s)
- Antonio Scarano
- Dean of Master course in Aesthetic MedicineDepartment of Innovative Technologies in Medicine and DentistryUniversity of Chieti‐PescaraChietiItaly
| | - Domenico Amuso
- Dean of Master course in Aesthetic MedicineDepartment of Innovative Technologies in Medicine and DentistryUniversity of Chieti‐PescaraChietiItaly
| | - Roberto Amore
- Dean of Master course in Aesthetic MedicineDepartment of Innovative Technologies in Medicine and DentistryUniversity of Chieti‐PescaraChietiItaly
| | - Sergio Alexandre Gehrke
- Department of ResearchBioface/PgO/UCAMMontevideoUruguay. Department of BiotechnologyUniversidad Católica de Murcia (UCAM)MurciaSpain
| | - Sergio Rexhep Tari
- Dean of Master course in Aesthetic MedicineDepartment of Innovative Technologies in Medicine and DentistryUniversity of Chieti‐PescaraChietiItaly
| |
Collapse
|
4
|
Kim I, Lee DM, Shin JW, Lee GJ, Kim ES, Kim NY. Radio frequency hyperthermia system for skin tightening effect by filled waveguide aperture antenna with compact metamaterials. Front Bioeng Biotechnol 2024; 12:1378084. [PMID: 38605987 PMCID: PMC11007180 DOI: 10.3389/fbioe.2024.1378084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
Radio frequency (RF) hyperthermia focuses on raising the target area temperature to a value exceeding 45°C. Collagen is stimulated when the temperature rises to 45°C at the dermal layer, resulting in skin tightening. However, most studies on RF hyperthermia have focused on tumor ablation or using electrodes to radiate an electromagnetic field, which is highly inefficient. This study proposed a non-invasive RF hyperthermia skin-tightening system with a compact metamaterial-filled waveguide aperture antenna. The proposed RF system increased the temperature by 11.6°C and 35.3°C with 20 and 80 W of 2.45 GHz RF power, respectively, within 60 s and exhibited a very focused effective area. Furthermore, a metamaterial was proposed to reduce the size of the waveguide aperture antenna and focus the electromagnetic field in the near-field region. The proposed metamaterial-filled waveguide aperture antenna was compact, measuring 10 mm × 17.4 mm, with a peak gain of 2.2 dB at 2.45 GHz. The measured hyperthermia performance indicated that the proposed RF system exhibited better power- and time-efficient hyperthermia performance than other RF hyperthermia systems in the cosmetic skin lifting commercial market. The proposed RF hyperthermia systems will be applied into a new generation of beauty cosmetic devices.
Collapse
Affiliation(s)
- Ikhwan Kim
- RFIC Bio Center, Kwangwoon University, Seoul, Republic of Korea
- Department Electronic Engineering, Kwangwoon University, Seoul, Republic of Korea
| | - Dong-Min Lee
- RFIC Bio Center, Kwangwoon University, Seoul, Republic of Korea
- Department Electronic Engineering, Kwangwoon University, Seoul, Republic of Korea
| | - Jae-Woo Shin
- RFIC Bio Center, Kwangwoon University, Seoul, Republic of Korea
- APR Device Center, Seoul, Republic of Korea
| | - Gyoun-Jung Lee
- RFIC Bio Center, Kwangwoon University, Seoul, Republic of Korea
- APR Device Center, Seoul, Republic of Korea
| | - Eun-Seong Kim
- RFIC Bio Center, Kwangwoon University, Seoul, Republic of Korea
- APR Device Center, Seoul, Republic of Korea
| | - Nam-Young Kim
- RFIC Bio Center, Kwangwoon University, Seoul, Republic of Korea
- Department Electronic Engineering, Kwangwoon University, Seoul, Republic of Korea
- APR Device Center, Seoul, Republic of Korea
| |
Collapse
|
5
|
Dullnig AW, Perenack JD, Chapple AG, Kirby CL, Christensen BJ. Is Bipolar Radiofrequency-Assisted Liposuction Equivalent to Open Anterior Platysmaplasty in Facelift Surgery? J Oral Maxillofac Surg 2024; 82:169-180. [PMID: 37992758 DOI: 10.1016/j.joms.2023.11.004] [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: 08/01/2023] [Revised: 10/20/2023] [Accepted: 11/01/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND During facelift surgery, anterior platysmaplasty (AP) has been used for decades, but it limits lateral advancement and can induce contour irregularities. Radiofrequency (RF)-assisted-liposuction in the anterior neck can avoid these disadvantages by tightening skin without open surgery. PURPOSE The purpose of the study was to compare the esthetic outcomes of facelift surgery with those of AP and RF. STUDY DESIGN, SETTING, SAMPLE A 5-year retrospective cohort study was performed on facelift patients treated by a single surgeon. Exclusions were single-side surgery, previous facelift, chin/lip augmentation/reduction, and inadequate data. PREDICTOR VARIABLE The predictor variable was neck management technique (AP vs RF). MAIN OUTCOME VARIABLES The primary outcome variable was the change in cervicomental angle (CMA) following surgery as measured on facial photographs. Secondary outcomes included distance changes from the central CMA point in vertical and horizontal planes to repeatable reference planes. COVARIATES Covariates were age, body mass index, American Society of Anesthesiologists classification, smoking, and simultaneous procedures. ANALYSES The statistical analysis was performed using Wilcoxon rank-sum, Fisher's exact, Kruskal-Wallis tests, Pearson's correlation, and linear regressions. The level of statistical significance was P < .05. RESULTS There were 132 patients included in the study; 67 received AP and 65 received RF. AP trended toward better performance in CMA change in the unadjusted analysis (-18.7° ± 13.8° vs -22.3° ± 13.7°, respectively, P = .08). AP and RF performed similarly in the adjusted analysis (P = .29). Techniques were similar in horizontal distance change to the CMA (P = .31). RF was associated with less change in the vertical distance to the CMA in the unadjusted analysis (-11.9 mm ± 11.0 mm vs -6.7 mm ± 8.7 mm, respectively, P = .01) and adjusted analysis (β = 4.3 mm, 95% confidence interval .8 to 7.9 mm, P = .02). CONCLUSION AND RELEVANCE Utilization of the RF technique for management of the anterior neck in facelift surgery is associated with similar outcomes to the AP technique in horizontal distance to the CMA, but AP performed better in CMA change and vertical distance to the CMA.
Collapse
Affiliation(s)
- Andrew W Dullnig
- Assistant Professor, Uniformed Services University of the Health Sciences, Bethesda, MD.
| | - Jon D Perenack
- Fellowship Director and Associate Clinical Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center - New Orleans, New Orleans, LA; Medical and Surgical Director, Williamson Cosmetic Center and Perenack Aesthetic Surgery, Baton Rouge, LA
| | - Andrew G Chapple
- Assistant Professor, Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center - New Orleans, New Orleans, LA
| | - Christopher L Kirby
- Dental Student, Louisiana State University School of Dentistry, New Orleans, LA
| | - Brian J Christensen
- Associate Professor, Department of Oral Medicine and Maxillofacial Surgery, Geisinger Health System, Danville, PA
| |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Kim Y, Yu H, An S, Ha D, Jung B. Handheld microfocused ultrasound device for facial lifting: A preliminary study of ULTIGHT. J Cosmet Dermatol 2023; 22:2982-2988. [PMID: 37183576 DOI: 10.1111/jocd.15813] [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: 01/15/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Although focused ultrasound modalities have achieved positive clinical results in noninvasive skin rejuvenation, they presented various side effects and particularly severe pain during treatment. This study introduces a microfocused ultrasound (MFU) device, ULTIGHT, to overcome the severe pain issue, providing quasi-facial lifting. MATERIALS AND METHODS Transducer surface was imaged with a scanning electron microscope. The energies of four treatment cartridges were measured using an ultrasound power meter. In vitro experiments were performed to quantitatively evaluate the MFU thermal zones (MFUTZs) and treatment line (TL) of 10 MFUTZs. Ex vivo experiments were performed to evaluate the MFUTZs and temperature rise in tissue. Clinical trials using eight volunteers were performed to qualitatively evaluate facial lifting. RESULTS The MFU transducer clearly showed a smooth and no air gap surface. ULTIGHT produced 10 discrete MFUTZs in a TL of length 10 mm. In ex vivo tissue, discrete linear MFUTZs were clearly observed at lower number of TLs; however, they started to aggregate at higher number of TLs. The temperature rise was linearly increased as a function of the number of treatments. A single MFUTZ resulted in a temperature rise of 3°C-10°C that could cause hyperthermia for body temperature. In the clinical trials, the volunteers showed quasi-facial lifting right after treatment on the lower facial region. CONCLUSIONS ULTIGHT provides relatively low energy, which may be advantageous or disadvantageous depending on clinical applications. Additionally, it has the advantage of being pain-free even without anesthetic during treatment, providing quasi-facial lifting right after treatment.
Collapse
Affiliation(s)
- Yongheon Kim
- Department of Biomedical Engineering, Yonsei University, Wonju-si, Korea
| | - Hyunseon Yu
- Department of Biomedical Engineering, Yonsei University, Wonju-si, Korea
| | | | | | - Byungjo Jung
- Department of Biomedical Engineering, Yonsei University, Wonju-si, Korea
| |
Collapse
|
8
|
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.
Collapse
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.
| |
Collapse
|
9
|
Laura S, Veronese S, Alberti G, Bacci PA, Beatini A, Fulgione E, Urbani C, Sbarbati A. Vacuum and electromagnetic field in synergy for skin rejuvenation: A retrospective study on 217 patients. J Cosmet Dermatol 2023; 22:2989-2995. [PMID: 37340588 DOI: 10.1111/jocd.15871] [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: 12/18/2022] [Revised: 05/24/2023] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND There are many aesthetic treatments aimed at combating aging. In the most common and frequently used ones there are often side effects, albeit minor ones. However, sometimes it is necessary to use medications before or after treatments. OBJECTIVES To evaluate the anti-aging efficacy and application safety of a therapy based on the combination of vacuum and electromagnetic fields (EMFs). METHODS A retrospective study was conducted to evaluate the aesthetic effects of the treatment on 217 subjects. Before treatment (T0) and after the last session (T1), skin hydration levels, the amount of sebum present and the pH were measured. The presence of discomfort during the sessions and side effects at T1 was verified. At T1, the levels of satisfaction of the patients and of the doctors who performed the treatment were assessed. At 3 and 6 months of follow-up the aesthetic results were re-evaluated. RESULTS For all treated subjects, an evident qualitative improvement was observed in the quality of the skin of the neck and face, with an increase in tone and a reduction in wrinkles. The instrumental tests highlighted a normalization of skin hydration, pH, and sebum values. High levels of satisfaction at T0 and good stability of results up to 6 months of follow-up were reported. No discomfort was referred during the treatment sessions, nor any side effects after the entire treatment. CONCLUSIONS The treatment that exploits the synergy between vacuum and EMFs is very promising given the effectiveness and safety of the technique.
Collapse
Affiliation(s)
| | - Sheila Veronese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giovanni Alberti
- International School of Aesthetic Medicine of the Fatebenefratelli Foundation, Rome, Italy
| | - Pier Antonio Bacci
- Medical Centre for Vascular Diseases and Aesthetic Pathologies, Arezzo, Italy
| | | | - Elisabetta Fulgione
- Dermatological Clinic University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| |
Collapse
|
10
|
Razavi CR, Byrne PJ. Intellectual Property in Facial Plastic and Reconstructive Surgery: The Importance and Process of Obtaining Intellectual Property Rights. Facial Plast Surg 2023; 39:460-465. [PMID: 37196666 DOI: 10.1055/a-2095-6367] [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: 05/19/2023] Open
Abstract
Understanding the purpose and process of obtaining intellectual property rights (IPR) is fundamental to health care innovation. Facial plastic and reconstructive surgeons are natural innovators; however, knowledge deficit in this space may hinder the ability to move ideas from the "bench to bedside." Here we provide an overview of IPR, outlining the steps necessary to obtain intellectual property protection in an academic setting while highlighting recent U.S. Food and Drug Administration (FDA) approvals pertaining to facial plastic and reconstructive surgery.
Collapse
Affiliation(s)
- Christopher R Razavi
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Patrick J Byrne
- Section of Facial Plastic and Microvascular Surgery, Cleveland Clinic, Head and Neck Institute, Cleveland, Ohio
| |
Collapse
|
11
|
Ling J, Zhao H. A Systematic Review and Meta-Analysis of the Clinical Efficacy and Patients' Satisfaction of Micro-focused Ultrasound (MFU) Treatment for Facial Rejuvenation and Tightening. Aesthetic Plast Surg 2023; 47:1806-1823. [PMID: 37198297 DOI: 10.1007/s00266-023-03384-1] [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: 01/30/2023] [Accepted: 04/23/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE Micro-focused ultrasound (MFU) is commonly used to improve facial relaxation and wrinkles. The objective of this study was to determine the efficacy of MFU for facial rejuvenation and patients' satisfaction with the treatment. METHOD Articles published before December 2022 were retrieved using PubMed, Embase, Web of Science, and Cochrane Library databases. The retrieved literature was screened according to strict criteria, and the risk of bias of each study was assessed. RESULT A total of 13 MFU studies for facial rejuvenation and tightening were included, involving 477 participants. Efficacy was assessed using the Global Aesthetic Improvement Scale (GAIS), and meta-analysis showed an overall response rate of 0.77 (95%CI: 0.58, 0.96) at 90 days after intervention and 0.69 (95%CI: 0.51, 0.87) at 180 days. 0.78 (95%CI: 0.61, 0.95) and 0.71 (95%CI: 0.54, 0.87) patients were satisfied and very satisfied overall at 90 days and 180 days, respectively. The pain score was on a 10-point scale, and the overall score was 3.10 (95%CI: 2.71, 3.94). There were no instances during treatment where patients could not tolerate pain. Sensitivity analysis showed that the results were robust. CONCLUSION In conclusion, MFU is an effective way to treat facial rejuvenation and tightening. More large-sample, multicenter and randomized studies are needed to determine the optimal treatment parameters in the future. LEVEL OF EVIDENCE I 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)
- Jiaqi Ling
- Department of Plastic Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Haiguang Zhao
- Department of Plastic Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
| |
Collapse
|
12
|
Chao JR, Porter JP, Hessler J. Cosmetic Treatments with Energy-Based Devices in Skin of Color. Facial Plast Surg 2023; 39:496-500. [PMID: 37557909 DOI: 10.1055/s-0043-1772197] [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: 08/11/2023] Open
Abstract
The use of energy-based devices in cosmetic treatments for patients with higher Fitzpatrick skin types is a topic of concern due to the increased risk of complications such as hyperpigmentation and scarring. Advancements in technology have enabled the development of safe and effective energy-based modalities for improving skin tone, texture, and signs of aging in patients with higher Fitzpatrick skin types. This article reviews various modalities that have shown positive outcomes in Fitzpatrick skin types 4 to 6.Radiofrequency (RF) skin tightening devices have emerged as a noninvasive method for improving skin laxity by stimulating collagen and elastin production without generating excessive heat, making them suitable for darker skin tones. Microfocused ultrasound (MFUS) is another noninvasive option for skin tightening and lifting. By producing thermal coagulation in the deeper layers of the skin, MFUS stimulates collagen production, resulting in improved skin tightness. Fractional laser resurfacing, both ablative and nonablative, offers effective treatment options for various concerns such as acne scars, skin texture, and dyspigmentation. Nonablative fractional lasers, which target water rather than melanin, are particularly safer for darker skin types. Broadband light devices that emit different wavelengths have shown success in skin rejuvenation, improving wrinkles, pore size, erythema, telangiectasias, and dyspigmentation. Additionally, RF microneedling combines the benefits of both modalities, delivering safe treatment for skin laxity and textural concerns. The short-pulse neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has become a transformative tool for patients with Fitzpatrick skin types 4 to 6. This laser targets melanin, hemoglobin, and water, providing improvements in hyperpigmentation, acne, fine lines, and scar texture. Combining the short-pulse Nd:YAG laser with other treatments like chemical peels or microneedling has shown synergistic effects and enhanced outcomes. Understanding these modalities and tailoring treatments to specific concerns is crucial for safe and effective solutions in patients with higher Fitzpatrick skin types.
Collapse
Affiliation(s)
- Janet Ren Chao
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Jennifer Parker Porter
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, District of Columbia
- Chevy Chase Facial Plastic Surgery, Bethesda, Maryland
| | | |
Collapse
|
13
|
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.
Collapse
|
14
|
Chakraborty S, Sanshita, Singh I. Therapeutic treatment strategies for the management of onychomycosis: a patent perspective. Expert Opin Ther Pat 2023; 33:613-630. [PMID: 37800854 DOI: 10.1080/13543776.2023.2268278] [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: 06/09/2023] [Accepted: 10/04/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Onychomycosis, a multifactorial fungal infection of the nails, shows a global prevalence of about 5.5% and is responsible for 50% of all nail infections. To develop effective management strategies, it is necessary to understand the etiology, pathophysiology, and risk factors of onychomycosis. Oral route of drug delivery is one of the routes utilized to deliver anti-fungal agents, but, has its own limitations like longer duration of treatment, increased adverse effects, and potential for drug interaction. The ungual route has received greater attention due to its localized, non- invasive action and improved patient compliance. AREAS COVERED This review comprehensively discusses conventional onychomycosis therapies and patented novel drug delivery systems for the management of onychomycosis including chemical permeation enhancers, non-particulate drug delivery systems, penetration enhancing devices etc., Databases such as PubMed, ResearchGate, and Google Patents were searched by using the keywords onychomycosis and trans-ungual drug delivery. EXPERT OPINION Enormous research has been conducted and is still ongoing to find the best possible novel drug delivery system for onychomycosis management. Approaches like incorporation of herbal constituents in nano-formulations, inkjet printing, laser devices, iontophoretic techniques, etc. can be employed to make safe and effective drug delivery systems which are regulatory compliant.
Collapse
Affiliation(s)
| | - Sanshita
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Inderbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| |
Collapse
|
15
|
Nelson K, Nelson J, Bradley T, Burgess C. Cosmetic Enhancement Updates and Pitfalls in Patients of Color. Dermatol Clin 2023; 41:547-555. [DOI: 10.1016/j.det.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
|
16
|
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.
Collapse
|
17
|
Wanitphakdeedecha R, Evangelista KER, Yan C, Apinuntham C, Techapichetvanich T, Eimpunth S, Lektrakul N, Manuskiatti W. The Efficacy of Noninvasive 1060-Nm Diode Lasers for Submental Lipolysis: A Pilot Study. Clin Cosmet Investig Dermatol 2022; 15:2775-2783. [PMID: 36569419 PMCID: PMC9788834 DOI: 10.2147/ccid.s382582] [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: 08/13/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022]
Abstract
Background Submental fat is a noticeable fat in the submental region that is of great concern aesthetically, especially to female patients. A 1060-nm diode laser is a clinically proven device for the laser lipolysis of subcutaneous fat cells. This study aimed to evaluate the safety and efficacy of a 1060-nm diode laser for submental fat reduction. Methods Twenty subjects with unwanted localized submental fat were treated with a single session of a 1060-nm diode laser with an energy setting between 0.95 and 1.40 W/cm2, depending on each patient's tolerance. Submental fat thickness measurements were documented at baseline, and 1, 3, and 6 months after treatment. Clinical photographs, ultrasound images, and adverse events were evaluated at each follow-up visit. Subjects responded to a satisfaction questionnaire at the end of the study. Results The subjects had a mean age of 34.55 ± 6.19 years, a mean body weight of 70.66 ± 10.55 kilograms, and most (95%) were women. The average energy setting was 0.95-1.40 W/cm2, with a pain score of 3.90 ± 1.30 on a 0-to-10 scale. A significant reduction in submental fat thickness measured by ultrasound was noted at post-treatment month 3 (falling to 0.46 ± 0.13; P = 0.013). However, there was a slight increase in the submental fat thickness at the 6-month follow-up (to 0.48 ± 0.12); the change in the thickness relative to the baseline was nonsignificant (P = 0.121). Most subjects reported an improvement 6 months after the treatment. No severe adverse events were observed throughout the study period. Conclusion Our study demonstrated the potential role of 1060-nm Diode laser for the treatment of localized submental subcutaneous adiposities. It is a promising alternative treatment modality for patients seeking an in-office, nonsurgical procedure for fat reduction without severe complications.
Collapse
Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Correspondence: Rungsima Wanitphakdeedecha, Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, 10700, Thailand, Tel +66 2 419 4333, Fax +66 2 411 9922, Email
| | - Kristy Elleza R Evangelista
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Department of Dermatology, Research Institute for Tropical Medicine, Manila, Philippines
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chalermkwan Apinuntham
- 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
| | - Nittaya Lektrakul
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
18
|
Kolczewski P, Kozłowski M, Cymbaluk-Płoska A. Micro-Focused Ultrasound Therapy in Patients with Urogenital Atrophy and Vaginal Laxity. J Clin Med 2022; 11:jcm11236980. [PMID: 36498554 PMCID: PMC9739894 DOI: 10.3390/jcm11236980] [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: 09/09/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Vaginal laxity (VL) and genitourinary syndromes of menopause (GSM) create physical, psychological, and functional problem for women and their partners. We aimed to evaluate the efficacy and safety of micro-focused ultrasound (MFU) therapy performed twice in the vaginal canal in a patients with VL and GSM. A total of 20 women with GSM and VL were treated with MFU Ultravera by Hironic. The treatment course consisted of two vaginal applications of MFU at an interval of 6 weeks. The clinical effects of the protocol were evaluated using the Vaginal Laxity Questionnaire (VLQ), the Vaginal Health Index (VHI), and the Female Sexual Function Index (FSFI). The overall values of the vaginal laxity evaluation for the total subject population showed a statistically significant improvement between the baseline and the findings at 3 and 6 months after treatment. The effect of therapy was consistent across all domains of FSFI. It peaked at the 6 week follow-up visit (from 26.5 to 32) and plateaued at 12 weeks and 6 months. There was a significant VHI improvement over time, with the greatest and most significant change between the study entry and 21 days after treatment; the VHI score leveled off up to 3 months after the procedures. MFU therapy, performed twice in the vaginal canal, showed promising efficacy and safety profiles, meriting further investigation.
Collapse
|
19
|
Bravo BSF, de Melo Carvalho R, Penedo L, de Bastos JT, Calomeni Elias M, Cotofana S, Frank K, Moellhoff N, Freitag L, Alfertshofer M. Applied anatomy of the layers and soft tissues of the forehead during minimally-invasive aesthetic procedures. J Cosmet Dermatol 2022; 21:5864-5871. [PMID: 35634970 DOI: 10.1111/jocd.15131] [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: 01/04/2022] [Revised: 04/21/2022] [Accepted: 05/25/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND An increasing demand of minimally-invasive aesthetic procedures of the forehead concomitantly leads to higher numbers of adverse events. Adequate application of anatomical knowledge is required to increase safety and efficacy of different minimally-invasive aesthetic procedures in this anatomical region. OBJECTIVE To describe the layered anatomy of the forehead soft tissues with respect to their thicknesses and how they relate to different minimally-invasive aesthetic treatments. METHODS A total of n = 85 healthy study participants (69 females and 16 males) with a mean age of 40.84 ± 10.9 years and a mean body mass index of 22.65 ± 2.6 kg/m2 were investigated with ultrasound-based imaging to measure the thickness of different forehead soft tissues. RESULTS The mean overall soft tissue thickness of the forehead was measured to be 4.18 ± 0.7 mm for the entire study population. Increasing BMI values correlated statistically significantly with increasing thickness of all measured forehead soft tissues with exception of the frontalis muscle. On a statistically significant level, males showed thicker forehead soft tissues than females, with exception of the retrofrontalis fat and the frontalis muscle. CONCLUSION On basis of the findings obtained in this study, basic treatment principles can be derived and improved for the injection of neuromodulators, hyaluronic acid as well as the application of polydiaxonane (PDO) threads and micro-focused ultrasound. Precise knowledge and thorough understanding of the layers and soft tissues of the forehead is required to guarantee safe and effective procedures in this aesthetically important facial region.
Collapse
Affiliation(s)
| | | | - Lais Penedo
- Dermatology Department, Bravo Private Clinic, Rio de Janeiro, Brazil
| | | | | | - Sebastian Cotofana
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Konstantin Frank
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| | - Nicholas Moellhoff
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| | - Lysander Freitag
- Department of General Surgery, Community Hospital Havelhöhe, Berlin, Germany
| | - Michael Alfertshofer
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| |
Collapse
|
20
|
Bader KB, Makin IRS, Abramowicz JS. Ultrasound for Aesthetic Applications: A Review of Biophysical Mechanisms and Safety. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1597-1607. [PMID: 34709673 DOI: 10.1002/jum.15856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 06/13/2023]
Abstract
Aesthetic ultrasound is used for fat reduction and to improve skin appearance. In this review, the fundamental mechanisms by which ultrasound can alter tissue are outlined. The technologies that are commercially available or under development are discussed. Finally, recommendations are made for safe and effective use of aesthetic ultrasound.
Collapse
Affiliation(s)
- Kenneth B Bader
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Inder Raj S Makin
- School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, Arizona, USA
| | - Jacques S Abramowicz
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
21
|
Choi AM, Brenner MJ, Gorelik D, Erbele ID, Crowson MG, Kadkade P, Takashima M, Santa Maria PL, Hong RS, Rose AS, Ostrander BT, Rabbani CC, Morrison RJ, Weissbrod PA, Tate AD, Kain JJ, Lina IA, Shaffer SR, Ahmed OG. New Medical Device and Therapeutic Approvals in Otolaryngology: State of the Art Review of 2021. OTO Open 2022; 6:2473974X221126495. [PMID: 36171808 PMCID: PMC9511340 DOI: 10.1177/2473974x221126495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate new medical devices and drugs pertinent to otolaryngology–head and neck surgery that were approved by the Food and Drug Administration (FDA) in 2021. Data Sources Publicly available FDA device and drug approvals from ENT (ear, nose, and throat), anesthesia, neurosurgery, plastic surgery, and general surgery FDA committees. Review Methods FDA device and therapeutic approvals were identified and reviewed by members of the American Academy of Otolaryngology–Head and Neck Surgery’s Medical Devices and Drugs Committee. Two independent reviewers assessed the relevance of devices and drugs to otolaryngologists. Medical devices and drugs were then allocated to their respective subspecialty fields for critical review based on available scientific literature. Conclusions The Medical Devices and Drugs Committee reviewed 1153 devices and 52 novel drugs that received FDA approval in 2021 (67 ENT, 106 anesthesia, 618 general surgery and plastic surgery, 362 neurosurgery). Twenty-three devices and 1 therapeutic agent relevant to otolaryngology were included in the state of the art review. Advances spanned all subspecialties, including over-the-counter hearing aid options in otology, expanding treatment options for rhinitis in rhinology, innovative laser-safe endotracheal tubes in laryngology, novel facial rejuvenation and implant technology in facial plastic surgery, and advances in noninvasive and surgical treatment options for obstructive sleep apnea. Implications for Practice FDA approvals for new technology and pharmaceuticals present new opportunities across subspecialties in otolaryngology. Clinicians’ nuanced understanding of the safety, advantages, and limitations of these innovations ensures ongoing progress in patient care.
Collapse
Affiliation(s)
- Alexander M. Choi
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Michael J. Brenner
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Daniel Gorelik
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Isaac D. Erbele
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - Matthew G. Crowson
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Prajoy Kadkade
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, North Shore University Hospital, Sunnyside, New York, USA
| | - Masayoshi Takashima
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Peter L. Santa Maria
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Robert S. Hong
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University, Detroit, Michigan, USA
- Michigan Ear Institute, Farmington Hills, Michigan, USA
| | - Austin S. Rose
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Benjamin T. Ostrander
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA
| | - Cyrus C. Rabbani
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Case Western Reserve University and University Hospitals, Cleveland, Ohio, USA
| | - Robert J. Morrison
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Philip A. Weissbrod
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA
| | - Alan D. Tate
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - Joshua J. Kain
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Ioan A. Lina
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Scott R. Shaffer
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Marlton, New Jersey, USA
| | - Omar G. Ahmed
- Medical Devices and Drugs Committee, American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
- Department of Otolaryngology–Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas, USA
| |
Collapse
|
22
|
Engerer N, Frank K, Moellhoff N, Alfertshofer M, Giunta RE, Green JB, Lorenc PZ, Chaney GK, Ehrl D, Cotofana S. Aging of the Neck Decoded: New Insights for Minimally Invasive Treatments. Aesthetic Plast Surg 2022; 46:1698-1705. [PMID: 35701594 DOI: 10.1007/s00266-022-02961-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Many signs of aging manifest in the neck region, including platysmal bands, excess skin, horizontal neck lines and decreasing contour of the neck. While the clinical signs of an aged neck are well-known, data determining the underlying aging process are limited. OBJECTIVE To decode aging of the neck. MATERIALS AND METHODS This prospective study investigated elasticity and firmness of skin, muscle activity and skin displacement upon muscular contraction in the neck in 77 young-, middle- and old-age individuals. Objective outcome measures, including 3-dimensional imaging, cutometry and surface electromyography, were utilized for all assessments. RESULTS Mean firmness of skin decreased significantly from young to old individuals (0.37 ± 0.13 mm, 0.30 ± 0.12 mm and 0.26 ± 0.12 mm in young, middle and old subjects, respectively; p < 0.001). Gross elasticity decreased significantly from 75.1 ± 13.0% in young subjects, to 64.53 ± 15.7% in middle-aged subjects and 55.79 ± 13.0% in old subjects (p < 0.001). The mean y-axis skin displacement increased from 2.48 ± 4.33 mm in young subjects, to 3.11 ± 4.49 mm in middle-aged subjects and 3.61 ± 5.38 mm in old subjects (p = 0.006). The mean signal-to-noise ratio decreased significantly from 16.74 ± 5.77 µV in young subjects, to 14.41 ± 4.86 µV in middle-aged subjects and to 12.23 ± 5.99 µV in old subjects (p < 0.001). CONCLUSION This study provides insights into the interplay between skin elasticity, muscular activity and the reflected movement of the skin of the neck. Appreciation of these age-related changes lays the fundament for aesthetic treatments in this delicate region. 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 .
Collapse
Affiliation(s)
- Nina Engerer
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Konstantin Frank
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Nicholas Moellhoff
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Michael Alfertshofer
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Riccardo E Giunta
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Jeremy B Green
- Skin Associates of South Florida and Skin Research Institute, Coral Gables, Florida, USA
| | | | - Grace K Chaney
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Stabile Building 9-38, 200 First Street, Rochester, MN, 55905, USA
| | - Denis Ehrl
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany
| | - Sebastian Cotofana
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Stabile Building 9-38, 200 First Street, Rochester, MN, 55905, USA.
| |
Collapse
|
23
|
Lee TJ, Kim D, Kim T, Pak CJ, Suh HP, Hong JP. Rejuvenation of photoaged aged mouse skin using high intensity focused ultrasound. J Plast Reconstr Aesthet Surg 2022; 75:3859-3868. [DOI: 10.1016/j.bjps.2022.06.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022]
|
24
|
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]
|
25
|
Khan U, Khalid N. A Systematic Review of the Clinical Efficacy of Micro-Focused Ultrasound Treatment for Skin Rejuvenation and Tightening. Cureus 2021; 13:e20163. [PMID: 35003992 PMCID: PMC8722640 DOI: 10.7759/cureus.20163] [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] [Accepted: 12/04/2021] [Indexed: 11/23/2022] Open
Abstract
The demand for non-invasive skin-tightening techniques is continuously on the rise, as now numerous patients seek safe and effective alternative body, neck, and facial aesthetic surgical procedures. Micro-focused ultrasound (MFU) has been recently introduced as a novel energy modality for skin rejuvenation to produce a more significant wound healing response at various levels, including strong collagen remodeling and long-lasting clinical response. This literature study was intended to find the role and efficiency of using micro-focused ultrasound therapy in male and female patients aged 35-65. A total of 139 articles were extracted from the PubMed and Science Direct electronic databases. After a thorough evaluation and following the exclusion and inclusion criteria, 10 full-text articles were relevant to the study. The goal was to analyze and examine the effects and benefits of MFU treatment to improve the skin. In addition, all of the patients were evaluated to report the harms and risks associated with MFU treatment. The literature study results revealed that significant improvements in the overall aesthetics of sagging of the mid and lower face could be accomplished by using a micro-focused ultrasonic treatment plan. Patients report no considerable side effects, and the results were also long-lasting. MFU treatment can activate deeper tissues without causing injury to the epidermis, which sets it apart from all other skin tightening methods. Better improvements rates have been reported by both patients' self-assessment and clinical investigators' evaluation.
Collapse
|
26
|
Wang JV, Ferzli G, Jeon H, Geronemus RG, Kauvar A. Efficacy and Safety of High-Intensity, High-Frequency, Parallel Ultrasound Beams for Fine Lines and Wrinkles. Dermatol Surg 2021; 47:1585-1589. [PMID: 34417390 DOI: 10.1097/dss.0000000000003208] [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: 11/27/2022]
Abstract
BACKGROUND Ultrasound energy has been used for cutaneous rejuvenation, including treatment of fine lines and wrinkles. Ultrasound waves of high intensity can induce thermal injury in the dermis, which causes tissue coagulation and remodeling. OBJECTIVE To examine the safety and utility of a novel ultrasound device that uses high-intensity, high-frequency, parallel ultrasound beams to improve fine lines and wrinkles of the face and neck. MATERIALS AND METHODS A prospective, multicenter, clinical study investigated the utility of this novel ultrasound device to improve fine lines and wrinkles. Sixty subjects were enrolled for single treatment to the face and neck. RESULTS Fifty-eight subjects completed the study. The mean age was 58 years, and 87.9% were women. Fitzpatrick skin Types I to VI were represented. Assessments compared 12-week follow-up with baseline. Two blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 78% of subjects. There was significant improvement of 1 to 3 Fitzpatrick Wrinkle and Elastosis Scale units in 86% of subjects. For investigator global improvement scores, 88% of subjects had improvement. Overall, 72% of subjects noted improvement, and the majority were satisfied. There were no device-related adverse events. CONCLUSION Treatment with a novel ultrasound device that uses high-intensity, high-frequency, parallel ultrasound beams safely improved the clinical appearance of fine lines and wrinkles of the face and neck.
Collapse
Affiliation(s)
- Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York
| | | | - Hana Jeon
- Laser & Skin Surgery Center of New York, New York, New York
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York, New York
- The Ronald O Perelman Department of Dermatology, New York University Langone Health, New York, New York
| | - Arielle Kauvar
- The Ronald O Perelman Department of Dermatology, New York University Langone Health, New York, New York
- New York Laser & Skin Care, New York, New York
| |
Collapse
|
27
|
Albornoz CA, Nichols SE, Wang JV, Saedi N, Munavalli GS. Optimizing skin tightening in aesthetics in men. Clin Dermatol 2021; 40:244-248. [PMID: 34838655 DOI: 10.1016/j.clindermatol.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The field of cosmetic dermatology has recently witnessed unbridled growth in the past several years. Part of this has been due to the increasing popularity of aesthetic treatments in men, who represent a growing patient population. Men tend to have higher levels of collagen density and greater skin thickness, but these begin to decrease earlier on. They can also more frequently have severe photodamage. Their clinical presentations can affect the selection of treatments. Physicians should be familiar with the subtle differences between treating men and women. Early studies and literature are beginning to shed more light on these important distinctions. We review the notable differences in facial aging, pathophysiology, and patient selection and discuss available treatment options with these factors in mind.
Collapse
Affiliation(s)
- Christian A Albornoz
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sarah E Nichols
- Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, North Carolina, USA
| | - Jordan V Wang
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Laser & Skin Surgery Center of New York, New York, NY, USA.
| | - Nazanin Saedi
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Girish S Munavalli
- Dermatology, Laser & Vein Specialists of the Carolinas, Charlotte, North Carolina, USA
| |
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
|
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]
|
30
|
Guida S, Longhitano S, Spadafora M, Lazzarotto A, Farnetani F, Zerbinati N, Pellacani G, Galadari H. Hyperdiluted calcium hydroxylapatite for the treatment of skin laxity of the neck. Dermatol Ther 2021; 34:e15090. [PMID: 34363289 DOI: 10.1111/dth.15090] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/25/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022]
Abstract
Despite being a common concern, there are very few minimally invasive treatments targeting neck skin laxity (NSL) reported in the literature. To assess the efficacy of hyperdiluted calcium hydroxyapatite (hy-CaHA) for the treatment of NSL, according to the NSL scale, and to estimate safety. Twenty patients showing NSL were treated with hy-CaHA 1:2. To evaluate the efficacy of hy-CaHA treatment for NSL, pictures of treated subjects were collected before and 3 months after treatment and graded according to the NSL scale, and T-student's test was applied to estimate differences. Hy-CaHA for the neck was effective according to the previously unreported NSL scale (p < 0.001) and safe. There were no major adverse events reported. This study supports the efficacy (according to the NSL scale) and safety of hy-CaHA (1:2) for NSL. Our results also highlight the utility of the newly developed NSL scale, being a useful tool to evaluate the level of NSL before treatment and to measure the outcome.
Collapse
Affiliation(s)
- Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabrina Longhitano
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Spadafora
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Lazzarotto
- Maxillofacial Surgery Unit, Academic Hospital of Udine, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Zerbinati
- Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Hassan Galadari
- Department of Dermatology, United Arab Emirates University, Dubai, United Arab Emirates
| |
Collapse
|
31
|
Vachiramon V, Namasondhi A, Anuntrangsee T, Kositkuljorn C, Jurairattanaporn N. A study of combined microfocused ultrasound and hyaluronic acid dermal filler in the treatment of enlarged facial pores in Asians. J Cosmet Dermatol 2021; 20:3467-3474. [PMID: 34352146 DOI: 10.1111/jocd.14360] [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: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Enlarged facial pores are a common cosmetic complaint in practice. Microfocused ultrasound with visualization (MFU-V) and low-degree crosslinked hyaluronic acid filler (L-HA) injection has recently become a popular procedure for skin rejuvenation. The effectiveness of the combined MFU-V and L-HA injection in the treatment of enlarged pores has not been evaluated. OBJECTIVES To compare the efficacy of MFU-V monotherapy (single technique) and MFU-V combined with L-HA injection (combined technique) for the treatment of enlarged facial pores in Asians. METHODS We conducted a randomized, single-blinded, split-face study on participants with enlarged facial pores. Each side of the face was randomly assigned to treatment with one session of single technique or combined technique. Pore volume was objectively measured by an Antera 3D® system. Subjective assessment was evaluated by one-blinded physician using a pore grading score (0-4). Patients rated the improvement in terms of satisfaction using the visual analog scale (VAS, 0-10). RESULTS Forty-six participants completed the study. The mean pore volume of both sides declined with statistical significance at every visit compared to baseline, with the lowest mean at 4 months post-treatment. The combined technique showed a lower mean pore volume than single technique throughout the follow-ups. Physician's subjective evaluation showed no statistically significant difference between the two techniques. The patient satisfaction score showed a similar trend to the mean pore volume, with a statistically significant difference at 4 and 6 months post-treatment. CONCLUSIONS Both techniques are effectively minimize enlarged facial pores. The combined technique resulted in more patient satisfaction.
Collapse
Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Amornrut Namasondhi
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanaporn Anuntrangsee
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaninan Kositkuljorn
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | |
Collapse
|
32
|
Single Treatment, Single Depth Superficial Microfocused Ultrasound with Visualization for Rhytid Improvement. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3662. [PMID: 34277316 PMCID: PMC8277253 DOI: 10.1097/gox.0000000000003662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
Background Standard lifting and tightening protocols with microfocused ultrasound with visualization (MFU-V, Ultherapy) comprise the use of multiple transducer depths. We developed a shortened, single depth treatment protocol for patients seeking skin rejuvenation. Methods Single-center, prospective case series. Subjects with static periorbital wrinkles, perioral wrinkles, or accordion lines had a single MFU-V treatment comprising up to 340 lines (periorbital 120, perioral 100, and accordion 120) with the superficial depth transducer (10.0 MHz/1.5 mm). Efficacy was assessed using established rating scales as well as clinician- and subject-reported Global Aesthetic Improvement Scales at baseline, 90, and 180 days, and each subject served as their own control. Adverse events were documented. Results Nine subjects, women aged 38-64, received treatment. At 180 days, post treatment clinicians reported visible improvements in periorbital lines (6/6 cases), accordion lines (5/6 cases), and perioral lines (3/6 cases). Subjects' self-assessments mirrored those of the clinicians, reporting improvements in accordion lines (5/6 cases improved, 1/6 cases much improved), periorbital lines (3/6 cases improved, 3/6 cases much improved) and perioral lines (2/6 cases improved, 2/6 cases much improved). Subject-rated satisfaction was high (accordion lines 6/6 cases, periorbital lines 4/6 cases and perioral lines 4/6 cases). All subjects experienced mild, transient erythema; in one subject, wheals persisted for 24 hours, resolving on application of mild topical corticosteroid. Conclusions Shortened protocol, single depth MFU-V treatment was well-tolerated. It provided aesthetic improvements in periorbital and accordion lines, and to a lesser extent in perioral lines. Its utility as a noninvasive therapy for superficial skin rejuvenation warrants further investigation.
Collapse
|
33
|
Park JY, Lin F, Suwanchinda A, Wanitphakdeedecha R, Yu J, Lim TS, Chen JF, Ho W, Lim J, Juniarty L, Kee YS, Youn SJ, Fabi S. Customized Treatment Using Microfocused Ultrasound with Visualization for Optimized Patient Outcomes: A Review of Skin-tightening Energy Technologies and a Pan-Asian Adaptation of the Expert Panel's Gold Standard Consensus. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:E70-E79. [PMID: 34188753 PMCID: PMC8211327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND: Noninvasive facial-rejuvenation devices, such as nonablative radiofrequency (RF) and laser-assisted technology, are increasingly replacing higher-risk surgeries for face and body skin laxity. OBJECTIVE: We sought to review published information on noninvasive energy device safety and efficacy in aesthetic skin tightening, compare these with our experiences in Asian patients, and disseminate a consensus for optimizing microfocused ultrasound with visualization (MFU-V) in Asian patients. METHODS: A broad, nonexhaustive, nonsystematic literature search of published studies indexed in PubMed was performed to compare selected energy technologies to MFU-V for noninvasive face and body skin tightening, in particular, among Asian patients. This was supplemented with internal documents to provide evidence and support arguments if no peer-reviewed data were available. RESULTS: We highlighted the differences between devices and platforms and identified factors requiring attention and caution. Due to the increase in new devices lacking strong supporting clinical evidence of both safety and efficacy in Asia, it is necessary to convene physicians with substantial experience in MFU-V and devise a consensus on Asian patient selection, treatment planning, and customization. CONCLUSION: Many platforms duplicate or claim similar technologies, efficacy, or safety without significant peer-reviewed scientific or clinical evidence. We showed that MFU-V satisfies this clinical imperative. Further, the patented DeepSEE® technology allows users to noninvasively "see" through the skin to ensure treatment precision, facilitate optimal skin lifting and tightening, and enhance patient comfort and safety. Therefore, we believe that MFU-V is the gold standard for nonsurgical lifting and skin tightening.
Collapse
Affiliation(s)
- Je-Young Park
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Frank Lin
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Atchima Suwanchinda
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Rungsima Wanitphakdeedecha
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Jonathan Yu
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Ting Song Lim
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Jeng Feng Chen
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Wilson Ho
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Joyce Lim
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Lanny Juniarty
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Yong Seng Kee
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Seong Jae Youn
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| | - Sabrina Fabi
- Dr. Park is with the Apkoo-Jung Department of Oracle Dermatology Center in Seoul, South Korea
- Dr. Lin is with Eastern Plastic Surgery in Melbourne, Australia and the Department of Plastic Surgery at Eastern Health Box Hill Hospital in Melbourne, Australia
- Dr. Suwanchinda is with Medisci Biointegrative and Antiaging Center in Bangkok, Thailand
- Dr. Wanitphakdeedecha is with the Department of Dermatology, Faculty of Medicine at Siriraj Hospital, Mahidol University in Bangkok, Thailand
- Dr. Yu is with JY Dermatology & Aesthetic Center in Manila, Philippines
- Dr. T. Lim is with Clique Clinic in Kuala Lumpur, Malaysia
- Dr. Chen is with Beauté J'adore Dermatology and Esthetic Medicine in Taipei, Taiwan
- Dr. Ho is with The Specialists: Lasers, Aesthetic & Plastic Surgery in Hong Kong
- Dr. J. Lim is with Joyce Lim Skin and Laser Clinic in Singapore
- Dr. Juniarty is with Miracle Aesthetic Clinic in Surabaya, Indonesia
- Dr. Kee is with Premier Clinic in Kuala Lumpur, Malaysia
- Dr. Youn is with Leaders Dermatology Clinic in Seoul, South Korea
- Dr. Fabi is with Cosmetic Laser Dermatology and the Department of Dermatology, University of California in San Diego, California
| |
Collapse
|
34
|
Majidian M, Kolli H, Moy RL. Management of skin thinning and aging: review of therapies for neocollagenesis; hormones and energy devices. Int J Dermatol 2021; 60:1481-1487. [PMID: 33739464 DOI: 10.1111/ijd.15541] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/15/2020] [Accepted: 02/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hormone replacement therapy and various devices exist to treat signs of aging, such as skin thinning, yet there are no reviews summarizing or evaluating their role in neocollagenesis and the associated increase in skin thickness. OBJECTIVE To review the literature regarding stimulation and generation of new collagen in the dermis in two parts. Part 2 reviews oral and topical hormone replacement therapy as well as energy-based devices. METHODS The PubMed database was searched for related literature. Studies involving the use of hormone supplements and energy devices with a resultant change in collagen production or skin thickness were obtained and reviewed for evidence. RESULTS Hormones, including estrogen, testosterone, and dehydroepiandrosterone, and human growth hormone have been reported with substantiating evidence for neocollagenesis and dermal thickening. Energy devices, including radiofrequency, ultrasound, and laser therapy, have also been reported to stimulate neocollagenesis. LIMITATIONS The results presented in certain literature are not based on randomized controlled trials. CONCLUSION Hormone deficient individuals can regain skin thickness with hormone replacement therapy. Dermal heating can provide a substantial amount of neocollagenesis; however, laser technology, specifically CO2 , appears to be the most effective at increasing skin collagen and tightening.
Collapse
Affiliation(s)
- Mandy Majidian
- Tulane University School of Medicine, New Orleans, LA, 70112, USA.,Research Department, Moy-Fincher-Chipps Facial Plastics and Dermatology, Beverly Hills, CA, 90210, USA
| | - Hiren Kolli
- Research Department, Moy-Fincher-Chipps Facial Plastics and Dermatology, Beverly Hills, CA, 90210, USA.,Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Ronald L Moy
- Research Department, Moy-Fincher-Chipps Facial Plastics and Dermatology, Beverly Hills, CA, 90210, USA
| |
Collapse
|
35
|
Lim HG, Kim H, Kim K, Park J, Kim Y, Yoo J, Heo D, Baik J, Park SM, Kim HH. Thermal Ablation and High-Resolution Imaging Using a Back-to-Back (BTB) Dual-Mode Ultrasonic Transducer: In Vivo Results. SENSORS (BASEL, SWITZERLAND) 2021; 21:1580. [PMID: 33668260 PMCID: PMC7956793 DOI: 10.3390/s21051580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/13/2021] [Accepted: 02/20/2021] [Indexed: 02/06/2023]
Abstract
We present a back-to-back (BTB) structured, dual-mode ultrasonic device that incorporates a single-element 5.3 MHz transducer for high-intensity focused ultrasound (HIFU) treatment and a single-element 20.0 MHz transducer for high-resolution ultrasound imaging. Ultrasound image-guided surgical systems have been developed for lesion monitoring to ensure that ultrasonic treatment is correctly administered at the right locations. In this study, we developed a dual-element transducer composed of two elements that share the same housing but work independently with a BTB structure, enabling a mode change between therapy and imaging via 180-degree mechanical rotation. The optic fibers were embedded in the HIFU focal region of ex vivo chicken breasts and the temperature change was measured. Images were obtained in vivo mice before and after treatment and compared to identify the treated region. We successfully acquired B-mode and C-scan images that display the hyperechoic region indicating coagulation necrosis in the HIFU-treated volume up to a depth of 10 mm. The compact BTB dual-mode ultrasonic transducer may be used for subcutaneous thermal ablation and monitoring, minimally invasive surgery, and other clinical applications, all with ultrasound only.
Collapse
Affiliation(s)
- Hae Gyun Lim
- Department of Biomedical Engineering, Pukyong National University, Busan 48513, Korea;
| | - Hyunhee Kim
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang 37673, Korea; (H.K.); (J.P.); (J.Y.)
| | - Kyungmin Kim
- Department of Convergence IT Engineering, Pohang University of Science and Technology, Pohang 37673, Korea; (K.K.); (Y.K.); (J.B.); (S.-M.P.)
| | - Jeongwoo Park
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang 37673, Korea; (H.K.); (J.P.); (J.Y.)
| | - Yeonggeun Kim
- Department of Convergence IT Engineering, Pohang University of Science and Technology, Pohang 37673, Korea; (K.K.); (Y.K.); (J.B.); (S.-M.P.)
| | - Jinhee Yoo
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang 37673, Korea; (H.K.); (J.P.); (J.Y.)
| | - Dasom Heo
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang 37673, Korea;
| | - Jinhwan Baik
- Department of Convergence IT Engineering, Pohang University of Science and Technology, Pohang 37673, Korea; (K.K.); (Y.K.); (J.B.); (S.-M.P.)
| | - Sung-Min Park
- Department of Convergence IT Engineering, Pohang University of Science and Technology, Pohang 37673, Korea; (K.K.); (Y.K.); (J.B.); (S.-M.P.)
| | - Hyung Ham Kim
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang 37673, Korea; (H.K.); (J.P.); (J.Y.)
- Department of Convergence IT Engineering, Pohang University of Science and Technology, Pohang 37673, Korea; (K.K.); (Y.K.); (J.B.); (S.-M.P.)
- Department of Electrical Engineering, Pohang University of Science and Technology, Pohang 37673, Korea
| |
Collapse
|
36
|
Affiliation(s)
- Diane I. Duncan
- Department of Plastic Surgery Plastic Surgical Associates of Fort Collins, P. C. Fort Collins Colorado USA
| |
Collapse
|
37
|
Vachiramon V, Triyangkulsri K, Iamsumang W, Chayavichitsilp P. Single-Plane Versus Dual-Plane Microfocused Ultrasound With Visualization in the Treatment of Upper Arm Skin Laxity: A Randomized, Single-Blinded, Controlled Trial. Lasers Surg Med 2020; 53:476-481. [PMID: 32770693 DOI: 10.1002/lsm.23307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/28/2020] [Accepted: 07/25/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Non-invasive skin tightening devices have become a safe and non-invasive treatment for patients with skin laxity of the upper arm. The efficacy of microfocused ultrasound with visualization (MFU-V) in skin tightening had been demonstrated in several studies. This study aimed to evaluate the efficacy and safety of MFU-V in treating skin laxity of the upper arm using different treatment protocols. STUDY DESIGN/MATERIALS AND METHODS Thirty patients with upper arm laxity were enrolled. Patients were randomly assigned to receive single-plane MFU-V treatment (4 MHz/4.5 mm transducer) on one arm and dual-plane treatment (4 MHz/4.5 mm and 7 MHz/3.0 mm transducer) on the contralateral arm, totaling 200 lines in each arm. Investigator Assessment Skin Laxity Scoring System (IASLSS) and improvement scores were evaluated at 1, 3, and 6 months after the treatment. Adverse events were recorded. RESULTS A modest reduction of mean arm circumference was observed on both sides. Mean physician-rated improvement scores, single-plane treatment received 2.22 (±1.05), 2.70 (±1.32), and 1.61 (±0.79), respectively. Dual-plane treatment received 2.00 (±1.00), 2.56 (±1.05), and 1.39 (±0.54), respectively. Single-plane treatment was superior from physician's ratings (P < 0.05). IASLSS followed the same trend as the improvement scores. Mean patient-rated improvement scores in single-plane treatment were 3.63 (±2.63), 3.69 (±2.83), 1.90(±2.51) for 1, 3, and 6 months, respectively. Dual-plane treatment received 3.5 (±2.57), 3.22 (±2.59), 1.78 (±2.48), respectively. The median pain scores were 2.6 (0-8) for single-plane treatment and 1.9 (0-8) for dual-plane treatment (P = 0.136). No other significant side effects were observed. CONCLUSION Both single-plane and dual-plane treatment provide a modest skin tightening effect in the upper arm for at least 3 months. Physicians should assess skin thickness in every patient using the visualization screen to select the appropriate transducer for each individual patient. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Korn Triyangkulsri
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Wimolsiri Iamsumang
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Pamela Chayavichitsilp
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| |
Collapse
|
38
|
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
| |
Collapse
|
39
|
Fabi SG, Few JW, Moinuddin S. Practical Guidance for Optimizing Patient Comfort During Microfocused Ultrasound with Visualization and Improving Patient Satisfaction. Aesthet Surg J 2020; 40:208-216. [PMID: 30869754 DOI: 10.1093/asj/sjz079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Microfocused ultrasound with visualization (MFU-V; Ultherapy®) is an effective method for correction of skin laxity through lifting and tightening skin on the face, neck, and décolleté as well as on other parts of the body such as the knees, arms, and abdomen. In addition to being a noninvasive modality for tissue tightening, MFU-V has a biological effect on tissue, rejuvenating the skin through stimulation of elastogenesis and neocollagenesis. MFU-V is also commonly combined with other interventions such as fillers, neuromodulators, and absorbable suspension sutures. OBJECTIVES The aim of this study was to share the extensive experience of the authors in optimizing comfort for their MFU-V patients in order to provide guidance to the broader community surrounding optimal patient comfort with this procedure. METHODS The authors discuss their approaches to patient comfort and satisfaction. Elements of each approach include patient selection, pharmacologic and nonpharmacologic comfort measures, and how prioritization of patient comfort affects both their individual patients and practices. RESULTS The authors share their approaches for optimizing patient comfort during the procedure and provide an overview of both pharmacologic and nonpharmacologic measures that can be adopted to support patient comfort and satisfaction. The similarities and differences of each approach are discussed. CONCLUSIONS In addition to diligent patient selection, the authors find that attention to patient comfort is directly related to satisfaction and appears to be a primary factor in patients' decisions to return for additional treatments.
Collapse
Affiliation(s)
- Sabrina G Fabi
- dermatologist and cosmetic surgeon in private practice in San Diego, CA
| | - Julius W Few
- University of Chicago Pritzker School of Medicine, Chicago, IL
- Northwestern University, Evanston, IL
| | - Shay Moinuddin
- aesthetic nurse specialist in private practice in Chicago, IL
| |
Collapse
|
40
|
Duncan DI. Commentary on: Practical Guidance for Optimizing Patient Comfort During Microfocused Ultrasound With Visualization and Improving Patient Satisfaction. Aesthet Surg J 2020; 40:217-219. [PMID: 31504140 DOI: 10.1093/asj/sjz123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
41
|
Jeon HC, Kim DY, Jin SP, Lee DH. A new treatment protocol of microfocused ultrasound for lower eyelid fat bulging. J DERMATOL TREAT 2020; 32:1005-1009. [PMID: 31971035 DOI: 10.1080/09546634.2020.1720581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Microfocused ultrasound (MFU) causes tissue tightening by producing thermal injury zones and is used to treat various age-related changes including lower eyelid fat bulging. OBJECTIVE To investigate the efficacy of a new treatment protocol of MFU for lower eyelid fat bulging. METHODS AND MATERIALS We reviewed the medical records of all patients who began MFU for lower eyelid fat bulging from March 2017 to September 2018. MFU was performed in two steps to tighten the lower eyelid dermis and orbital septum. Data on age, sex, bulging severity, and the number of treatment sessions were obtained. Associations of these variables with treatment response were determined through an ordinal logistic regression analysis. RESULTS Among 191 enrolled patients, 119 (62.3%) and 47 (24.6%) achieved fair and good responses, respectively. In the multivariable analysis, multiple treatment sessions (odds ratio (OR) 6.618; 95% confidence interval (CI) 3.242-13.513; p < .001), moderate bulging (OR 4.328; 95% CI 1.755-10.671; p = .001), and severe bulging (OR 7.570; 95% CI 2.537-22.585; p < .001) were associated with greater treatment response. There were no serious adverse events. CONCLUSIONS The new treatment protocol of MFU is an effective and safe strategy for lower eyelid fat bulging.
Collapse
Affiliation(s)
| | - Do-Yeop Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Seon-Pil Jin
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Dong Hun Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
42
|
Use of Micro-focused Ultrasound for Skin Tightening of Mid and Lower Face. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2498. [PMID: 32537285 PMCID: PMC7288869 DOI: 10.1097/gox.0000000000002498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/26/2019] [Indexed: 11/26/2022]
Abstract
The changes in the mid face and lower face are among the most prominent features of the aging process. Intense focused ultrasound, known as the Ulthera System (Ulthera Inc., Mesa, AZ, USA), was designed to correct this process. It employs micro-focused ultrasound to cause discrete focal heating of the dermis and stimulates neocollagenesis and elastin remodeling.
Collapse
|
43
|
Stepanova TV, Yusova ZY, Baranova EL, Demidion DV. Correction of involutional skin changes using microfocused ultrasound combined with PRP-therapy. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2019. [DOI: 10.29333/ejgm/115851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
44
|
Park JY, Byun EJ, Kim HS. Rejuvenation of periocular region in Koreans: A multimodal approach combining botulinum toxin, fillers, and micro‐focused ultrasound with visualization for optimal results. Dermatol Ther 2019; 33:e13159. [DOI: 10.1111/dth.13159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/29/2019] [Accepted: 11/01/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Je Young Park
- Department of DermatologyOracle Dermatology Clinic, Seoul National University Seoul South Korea
| | - Eun Jung Byun
- Department of DermatologyIncheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea Incheon South Korea
| | - Hei Sung Kim
- Department of DermatologyIncheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea Incheon South Korea
- Department of Biomedicine & Health SciencesThe Catholic University of Korea Seoul South Korea
| |
Collapse
|
45
|
Influence of Age, Sex, and Body Mass Index on the Depth of the Superficial Fascia in the Face and Neck. Dermatol Surg 2019; 45:1365-1373. [DOI: 10.1097/dss.0000000000001909] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
46
|
Dayan S. Aesthetic evolution drives birth of minimally invasive surgery subgroup. J Cosmet Dermatol 2019; 18:1182-1185. [PMID: 31243875 DOI: 10.1111/jocd.13057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 04/04/2019] [Accepted: 04/26/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Facial and neck skin tightening, and rejuvenation began decades ago with maximally invasive incisional face-lift surgery. Aesthetic trends, patient demands, and innovative technology brought about minimally invasive and noninvasive interventions-such as radiofrequency, ultrasound, laser and intense pulsed light as well as dermal fillers and other injectables-to address facial and neck skin laxity. These procedures reduce facial and neck skin laxity with less risk and less downtime than maximally invasive face-lift or face-lift plus liposuction; however, these interventions are often deemed to offer reduced results. AIMS To evaluate the safety and efficacy-as well as patient satisfaction-of Rotational Fractional Resection (RFR) in subjects with mild-to-moderate submental fat and mild-to-moderate submental skin laxity. MATERIALS Rotational fractional resection with the Nuvellus (Recros, Inc) platform, which uses 1.5 mm in diameter rotating scalpels-termed scalpets-to resect lax skin followed by a rotating cannulas to perform focal lipectomy through resected access ports. METHODS Thirtyone patients were evaluated 30 days after RFR, in an ongoing prospective, multi-center, nonrandomized study. RESULTS The majority of subjects had a ≥1-grade improvement in investigator-evaluated skin laxity and lipodystrophy; 84% of subjects were satisfied with their neck and jawline appearance and 97% of subjects they would likely recommend the procedure. Minimal procedural and post-procedural pain, minimal scarring in 94% of subjects, and no severe skin-related adverse effects. DISCUSSION Rotational fractional resection is essentially a new concept that has a risk and side effect profile that is comparable or better than-surgical skin tightening, with measurable permanent results approaching that of surgical skin tightening. This investigational procedure advances the evolution of facial and neck aesthetic procedures with results approaching those of surgery in a single treatment. CONCLUSION Early RFR results are promising but, yet to be conclusive. However current outcome reports identify a procedure that meet patient demands for a minimally invasive office- based procedure to look better with limited downtime.
Collapse
Affiliation(s)
- Steve Dayan
- Department of Otolaryngology, University of Illinois, Chicago, Illinois
| |
Collapse
|
47
|
Cellulite: Patient Selection and Combination Treatments for Optimal Results—A Review and Our Experience. Dermatol Surg 2019; 45:1171-1184. [DOI: 10.1097/dss.0000000000001776] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
48
|
Mazzoni D, Lin MJ, Dubin DP, Khorasani H. Review of non-invasive body contouring devices for fat reduction, skin tightening and muscle definition. Australas J Dermatol 2019; 60:278-283. [PMID: 31168833 DOI: 10.1111/ajd.13090] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/13/2019] [Indexed: 12/13/2022]
Abstract
Non-invasive body contouring is a rapidly growing field in cosmetic dermatology. Non-invasive contouring devices improve the body's appearance through the removal of excess adipose tissue, particularly in areas in which fat persists despite optimal diet and exercise routine. The technology can also be used for skin tightening. This article reviews the five FDA-approved non-invasive body contouring modalities: cryolipolysis, laser, high-intensity focused electromagnetic field, radiofrequency and high-intensity focused ultrasound. These devices have emerged as a popular alternative to surgical body contouring due to their efficacy, favourable safety profile, minimal recovery time and reduced cost. Although they do not achieve the same results as liposuction, they are an attractive alternative for patients who do not want the risks or costs associated with surgery. When used appropriately and correctly, these devices have demonstrated excellent clinical efficacy and safety.
Collapse
Affiliation(s)
- Daniel Mazzoni
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Matthew J Lin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Danielle P Dubin
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Hooman Khorasani
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| |
Collapse
|
49
|
Cotofana S, Lachman N. Anatomie der Fettkompartimente des Gesichts und ihre Bedeutung für die ästhetische Chirurgie. J Dtsch Dermatol Ges 2019; 17:399-415. [PMID: 30958928 DOI: 10.1111/ddg.13737_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/03/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Sebastian Cotofana
- Department of Medical Education, Albany Medical College, Albany, New York, USA
| | - Nirusha Lachman
- Department of Anatomy and Department of Surgery, Division of Plastic Surgery, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
50
|
Ruiz-Rodriguez R, Martin-Gorgojo A. Integral Facial Management of the Aesthetic Patient: The Skin Age Management Protocol. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|