1
|
Georgievskaya A, Tlyachev T, Kiselev K, Hillebrand G, Chekanov K, Danko D, Golodyaev A, Majmudar G. Predicting human chronological age via AI analysis of dorsal hand versus facial images: A study in a cohort of Indian females. Exp Dermatol 2024; 33:e15045. [PMID: 38509744 DOI: 10.1111/exd.15045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/11/2024] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
Predicting a person's chronological age (CA) from visible skin features using artificial intelligence (AI) is now commonplace. Often, convolutional neural network (CNN) models are built using images of the face as biometric data. However, hands hold telltale signs of a person's age. To determine the utility of using only hand images in predicting CA, we developed two deep CNNs based on 1) dorsal hand images (H) and 2) frontal face images (F). Subjects (n = 1454) were Indian women, 20-80 years, across three geographic cohorts (Mumbai, New Delhi and Bangalore) and having a broad variation in skin tones. Images were randomised: 70% of F and 70% of H were used to train CNNs. The remaining 30% of F and H were retained for validation. CNN validation showed mean absolute error for predicting CA using F and H of 4.1 and 4.7 years, respectively. In both cases correlations of predicted and actual age were statistically significant (r(F) = 0.93, r(H) = 0.90). The CNNs for F and H were validated for dark and light skin tones. Finally, by blurring or accentuating visible features on specific regions of the hand and face, we identified those features that contributed to the CNN models. For the face, areas of the inner eye corner and around the mouth were most important for age prediction. For the hands, knuckle texture was a key driver for age prediction. Collectively, for AI estimates of CA, CNNs based solely on hand images are a viable alternative and comparable to CNNs based on facial images.
Collapse
Affiliation(s)
| | | | | | - Greg Hillebrand
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio, USA
| | | | | | | | - Gopa Majmudar
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio, USA
| |
Collapse
|
2
|
Kim JS. Changes in Sonographic Thickness with Identification of Nine Layers, Roughness, and Hydration in the Dorsal Hand after Injectables. Plast Reconstr Surg 2023; 152:1212-1225. [PMID: 36877607 PMCID: PMC10666936 DOI: 10.1097/prs.0000000000010372] [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: 02/19/2021] [Accepted: 10/10/2022] [Indexed: 03/07/2023]
Abstract
BACKGROUND With the use of sonography, soft-tissue thickness can be measured accurately to assess the volumizing effects of fillers. METHODS In this prospective study, monophasic stabilized hyaluronic acid filler (1 cc) was injected into the dorsal superficial and intermediate laminae of 20 patients using a subdermal scraping fanning injection technique. Sonograms and topographic computer analyses were used to measure soft-tissue thickness, skin roughness, and stratum corneum hydration (SCH) at 1 week and 1, 2, 3, and 6 months. RESULTS Hand appearance and skin roughness improved in all patients. Sonography showed that soft-tissue thickness was increased by 4.52 mm (immediately after treatment), 5.52 mm (1 week), 4.89 mm (1 month), 4.25 mm (2 months), 4.08 mm (3 months), and 3.86 mm (6 months) from the pretreatment baseline of 3.20 mm. Roughness was reduced by 15.39 au (16.17%) at 1 month, 21.5 (18.12%) at 2 months, 22.7 (23.91%) at 3 months, and 27.16 (38.12%) at 6 months, indicating improvements in fine wrinkles. SCH also improved during follow-up. CONCLUSIONS Detailed subdivision of nine layers of hand dorsum was established in this sonography study for the first time. Soft-tissue thickness was increased more than 207% during follow-up, and placement of hyaluronic acid materials was confirmed in the dorsal superficial and dorsal intermediate laminae. Hand appearance and skin roughness improved in all patients. Veins and tendons became less apparent, with volumizing effects. All patients stated that their skin became more moisturized, youthful, and smooth during the follow-up period after only one session of the subdermal scraping, fanning injection technique. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Collapse
|
3
|
Chandan N, Puyana C, Haber R. Combination Approaches to Hand Rejuvenation: A Review of the Literature and Discussion. Dermatol Surg 2023; 49:164-170. [PMID: 36728067 DOI: 10.1097/dss.0000000000003673] [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: 02/03/2023]
Abstract
BACKGROUND Various noninvasive/minimally invasive modalities for hand rejuvenation exist, and the efficacy and safety of these procedures as both monotherapy and same-day procedures is increasingly being studied. OBJECTIVE To review data on the efficacy and safety of hand rejuvenation modalities and suggest a practical combination approach for these procedures. METHODS The PubMed database was queried for peer-reviewed articles regarding hand rejuvenation techniques, including chemical peels, laser and light sources, sclerotherapy, autologous fat transfer, and injectable volumetric fillers. RESULTS Chemical peels have been studied the least, with most studies evaluating the use of fillers and laser/light-based devices. Most studies reported overall good results with high patient satisfaction. Satisfaction rates were lower in laser/light-based treatments compared with other modalities. Transient erythema, edema, or pain after procedures was common; most studies did not report serious postprocedure complications. Importantly, there was no significant increase in adverse effects after same-day procedures. CONCLUSION Using same-day procedures allows practitioners to address hand rejuvenation from different aspects, seems to improve outcomes, and reduces time spent in the office for patients. The authors suggest a practical framework for combining cosmetic approaches to achieve the most optimal outcome for hand rejuvenation.
Collapse
Affiliation(s)
- Neha Chandan
- All authors are affiliated with the Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois
| | | | | |
Collapse
|
4
|
Christen MO. Collagen Stimulators in Body Applications: A Review Focused on Poly-L-Lactic Acid (PLLA). Clin Cosmet Investig Dermatol 2022; 15:997-1019. [PMID: 35761856 PMCID: PMC9233565 DOI: 10.2147/ccid.s359813] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/18/2022] [Indexed: 11/25/2022]
Abstract
The number of aesthetic procedures performed worldwide continues to grow together with an increase in the population seeking the restoration or preservation of a youthful appearance. Requests for non-surgical body rejuvenation are increasing. Patients are looking for safe and effective minimally invasive aesthetic procedures. Soft-tissue dermal fillers can meet these expectations. Based on the beneficial outcomes of these treatments in many facial areas, a new trend is developing to target body areas. Different dermal fillers are available and include collagen stimulators initially developed to restore facial volume. Furthermore, they are associated with long-lasting efficiency, a high level of patient satisfaction and a good safety profile, with mainly minor adverse events reported. In appropriate conditions of use, they are now used for body rejuvenation in clinical practice. Their use is expanding and allows addressing various issues including volume loss, skin laxity, cellulite, striae distensae and wrinkles. This review focuses on poly-L-lactic acid (PLLA), used in the first collagen stimulator and one of the most investigated in facial and in off-facial body applications. The available published data, although still limited, are presented by body area, neck and chest, buttocks, abdomen, upper arms, thighs, knees, and hands. Key features of the concerned zones and the main clinical signs affecting the body part as well as the injection modalities are provided along with the aesthetic results. This represents the state of the art on which to base further developments necessary for optimal and safe outcomes of treatment with the PLLA-based collagen stimulators and others in this class for body rejuvenation.
Collapse
|
5
|
Vermeersch N, De Fré M, Verhoeven V, Hunter JE, Tondu T, Thiessen FE. Autologous fat transfer for hand rejuvenation: systematic review on technique and outcome. JPRAS Open 2022; 32:182-194. [PMID: 35449731 PMCID: PMC9018121 DOI: 10.1016/j.jpra.2022.03.001] [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: 02/23/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Age-related changes to the dorsum of the hand present as dyschromia, soft-tissue atrophy, and volume loss, resulting in wrinkles and prominent deep structures. Volume augmentation by means of autologous fat transfer (AFT) is one of the options to rejuvenate the hand; theoretically, autologous fat is the ideal filler because of durability and biocompatibility. Objective This systematic review aims to summarize and describe the current evidence on the technique, effectiveness, and safety of AFT in hand rejuvenation. Methods Three major databases, PubMed, Embase, and Web of Science, were systematically searched up to November 2020 for studies reporting on AFT and hand rejuvenation. Results A total of 10 articles were included, reporting on a total of 320 patients treated by AFT to improve the aesthetic appearance of the dorsum of the hand. Some degree of postoperative oedema was present in nearly all patients. Other complications were infection (0.67%), cysts/irregularities (1.3%), temporary dysesthesia (5.3%), and ecchymosis (7%). There were no major complications. Of all patients, 97.6% self-reported to be satisfied with the result. Conclusions Overall, by combining the current evidence, AFT is considered a promising and safe technique to rejuvenate the aging hand with very high patient satisfaction. Future research, using validated patient questionnaires, objective volumetric measurements, and longer follow-up, is needed to confirm these results. Level of Evidence 3
Collapse
Affiliation(s)
- Nicolas Vermeersch
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
- Corresponding author: Dr. Nicolas Vermeersch.
| | - Maxime De Fré
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
| | - Veronique Verhoeven
- Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium
| | - Judith E. Hunter
- Department of Plastic and Reconstructive Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Thierry Tondu
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
| | - Filip E.F. Thiessen
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, B-2650 Antwerp, Belgium
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Lindendreef 1, B-2020, Antwerp, Belgium
| |
Collapse
|
6
|
McGuire C, Boudreau C, Tang D. Hand Rejuvenation: A Systematic Review of Techniques, Outcomes, and Complications. Aesthetic Plast Surg 2022; 46:437-449. [PMID: 34382097 DOI: 10.1007/s00266-021-02519-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hand rejuvenation is an increasingly popular cosmetic procedure for hand atrophy and aging. The objective of this study is to systematically evaluate the techniques, outcomes, and complications of surgical hand rejuvenation. METHODS A systematic review was undertaken using a computerized search. Publication descriptors, methodological details, techniques, outcomes, and complications were extracted. Articles were assessed using the MINORS and Cochrane instruments. RESULTS Thirty-one studies were included. Most studies were published in the last five years (51.6 percent) and were prospective case series (35.5 percent). The mean age of patients was 56 (range 21-82), while the mean sample size was 47 (range 10-220). The most commonly examined interventions were Radiesse (32.2 percent) and fat grafting (32.2 percent). Major complications were not observed in any study, while minor complications such as edema and pain were temporary. Injection techniques varied, however, the proximal to distal fanning technique and using a cannula was associated with a lower risk of complications. Both Radiesse and fat grafting had robust long-term esthetic outcomes. CONCLUSIONS Hand rejuvenation is a safe and efficacious surgical intervention to reduce dorsal hand atrophy. Further studies are needed to compare the long-term outcomes of common interventions. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
|
7
|
Kapoor KM, Chatrath V, Li CQ, Bertossi D. Pinch Anatomy of Forehead: An Injection Guide for Forehead Filler Treatment. Facial Plast Surg 2022; 38:156-162. [PMID: 34983076 DOI: 10.1055/a-1730-8436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
With the popularity of filler injections globally, more and more injectors are using them for facial shaping and reversing the aging changes of the face. Detailed knowledge of facial anatomy, especially of important vessels and tissue planes is essential for injectors. While performing filler injections, injectors tend to pinch the tissue layers with their non-dominant hand for ease of doing the procedure. Such deformational forces cause some changes in the anatomy of tissue layers held in a pinch. During a deep pinch, the important arteries in that area can get pulled up in the pinch's tissue layers, or they can stay in their position being unaffected by pinching. The 'pinch and pull' can also improve the tissue space for injections, by pulling away the mobile tissue layers from the fixed ones. Knowledge of the 'pinch anatomy' in the forehead can be used to the injector's advantage to avoid important arteries and place filler in the correct plane. By knowing the anatomical changes during the pinched state of tissue layers, filler injections in the forehead can be performed with relative safety in the correct tissue plane.
Collapse
|
8
|
Corduff N, Chen JF, Chen YH, Choi HS, Goldie K, Lam Y, Lesthari NI, Lim TS, Luo S, Quiambao A, Siew TW, Tseng FW, Chao YYY. Pan-Asian Consensus on Calcium Hydroxyapatite for Skin Biostimulation, Contouring, and Combination Treatments. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:E76-E85. [PMID: 34840663 PMCID: PMC8570653] [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 Several usage guidelines for calcium hydroxylapatite (CaHA), a dermal filler material, exist for non-Asian patients, making it necessary to determine whether their findings and consensuses are applicable to Asian patients who have distinct anatomies, cultural preferences, and aesthetic requests. OBJECTIVE We sought to develop a Pan-Asian consensus on CaHA use in skin biostimulation, contouring, and combination treatments for face and body indications. METHODS A survey on CaHA usage for contouring and biostimulation indications in Asian patients was conducted, followed by discussions to establish consensus statements and topics for examination. RESULTS Several aspects of facial shaping and contouring or skin biostimulation with CaHA were agreed on, including that dilution is not a key consideration, that microfocused ultrasound with visualisation precedes CaHA in same day or session treatments, and that cannulas should be used. Among the many agreements on interventions in specific facial and body areas, there were also disagreements due to the diverse Asian patient presentations, requests, and access to tools or products; for example, CaHA should be placed in the interfascial layer for temple contouring, CaHA should not be injected directly into the infraorbital area for safety, and diluted CaHA should be injected subdermally for nonfacial or whole-face biostimulation and contouring. CONCLUSION Our disagreements highlight the diversity of Asian facial morphotypes and desired aesthetic outcomes and underscore the need for customized aesthetic strategies to accommodate the heterogeneity of Asian anatomies, cultural preferences, and aesthetic ideals. Establishing consensus statements on critical aspects of Asian patient considerations, efficacy and safety, is crucial. This document provides strategic guidance on the use of classic, diluted CaHA for biostimulation or undiluted Radiesse®(+) (Merz Pharma GmbH & Co. KGaA, Frankfurt, Germany) for lifting and contouring to ensure consistent CaHA delivery for successful patient outcomes.
Collapse
Affiliation(s)
- Niamh Corduff
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Jeng Feng Chen
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Ya Hui Chen
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Ho Sung Choi
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Kate Goldie
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Yui Lam
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Nyoman Indra Lesthari
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Ting Song Lim
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Suzanna Luo
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Arnelle Quiambao
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Tuck Wah Siew
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Fang Wen Tseng
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| | - Yates Y Y Chao
- Dr. Corduff is with the Cosmetic Refinement Clinic in Geelong, Australia
- Dr. J. F. Chen is with Tri-Service General Hospital in Taipei, Taiwan
- Dr. Y. H. Chen is with YaSkin Dermatology Clinic in Kaohsiung, Taiwan
- Dr. Choi is with PIENA Aesthetic Medical Clinic in Gangnam, Seoul, South Korea
- Ms. Goldie is with European Medical Aesthetics in London, England
- Dr. Lam is with the Skin Care Clinic in Tsim Sha Tsui, Hong Kong
- Lesthari is with Sano Clinic in Denpasar, Bali, Indonesia
- Dr. Lim is with Clique Clinic in Petaling Jaya, Selangor, Malaysia
- Ms. Luo is with Medical Aesthetics 360 in Hurstville, New South Wales, Australia
- Dr. Quiambao is with YouPlus Intelligent Aesthetic Clinic in Taguig City, the Philippines
- Dr. Siew is with Radium Medical Aesthetics in Singapore
- Dr. Tsend is with Milano Aesthetic Clinic in Taoyuan, Taiwan
- Dr. Chao is with the CHAO Institute of Aesthetic Medicine in Taipei, Taiwan
| |
Collapse
|
9
|
A Review of Hand Feminization and Masculinization Techniques in Gender Affirming Therapy. Aesthetic Plast Surg 2021; 45:589-601. [PMID: 32997239 DOI: 10.1007/s00266-020-01963-0] [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: 07/06/2020] [Accepted: 09/05/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Anatomical characteristics that are incongruent with an individual's gender identity can cause significant gender dysphoria. Hands exhibit prominent dimorphic sexual features, but despite their visibility, there are limited studies examining gender affirming procedures for the hands. This review is intended to cover the anatomical features that define masculine and feminine hands, the surgical and non-surgical approaches for feminization and masculinization of the hand, and to adapt established aesthetic hand techniques for gender affirming care. METHODS The authors performed a comprehensive database search of PubMed, Embase OVID and SCOPUS to identify articles on the characterization of masculine or feminine hands, hand treatments related to gender affirmation, and articles related to techniques for hand masculinization and feminization in the non-transgender population. RESULTS From 656 possibly relevant articles, 42 met the inclusion criteria for the current literature search. There is currently no medical literature specifically exploring the surgical or non-surgical options for hand gender affirmation. The available techniques for gender affirming procedures discussed in this paper are appropriated from those more commonly used for hand rejuvenation. CONCLUSION There is a dearth of literature addressing the options for transgender individuals seeking gender affirming procedures of the hand. Though established procedures used for hand rejuvenation may be utilized in gender affirming care, further study is required to determine relative salience of various hand features to gender dysphoria in transgender patients of various identities, as well as development of novel techniques to meet these needs. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. .
Collapse
|
10
|
Kim JS, Lee W, Oh W, Park JA, Yang EJ. Identification of a suitable layer for injecting calcium hydroxylapatite fillers in the hands. J Plast Reconstr Aesthet Surg 2020; 74:866-873. [PMID: 33214113 DOI: 10.1016/j.bjps.2020.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/06/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hand rejuvenation has become increasingly popular in esthetic medicine. Hand rejuvenation with injectables remains challenging, and there are no established practice guidelines. The calcium hydroxylapatite (CaHA) filler injection is currently one of the most common procedures. This study aimed to identify the layer of the hand dorsum that is lifted by skin pinching and to identify the layer where an injectable filler would be placed based on the anatomical study and ultrasound findings. METHODS The anatomic layers of the cadaveric hands were examined using the skin pinching method. Anatomic dissections and histological examinations were performed on four fixed and five fresh cadaveric hands to reveal the anatomical layers in which the CaHA filler was administered. Furthermore, 20 patients were treated with the CaHA filler, and the Doppler ultrasound was used to reveal the proper anatomical layers for filler placement. RESULTS The study of the cadaveric hands showed that skin pinching can ensure safe entry points and can guide the cannula into safe planes without compromising the large superficial veins. A filler injection with skin pinching in cadaveric hands demonstrated that the filler was introduced primarily in the dorsal intermediate lamina where the veins are present. This was further confirmed by ultrasound findings. CONCLUSION The dorsal intermediate lamina, which has the veins is a relatively loose structure, and the cannula was moved along this space. When the layer is stretched by skin pinching, the veins run underneath. The dorsal intermediate lamina is the appropriate layer to inject the filler.
Collapse
Affiliation(s)
| | - Won Lee
- Yonsei E1 Plastic Surgery Clinic, Anyang, South Korea
| | - Wook Oh
- Samsung Feel Clinic, Seoul, South Korea
| | - Jung-Ah Park
- Department of Anatomy, Konkuk University School of Medicine, Seoul, South Korea
| | - Eun-Jung Yang
- Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
| |
Collapse
|
11
|
Samadi P, Sheykhhasan M, Khoshinani HM. The Use of Platelet-Rich Plasma in Aesthetic and Regenerative Medicine: A Comprehensive Review. Aesthetic Plast Surg 2019; 43:803-814. [PMID: 30552470 DOI: 10.1007/s00266-018-1293-9] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 11/24/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality for the use in aesthetic and regenerative medicine. PRP is a high concentration of platelets derived from whole blood which is isolated by centrifugation to separate and concentrate platelet-containing plasma from red blood cells. PRP comprises hundreds of bioactive proteins, including growth factors, peptides, and cytokines that stimulate healing of skin and soft tissues. Attractive features of PRP are the extended release of various growth and differentiation factors from activated platelets, tissue regenerative, and healing capabilities, as well as the lack of problems associated with immunogenicity. Because of the unique biological features of this whole blood-derived biological agent, multiple clinical uses for PRP exist for aesthetic and regenerative medicine. EVIDENCE ACQUISITIONS A comprehensive review of the literature regarding the use of platelet-rich plasma in aesthetic and regenerative medicine was performed. EVIDENCE SYNTHESIS Therapeutic applications of PRP including several methods for its clinical deployment in conditions related to aesthetic and regenerative medicine including wound healing, skin and facial rejuvenation, hair restoration, hand rejuvenation, breast augmentation, and musculoskeletal regeneration were reviewed. CONCLUSION PRP treatment has shown itself as a bright future for a safe and efficient cosmetic intervention. However, more studies are needed to better our understanding of limitations and benefits in clinical phases associated with the aesthetic use of PRP. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- Pouria Samadi
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Sheykhhasan
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
- Department of Mesenchymal Stem Cell, The Academic Center for Education, Culture and Research, Qom Branch, Qom, Iran.
| | - Hamed Manoochehri Khoshinani
- Department of Molecular Medicine and Genetics, Research Center for Molecular Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
12
|
The 5-Step Filler Hand Rejuvenation: Filling with Hyaluronic Acid. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2073. [PMID: 30859035 PMCID: PMC6382238 DOI: 10.1097/gox.0000000000002073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 10/19/2018] [Indexed: 12/02/2022]
Abstract
Supplemental Digital Content is available in the text. Many patients are pursuing simultaneous facial and hand rejuvenation with the latter receiving increased interest in recent years. Various materials have been purported to rejuvenate the hands including fat, calcium hydroxyapatite, and hyaluronic fillers. Despite the seemingly ubiquitous use of fillers, the Food and Drug Administration has approved only a select number for hand rejuvenation. This year, Restylane Lyft (Galderma, Texas) became the first hyaluronic acid filler to garner Food and Drug Administration approval for hand rejuvenation. The purpose of this video plus article was to demonstrate the technical nuances in administering hyaluronic filler in a safe and effective manner as it relates to hand rejuvenation.
Collapse
|
13
|
Abstract
BACKGROUND Aging hands tend to lose subcutaneous volume resulting in prominence of the underlying vessels, tendons, and bone contributing to an aged appearance. Dermal fillers have been successfully used to improve the appearance of the aging dorsal hand. OBJECTIVE The objective is to evaluate the safety and efficacy of a small-particle hyaluronic acid (SPHA) injectable gel for the treatment of photoaged volume loss of the hands. MATERIALS AND METHODS This is an open-label, prospective, randomized, interventional, study. Twenty-five healthy female volunteer subjects aged 40 to 70 years with photoaged thinning of the hands received an injection of an SPHA gel to the dorsal aspect of 1 hand. Subjects were followed up for 6 months. The hands were evaluated at regular intervals according to a 5-point validated hand grading scale. RESULTS The average hand grading scores demonstrated statistically significant improvement at all time points compared with baseline. Eighty-eight percent to 100% of subjects achieved improvement at 1 month after treatment, and 50% to 83% maintained at least 1 point improvement at 6 months. There were no adverse events reported. CONCLUSION The investigated SPHA is a safe and effective method for improving the thinned and photoaged appearance of the hands.
Collapse
|
14
|
Yun-Nan L, Shu-Hung H, Tsung-Ying L, Chih-Kang C, Yu-Hao H, Hidenobu T, Chung-Sheng L, Sin-Daw L, Tsai-Ming L. Micro-autologous fat transplantation for rejuvenation of the dorsal surface of the aging hand. J Plast Reconstr Aesthet Surg 2018; 71:573-584. [DOI: 10.1016/j.bjps.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/06/2017] [Accepted: 09/12/2017] [Indexed: 11/17/2022]
|
15
|
Technical Considerations for Filler and Neuromodulator Refinements. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1178. [PMID: 28018778 PMCID: PMC5172486 DOI: 10.1097/gox.0000000000001178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/24/2016] [Indexed: 11/27/2022]
Abstract
Supplemental Digital Content is available in the text. Background: The toolbox for cosmetic practitioners is growing at an unprecedented rate. There are novel products every year and expanding off-label indications for neurotoxin and soft-tissue filler applications. Consequently, aesthetic physicians are increasingly challenged by the task of selecting the most appropriate products and techniques to achieve optimal patient outcomes. Methods: We employed a PubMed literature search of facial injectables from the past 10 years (2005–2015), with emphasis on those articles embracing evidence-based medicine. We evaluated the scientific background of every product and the physicochemical properties that make each one ideal for specific indications. The 2 senior authors provide commentary regarding their clinical experience with specific technical refinements of neuromodulators and soft-tissue fillers. Results: Neurotoxins and fillers are characterized by unique physical characteristics that distinguish each product. This results in subtle but important differences in their clinical applications. Specific indications and recommendations for the use of the various neurotoxins and soft-tissue fillers are reviewed. The discussion highlights refinements in combination treatments and product physical modifications, according to specific treatment zones. Conclusions: The field of facial aesthetics has evolved dramatically, mostly secondary to our increased understanding of 3-dimensional structural volume restoration. Our work reviews Food and Drug Administration–approved injectables. In addition, we describe how to modify products to fulfill specific indications such as treatment of the mid face, décolletage, hands, and periorbital regions. Although we cannot directly evaluate the duration or exact physical properties of blended products, we argue that “product customization” is safe and provides natural results with excellent patient outcomes.
Collapse
|
16
|
Hand Rejuvenation: A Comprehensive Review of Fat Grafting. J Hand Surg Am 2016; 41:639-44. [PMID: 27113709 DOI: 10.1016/j.jhsa.2016.03.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/01/2016] [Accepted: 03/17/2016] [Indexed: 02/06/2023]
Abstract
Dermal atrophy, bulging reticular veins, and prominent bones and tendons are characteristic of the aging hand. Demand for cosmetic procedures to restore a youthful appearance to the dorsum of the hand has risen in recent years. A review of the literature reveals that of the many options for hand restoration, autologous fat grafting stands out as the most promising choice compared with many available alternative options such as microdermabrasion, peeling agents, and dermal fillers. This article details the surgical technique and relevant anatomy necessary for successful hand rejuvenation. Future advancements may rely on further study into adipose-derived stem cells.
Collapse
|
17
|
Evaluation of the Merz Hand Grading Scale After Calcium Hydroxylapatite Hand Treatment. Dermatol Surg 2016; 41 Suppl 1:S389-96. [PMID: 26618470 DOI: 10.1097/dss.0000000000000546] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Measurement scales that quickly and rigorously evaluate the effectiveness of filler treatment in hands are important tools in clinical practice. The Merz Hand Grading Scale (MHGS) is used to grade the appearance of the dorsal hand. The MHGS has been validated for photographic and live assessment of the hands. OBJECTIVE To evaluate the sensitivity of the 5-point MHGS to detect clinically meaningful and aesthetically pleasing changes in hand appearance after treatment with a calcium hydroxylapatite (CaHA)-based dermal filler. METHODS The controlled 4-week study randomized 30 subjects (60 hands) 2:1 to a Treatment group (treatment at enrollment) or a Control group (treatment at end of study). Effectiveness was evaluated with live MHGS ratings and photographic assessments with the Global Aesthetic Improvement Scale (GAIS). RESULTS At Week 4, all Treatment group subjects (20/20) achieved a ≥1-point improvement on the MHGS compared with 0/10 (0%) of the Control group (p < .0001). Subjects and treating physicians rated 92.5% (37/40) and 100% (40/40), respectively, of hands as at least "improved," using the GAIS. CONCLUSION The MHGS is an appropriate and validated tool that clinicians can use to counsel patients and evaluate clinically meaningful and aesthetically pleasing changes after hand treatment with CaHA.
Collapse
|
18
|
Abstract
BACKGROUND The terms "biphasic" and "monophasic" have been used frequently as a means of differentiating hyaluronic acid (HA) fillers. This type of categorization is based on misinterpretations of the term "phase" and provides no help to the practitioner when selecting the most appropriate product for each indication, patient, and injection technique. OBJECTIVE The purpose of this study was to analyze the properties of 2 HA filler families; Juvederm (JUV) (Allergan), often stated to be monophasic and Restylane (RES) (Galderma), often stated to be biphasic, and discuss what properties may have led to the use of the terms monophasic and biphasic. MATERIALS AND METHODS Three different methods were used for JUV and RES: determination of extractable HA; determination of water uptake; and microscopy. RESULTS The analyzed products were shown to contain both observable gel particles and extractable HA and have the ability to absorb added water. CONCLUSION The categorization of HA fillers as biphasic or monophasic was shown to be scientifically incorrect and should therefore be avoided. Further analytical measurement of the properties leading to this misinterpretation can provide information to discriminate and categorize HA fillers on a sounder scientific basis.
Collapse
|
19
|
Gubanova EI, Starovatova PA. A Prospective, Comparative, Evaluator-blind Clinical Study Investigating Efficacy and Safety of Two Injection Techniques with Radiesse(®) for the Correction of Skin Changes in Aging Hands. J Cutan Aesthet Surg 2015; 8:147-52. [PMID: 26644738 PMCID: PMC4645144 DOI: 10.4103/0974-2077.167271] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Dermal fillers are used to correct age-related changes in hands. Aims: Assess efficacy and safety of two injection techniques to treat age-related changes in the hands using calcium hydroxylapatite filler, Radiesse®. Settings and Design: This was a prospective, comparative, evaluator-blind, single-center study. Materials and Methods: Radiesse® (0.8 mL/0.2 mL 2% lidocaine) was injected subdermally on Day (D)01, using a needle multipoint technique in one hand (N) and a fan-like cannula technique in the other (C). Assessments were made pre-injection, on D14, Month (M)02, M03 and M05 using the Merz Aesthetics Hand Grading Scale (MAS) and Global Aesthetic Improvement Scale (GAIS). Participants completed questionnaires on satisfaction, pain and adverse events (AEs). Statistical Analysis Used: Data distribution was tested with the Shapiro-Wilk and Levene's tests. The Wilcoxon signed-rank and Chi-square tests were employed to evaluate quantitative and qualitative data, respectively. Results: All 10 participants completed the study, four opted for a M03 touch-up (0.8 mL Radiesse®). Evaluator-assessed mean GAIS scores were between 2 (significant improvement but not complete correction) and 3 (optimal cosmetic result) at each time point. The MAS score improved from D01 to M05 (N: 2.60 to 1.40; C: 2.20 to 1.30). Following treatment, participants reported skin was softer, more elastic, more youthful and less wrinkled. Other than less noticeable veins and tendons on the C hand, no differences in participant satisfaction were noted. All AEs were mild, with no serious AEs reported. Conclusions: Both injection techniques (needle and cannula) demonstrated equivalent clinical efficacy with a comparable safety profile for the correction of age-related changes in hands with Radiesse®.
Collapse
Affiliation(s)
- Elena I Gubanova
- Vallex M Clinic of Preventive Medicine, Moscow National University of Food Production, Moscow, Russia ; Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, Russia
| | - Polina A Starovatova
- Vallex M Clinic of Preventive Medicine, Moscow National University of Food Production, Moscow, Russia ; Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, Russia
| |
Collapse
|
20
|
Agostini T, Perello R. Lipomodeling: An Innovative Approach to Global Volumetric Rejuvenation of the Hand. Aesthet Surg J 2015; 35:708-14. [PMID: 26229128 DOI: 10.1093/asj/sju163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Rejuvenation of the hand, particularly the dorsum, has garnered increased attention because of its unique aesthetic importance. Various methods have been advocated for achieving optimal aesthetic results. OBJECTIVES The authors describe their experience applying lipotransfer to total hand rejuvenation, including rejuvenation of the radial and ulnar aspects of the fingers. METHODS The authors conducted a retrospective review of 22 women who underwent global hand rejuvenation by lipotransfer. Aesthetic outcomes were assessed objectively by serial photography and subjectively by patient self-assessments. RESULTS No major postoperative complications were observed. Of 22 patients, 21 indicated that they were "satisfied" or "very satisfied" with the procedure. Plastic surgeons noted improvement in the aesthetic appearance of the hands after treatment. CONCLUSIONS Global hand rejuvenation should aim to restore volume and reduce skin laxity to reverse the signs of extrinsic aging. The fingers represent almost 50% of the length of the hand and should be included in treatments to achieve optimal aesthetic outcomes. LEVEL OF EVIDENCE 4 Therapeutic.
Collapse
Affiliation(s)
- Tommaso Agostini
- Dr Agostini is a Consultant Plastic Surgeon in the Department of Maxillo-Facial Surgery and Consultant Plastic Surgeon Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy. Dr Rafaella Perello is a Consultant Plastic Surgeon, Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
| | - Raffaella Perello
- Dr Agostini is a Consultant Plastic Surgeon in the Department of Maxillo-Facial Surgery and Consultant Plastic Surgeon Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy. Dr Rafaella Perello is a Consultant Plastic Surgeon, Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
| |
Collapse
|
21
|
Yeo KK, Park TH, Chang CH. Treatment of Foreign Body Granuloma of the Hand Associated with Unregulated Material Injection for Aesthetic Purpose. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2013. [DOI: 10.14730/aaps.2013.19.1.71] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kwan Koo Yeo
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hwan Park
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Choong Hyun Chang
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|