Evaluation and management of facial granuloma caused by various injection materials

Augmenting dermal collagen synthesis through hyaluronic acid-based microneedle-mediated delivery of poly(l-lactic acid) microspheres

Poly(L-lactic acid) (PLLA) can stimulate collagen synthesis through a foreign body response. However, inappropriate injection techniques and localized PLLA clustering can lead to complications and adverse events. This study developed a composite microneedle (MN) device comprising an array of PLLA microsphere (PLLA MP)-loaded hyaluronic acid needle tips with a supporting patch (PLLA MP-MN). This device was designed to deliver PLLA MPs precisely and uniformly to the dermis and to provide dual stimulation through MN puncture and MP implantation, thereby enabling the rapid and long-lasting regeneration of dermal collagen. When applied to rat skin, the MN array evenly distributed the PLLA MPs throughout the penetrated regions, which prevented local PLLA overdosing and elicited a milder inflammatory response compared with that induced by intradermal PLLA MP injections. An in vivo efficacy study revealed that MN-mediated delivery of PLLA MPs not only promptly initiated collagen production through microwound-triggered wound-healing cascades in the early treatment stage but also enabled the long-term stimulation of collagen deposition through MP-induced foreign body reactions, thereby significantly enhancing neocollagenesis. This innovative PLLA MP-MN system can augment the benefits and minimize the adverse effects associated with traditional PLLA fillers, providing a safe and reliable anti-aging therapeutic option.

Treatment of Morbihan disease

Morbihan disease (MD) is a rare condition that involves rosaceous lymphedema or erythematous lymphedema of the middle and upper thirds of the face. It typically affects the periorbital region, forehead, glabella, nose, and cheeks. The etiology of MD remains unclear, and its diagnosis is challenging. MD often tends to be unresponsive to therapies commonly used to treat rosacea, including corticosteroids, isotretinoin, and antibiotics. Surgical treatments have therefore been attempted, but most cases showed unsatisfactory responses. These problems could have resulted from an incorrect recognition and interpretation of the pathophysiology of MD and inaccurate planning of the operation, resulting in recurrence or exacerbation of edema.