多层次不同剂型透明质酸钠溶液注射在面部年轻化治疗中的疗效分析

目的:探讨分析多层次不同交联度医用羟丙基甲基纤维素-透明质酸钠溶液复合式注射在面部年轻化中的临床疗效。方法:自2011年2月—2013年3月,对118例要求进行面部年轻化处理的患者行多层次注射不同剂型即不同交联度医用羟丙基甲基纤维素-透明质酸钠溶液于额部、颞部(太阳穴)、鼻唇沟、下颌部、颊部。于治疗后第7天、30天、3个月、6个月进行随访,而后每间隔半年随访1次,共随访8次。结果:随访的患者中,注射部位皱纹完全消失或基本消失平均维持时间为(13.42±3.29)个月(n=118),术后3个月满意率达98.4%,术后无面部表情僵硬,局部臃肿,结节坏死等并发症发生。结论:应用多层次不同剂型医用羟丙基甲基纤维素-透明质酸钠溶液复合式注射治疗额部、颞部(太阳穴)、鼻唇沟、下颌部、颊部凹陷及皱纹,维持时间长,表面轮廓更加柔和,可以获得更满意的年轻化效果。     

透明质酸类皮肤软组织填充剂及其研究进展

近几年透明质酸类皮肤软组织填充剂在世界各地美容医学的临床应用可谓如火如荼,已经证明它是对手术或非手术治疗面部年轻化的有力补充。本文将对各种透明质酸类填充剂的历史、理化性质和特性、临床应用及其研究进展做一介绍。     

微(无)创面部皮肤年轻化的临床进展

皮肤老化是人体衰老的外部表现,其临床表现多样且具有较大个体差异。科技的发展和医疗美容技术的进步,为面部年轻化提供了从防护、药物、光电技术、注射、微创及手术等多种手段。而随着医学科学的进展,富血小板血浆(PRP)、自体脂肪、脂肪干细胞、多能干细胞等细胞生物疗法也在抗衰老、促进年轻化的临床上取得了良好的效果。未来的面部年轻化治疗必定是手术与非手术等多种治疗技术相结合的时代。     

富血小板血浆在面部年轻化中的应用

富血小板血浆(PRP)是自体全血经离心后得到的血小板浓缩物,内含大量生长因子及蛋白质,可以促进组织的再生修复及加快愈合。近年来PRP在骨科、神经外科、口腔颌面外科以及美容整形科等学科的应用日益广泛。有研究表明PRP在单独使用或联合脂肪移植、激光及去皱整形手术等其他疗法在面部年轻化领域具有显著的疗效,该文对PRP在面部年轻化中的应用和尚未解决的问题作一综述。     

线技术在面部年轻化中的应用

自Sulamanidze在上世纪末提出埋线提升面部年轻化的治疗理念后,线技术在近几十年里发展迅速。与传统整形外科手术相比,因其具有创面小、效果好、见效快、低风险、术后恢复快等特点成为目前备受关注的医美项目之一。线技术不仅可用于面部年轻化治理,也可用于躯干、四肢局部,达到消脂、提升、塑形的目的。本文就线技术在面部年轻化中的应用作一简单介绍。     

注射美容的并发症及防治措施

注射美容是指应用经皮注射的方法,把特定的注射物注射到目标位置以达到年轻化、美丽化效果的一种医学美容手段。注射美容最常用的两类制剂是A型肉毒毒素和透明质酸类填充剂。A型肉毒毒素用于额前、眼周、口周和颈部区域的除皱,以及面部形态不对称和面肌抽搐的治疗;透明质酸类填充剂用于矫正皱纹和凹陷、美化面部器官及调整面部轮廓。虽然已有的报道显示两类制剂在注射美容方面的应用是安全、有效的,但不可忽视对其使用后并发症的防治。     

面部年轻化注射治疗疗效观察与判定

注射治疗是面部年轻化的重要手段,根据注射目的和要求不同,可选择的注射药品和注射方法多种多样,注射疗效的观察和判定也各有不同。面部皱纹年轻化注射治疗可以通过皱纹形态变化和WSRS量表等来观察和评价,面部轮廓年轻化注射治疗可以直接观察或通过3D测量方法对注射前后面部轮廓变化进行比较,面部皮肤年轻化注射可以直接观察,也可借助VISIA等仪器检测皮肤纹理、皱纹、毛孔、色素等的变化来评价,病人的满意程度也是重要的疗效判定内容。     

视黄醛联合透明质酸抗皮肤老化功效及安全性评价

目的:观察外用0.05%视黄醛联合0.5%及1%透明质酸片段对中国人面部皮肤抗老化的功效性和安全性.方法:采用多中心研究.将受试者分为3组,分别于整个面部使用含0.05%视黄醛+0.5%透明质酸片段制剂;于深皱纹区域使用含O.05%视黄醛+1%透明质酸片段制剂及两种制剂联合应用.经90d观察期,评估包括照片分级评分、面部肤色均匀度、皮肤干燥度、色素沉着、皮肤弹性及局部皱纹程度等多项老化指标,对2种外用制剂进行耐受性评估.结果:3组老化指标均有改善.照片分级评分降低,面部肤色均匀度改善,皮肤干燥度、色素沉着、皮肤弹性等皮肤老化体征均有改善.除1组受试者眉间纹外局部深皱纹程度均有改善.不良反应轻微.结论:视黄醛联合透明质酸片段外用可改善多种皮肤老化征象,安全有效.     

第九届全国激光美容与面部年轻化学术大会

正由中国医师协会美容与整形医师分会主办的第九届全国激光美容与面部年轻化学术大会暨中国(厦门)国际美容产业博览会将于2019年3月21日—3月24日在厦门国际会展中心召开。本次大会将设立黄褐斑、血管瘤及鲜红斑痣、敏感皮肤、眼周年轻化、颈部年轻化、下面部松弛、私密激光整形、线雕、注射美容、抗衰老、疑难与典型病例、经营管理等热门专     

埋线提升与注射美容的联合应用

面部年轻化是美容整形外科的重要组成部分,其治疗包括各种非手术及手术方法。目前,随着微创美容外科技术的发展以及人们对面部解剖研究的深入,埋线提升被越来越多地应用在面部年轻化治疗中。本文旨在通过分析面部老化的解剖学变化,对埋线提升的历史、演变、适应证与禁忌证、方法、效果、并发症及与注射填充的联合应用做一综述。     

Efficacy and durability of hyaluronic acid fillers for malar enhancement: A prospective,randomized, split-face clinical controlled trial

Various hyaluronic acid fillers can be used for facial attenuation and rejuvenation. The efficacy and durability of hyaluronic acid fillers are of major concern to dermatologists and patients. This study aimed to evaluate three-dimensional morphology, tissue distribution, and changes in volume after injection of two different hyaluronic acid fillers. Ten Korean women were enrolled in this study. Each subject was injected with monophasic hyaluronic acid filler in one malar area and biphasic filler in the other. Clinical outcome was measured before and after injection, and after 2, 4, 6, 8, 12, and 24 weeks, using the Global Aesthetic Improvement Scale, photographs and Moire’s topography. Facial magnetic resonance imaging (MRI) was performed twice over six months. Both products showed good results after injection and demonstrated good durability over time. MRI was a useful modality for assessing tissue distribution and volume changes. The effects and durability after injection of monophasic hyaluronic acid filler and biphasic hyaluronic acid filler are generally comparable.     

The third dimension in facial rejuvenation: a review

Background Facial rejuvenation has long been dominated by surgical techniques that act on only two dimensions of the face, ignoring the third dimension (facial volume); therefore, a truly youthful look remains elusive. Objectives This paper aims to define the various surgical procedures employed by cosmetic surgeons that can be combined with alloplastic implants or injectable devices in order to restore lost facial volume. Methods and materials A search of the literature was performed. Results Alloplastic augmentation and implants provide permanent restoration of facial volume, but require invasive surgery. Soft‐tissue fillers include autologous fat, calcium hydroxylapatite, and a variety of polymers. Devices based on collagen and hyaluronic acids provide correction of superficial lines and folds, but cannot offer long‐lasting restoration of facial volume. The only fillers that have been proven to augment facial volume are autologous fat, calcium hydroxylapatite, poly‐l ‐lactic acid, polyacrylamide, poly‐alkyl‐imide, and methylpolysiloxane. Conclusions For optimal facial rejuvenation, the accepted surgical techniques of skin lifting and tightening could be combined with volumizing devices, thereby addressing ptosis, lines, folds, and volume loss.     

Surgery for foreign body reactions due to injectable fillers

BACKGROUND: An increasing number of soft tissue fillers have been introduced to the beauty market and these filler substances are widely used as non-toxic, non-immunogenic and relatively harmless injectable alternatives to surgical rejuvenation. Generally, facial fillers are injectable - or surgically insertable - products that are used to fill up the volume loss in the aging face. Depending on bioavailability, chemical composition and degradation, fillers can be classified as temporary or permanent, organic or inorganic and autologous or heterologous. OBJECTIVE: A plethora of new products has swamped the beauty market since face rejuvenation has become socially acceptable as well as affordable to a wider population, but adverse reactions cannot be excluded. We present 4 patients with complications after injection of facial fillers [including Artecoll(polymethylmethacrylate microspheres), Restylane (hyaluronic acid), DermaLive (hyaluronic acid plus acrylic hydrogel particles) and Newfill (polylactic acid)] and surgical correction. RESULTS: Surgical intervention led to good aesthetic and functional results after multiple unsuccessful conservative therapies. CONCLUSION: We recommend that only physicians familiar with the injection techniques and the biological and chemical characteristics of the various injectable products should perform such interventions. Especially permanent fillers should be used with utmost reticence in cosmetic surgery and we would recommend their application only in reconstructive procedures. Additionally, documentation and reporting of all adverse effects must be mandatory.     

Soft tissue augmentation--use of hyaluronic acid as dermal filler

Soft tissue augmentation has revolutionized the treatment of the aging face. It is a technique in which a substance is injected under the skin. The concept of utilizing materials for soft tissue augmentation actually began around 1950 with the use of fluid silicone. Today we have a large armamentarium of implant materials to delay the tell tale signs of aging. Filling has replaced conventional surgery in facial rejuvenation. In this article, the emphasis will be on hyaluronic acid as this substance is easily available in India and ranks among the most widely used dermal fillers.     

Hyaluronic acid fillers

Although hyaluronic acids are a relatively new treatment for facial lines and wrinkles, they have provided numerous advances in the area of cosmetic surgery. This article discusses the inherent properties of hyaluronic acid fillers that make them ideal for treatment of facial lines. It encompasses a review of the current literature on U.S. Food and Drug Administration-approved hyaluronic acid fillers and the role that each of these fillers currently has in facial cosmetics. This article also discusses the potential pitfalls and adverse effects that can be associated with using hyaluronic acids for filling facial lines. Finally, it serves as an overview of current techniques for clinical assessment of patients as well as administration and treatment of facial lines and wrinkles.     

A single injection technique for midface rejuvenation

The correction of volume loss has become an important part of facial rejuvenation treatments, particularly in the midface region. Techniques to date have largely relied on multiple injections, fanning techniques and deep placement of product under muscle or on periosteum. This article describes a new technique to enhance volume in the midface using a single injection of cross-linked hyaluronic acid at the subdermal level and above the muscle. The technique approaches midface rejuvenation with reference to both the bony skeleton and the medial malar fat compartment. After appropriately marking the skin, the filler is placed using a blunt cannula. The treatment achieves satisfactory volume correction, enhancing the sharp cheek bones and malar fullness typical of an attractive adult face. The approach is simple, quick, and well tolerated by the patient and may result in less bruising than deeper techniques.     

透明质酸敷料对皮肤基础状态影响的研究

目的探讨透明质酸敷料提升皮肤基础状态的效果和安全性。方法招募女性健康志愿者200名。对所有受试者使用透明质酸敷料每晚1次,连续使用28 d。于透明质酸敷料使用前、使用第14天、第28天,检测皮肤水分、油分、弹性、黑色素、血红素等基础状态,评价使用满意度和安全性。结果透明质酸敷料使用前、后不同时间,其皮肤水分、弹性改善有统计学意义(F=76.26、7.07,P0.05),油分、黑色素、血红素差异无统计学意义(F=2.04、1.47、2.22,P0.05)。透明质酸敷料使用28 d后,其使用贴合度、气味及使用舒适度的满意度均为100%,即刻滋润度及皮肤改善度的满意度均为99.5%,无明显不良反应。结论透明质酸敷料可提升皮肤的水分和弹性,受试者满意度高,安全性好。     

透明质酸凝胶与他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的分别探讨透明质酸凝胶和他克莫司软膏治疗面部脂溢性皮炎的疗效、安全性和对皮肤屏障功能的影响。方法 89例面部脂溢性皮炎患者随机分为试验组和对照组。试验组外用透明质酸凝胶,对照组外用他克莫司软膏,在0、7、14、28 d进行随访,每次随访用VISIA皮肤图像分析仪观察面部红色区,评估患者病情,并测定皮肤屏障功能相关指标。结果疗程结束后,试验组和对照组显效率分别为82.2%和86.4%,差异无统计学意义(P0.05);试验组和对照组角质层含水量分别为(56.60±9.54)和(55.14±11.57),两组差异无统计学意义(P=0.610);试验组和对照组经表皮水分丢失值分别为[(19.37±5.18)g/(m~2·h)]、[(25.10±14.0)g/(m~2·h)],两组差异无统计学意义(P=0.142)。结论透明质酸凝胶治疗面部脂溢性皮炎疗效与他克莫司软膏同样有效,透明质酸凝胶能改善皮肤屏障功能,减轻皮损,使用安全,耐受性好,值得临床推广。     

The potpourri approach to hyaluronic acid filler injections

There is an ever-expanding range of hyaluronic acid fillers with varying physical characteristics available to cosmetic dermatologists. These fillers are commercially packaged in syringes of approximately 1 mL (range 0.5–2 mL) volume. Filler injectors are currently qualitatively and quantitatively restricted to fillers packaged in ready-to-go syringes. Patients often present for pan-facial rejuvenation requiring varying amounts of fillers as well as more than one type/subtype of filler for optimum correction. The potpourri approach allows access to a range of prepared hyaluronic acid filler subtypes that can be used on the same patient in the one session. The potpourri method centres on the use of multiple 31-gauge insulin syringes prepared with a range of different hyaluronic acid filler products that are ready for use. This increases flexibility with filler selection and has the potential to provide better filler-to-tissue match for patients.