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1.

Objectives

Microfocused ultrasound (MFU) and hyaluronic acid (HA) filler injection are increasingly popular aesthetic procedures. HA filler injection is generally recommended after MFU if combined treatment is required in a single visit. However, data regarding the safe and optimal time of MFU treatment after HA injection is still limited. The purpose of this study was to evaluate the degree of HA loss when performing MFU treatment after dermal filler injection.

Methods

Fourteen subjects were recruited in this pilot study. HA was injected intradermally on four 2 × 2 cm areas at the abdomen (0.25 ml/site). Site A was served as control whereas site B, C, D were treated with MFU using 1.5 mm transducer at 60 min, Day 14, and Day 28 after the injection, respectively. All experimental sites were biopsied using a 3-mm punch biopsy to evaluate the histopathological profile at baseline and Day 56. Grading of the quantity of retained HA was evaluated by a blinded experienced dermatopathologist.

Results

All 14 subjects completed the study. One subject has been excluded due to the poor quality of histopathologic slides. Seven subjects (53.9%) at site B and 6 subjects (46.2%) at site C had HA loss at Day 56 compared with baseline. The mean HA grading at baseline and Day 56 was 3.7 vs. 2.8 (p < 0.001) at site B and 3.7 vs. 3.0 (p = 0.001) at site C, respectively. There was no statistical difference between the mean HA grading at baseline and Day 56 at site D (3.7 vs. 3.3, p = 0.073). No inflammation or granuloma was observed on Day 56 of the study.

Conclusions

MFU treatment after HA injection appears to be safe. However, some degree of HA loss was observed if MFU treatment was done within 2 weeks after HA injection.  相似文献   

2.

Background

Recent studies demonstrate that PDO threads, after being introduced into the facial skin, provide benefits due to collagen formation around the thread and improved vascularization.

Aims

This work aims to report the ultrasound and photographic follow-up after the execution of the facelift thread technique, thus evaluating the anti-aging treatment that PDO threads will provide for human facial skin.

Methods

The facelift will be performed using PDO thread 18G cannulated Sculpt i- Thread FML 100 × 185 mm, and 29G PDO thread Needled Flat i-Thread 38 × 50 mm. A total of 10 patients were selected for the study; all of them had medium-grade facial ptosis and aged 40–50 years old. In order to control tissue changes after thread, insertion ultrasound measurements will be made with Philips ultrasound 12 MHz linear probe at maximum resolution, initial evaluations and control of 30, 60, 90, and 120 days, measuring the skin layers: epidermis\dermis and hypodermis. Photographic control was performed before and after 120 days of intrusion of the PDO threads.

Results

The formation of collagen around the PDO thread was evidenced through ultrasound images in all patients in this study, as well as improvement in the appearance of the skin and sagging, evaluated by photographic control.

Conclusions

We can define that the PDO threads used for the facelift are effective in the formation of collagen around the thread (observed through the increase in the dermal layer), and improvement of the condition of the anti-aging factor through sagging skin, vascularization and thinning of the superficial fat layer (observed through the reduction of the subcutaneous or hypodermis layer).  相似文献   

3.

Background

Microfocused ultrasound with visualization (MFU-V) delivers focused ultrasound energy to heat tissue and has emerged as a fast and effective noninvasive method for treating skin laxity. After obtaining approval in 2009 by the Food and Drug Administration, satisfactory feedback was recorded using several scoring systems for MFU-V treatment for facial and neck laxity.

Aim

To evaluate the efficacy and satisfaction rates of MFU-V for facial and neck laxity treatment by providing a basis for developing a validated scoring system for MFU-V treatment.

Method

A constrictive survey was carried out by selecting relevant publications on MFU-V treatment of facial and neck laxity using PubMed, Medline, and Embase electronic databases from January 2017 to March 2022.

Results

Of the 11 original articles used in this review, the majority of the scoring methods used were the subjective global aesthetic improvement scale and the 5-point scale rating global aesthetic improvement in appearance. Around half of the patients were described as much improved or very much improved on days 30 and 90, while most returned to baseline on Day 360. Most of the adverse events reported were mild bruising, redness, and pain. None of the patients reported serious adverse events. A burn occurred in one case because of improper application of the probe.

Conclusion

The MFU-V provides excellent and promising responses for treating facial and neck laxity. A few mild events were observed, such as erythema, pain, edema, and injection-site induration, all of which resolved within approximately 2–3 days.  相似文献   

4.
5.

Background

Knowledge of normal facial vascular variations could prevent catastrophic complications of cosmetic procedures as well as providing a guide for surgical planning. Color Doppler ultrasound is a safe and noninvasive method for real time vascular evaluation.

Objective

The aim of this study was to evaluate the normal variations of the facial, angular, transverse facial, supratrochlear and supraorbital arteries in a sample of normal individuals.

Methods

Normal individuals referred for dermal filler injection to the tertiary dermatologic center, were selected. Patients who were smoker or had a history of facial filler injection, facial surgery, or trauma were excluded from the study. Facial artery at three levels as well as angular, supratrochlear, supraorbital, and transverse facial arteries were evaluated by an 18 MHz ultrasound linear probe regarding their distance from facial reference lines and landmarks, and also their depths in various regions of face.

Results

A total number of 43 individuals were evaluated in this study. Thirty-one (72.1%) were women. The number of absent facial artery was zero in level one, three (3.48%) in level two, and nine (10.46%) in level three. The angular artery was absent in 10 (11.62%) participants. The transverse facial artery was absent in 27 (31.39%) assessed individuals. Distance from reference lines at level 2 and 3 of facial artery and its depth at level 2 were significantly different between left and right side (p-values: <0.001, 0.01, and 0.03, respectively). No significant difference was seen between depth and distance of two sides for angular and transverse facial arteries. The comparison of the depths and distances from the reference lines of the assessed arteries between two sexes revealed only a significantly greater value of facial artery distance in level 1 in males (p-value: 0.001). BMI was also significantly correlated with the depth of facial artery in level 2 (Pearson correlation coefficient = 0.471, p-value = 0.002) and level 3 (Pearson correlation coefficient = 0.357, p-value = 0.03) and the distance of the facial artery in level 1 (Pearson correlation coefficient = 0.333, p-value = 0.029).

Conclusions

Color Doppler ultrasound could be used to map the arteries of face to prevent vascular complications and safely guide cosmetic procedures.  相似文献   

6.

Introduction

Changes in brow positioning are one of the first facial aging signs. A more beautiful and younger look can be achieved by repositioning the tissues involved in brow descent and sagging eyelids.

Methods

We report the outcome of eyebrow thread lifting in a series of patients who came to our clinic to improve their gaze. Response to treatment was assessed at 6- and 12-months using FACE-Q upperlids and eyebrow/forehead scales.

Results

A total of 38 patients with mild-to-moderate brow ptosis or without ptosis underwent eyebrow thread lifting (mean age 35.5, all female). No serious complications were observed during or after treatment. All patients were satisfied with the outcome of the intervention. Mean FACE-Q scores improved at six months compared with baseline. A statistically significant increase in mean FACE-Q scores was still seen at 12 months and was more evident in younger women. Patients were able to go back to their daily lives the day after the procedure.

Conclusion

Eyebrow thread lifting is a minimally invasive procedure able to overcome mild-to-moderate ptosis with excellent aesthetic results. In the absence of ptosis, thread lifting is a good choice to reposition the brow and improve the gaze. The technique is simple to perform and safe.  相似文献   

7.

Introduction

Skin pores are enlarged openings of the pilosebaceous follicles that can be affected by age, gender, genetics, exposure to UV light, ethnicity, and sebum secretion. Many treatment modalities reduce facial pores’ count and area, including oral and topical medications as well as different wavelengths of lasers. Finding a safe and cost-effective treatment protocol is necessary since facial pores are one of the main reasons for cosmetic complaints.

Aim

This review compares available treatment options for reducing facial pores’ number and area according to the published clinical trials.

Methods

A search on PubMed and Google Scholar was performed. Nineteen published clinical trials regarding treatment options for facial pores were included and reviewed based on the authors’ clinical experience.

Results

A total number of 591 cases (83.7% female) aged 18–80 years were included. Three assessment methods including digital imaging, physician assessment, and patient’ satisfaction were used in the studies to evaluate the therapeutic efficacy of each modality. Furthermore, combining different modalities increased the efficacy of reducing pores’ size and number. Mild, reversible burning and erythema were common side effects.

Conclusion

Multiple sessions and combination therapies improve facial pores’ area and number. In young patients, the focus should be on controlling sebum production, while in older patients, the focus should be on rejuvenation in addition to the control of sebum production.  相似文献   

8.
【摘要】 近年来,微聚焦超声作为一种面部紧致的新手段,得到了广泛的应用,其机制为通过精确的、深度一致的微凝固区将热传导到真皮深层至表浅肌肉筋膜系统层,引起皮肤胶原收缩和重塑,而不损伤表皮,安全性高,很少出现严重不良反应。但关于其是否会导致皮下瘢痕形成、溶脂风险、神经血管及眼部损伤等仍然存在质疑,合理使用和选择患者可以最大程度避免这些罕见不良反应的发生。  相似文献   

9.

Background

Facial overfilled syndrome is an adverse event following minimally invasive soft tissue filler injections. It presents in most cases as excess midfacial volume and/or as unnatural smile which is difficult to detect due to the absence of standardized evaluation methods.

Objective

To showcase how to identify, evaluate, and treat facial overfilled syndrome by utilizing facial ultrasound and simultaneous hyaluronidase injections.

Methods

Twenty-eight consecutive patients (26 females, 2 males) were enrolled in this study in which facial ultrasound was performed to evaluate the location previously implanted filler material. The position of the oral commissure was objectively measured in relation to bony landmarks, and the severity of lateral canthal lines was assessed by independent and blinded raters.

Results

The material was identified in 35.7% inside the subdermal fatty layer, in 28.6% inside the deep supra-periosteal fatty layer, in 10.7% inside the fibrous layer deep to the subdermal fatty layer, whereas in 25.0%, the product was not possible to locate clearly inside one specific layer. On average, 81.6 I.U. [range: 75–150] of hyaluronidase were injected. Lateral canthal line severity was before the treatment 2.28 (1.4) and was after the hyaluronidase treatment 2.02 (1.3) with p = 0.578. The position of the oral commissure increased by 0.60 cm in vertical and by 0.30 cm in horizontal directions (both p < 0.001).

Conclusion

Facial overfilled syndrome following aesthetic soft tissue filler injections can present as excess midfacial volume but also as unnatural smile. Targeted hyaluronidase injections into the culprit pockets inside the midfacial soft tissues have shown to re-establish a natural smile, to reduce excess midfacial volume, and to decrease lateral canthal line severity.  相似文献   

10.

Background

Age-related changes of facial soft tissue cause clinical signs of facial aging such as lip atrophy, marionette lines, and an accentuated nasolabial fold. These changes can be modified using dermal fillers.

Aims

To evaluate efficacy, longevity, and safety of a cross-linked hyaluronic acid-based filler with Tri-Hyal technology in the treatment of lips, nasolabial folds, and marionette lines.

Materials and Methods

This prospective, multi-center trial evaluated injections of three different areas (lips, nasolabial fold alone, or with marionette wrinkles) with a soft tissue filler containing 25 mg/ml cross-linked hyaluronic acid and 0.3% lidocaine. Primary endpoint was the aesthetic correction 3 weeks after one injection session without touch-up. Follow-up was 18 months. Assessments were performed using the Global Aesthetic Score (GAS), clinical scoring based on photographic scales, high-frequency ultrasound imaging, and the Global Aesthetic Improvement Scale (GAIS).

Results

In total, 100 subjects were injected. GAS improved significantly for all treatment indications at 3 weeks (p < 0.0001). Success rates were highest for nasolabial folds (98.4%), followed by marionette lines (94.4%) and lips (73.5%). After 18 months post-injection, success was observed in 91%, 88%, and 33% of subjects injected into nasolabial folds, marionette lines, and lips, respectively. GAIS scored highest for nasolabial folds (SGAIS: 71%; IGAIS: 40%), followed by marionette lines (SGAIS: 56%; IGAIS: 33%) and lips (SGAIS: 30%; IGAIS: 22%) at 18 months follow-up.

Conclusions

The filler demonstrated high efficacy and safety in all indications. Regional differences in longevity were evident. Thus, the necessity of regional retreatments should be discussed with patients before injection.  相似文献   

11.

Introduction

It is well known that, due to the presence of growth factors, platelet-rich plasma (PRP), is able to produce histological changes in the dermis that reproduce the process of biological tissue repair without previous damage. Biostimulation with PRP has been used clinically for skin rejuvenation of the face and neck. Skin ultrasound can be helpful to evaluate several aspects of skin aging. This study was designed to perform an objective evaluation of the beneficial effects of this treatment on skin aging.

Material and methods

Autologus PRP was injected by mesotherapy in 10 women, aged between 45 and 60 years, in the face, neck and cleavage. Three-monthly sessions were carried out and the final results were measured 1 month after the final treatment. Pictures were taken and skin ultrasound was performed of the same area of the face before and after the treatment.

Results

All patients noted an improvement in their skin quality: the skin was brighter, more hydrated, more compact and plumper. An increase of dermal thickness and a decrease in subepidermic low echogenic band (SLEB) was observed on skin ultrasound. However, this improvement was not statistically significant, probably due to the small number of patients.

Conclusions

Biotestimulation with autologous PRP improved skin quality and reversed ultrasound signs of skin aging. More studies are required to confirm these results.  相似文献   

12.
Background: Although various minimal invasive approaches are available for aging skin laxity, they alone may not lead to notably satisfactory results. Objective: To evaluate the effectiveness and safety of combination regimen with monopolar radiofrequency (MRF) and intense-focused ultrasound (IFUS) in facial lifting and tightening. Methods: Twenty-two Korean participants with aging face received a sequential single session of MRF and IFUS treatment. Objective and subjective assessments for improvement were performed at the 20-week post-treatment. Safety profiles were also recorded, and skin biopsies were taken at baseline and follow-up visit. Results: Based on the objective assessment for the overall facial skin tightening and laxity, 19 patients (90%) demonstrated “moderate” or better improvements (more than 25%) compared with baseline. Specifically, improvements of skin laxity and sagging, and droopy jaw line were more noticeable compared with that of superficial skin texture (P < 0.05). Subjective satisfactions were generally consistent with objective findings, and no serious adverse effect was observed. Histologic evaluation showed increased dermal collagen fibers throughout the dermis after treatments (P < 0.05). Conclusion: Combination treatment of MRF and IFUS has cumulative benefits for skin lifting and tightening with satisfactory safety profiles in Asian subjects.  相似文献   

13.

Background

Chemical peeling is the controlled wounding of the epidermis and dermis for skin rejuvenation, involving the application of ablative agents to induce keratolysis and regeneration of damaged cell layers. Prolonged erythema is one complication of this procedure. We report the prevalence and probable etiology of prolonged facial erythema in a cohort of patients treated with medium-depth chemical peels.

Materials and Methods

A retrospective audit was conducted of all medium-depth facial chemical peels performed at two major teaching hospitals. All patients had severe facial photodamage affecting at least 75% surface area of the face. The occurrence of prolonged erythema following this peel was then identified and analyzed.

Results

Of our treatment cohort (n = 82, 51 women, 31 men) with 60 years mean (61.3 years for women, 56.7 years for men), 10 patients (12%; eight women, two men) experienced prolonged erythema beyond a month of treatment. Facial psoriasis was not apparent at the time of chemical peel but manifested as prolonged erythema beyond the expected timeframe following the procedure.

Conclusion

When patients experience prolonged erythema beyond a month of treatment and fail to respond to standard treatments, clinicians should examine carefully for extra-facial psoriasis prior to this procedure, and also consider facial psoriasis a possible cause of prolonged post-peel erythema.  相似文献   

14.

Background

Enlarged facial pores and seborrhea are common cosmetic problems. Mesobotox has been proved to be effective safe therapeutic option.

Objective

To compare the efficacy and longevity of intradermal mesobotox injection versus its topical application with microneedling for treatment of wide facial pores and seborrhea.

Materials and Methods

This split face study was conducted on 20 patients with enlarged facial pores and seborrhea. One side of the face was treated with intradermal injection of botulinum toxin, the other was treated with its topical application following microneedling. Patient evaluation was performed after 1 month then after 4 months.

Conclusion

Microbotox can effectively and safely minimize enlarged facial pores with no downtime. Intradermal injection showed more patient satisfaction on the basis of greater efficacy, longevity of treatment than its topical application following microneedling.  相似文献   

15.

Background

Hyaluronic acid (HA) filler injections have increased in popularity. They are usually performed in combination with other treatment modalities, including lasers and energy-based devices, to enhance cosmetic results. Theoretically, HA and other filler injections should be performed after laser- or energy-based device treatments. In some instances, however, practitioners are asked to administer laser- or energy-based device treatment after HA dermal filler injection. There is a concerning possibility of HA filler degradation as a result of bulk heating generated by lasers or energy-based devices, especially radiofrequency (RF).

Aim

To evaluate the effect of RF treatment at different time points on HA degradation in vivo, using clinicohistological analysis.

Patients/methods

Fourteen volunteers were recruited and received intradermal HA filler injections in four sites on the abdomen. One site served as the control, and the other three sites were treated with monopolar RF on the same day after injection, at 14 and 28 days post-injection. Skin biopsies were performed at baseline and 56 days after HA injection. Histopathological sections were reviewed for residual filler in the tissue.

Results

The results showed that HA grading scores decreased in five (35.71%), one (7.14%), and one (7.14%) participants when RF was performed immediately, 14 and 28 days after injection, respectively.

Conclusion

In conclusion, RF treatment after HA filler injection may affect the integrity of the HA filler in the tissue, especially if RF treatment was performed on the same day after HA injection.  相似文献   

16.

Background

Thread lifting is a minimally invasive aesthetic procedure that lifts and realigns sagging tissue. Definisse double-needle threads are the latest fourth generation absorbable, monofilament, suspension barbed threads of synthetic origin with convergent bidirectional barbs. Definisse thread produces dual action; mechanical action gives a lifting effect and over a period, it promotes histological revitalizing action.

Objectives

To evaluate the real-world efficacy and safety of Definisse double-needle threads for lower facial lifting for jaw line reshaping in Indian patients.

Methods

This is an observational, retrospective study involving patients who underwent treatment for lower-face reshaping using Definisse double-needle 12 cm threads.

Results

Fifty patients with a mean age of 47.44 years were included in the study with an average follow-up of 5.14 months. All the patients have undergone Jawline Reshaping (JR) procedure, while 70% of patients also underwent Malar Reshaping (MR) technique simultaneously. Mean of Physician and Subject Global Aesthetic Improvement Scale (PGAIS and SGAIS) showed improvement immediately after the procedure (mean scores 2.82 and 2.7, respectively) and showed further improvement at the follow-up (3.72 and 3.58, respectively). Moreover, most of the patients immediately after the procedure rated the improvement in PGAIS and SGAIS as “much improved” compared to pre-procedure appearance (78% and 66%, respectively), while, at follow-up, 76% and 66% of the patients, respectively, rated “improved very much” compared to pre-procedure appearance.

Conclusion

Current study has demonstrated the effectiveness of the latest Definisse threads in Indian patients in performing tissue repositioning to provide a noticeable lifting effect. Procedure was also well tolerated and none of the patients developed serious complications.  相似文献   

17.

Background:

Intense pulsed light (IPL) has been used for the treatment of facial acne. Modifications of various parameters allow flexibility in treatment, which include energy fluence, pulse duration, and pulse delay. We compared the efficacy of burst-pulse (multiple pulse) mode with single-pulse mode in treatment of acne.

Objective:

This study was designed to evaluate the efficacy of the IPL in treatment of facial acne and to compare burst-pulse and single-pulse mode in treatment of acne.

Materials and Methods:

Ten patients with facial acne were subjected to monotherapy with IPL. Baseline grading of acne was done with Michelsons acne severity index; however, right and left side of face were scored separately and a total score was also taken. IPL was administered once weekly for four sessions. Right side was subjected to IPL with burst-pulse mode, and left side was subjected to single-pulse mode. Severity score assessed after the end of treatment. Clinical photographs were also obtained for evaluation.

Results:

All patients revealed a reduction in number of acne for both single- and burst-pulse mode treated sides. The mean total score was 49.4 at baseline and showed 49.19% reduction after four sessions of IPL. Burst-pulse mode treated side showed a better control than that of single-pulse mode.

Conclusion:

IPL as a monotherapy showed beneficial effect in treatment of facial acne. Burst-pulse mode was better than the single-pulse mode in clearing acne.  相似文献   

18.

Background

Cosmeceutical preparations containing growth factors (GFs) are widely used for facial rejuvenation.

Objective

We performed a systematic review to assess the evidence regarding their safety and effectiveness for facial rejuvenation.

Methods

Electronic databases (Cochrane Library, EMBASE, MEDLINE, and Scopus) were searched from 2000 to October 2022 for prospective trials and case series assessing topical GF preparations for facial rejuvenation in 10 or more participants.

Results

Thirty-three studies, including 9 randomized controlled trials (RCTs) and 24 uncontrolled case series, representing 1180 participants receiving 23 different topical preparations containing GFs met the inclusion criteria and were included. Of the 33 studies, nine used a placebo or active control. The GF preparations were applied twice daily in all except two studies, with a mean treatment duration of 3 months. Based on the investigator's assessment, preparations containing GFs induce a modest improvement in skin texture (median < 50%), fine lines/wrinkles (median < 35%), and overall facial appearance (median < 20%) versus baseline. Participant-assessed improvement was generally higher than investigator-assessed response. Three comparative RCTs showed no statistically significant differences between treatments. Studies were limited by heterogeneity with regard to the source and number of GFs used in the preparations, information about additional ingredients, and lack of standardization in the outcome measures. The preparations were associated with a low risk of adverse events. The persistence of the clinical improvements beyond 6 months is not known.

Conclusions

Administration of topical preparations containing GFs appears to be effective for facial skin rejuvenation, as demonstrated by the investigator- and participant-reported outcome measures.  相似文献   

19.
Background: Trichilemmoma (TL) can occur as a solitary sporadic lesion usually on the face or as multiple facial lesions almost invariably associated with Cowden syndrome (CS). CS is a multisystem disorder caused by a germline inactivating mutation in PTEN (10q23.31), a tumor suppressor gene. We sought to identify PTEN loss by immunohistochemistry (IHC) in sporadic and CS‐associated TL to determine whether IHC is a useful tool to assess an individual for CS. Methods: Six TL biopsies associated with CS and 33 biopsies without CS were retrieved. IHC for PTEN was performed. Results were scored as positive (reactivity in TL cells) or negative (no reactivity in TL cells); normal squamous epithelium and vascular endothelium served as internal positive controls. Results: Complete PTEN loss was noted in 5/6 (83%) CS‐associated TL and 1/33 (3%) sporadic (non‐CS) TL. Conclusion: Demonstration of complete PTEN loss in TL by IHC is strongly suggestive of association with CS, but retention of PTEN staining does not entirely exclude CS. Therefore, PTEN IHC in TLs may be helpful in screening TL for association with CS, but should be used in context with other established clinical criteria, and possibly germline PTEN genotyping to confirm a diagnosis of CS. Al‐Zaid T, Ditelberg JS, Prieto VG, Lev D, Luthra R, Davies MA, Diwan AH, Wang W‐L, Lazar AJ. Trichilemmomas show loss of PTEN in Cowden syndrome but only rarely in sporadic tumors.  相似文献   

20.

Background

The neck region is an area that can be indicative of signs of skin aging. A novel topical product that combines multiple active ingredients including retinol, tripeptide and glaucine was formulated to specifically target neck aging correction and complement post-procedure as part of an integrated skincare regimen.

Objectives

To evaluate the efficacy of a topical neck treatment through clinical subject evaluation, in addition to ultrasound and biopsy assessment.

Methods

Evaluation for the efficacy of this novel topical product on improving the aging signs of neck skin was performed in multiple clinical trials. The first trial focused on clinical efficacy and included clinical assessment, subject questionnaires, ultrasound imaging and digital photographs. The second trial focused on biomarker analysis through skin biopsy.

Results

Data from the clinical trials showed that aging signs on the neck were significantly improved after 12 or 16 weeks of product usage. Changes were readily observed by clinical evaluators and participants. They were documented with digital photos, ultrasound images, and biomarker expression in the skin which clearly display the improvements.

Conclusions

This novel topical product is effective in treating the aging signs on the neck skin and has been shown to provide statistically significant improvement on a myriad of neck aging attributes including fine lines/wrinkles, crepiness, laxity, and texture.  相似文献   

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