A technical approach for redefinition and volumization of lip area with hyaluronic acid: A case series

Background and Aim

Non-surgical procedures using injectable filler products for perioral rejuvenation have emerged and evolved rapidly to become one of the most frequently performed aesthetic treatments. We report a case series describing the administration of two hyaluronic acid-based dermal fillers (HA filler) with excellent characteristics and formulation using a technique developed by the author.

Patient/Methods

We describe a series of nine female subjects who underwent perioral rejuvenation performed by a single physician in her private clinic. The HA filler (Alaxin® FL or Alaxin® LV) was injected into the lips using the specially developed Clodia technique. Patients were given post-treatment advice for optimal results. Patient- and investigator-perceived outcomes were rated using the Global Aesthetic Improvement Scale (GAIS) and adverse events (AEs) were collected.

Results

All subjects described the injection method as painless and well tolerated, as shown by the immediate post-treatment photographs. Mean GAIS scores for both the patients and the investigator were 4.8/5, indicating significant improvement 12 months after the treatment. No AEs were reported during follow-up. The HA filler showed a high degree of dermal integration in all subjects, and the investigator reported excellent handling and injection properties.

Conclusion

Perioral rejuvenation with an HA filler administered using the developed injection technique gave highly satisfactory results in all subjects and was not associated with AEs.     

Safety and efficacy of superficial micro-focused ultrasound with visualization for melasma in Asians: An uncontrolled pilot study

Background

The pathophysiology of melasma is multifactorial, resulting in treatment resistance and a high recurrence rate. Recent research suggests that focused ultrasound might treat melasma effectively.

Objectives

To investigate the efficacy and safety of superficial micro-focused ultrasound with visualization (MFU-V) for melasma in Asians.

Methods

Patients (n = 20) with mixed melasma on both cheeks received 2 MFU-V treatments spaced 1 month apart. At monthly visits over 5 months, treatment efficacy and safety were evaluated. Standardized photographs were clinically assessed using the modified Melasma Area and Severity Index (mMASI), and 6-point grading scales for melasma lightening and area of involvement. Patients provided pain, global aesthetic improvement scale (GAIS), and satisfaction assessments.

Results

In 40 cheeks, the mean mMASI score was significantly reduced from 13.2 at baseline to 2.4 at month 4, and 2.8 at month 5. Twenty-nine cheeks (72.5%) showed lightening of melasma at month 4 that persisted until month 5, with improvements up to 75% compared to baseline. Melasma area decreased overall, with sites containing >30% melasma involvement decreasing from 55% to 20% by month 5, and none with 70%–89% involvement. Melasma lightening and area improved visibly in 40% and 20% of cheeks, respectively, as early as 1 month after index MFU-V treatment. Improvements continued after the second treatment and persisted until study closure, correlating with patient GAIS and satisfaction scores. Procedure was well tolerated with only mild-to-moderate pain reported in 92.5% of treatments.

Conclusion

Superficial MFU-V is a safe and effective treatment for melasma.     

Treatment of Striae Distensae with Nonablative Fractional Laser versus Ablative CO2 Fractional Laser: A Randomized Controlled Trial

Background

Striae distensae are atrophic dermal scars with overlying epidermal atrophy causing significant cosmetic concern. Although a variety of laser and light sources have been used for the treatment of striae distensae, to date no definite ''gold standard'' treatment modality has been determined.

Objective

To assess and compare the efficacy and safety of nonablative fractional photothermolysis and ablative CO₂ fractional laser resurfacing in the treatment of striae distensae.

Methods

Twenty-four ethnic South Korean patients with varying degrees of atrophic striae alba in the abdomen were enrolled in a randomized blind split study. The patients were treated with 1,550 nm fractional Er:Glass laser and ablative fractional CO₂ laser resurfacing. Each half of the abdominal lesion was randomly selected and treated three times at intervals of 4-weeks using the same parameters. Digital photography was conducted and skin elasticity and the width of the widest striae in each subject were measured at the baseline and 4 weeks after the final treatment. Clinical improvement was assessed by comparing pre- and post-treatment clinical photographs by two blinded physicians and participant satisfaction rates were evaluated. Skin biopsies were taken from three participants. All adverse effects were reported during the study.

Results

Although they do not statistically differ, both treatments with nonablative fractional laser and ablative CO₂ fractional laser showed a significant clinical and histopathologic improvement of striae distensae over pretreatment sites.

Conclusion

These results support the use of nonablative fractional laser and ablative CO₂ fractional laser as effective and safe treatment modalities for striae distensae of Asian skin. However, neither treatment showed any greater clinical improvement than the other treatment.     

Clinical evaluation of the safety and efficacy of a 1060 nm diode laser for non-invasive fat reduction of the flanks

Background

Laser hyperthermia-induced lipolysis is a non-invasive method of localized fat treatment. Non-invasive approaches could be an option for a growing number of patients who are risk-averse and are seeking out non-invasive alternatives to surgical procedures such as liposuction. This study evaluated the safety and efficacy of a 1060 nm diode laser for the non-invasive fat reduction of the flanks.

Methods

A total of 30 subjects were enrolled in this prospective, single center study. Subjects received one 25-min treatment with a 1060 nm diode laser to both flanks. Follow-up visits were conducted at 6 and 12 weeks after the last treatment. Ultrasound adipose thickness, body weight, and circumference measurements were taken at baseline and at the 6- and 12-week follow-up visits. Subject satisfaction was assessed using a self-assessment of fat reduction, pain, and tolerability scales, and a subject satisfaction questionnaire. Safety was assessed via the presence or absence of any adverse events.

Results

The average age of subjects was 47.3 years. A total of 27 subjects completed the treatment and returned for both follow-up visits. An adipose reduction of 7.57 ± 1.15% at 6 weeks post-treatment (p < 0.0001) was measured using ultrasound. High subject satisfaction was seen, with 74% of subjects reporting being either “satisfied” or “very satisfied” with their results on a 5-point Likert Scale. Eighty-two percent of subjects stated they would recommend the treatment to their friends. All subjects had either mild or moderate pain, with 52% of subjects rating their pain as “mild” (1–3), while 48% rated their pain as moderate (4–7) on the Wong-Baker Scale.

Conclusions

A single treatment with a 1060 nm diode laser was both safe and effective in reducing unwanted fat in the flanks without any unanticipated adverse events. Subjects described their treatment pain as mild or moderate and were highly satisfied with their treatment outcomes.     

Treatment of abdominal cellulite and circumference reduction with radiofrequency and dynamic muscle activation

Background: Cellulite is a frequent skin condition for which treatment remains a challenge. A wide variety of treatments are available but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Only few therapeutic options have proven efficacy in the treatment of cellulite. Objective: To determine the efficacy and the safety profiles of radiofrequency and dynamic muscle activation technology in treatment of abdominal cellulite and circumference reduction. Methods: Twenty-five females with abdominal cellulite received 6 weekly radiofrequency and dynamic muscle activation treatments. Treatment areas included the abdomen and both sides of flanks. Subjects were evaluated using standardized photographs, and measurements of body weight and abdominal circumference at baseline, before every treatment visit, and 1 week and four weeks after the final treatment. Subcutaneous tissue thickness was recorded by ultrasound at baseline and 4 weeks after completion of treatment protocol. Physicians’ evaluation and patient's satisfaction of clinical improvement were also measured. Results: All subjects completed the treatment protocol and attended every follow-up visits. There was significant abdominal circumference reduction of 2.96 and 2.52 cm at 1-, and 4-week follow-up visits (p < 0.05), respectively. At four weeks after the last treatment, the average circumferential reduction was sustained. Most of the patients were rated to have 25–49% improvement at 5th treatment, and 1- and 4-week follow-up visits. Ninety-two percent of the patients were satisfied with the treatment outcome. Conclusions: Radiofrequency provided beneficial effects on the reduction of abdomen and cellulite appearance. The benefit of muscle activation is yet to be determined.     

Pressure- and dose-controlled transcutaneous pneumatic injection of hypertonic glucose solution for the treatment of atrophic skin disorders

Background: Needleless transcutaneous pneumatic injections (TPIs) are a minimally invasive way to deliver the solution into the skin for therapeutic purposes. The suggested action mechanisms of TPI therapy include mechanical stimulation, immediate tissue shrinkage and late wound healing. Methods: Thirteen Korean patients were treated with TPI for atrophic skin disorders, including acne scars, striae albae, post-furuncle, or carbuncle scars, and horizontal wrinkles with lipoatrophy. At each TPI treatment session, a single pass was made along with the atrophic skin lesions without overlapping. Thereafter, two dermatologists objectively evaluated the clinical improvement in the lesions in the photographs via the global aesthetic improvement scale (GAIS). Results: One month after the final treatment, the overall mean GAIS score was 2.3 ± 0.8. Six of the 13 (46.2%) patients exhibited clinical improvement of grade 3, five (38.5%) patients grade 2 and two (15.4%) patients grade 1. The overall mean subjective satisfaction score with the TPI treatment was 2.3 ± 0.9. Six of the 13 (46.2%) patients achieved subjective satisfaction of grade 3, six (46.2%) patients grade 2 and one (7.7%) patient grade 0. Conclusions: The present study demonstrated that the TPI treatment is effective and safe for treating atrophic skin disorders of varying causes in Korean patients.     

Safety and Efficacy of Growth Factor Concentrate in the Treatment of Nasolabial Fold Correction: Split Face Pilot Study

Background:

Growth factors have long been known as an effective treatment for facial wrinkles. We developed growth factor concentrate (GFC) from the platelets and evaluated their clinical outcome in nasolabial folds.

Aims and Objectives:

We evaluated safety and efficacy of autologous GFC on patients with nasolabial folds.

Materials and Methods:

Study was conducted on 80 patients for nasolabial folds in two groups. Group I (20) received bilateral single injection of GFC and group II (60) received single injection of GFC on the right side of the face and platelet-rich plasma (PRP) on the left side of the face. Severity of nasolabial folds was determined at the baseline and 3 months of follow-up visits based on wrinkle severity rating scale (WSRS), Global aesthetic improvement scale (GAIS) and atlas photographic grading at rest and at full smile. Objective clinical assessment and subjective satisfaction scale was determined for overall improvement at the end of the study.

Results:

In group I, 2 subjects showed improvement after GFC treatment with the score of 3.1–4 (76–100%), 3 subjects with the score of 2.1–3 (51–75%), 14 with the score of 1.1–2 (26–50%) and 1 subject with the score of 0–1 (<25%) at the end of study. In group II, 51 subjects were evaluated at the end of study where, 34 (66%) showed superior improvements after GFC, 6 (11%) patients showed similar improvement on both side of the face, 10 (19.6%) patients showed no noticeable improvement on the either side of the face and only 1 patient (1.96%) showed superior improvement for PRP at the end of the study. Overall improvement score analysis showed that GFC was significantly superior to PRP (P < 0.001).

Conclusion:

Present study is a strong evidence to support the use of GFC for nasolabial folds. The results showed that the single application of GFC is highly effective and safe.     

A prospective multicenter clinical trial evaluating the efficacy and safety of a hyaluronic acid-based filler with Tri-Hyal technology in the treatment of lips and the perioral area

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.     

Area four technique: An effective injection approach to the posterior facial frame aesthetic treatment with injectable hyaluronic acid fillers

Background

Defined as a contour line from the hairline, the zygomatic arch, to the ramus and gonial angle area of the mandible, posterior facial frame (PFF) is an important aesthetic units of the face. With the development of hyaluronic acid fillers and the improvement of injection techniques, minimally invasive injection has become one of the first options to improve PFF. However, effective and systematic injection methods to improve PFF are rarely reported in the literature.

Methods

We retrospectively analyzed 200 patients treated with area four technique for PFF. According to the clinical manifestations, PFF was divided into four types, and the injection strategies of the different types were described. GAIS (Global Aesthetic Improvement Scale) at 1 month and 3 months by patients after treatment was evaluated as primary end point. Nine-item aesthetic assessment scores reviewed by two independent observers with experience were performed.

Results

GAIS showed that patients' profile was remarkably improved for 90% of total number of subjects. Before and 3 months after treatment, the assessed scores of the lateral cheek lifting (3.17 ± 0.21 vs. 2.56 ± 0.31) and PFF (3.78 ± 0.56 vs. 2.19 ± 0.48) were statistically significant reduced (p < 0.01). The jawline contouring scale (2.32 ± 0.45 vs. 1.23 ± 0.31) and the lateral cheek fullness scale (3.01 ± 0.23 vs. 2.09 ± 0.17) showed a statistically moderate decrease (p < 0.05).

Conclusion

Area four technique provides a safe and convenient method for classifying and treating patients with insufficent PFF, which makes up for the multisite systematic injection of the face.     

Evaluation of a new hyaluronic acid dermal filler for volume restoration

Objectives: The present study aimed to evaluate the effectiveness and safety of hyaluronic acid gel for the treatment of volume loss or contour deficiency. Methods: This 6-month, open-label study recruited sixty adults aged 40–65 years with bilateral moderate to severe volume loss or contour deficiency (Facial Volume Loss Scale [FVLS] score: 2–5). Eligible subjects were treated at the baseline visit with an injection of hyaluronic acid gel in one or more of three facial subregions: the zygomatic malar region, the anteromedial cheek and nasolabial folds. Results: A significant improvement from baseline was observed in the FVLS score at each study visit up to 6 months post treatment (p < 0.0125 by Wilcoxon test). A significant improvement was also observed in the Global Aesthetic Improvement Scale (GAIS) at each visit up to 6 months. The study showed that the GAIS score improved in 100% of subjects at month 3, while at the end of the study (month 6) the percentage of improved subjects decreased to 91. Treatment effect was maintained by 100% of subjects up to month 3, while 57% of subjects showed a persistence of effect up to month 6. Conclusions: Volume loss or contour deficiency may be safely and effectively corrected using the new dermal filler.     

Treatment of striae distensae combined enhanced penetration platelet-rich plasma and ultrasound after plasma fractional radiofrequency

Abstract

Background: Striae distensae (striae alba) is a challenging cosmetic problem for which various treatment modalities have been applied. However, the treatment of striae distensae has not been satisfactory. Objectives: This study was done to evaluate the effectiveness and the safety of enhanced penetration of platelet rich plasma with ultrasound after plasma fractional radiofrequency for the treatment of striae distensae. Subjects and method: Eighteen participants with striae distensae were treated with a Legato system (Alma Lasers, Israel) every two weeks for a total of four sessions. Thereafter, in order to enhance platelet-rich plasma penetration, ultrasound is applied. Clinical photographs were taken before first treatment and two months after the final treatment. Objective and subjective improvement scores were evaluated to demonstrate the efficacy. Abdominal skin biopsies were obtained from three individuals and histological changes were analyzed by light microscopy. Results: During the two months after the last treatment, the average width of the widest striae had decreased from 0.75 to 0.27 mm. In the objective assessment, 71.9% of the participants reported ‘‘good” or “very good’’ overall improvement. In the subjective assessment, and 72.2% of the participants reported ‘‘very satisfied” or “extremely satisfied’’ with overall improvement. The only reported side effect was post-inflammatory hyperpigmentation (11.1%). Conclusions: The plasma fractional radiofrequency and transepidermal delivery of platelet-rich plasma using ultrasound is useful in the treatment of striae distensae.     

Efficacy and safety of innovative acne scar serum in Indian patients (ESTEEM India study)

Background

Scarring is a common and undesirable outcome of acne vulgaris. There are limited effective topical formulations for acne scar treatment. The investigational product, acne scar serum (HEXILAK® Acne Scar Serum) is latest topical formulation developed for treatment of acne scar with unique ingredients, Kollaren and Exo-T.

Objective

Evaluate safety and efficacy of latest acne scar serum on the reduction of acne scars in Indian population.

Materials and Methods

Subjects, diagnosed clinically with acne scars with or without hyperpigmentation, of either gender in the age group of 15 to 45 years were enrolled in the study. The investigational acne scar serum was applied twice daily for 3 months with monthly follow for outcome evaluation.

Results

Out of 72 subjects enrolled, 67 completed the study. Most of the subjects, 79.1% showed improvement in acne scar at Day 90. Significant reduction of mean total post-acne hyperpigmentation index (PAHI) was seen at all follow up visits compared with baseline. Significant improvement in mean acne scar depth, mean acne scar volume, and mean L value using 3D imaging were observed at all visits compared with baseline. All side effects reported were mild and overall, it was well tolerated by all subjects.

Conclusion

We found that there was a significant reduction in acne scar and post-acne pigmentation with new acne scar serum as a monotherapy, this needs further confirmation in larger randomized controlled studies. Therefore, topical acne scar serum with unique ingredients Kollaren and Exo-T can be a safe, effective, and new option in the armamentarium of acne scar management.     

Histological studies of facial acne and atrophic acne scars treated with a bipolar fractional radiofrequency system

Various fractional radiofrequency (FRF) treatments have demonstrated significant beneficial effects and minor side‐effects on atrophic acne scars and acne vulgaris by creating micro‐thermal injuries in the skins. However, histological studies to identify the precise mechanism responsible for the success of bipolar FRF treatments are lacking. In this study, six human subjects with these diseases were histologically analyzed after treatment with a bipolar FRF system (eMatrix; Syneron, Yokneam, Israel) and the effects of multiple passes were compared. Histopathological results showed that two‐pass FRF treatment created deeper dermal thermal injury zones compared to one‐pass treatment. Periadnexal collagen was coagulated, as well as that in the sebaceous glands, as evaluated in all cases with two‐pass FRF treatment. No severe side‐effects were observed after treatment. Our experience suggests that the level of dermal thermal injury is directly related to the number of passes, and that a large benefit of this treatment for these diseases is the preservation of adnexal structures.     

Prospective clinical and histological study to evaluate the efficacy and safety of a targeted high-intensity narrow band UVB/UVA1 therapy for striae alba.

OBJECTIVE: The purpose of this study was to determine the efficacy and safety of a targeted narrow band UVB/UVA1 therapy for the treatment of striae alba. METHODS: Fourteen individuals with skin types II-VI were enrolled in this 22-week trial that consisted of up to 10 treatments with a combination of UVB/UVA1 (MultiClear, Curelight Ltd, Israel). Participants were treated with a maximum of 10 treatments unless 100% repigmentation of stretch was achieved prior to the tenth treatment. Biopsies were taken from willing participants at baseline, immediately after the final treatment and 12 weeks after the last treatment. RESULTS: Nine participants completed all treatment visits. After the final treatment, all the participants had >51% repigmentation of the treated striae. At the 4-week follow-up visit, 67% of participants had greater than 51% improvement, and 56% had greater than 51% improvement at the 8-week and 12-week follow-ups. Hyperpigmentation of striae was seen in >50% of the participants treated. The pretreatment biopsies were confirmatory of striae. There were no diagnostic light microscopic differences in the 4-week post-treatment biopsy set available in one patient. CONCLUSION: This high intensity UVB\UVA1 device is an effective and safe modality for the short-term repigmentation of hypopigmented stretch marks. Additional morphologic studies over time are needed to confirm these clinical findings.     

Application of a new fractional radiofrequency device in the treatment of photoaging skin in Chinese patients

Background and objectives: Fractional radiofrequency (FRF) has been used in the treatment of photoaged skin for a long time. This study was intended to examine the efficacy and safety of electrode pin FRF in the treatment of photoaged skin in Chinese patients.

Materials and methods: Twenty healthy Chinese subjects with facial photoaged skin were enrolled in this study. Each subject received three FRF treatments at 4-week intervals. Changes of photoaging were analyzed by a global evaluation, subjective Assessment, a Mexameter, and VISIA.

Results: In total, 12 of 18 patients (66.7%) and 11 of 18 patients (61.1%) had good or excellent improvement respectively according to investigator A and investigator B. Also, 13 of 18 patients (72.2%) rated their satisfaction of the overall improvement as satisfied or very satisfied. Mean melanin index and erythema index values significantly decreased between baseline and 12-week follow up (P < 0.05). The average wrinkle percentile was increased at 12-week follow-up (79.0 ± 8.4) compared to baseline (58.8 ± 10.2). Adverse effects were limited to erythema, tiny scabs and mild pain.

Conclusions: FRF is a safe and effective method for photoaging skin in Chinese patients.     

Efficacy of fractional carbon dioxide laser versus microneedling in the treatment of striae distensae

Background: Fractional photothermolysis is creation of microscopic thermal zones of controlled depth, width and density. Microneedling is a simple treatment modality to reduce striae distensae.

Objective: Evaluate and compare the efficacy of fractional carbon dioxide laser and microneedling as a treatment of striae distensae.

Methods: Individuals with striae distensae received three split-body treatments at four-week intervals. The right side of the body was treated with fractional CO₂ laser, while the other side with microneedling. Assessment was done by comparing photographs before and after treatments by two blinded physicians using a quartile grading scale. Evaluation also included patient satisfaction score and histopathological examination.

Results: In total 33 subjects were enrolled and 30 completed the study. By quartile grading score, we recorded 55% moderate-excellent improvement of striae in the dermaroller-treated side but with fractional CO₂ laser-treated side, we recorded 76% of patients had moderate-excellent improvement. Patients were more satisfied with fractional CO₂ laser than the microneedling. Post-inflammatory hyperpigmentation, as a complication of fractional CO₂ laser, appeared in 11 patients.

Conclusion: Fractional CO₂ laser is more effective in treating striae with acceptable side effects but still microneedling can be afforded as an effective, safe and cheap method.     

Fractional radiofrequency treatment in acne scars: Systematic review of current evidence

Fractional radiofrequency (FRF) is renowned for its use in cosmetic dermatology, with regard to the treatment of rhytides, striae, scarring and cellulite. We have systemically analysed its evidence for the use of FRF in acne scars. Our search identified 15 articles, one single-blinded randomised controlled trial, two split-face trials and thirteen prospective clinical studies, mostly single-centred. Case reports were excluded. In total 362 patients were treated. The longest follow-up was for 210 days, and on average the follow-up was for three months, varying between one and seven months. This review has found that there are many small studies showing promising results for the use of FRF in acne scars, either as an adjunct or more importantly as the sole treatment. There is however a need for larger trials against ablative and non-ablative lasers, in order to affirm the evidence present already. This is the first systematic review on the use of FRF in acne scars.     

Efficiency and safety of microneedling fractional radiofrequency in the treatment of Chinese atrophic acne scars: A retrospective study of 3 consecutive treatments with 1-month intervals

Background

Atrophic acne scars (AAS) impact the aesthetic appearance, inducing social and psychological problems. Effective and safe therapy for AAS is urgently needed now. Microneedling fractional radiofrequency (MFRF) has emerged as a minimal invasive alteration for treating AAS lately, while the existing data on Chinese population was few.

Aims

We aimed to explore the effectivity and safety of MFRF in Chinese patients with facial AAS and analyze the response of different subtypes to MFRF treatment.

Methods

We conducted a retrospective analysis using data from medical records and clinical photographs of 40 Chinese patients with AAS with Fitzpatrick skin type III-IV, all of them had received 3 MFRF treatments with 1-month intervals and were followed up 3 months after the last treatment. The clinical severity was assessed through échelle d'évaluation clinique des cicatrices d'acné (ECCA) score at each visit. Clinical photographs were taken by VISIA. Patients were asked to evaluate their satisfaction of the treatment using a 5-point Likert scale at the last visit.

Results

ECCA score decreased more than a half at the last visit based on the baseline. Among the three types of AAS, the M-shaped scars respond most quickly to MFRF and the U-shaped scars improved the most after 3 months follow-up. A significant improvement was seen in clinical appearance, parallel to the change of ECCA, indicating the remarkable improvement of AAS after the MFRF treatment. Concomitant active acne was controlled along with the improvement of AAS. Statistics from VISIA showed excellent improvement in pores and texture as well. Side effects including pain and erythema were transient and mild. The number of MFRF treatment sessions was positively associated with the degree of improvement. Of the total 39 patients who had given a score of satisfaction, more than 89% (35 patients) were very satisfied or satisfied with the outcome.

Conclusions

To sum up, our study reveals that MFRF provides high efficiency in treating Chinese AAS patients with high satisfaction and low risk of adverse effects. M-shaped scars are the most sensitive type to the treatment, but the U-shaped scars improve most at the last visit. The simultaneous minimization of pores and improvement of skin texture imply the increased collagen stimulated by MFRF. Regular MFRF should be considered a good choice in treating AAS.     

Clinical comparison of two hyaluronic acid-derived fillers in the treatment of nasolabial folds: Mesoglow® and IAL System®

Hyaluronic acid (HA) dermal fillers are widely used to reduce the appearance of aging. However, comparative research on the efficacy and safety of products of similar composition is limited. We compared outcomes achieved with two non‐cross‐linked HA fillers of almost identical composition, Mesoglow^® and IAL System^®. Forty subjects with visible nasolabial folds (NLFs) were enrolled in a randomized study. Wrinkle severity was rated using the 5‐point Wrinkle Severity Rating Scale (WSRS). Each subject was injected with Mesoglow^® in one NLF and IAL System^® in the other. An optimal cosmetic result was established at two weeks after a second treatment. Participants were then reassessed at 2, 6, and 12 weeks, respectively, post‐optimal cosmetic result using the WSRS. The degree of improvement was also assessed by subjects and investigators using the Global Aesthetic Improvement Scale (GAIS). At baseline, the mean WSRS score was 3.20 ± 0.41. At the optimal cosmetic result, 98% of subjects showed a 1‐ or 2‐point change in WSRS score with either treatment. All subsequent WSRS scores were significantly improved over baseline for both treatments. There was no significant difference between treatments or improvement in WSRS score at any point in time. Investigator GAIS scores at weeks 4 and 6 were slightly but not significantly higher for Mesoglow^®‐treated skin. There was no significant difference in the frequency of local adverse responses. No serious systemic adverse events occurred. This study indicates that Mesoglow^® and IAL System^® are equally effective in achieving short‐term correction of NLFs, but the longevity of their effects is limited.     

Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study

Background  A wide variety of treatments for circumference reduction and cellulite are available, but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome.
Objective  To determine the safety and efficacy of the TriPollar radiofrequency device for cellulite treatment and circumference reduction.
Methods  Thirty-nine females with cellulite received eight weekly TriPollar treatments. Treatment areas included the abdomen, thighs, buttocks and arms. Subjects were evaluated using standardized photographs and measurements of body weight, circumference, subcutaneous thickness, and skin elasticity of the treatment sites at baseline, immediately after and 4 weeks after the final treatment. Physicians' evaluation of clinical improvement scores using a quartile grading scale was recorded.
Results  Thirty-seven patients (95%) completed the treatment protocol. There was significant circumference reduction of 3.5 and 1.7 cm at the abdomen ( P  = 0.002) and thigh ( P  = 0.002) regions, respectively. At 4 weeks after the last treatment, the average circumferential reductions of the abdomen and thighs were sustained. No significant circumferential reductions of the buttocks and arms at the last treatment visit compared to baseline were demonstrated ( P  = 0.138 and 0.152, respectively). Quartile grading scores correlating to approximately 50% improvement in cellulite appearance were noted.
Conclusions  Tripollar radiofrequency provided beneficial effects on the reduction of abdomen and thigh circumference and cellulite appearance.

Conflict of Interest

The authors have no financial interest in this article.