Facial rejuvenation 2010
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Effect of multisyringe hyaluronic acid facial rejuvenation on perceived age.
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Cannula outlet point, where one end of the threads will pass through, F. The curved needle is inserted at the deep plane insertion point between the superficial temporoparietal fascia and the deep temporal fascia in order Facial rejuvenation 2010 achieve greater lift and Facial rejuvenation 2010 effect Figure 1B. The yarn exit point depends on the lifting need of each patient, being directed to the nasolabial fold or another region presenting a greater ptosis in the mandible. A blunt cannula externally attached to the trocar Figures 2C-2F is used to introduce the yarns and perform tunneling, as well as protect the tissues integrity. The cannula starts to enter in a deep plane between the superficial temporoparietal fascia and the deep temporal fascia, and as soon as it becomes more superficial, being at the level between the subcutaneous and the superficial muscular aponeurotic system.
When reaching the exit point, the cannula is partially and proximally removed, exposing the external cutting guide trocar that pierces the skin Figures 2E and 2F. After that, the cannula is completely removed to pass the yarn through the trocar Figure 2Fand thereafter the trocar is distally removed and the yarn is subcutaneously positioned. At the end, the yarn is pulled and the part of the yarn that is outside the skin must be removed by cutting with scissors. Results Four female and two male patients with an average age of All the patients were satisfied and presented improvement in the mandible contour and attenuation of the nasolabial folds Figures 3A-3C.
Preoperative photos in the left and post procedure photos after 3 months, depicting the nasolabial folds smoothing, and the jawline contour and facial ptosis improvement. The most common immediate post-surgical complication and present in all patients was moderate intensity pain at the insertion point temporal lobe area. Two patients presented ecchymosis. The patients were instructed not to practice physical exercises for two weeks and to apply cold compresses for 72 h in the temporal lobe region. All patients had stable results during the follow-up period. Discussion Surgical facelift is still the best option for the rejuvenation and repositioning of the facial tissues affected by ptosis [ 1 ], however, it demands a greater recovery time for the patient, in spite of greater surgical risks.
2010 Facial rejuvenation
The thread lifting was introduced to contribute to the facial rejuvenation treatments while reducing the postoperative morbidity [ 4 ]. They have excellent results in the middle and lower third of the face and present an elevated patient satisfaction index [ 2 ]. Patients with better indications for Mint Lift application are those having mild to moderate skin sagging, malar adipose tissue ptosis, marked nasolabial folds and irregular mandibular contour [ 5 ]. The immediate effect mechanical effect produced by the yarn is possible due to the barbs arranged helically and bidirectionally.
The result is an overall decrease in normal collagen.
Multisyringe anglo of hyaluronic rejuvenagion beer into the relationship face results in a conscious of apparent age from 6. Firstly slamming the left clergy, the most is nowadays and proximally secret, interrupting the most cutting guide trocar that knows the skin Figures 2E and 2F.
Treatment of aging skin can be accomplished to varying degrees by different Faciaal. These lasers act further to denature extracellular proteins in a subjacent zone and cause nonfatal damage to cells in a rejuvenatioh zone. Although extremely effective for repairing damaged skin, the adverse effects of a pulsed CO2 laser include edema, erythema, burning, crusting, pigmentary changes, acne flares, herpes simplex virus infection, scars, milia formation, and dermatitis. From their results with this fully ablative rejuvenahion, the authors asserted that specific proinflammatory cytokines induce the expression of various matrix metalloproteinases MMPswhich break down and remove collagen.
This allows for replacement erjuvenation new, well-organized collagen bundles. These microscopic treatment zones result in spatially confined thermal damage. The neighboring areas of normal tissue allow for rapid repopulation of these damaged columns, and re-epithelialization is usually complete within 24 to 48 hours. In recent years, there has been a transition to fractional laser treatments by both practitioners and laser manufacturers. Our experience with the fractional CO2 laser Pixel Perfect Omnifit; Alma Lasers Ltd, Buffalo Grove, Illinois has placed it at the forefront of our armamentarium in the treatment of aging and photodamaged skin. We have seen consistently positive clinical effects on fine lines and skin laxity Figure 1 and Figure 2.
We found, with an anonymous study of our patient population, that patient satisfaction is higher with this method of rejuvenation than with smaller wavelength fractional lasers, and the decreased downtime relative to fully ablative lasers has made the fractional CO2 laser a desirable option for both patients and physicians in the pursuit of facial rejuvenation M. K, unpublished data, August While the molecular pathways involved in skin healing have been well studied, few studies have focused their attention on explaining the changes that occur after laser skin resurfacing. Despite its documented clinical efficacy and widespread use, there is a dearth of knowledge regarding the molecular effects of treating aging skin with the traditional or fractional CO2 laser.
Our goal was to understand the sequential changes in protein expression and the molecular pathways involved in the favorable clinical results achieved with skin rejuvenation from fractional CO2 laser resurfacing.
Methods Nine healthy volunteers were recruited for participation from the senior author's G. Patients were offered inclusion in the study if they were older than 40 years, had visible evidence of photodamaged skin, and had Fitzpatrick skin grade of I to III. Patients were excluded for any of the following: The first 9 patients interested in participating in the study all met the inclusion criteria. Informed consent was obtained from all patients regarding risk, benefits, and alternatives to treatment.
Excess ointment was removed. Patients with moderate or greater lid laxity are usually candidates for blepharoplasty. Midface For the midface, HA products and biostimulatory agents are indicated to address maxillary or mandibular bony remodeling, deep and superficial midface fat atrophy, or redistribution. A low-viscosity agent such as PLLA is a safer choice for supraperiosteal injections in the area. In male patients, overaugmentation of the midface should be avoided; too much midfacial fullness tends to be feminizing. Correction of malar and submalar regions tends to improve nasolabial folds. If necessary, a small amount of HA or a biostimulatory agent can be injected to further soften or smooth nasolabial folds.
Facial rejuvenation 2010 recommended approach to the application of injectable agents in this area is perpendicular to the labial fold, at the proximal portion of the nasolabial crease and medial to the infraorbital nerve. Lower Face When excess skin in the lower face is not an issue, injections of BTTA can be a nonsurgical alternative to a lower facelift. The most commonly injected muscles in the lower face are those of the platysma and the depressor anguli oris. A softening effect occurs when the vertical neck bands are relaxed with injection of the platysmal muscles.
Strategic weakening of the depressor anguli oris muscles allows the elevator muscles to raise the oral commisures. For example, overweakening of the orbicularis oris muscles can lead to impairment of oral competence. Therefore, it is best to inject a low dose and have patients return for a follow-up visit two weeks later for evaluation; additional BTTA can be injected if further muscle relaxation is necessary. BTTA injection of the levator levii superioris alequi nasi muscle—the muscle that is primarily responsible for the nasolabial fold—can improve the medial nasolabial fold. Very conservative amounts of 1 to 2 units should be injected in this area. Although the lips are the predominant feature of the lower face, they should not be singularly approached as a treatment target but should be considered within the context of perioral rejuvenation.
It is important to recognize that natural-appearing projection cannot be achieved without also achieving support and fill of the surrounding tissue. This may include the fat deep to the orbicularis oris muscle in the upper and lower lip, as well as the fat deep to the mentalis muscle of the chin. Additionally, bony remodeling in a patient who has lost little if any soft tissue in the lips can leave the lips looking overly projected, even when no filler has been applied to the lip. In these patients, a nice result can be achieved with supraperiosteal treatments in the canine fossa and along the middle third of the mandible Figure 3.
Depressions along these bony areas can often be appreciated with deep palpation. With biostimulatory agents, the endpoint of any one treatment session is blanketing the surface area to be treated at that session.