Search Results (12)

High-Intensity Focused Ultrasound (HIFU) is a non-invasive technology widely used in aesthetic dermatology for skin tightening and facial rejuvenation. This study aimed to evaluate the safety and efficacy of a modified HIFU device, More Young, compared to the standard 7D HIFU system through a randomized, single-blinded clinical trial. The More Young device features enhanced focal depth precision and energy delivery algorithms, including nine pre-programmed stabilization checkpoints to minimize treatment risks. A total of 100 participants with facial wrinkles and skin laxity were randomly assigned to receive either More Young or 7D HIFU treatment. Skin improvements were assessed at baseline and one to six months post-treatment using the VISIA^® Skin Analysis System (7th Generation), focusing on eight key parameters. Patient satisfaction was evaluated through the Global Aesthetic Improvement Scale (GAIS). Data were analyzed using paired and independent t-tests, with effect sizes measured via Cohen’s d. Both groups showed significant post-treatment improvements; however, the More Young group demonstrated superior outcomes in wrinkle reduction, skin tightening, and texture enhancement, along with higher satisfaction and fewer adverse effects. No significant differences were observed in five of the eight skin parameters. Limitations include the absence of a placebo group, limited sample diversity, and short follow-up duration. Further studies are needed to validate long-term outcomes and assess performance across varied demographics and skin types. Full article

The quest for surgical advancements regarding the enhancement of the submental and cervicofacial regions has witnessed a remarkable upsurge in recent years. Informed patients are actively seeking sophisticated plastic surgery techniques to achieve comprehensive rejuvenation in these specific areas. Common complaints expressed by these patients include sagging of the jawline, the emergence of deep perioral wrinkles, and the formation of “marionette lines” within the lower third of the face. Furthermore, the manifestation of age-related signs, including neck laxity, submental adipose accumulation, “witch’s chin” deformity, and weakened platysma musculature, are common within this anatomical region. This literature review aims to summarize recent technical improvements, historical evolution, indications, postoperative care, and challenges for facial rejuvenation of the lower third of the face and neck. The application of minimally invasive procedures as part of a comprehensive approach for an aging face will also be discussed. In this article, an extensive search of the available literature was conducted using leading databases, including PubMed and MEDLINE, with the keywords “neck lift”, “platysmaplasty”, “facial rejuvenation”, “medial platysmaplasty”, “lateral platysmaplasty”, “neck rejuvenation”, and “cervicofacial rejuvenation”. Full article

Background: Monopolar radiofrequency (RF) has emerged as a promising modality for tightening the skin of aged faces. Although many studies have assessed the efficacy of monopolar RF via the clinical evaluation of photographs, few have examined the long-term effectiveness and safety of this therapy using various skin testing devices. Methods: Twenty women with aged faces participated in this study. After a single monopolar RF treatment, three blinded dermatologists who were not involved in the treatment evaluated its clinical efficacy and safety after 4, 12, and 24 weeks. Skin firmness, fine wrinkles, skin pores, and skin tone were also measured using an indentometer (Courage+Khazaka Electronic GmbH, Köln, Germany) and a facial aging measurement device (Mark-Vu; PSI Plus, Suwon-si, Republic of Korea). Results: Skin laxity in the jowls and nasolabial folds showed significant improvement 12 weeks after the single monopolar RF treatment when evaluated by dermatologists, and this improvement lasted 24 weeks (p < 0.05). Moreover, the participants reported improvement at 4 weeks compared to baseline which lasted 24 weeks (p < 0.05). Skin firmness measured in the cheek increased 4 weeks after treatment and continued to improve during 24 weeks of follow-up (p < 0.01). Although there was a gradual increase in improvement in skin pores, fine wrinkles, and skin tones, there were no statistical differences compared to the baseline. No patients experienced pain during the treatment, and no burns, skin breakdown, or scarring occurred after treatment. Conclusions: A single monopolar RF treatment is effective for females with aged face. A significant improvement in the jowls and nasolabial folds and facial skin firmness was observed between the 4- and 24-week follow-ups without adverse effects. Full article

Both hyaluronic acid (HA) and calcium hydroxylapatite (CaHA) fillers have well-established indications in cosmetic medicine. Nevertheless, limited data are available on the effectiveness of combining CaHA and HA. The purpose of this report was to demonstrate the safety, tolerability, and clinical and ultrasonographic improvement of facial skin laxity using a blending technique that admixes HA and CaHA. Fifteen regular patients, including three men, between 25 and 71 years of age were reported. The participants were subjects who came regularly to the dermatologic office seeking a lifting effect without surgery. They were submitted to injection of an admixture of HA and CaHA and followed for 180 days. The clinical assessment consisted of photographic evaluation by two blind investigators, and a consensual subjective evaluation was performed by the physicians (PGAIS) using the five-point Global Aesthetic Improvement Scale. Dermal thickness was analyzed in jaw areas using high-frequency ultrasound. Subjects completed a satisfaction questionnaire with responses scored according to the five-point Global Aesthetic Improvement Scale (GAIS) to evaluate patient satisfaction. After 180 days of follow-up, clinical assessments by blinded physicians found that all patients improved. All the participants were highly satisfied with the results and reported exceptional improvement. Dermal thickness increased by 9.4% (8.2–10.8%), 14.0% (12.2–15.9%), and 18.8% (16.2–21.9%) at D90, D120, and D180, respectively, by ultrasonography. In conclusion, an injection technique using an admixture of CaHA and HA fillers was well tolerated, offering high satisfaction and long-lasting progressive benefits. The authors believe that this procedure optimizes the treatment time and results because HA promotes early volume restoration and CaHA stimulates long-term dermal remodeling through the synthesis of collagen and elastin. Full article

Thread-lifting traditionally addressed aging-related skin laxity by leveraging precise thread placement and traction. However, recent advancements, notably cog threads, expanded its application to younger patients seeking facial contour refinement. These newer threads effectively lift sagging areas and refine facial contours, broadening the procedure’s appeal. Challenges arise in selecting threads due to variable physician preferences and patient needs. Clear indications for thread efficacy are vital for credibility and tailored selection. Thread choice depends on tissue laxity, necessitating lighter threads for minimal laxity and stronger ones for significant sagging. However, no single thread universally suits all cases. Combining different threads is favored for optimal outcomes and minimizing side effects. Excessive traction post-procedure may lead to prolonged discomfort and skin irregularities. Post-procedural tension adjustments through massage remain debated, potentially conflicting with minimally invasive principles. Understanding thread characteristics guides tailored selection, considering patient conditions and procedural goals. This comprehensive understanding extends beyond specific products, aiming for optimal outcomes in thread-lifting procedures. Key factors influencing outcomes encompass thread materials, thickness, cog shapes, insertion depth, lifting vectors, and absorbable thread expiration dates. Full article

The pursuit of youth and attractiveness is a fundamental desire in contemporary society. For many individuals, the appearance of visible signs of aging, such as skin laxity, gravitational changes in facial and neck soft tissues, and loss of harmonious proportions, can be psychologically distressing. The choice of effective methods for addressing these changes depends on their specific characteristics, the patient’s anatomical features, and the type of facial aging. The introduction of 3D imaging to determine the hyoid bone level, the volume of soft tissue structures in the cervico-mental area, ptosis of subplatysmal structures, and the volume of submandibular glands, in addition to ultrasound study of the submental projection at the preoperative stage, are key for making the best decisions regarding preoperative planning. This case report aims to illustrate how modern imaging techniques are a fundamental part of the preoperative assessment of the mid and lower third of the face to ensure the most favorable aesthetic outcomes for each patient. Full article

Background: Age-associated changes in epidermal hydration, pigmentation, thickness and cell renewal influence skin appearance and can lead to laxity, dryness and poor skin tone. The aim of this pilot study was to assess the synergistic effects of a new bipolar radiofrequency plus non-crosslinked hyaluronic acid (HA) mesotherapy protocol compared with radiofrequency alone on skin appearance and markers of epidermal function. Methods: This prospective, single-center, split-face pilot study recruited women aged 25–65 years with dryness and laxity of the facial skin defined by a trans-epidermal water loss (TEWL) value of ≥26 g/m²/h. Subjects were treated with a bipolar radiofrequency device on both sides of the face. This was immediately followed by needle hyaluronic acid (HA) treatment on one side of the face with 2.5 mL of a non-crosslinked HA. Photographic documentation, analysis of epidermal barrier function parameters, and high frequency (HF) ultrasound analysis were performed prior to treatment and at 28 days. Results: Twenty female subjects with a mean age of 46 (range 29 to 54) years and dry and lax facial skin were included. TEWL was reduced and skin hydration improved to a greater extent with the combined radiofrequency plus mesotherapy protocol compared with radiofrequency alone (−5.8% vs. +3.9% and +23.1% vs. +1.0%, respectively). The combined protocol was also associated with greater improvements in melanin (−7.5% vs. −1.5%) and erythema values (−7.2% vs. +3.0%), respectively. Ultrasound measures of epidermal thickness and epidermal density were greater after the combined protocol compared with radiofrequency alone (12.0% vs. 5.6% and 57.7% vs. 7.1%, respectively). Both treatments were well-tolerated. Conclusions: The combined bipolar radiofrequency and HA mesotherapy protocol provided greater improvements in skin hydration, firmness and tone compared with radiofrequency alone. The combination treatment was also associated with greater epidermal thickness and density and increased keratinocyte differentiation suggesting a synergistic effect of both treatments on epidermal homeostasis and barrier function. Both treatments were well-tolerated and led to improvements in facial appearance. Full article

Background and Objectives: Photo/chrono-aging is usually expressed as facial discolouration, wrinkles, redness, elastosis, laxity, and dehydration, thus representing major signs of ageing that often lead to a negative phycological impact on a patient’s quality of life. Several types of treatment have been tested during the last decade, especially laser treatments. This article aims to share our experience in the treatment of photoaging with a new 675 nm laser source system on facial chrono-ageing. Materials and Methods: Thirty-five (35) patients were treated with the 675 nm laser device: 32 females (mean age 49 years) and 3 men (mean age 57 years), with Fitzpatrick skin types I–III (9% type I, 43% type II, 48% type III), facial wrinkles and hyperpigmented spots. The efficacy of this treatment was assessed using the Modified Fitzpatrick Wrinkles Scale (FWS), which was calculated before starting the treatment and after 6 months. The pain was evaluated using the VAS Pain Scale. Results: All 35 patients showed a significant improvement in facial wrinkles according to the FWS (from 1.96 to 1.73 at the 3-month follow-up, up to a value of 1.43 at 6 months). In a small group of patients, it was observed that 44% of them showed vascular moderate improvement and that 13% showed a vascular marked improvement after treatment. No side effects were detected except a mild erythematous rash in two patients, and the VAS Pain scale was assessed at 1.17. Conclusions: Red Touch allows a uniform and stable result to be achieved over time with minimum discomfort. Full article

Prosthesis discomfort and a lack of skin-like quality is a source of patient dissatisfaction with facial prostheses. To engineer skin-like replacements, knowledge of the differences between facial skin properties and those for prosthetic materials is essential. This project measured six viscoelastic properties (percent laxity, stiffness, elastic deformation, creep, absorbed energy, and percent elasticity) at six facial locations with a suction device in a human adult population equally stratified for age, sex, and race. The same properties were measured for eight facial prosthetic elastomers currently available for clinical usage. The results showed that the prosthetic materials were 1.8 to 6.4 times higher in stiffness, 2 to 4 times lower in absorbed energy, and 2.75 to 9 times lower in viscous creep than facial skin (p < 0.001). Clustering analyses determined that facial skin properties fell into three groups—those associated with body of ear, cheek, and remaining locations. This provides baseline information for designing future replacements for missing facial tissues. Full article

Objective: to systematically review the efficacy of microfocused ultrasound (MFU) for facial skin tightening. Methods: A systematic search was performed (Pubmed, Embase) to assess the efficacy of single MFU treatments for facial skin tightening. Eligible studies included randomised controlled trials, controlled trials, cohort studies and case series (n ≥ 10). Objective and subjective outcomes were assessed. Results: A total of 693 studies were identified of which 16 studies were eligible. All the studies involved female patients. MFU is capable of tightening the skin, as observed in studies measuring the results of brow lifts (0.47–1.7 mm) and submental lifts (measured as a 26–45 mm² reduction in the submental area on lateral photographs). Data from the Global Aesthetic Improvement Scale (GAIS) were pooled, and the day 90 pooled subjective investigator reported scores (IGAIS) (n = 337) showed that 92% of the patients demonstrated an improvement in skin tightening and/or in wrinkle reduction which continued up to one year. Longer-term follow-up data are not available. The patient-reported pooled scores (SGAIS) (n = 81) showed that the skin improvements were mild and continued to increase from 42% (90 days) to 53% (360 days) post-treatment. The MFU treatment was moderately painful and caused transient erythema with or without oedema. Other adverse effects were rare (2%), including dysesthesia (numbness or hypersensitivity), bruising and stinging, mandibular burns, striations and contact dermatitis. Various device settings, treatment protocols and energies were applied. Excessive skin laxity and a BMI > 30 were posed as relative contraindications for MFU treatment because positive results declined with an increase in laxity and BMI. Conclusions: MFU treatment is effective in tightening female patients’ mildly to moderately lax facial skin. Future studies should focus on objective treatment outcomes, optimising treatment regimens and male patients. Full article

Background: The face is the area most exposed to the normal course of skin aging, both intrinsically and extrinsically. The aim of the study was to evaluate the cellular and clinical response of a therapeutic protocol aimed at countering facial skin aging. Materials and Methods: Twenty female patients with facial skin laxity and photodamage underwent combined therapy including mesotherapy using non-cross-linked hyaluronic acid with calcium hydroxyapatite and an infrared energy-based device treatment with subsequent implementation of PEG-cross-linked hyaluronic acid soft tissue fillers. To evaluate the benefits, patients underwent histological, immunological, and biomechanical evaluations before the treatment and at 21 and 150 days after the treatment. Results: The histological results at 21 days and 150 days after the procedure showed an increase in the number of fibroblasts and angiogenesis. As for the immunological aspect, it was shown that the treatment has an immunomodulating action, avoiding the activation of CD4 and CD8 cells. Biomechanical data showed that, at 150 days after treatment, the average changes in skin elasticity increased by 72% and the skin hydration increased by 49%. Conclusions: A combination of an infrared energy-based device treatment with both non-cross-linked hyaluronic acid and novel PEG-cross-linked hyaluronic acid leads to numerous positive cutaneous changes after histological, immunological, and biomechanical evaluations. Full article

While injectables, lasers, and surgical interventions have traditionally been used to reverse the changes associated with facial aging, other alternative therapies such as facial acupuncture and facial exercises are now being studied for facial rejuvenation. In this paper, we both summarize the concepts of facial acupuncture and facial exercises, and review seven studies that evaluate the efficacy of these modalities. Data from these studies suggest that both facial acupuncture and facial exercises have the potential to improve the skin laxity, wrinkle length, muscle thickness, and pigmentary changes associated with aging. Patients frequently reported improvement and experienced very few side effects. However, further research is necessary before these modalities are widely accepted as effective by the medical community, though the results of these studies may ultimately make providers less hesitant when patients seek out these services. Full article