Showing papers in "Dermatologic Surgery in 2020"
TL;DR: Standard of treatment is surgery, with data suggesting that Mohs micrographic surgery may have superior clinical outcomes and lower recurrence rates.
Abstract: BACKGROUNDExtramammary Paget disease (EMPD) is a rare malignancy with unclear pathophysiology that occurs predominantly on apocrine rich skin. Surgery is the treatment of choice; however, procedures tend to be extensive and associated with a high rate of recurrence.OBJECTIVETo review the current lit
42 citations
TL;DR: Most recent cases of filler-related blindness have occurred with HA, which is a shift from previous reports, and it is imperative for providers to be familiar with strategies for managing soft-tissue filler blindness.
Abstract: Background Soft-tissue filler administration is an increasingly popular minimally invasive cosmetic procedure. Simultaneously, there have been a greater number of adverse events reported, including the devastating complication of blindness. Objective To report cases of filler-related blindness published since 2015. Materials and methods The Ovid MEDLINE database was searched from January 1, 2015, to August 1, 2018, using a previously described Boolean string. Results Sixty new cases of filler blindness were identified. The most common type of filler reported was hyaluronic acid (HA) (N = 42, 70.0%), followed by autologous fat (N = 7, 11.7%), and calcium hydroxyapatite (CaHA) (N = 7, 11.7%). The most common injection locations were the nose (N = 33, 55.0%), glabella (N = 21, 35.0%), and forehead (N = 11, 18.3%). Ten cases reported vision restoration (16.7%). Four of the successful cases involved hyaluronidase administration, including 1 retrobulbar hyaluronidase injection. Conclusion Since 2015, there have been 60 newly reported cases of soft-tissue filler blindness. Most recent cases have occurred with HA, which is a shift from previous reports. In HA cases, hyaluronidase injection may be successful in restoring vision if administered promptly. It is imperative for providers to be familiar with strategies for managing soft-tissue filler blindness.
38 citations
TL;DR: This research presents a novel probabilistic approach that allows us to assess the importance of knowing the carrier and removal status of canine coronavirus as a source of infection in animals and its role in the immune system is investigated.
Abstract: Background The etiology of cellulite is unclear. Treatment of cellulite has targeted adipose tissue, dermis, and fibrous septae with varying degrees of success and durability of response. Objective Results from clinical trials that target different anatomical aspects of cellulite can provide insights into the underlying pathophysiology of cellulite. Materials and methods A search of the PubMed database and ClinicalTrials.gov website was conducted to identify clinical trials that have investigated treatments for cellulite. Results A lack of trial protocol standardization, objective means for quantification of improvement and reported cellulite severity, and short-term follow-up, as well as variation in assessment methods have made comparisons among efficacy studies challenging. However, the lack of durable efficacy and inconsistency seen in clinical results suggest that dermal or adipose tissue changes are not the primary etiologies of cellulite. Clinical studies targeting the collagen-rich fibrous septae in cellulite dimples through mechanical, surgical, or enzymatic approaches suggest that targeting fibrous septae is the strategy most likely to provide durable improvement of skin topography and the appearance of cellulite. Conclusion The etiology of cellulite has not been completely elucidated. However, there is compelling clinical evidence that fibrous septae play a central role in the pathophysiology of cellulite.
37 citations
TL;DR: Although complications with dermal fillers are infrequent in comparison with the growing number of filler procedures being performed in the United States every year, this study underscores the importance of appropriate skill and training when administering dermal Fillers.
Abstract: BACKGROUNDWith the rising popularity of dermal fillers, the number of complications associated with fillers has increased.OBJECTIVETo identify and review reports of adverse events involving cosmetic injectable soft-tissue fillers from the FDA Manufacturer and User Facility Device Experience (MAUDE)
35 citations
TL;DR: The ability to induce epidermal changes in the upper dermis and promote the migration of melanocytes forms the basis for the hypothesis that in the case of vitiligo, microneedling can act not only as an agent in the promotion of drug delivery but also as a therapeutic agent.
Abstract: Skin microneedling was proposed in the transcutaneous delivery of latanoprost and tacrolimus, with favorable results in localized and stable forms. The combination of weekly microneedling followed by topical corticosteroid therapywithNBUVBphototherapy for3months resulted in significantly higher pigmentation compared with the use of phototherapy alone. Similarly, microneedling followed by the application of 5-fluorouracil demonstrated superior results compared with microneedling followed by the application of tacrolimus. The ability to induce epidermal changes in the upper dermis and promote the migration of melanocytes forms the basis for our hypothesis that in the case of vitiligo, microneedling can act not only as an agent in the promotion of drug delivery but also as a therapeutic agent. However, thus far, microneedling has been neither reported nor investigated as an exclusive treatment for vitiligo.
34 citations
TL;DR: The findings provide a basis for selection guideline regarding rheological properties in facial rejuvenation and help physicians select the appropriate fillers for more predictable and sustainable results.
Abstract: Background Hyaluronic acid (HA) fillers are the most commonly used fillers for soft-tissue augmentation. The face is a dynamic structure. Facial rejuvenation by filler products depends on mechanical forces on the region of the face. The successful use of injectable HA fillers requires an understanding of the options available. Objective The purpose of this study is to measure the rheological properties of HA fillers and to clarify how to select these fillers considering their rheological properties. Materials and methods Rheological characterization was performed on 41 fillers. Physical parameters directly linked to product performance were measured. Results The properties of the HA fillers varied. These findings provide a basis for selection guideline regarding rheological properties in facial rejuvenation. Conclusion The authors' report is the largest study to determine the rheological properties of HA fillers to date. Understanding the fillers' properties can help physicians select the appropriate fillers for more predictable and sustainable results.
33 citations
32 citations
TL;DR: Overall, practitioners believe medical spas are endangering to patient safety, think that stricter rules and regulations are necessary, and request more support from the specialty medical societies.
Abstract: BACKGROUND Medical spas have experienced a recent rise in popularity. However, rules and regulations vary nationwide. Given the number of complications attributable to medical spas, questions remain about currently regulatory practices and whether they are sufficient to protect patients from harm. OBJECTIVE Our study investigated the current state of medical spas and their associated patient complications in the aesthetic field as well as the experiences and attitudes of practitioners. MATERIALS AND METHODS A survey was distributed to current members of the American Society for Dermatologic Surgery. RESULTS Of all cosmetic complications encountered in the past 2 years, the majority reported that the percentage of complications seen in their practice attributable to medical spas ranged from 61% to 100%. The most commonly cited complications from medical spas were burn, discoloration, and misplacement of product, whereas the most commonly cited treatments resulting in complications were fillers, intense pulsed light, and laser hair removal. For safety and outcomes, medical spas were rated as inferior to physician-based practices. CONCLUSION Patient complications associated with medical spas are not uncommon. Overall, practitioners believe medical spas are endangering to patient safety, think that stricter rules and regulations are necessary, and request more support from the specialty medical societies.
31 citations
TL;DR: In this paper, a review of the current state-of-the-art procedures for Paget's disease (EMPD) on apocrine-rich skin is presented. But, procedures tend to be extensive and associated with a high rate of recurrence.
Abstract: BACKGROUNDExtramammary Paget's disease (EMPD) is a rare malignancy with unclear pathophysiology that occurs predominantly on apocrine-rich skin. Surgery is the treatment of choice; however, procedures tend to be extensive and associated with a high rate of recurrence.OBJECTIVETo review the current l
29 citations
TL;DR: Lymph-sparing liposuction using tumescent local anesthesia is currently the only effective treatment for lipedema.
Abstract: BACKGROUNDLipedema is a chronic, progressive disorder of subcutaneous adipose tissue that usually affects the lower extremities of women. Also known as “two-body syndrome,” the fat accumulations in lipedema are unsightly and painful. The disorder is well-known in Europe but is largely unrecognized a
28 citations
TL;DR: In this article, the authors investigated the functional anatomy behind the facial overfilled syndrome observed after soft-tissue filler injections, which can potentially be explained by the presence of the transverse facial septum.
Abstract: BACKGROUND The midface is an area of high demand for minimally invasive cosmetic procedures, that is, soft-tissue filler injections. OBJECTIVE To investigate the functional anatomy behind the facial overfilled syndrome observed after soft-tissue filler injections. MATERIALS AND METHODS The clinical part of the study enrolled 25 volunteers (12 men and 13 women, Caucasians); the anatomical part included 72 fresh frozen cephalic specimens obtained from 32 male and 40 female body donors. 3D surface scanning procedures were applied to calculate the maximal anterior projection of the midface. RESULTS Upon smiling, the point of maximal anterior projection shifted cranially in men by 12.43 ± 8.8 mm (difference between resting and smiling; p < .001) and by 8.75 ± 4.1 mm in women (p < .001). Cadaveric dissections identified a septum originated from the underside of the zygomaticus major muscle forming a transversely running boundary between the buccal space and the deep midfacial fat compartments. CONCLUSION Facial overfilled syndrome can potentially be explained by the presence of the transverse facial septum. Dynamic filling-injecting small amounts of filler and asking the patient to smile repeatedly during the procedure-seems to be a viable way to avoid this adverse event during soft-tissue filler injection.
TL;DR: Platelet-rich plasma is an effective treatment for hair regrowth in female AGA, although not as effective as minoxidil, and the improved quality of life responses after PRP, but not minoxido suggest a potential overall greater degree of satisfaction with PRP.
Abstract: BACKGROUNDAndrogenic alopecia (AGA) is a common hair loss disorder. Studies have demonstrated successful treatment with platelet-rich plasma (PRP) in men, but studies in women are few.OBJECTIVETo evaluate PRP in the treatment of AGA in women, compared with topical minoxidil.MATERIALS AND METHODSTwen
TL;DR: This review advocates for the use of platelet-rich plasma in 3 to 4 monthly sessions for the treatment of alopecia and calls for a standardized treatment protocol to allow for comparison among studies, provide reproducibility, and generate a standard treatment protocol.
Abstract: Background The use of platelet-rich plasma is becoming more prevalent in the field of dermatology. Variable preparation techniques and treatment methods have been described with reported success in alopecia. Objective To consolidate the available evidence of platelet-rich plasma and its utility in the treatment of alopecia for the practicing dermatologist. Methods Evaluating the available evidence up to May 31, 2018, a search was conducted in the PubMed database for "platelet rich plasma" or "platelet releasate" or "platelet gel" or "PRP" and "dermatology" or "skin" or "hair" or "cutaneous." Results Nineteen articles met the inclusion criteria for analysis including 3 alopecia areata studies with a total of 71 patients and 16 androgenetic alopecia studies with a total of 389 patients. Although the heterogeneity of the studies prevented direct comparisons and subsequent statistical analysis, the majority demonstrated that platelet-rich plasma produced successful hair growth in androgenetic alopecia and alopecia areata. Conclusion This review advocates for the use of platelet-rich plasma in 3 to 4 monthly sessions for the treatment of alopecia. Future studies should include a detailed description of the platelet-rich plasma isolation process to allow for comparison among studies, provide reproducibility, and generate a standardized treatment protocol.
TL;DR: The outcome supports the efficacy of lasers in minimizing primarily closed surgical scars when treated <1 month after surgery.
Abstract: BACKGROUND Studies investigating the efficacy of lasers to minimize early surgical scars are low powered and report variable results. To further examine the evidence, the authors performed a systemic review and meta-analysis. OBJECTIVE To present the evidence of randomized controlled trials investigating the efficacy of laser modalities in minimizing surgical scars when applied <1 month after operation. MATERIALS AND METHODS A literature search of PubMed, EMBASE, Northern Light Life Sciences Conference Abstracts, and Cochrane Library was performed between November 6, 2015, and November 20, 2015. After assessing for inclusion, data extraction used the PRISMA checklist. Assessment for quality, validity, and risk of bias applied a scale devised by Jadad and colleagues, the Oxford Pain Validity Scale, and the RevMan risk of bias assessment tool, respectively. The GRADEpro application graded overall quality, and statistical analysis was performed with RevMan. RESULTS Approximately 4,373/4,397 abstracts and 16/24 full articles were excluded using predefined criteria, leaving 8 articles in the systematic review and 4 in the meta-analysis. The primary outcome reached statistical significance favoring the intervention group with standardized mean difference 0.39 (95% confidence interval, 0.05-0.74) and p = .03. CONCLUSION The outcome supports the efficacy of lasers in minimizing primarily closed surgical scars when treated <1 month after surgery.
TL;DR: No statistically significant difference was found between varying concentrations of triamcinolone and NS for the treatment of HS lesions, suggesting that Steroid injections may be less effective for the management of acute HS than typically presumed.
Abstract: BACKGROUNDHidradenitis suppurativa (HS) is a chronic, inflammatory condition characterized by recurrent nodules, sinus tracts, comedones, and scarring. Hidradenitis suppurativa is often associated with pain and decreased quality of life. Limited clinical trial data exist regarding the management of
TL;DR: Intradermal administration of ADSC-CM on the scalp has strong potential to provide regenerative effects for hair follicles and the interfollicular scalp in an adipose-derived stem cell-conditioned medium as an alternative treatment for alopecia.
Abstract: Background An adipose-derived stem cell-conditioned medium (ADSC-CM) reportedly exerts skin-rejuvenating and hair growth-promoting effects. In the therapeutic application of ADSC-CM for alopecia, changes to the interfollicular scalp remain unclear although some evidence has indicated hair growth-promoting effects. Objective To evaluate the effects of ADSC-CM not only on hair follicles, but also on the interfollicular scalp. Methods Forty patients (21 men, 19 women; age range, 23-74 years) with alopecia were treated by intradermal injection of ADSC-CM every month for 6 months. Eighty fixed sites on patients were investigated by trichograms, physiological examinations, and ultrasonographic examinations at 4 time points (before treatment and 2, 4, and 6 months after the initial treatment). Results Hair density and anagen hair rate increased significantly. As physiological parameters, transepidermal water loss value gradually increased, with significant differences at 4 and 6 months after the initial treatment, but hydration state of the stratum corneum and skin surface lipid level showed no obvious changes. As ultrasonographic parameters, dermal thickness and dermal echogenicity were increased significantly. Conclusion Intradermal administration of ADSC-CM on the scalp has strong potential to provide regenerative effects for hair follicles and the interfollicular scalp. An adipose-derived stem cell-conditioned medium offers a promising prospect as an alternative treatment for alopecia.
TL;DR: Nanosecond pulsed electric field procedure is well tolerated and is very effective in the removal of SGHs.
Abstract: Background Nanosecond pulsed electric field (nsPEF) technology involves delivery of ultrashort pulses of electrical energy and is a nonthermal, drug-free technology that has demonstrated favorable effects on cellular structures of the dermis and epidermis. Objective Determine the tolerability and effectiveness of nsPEF treatment of sebaceous gland hyperplasia (SGH). Methods This study was a prospective, randomized, open-label, multisite, nonsignificant risk trial in which each subject served as their own control. After injection of local anesthetic, high-intensity, ultrashort pulses of electrical energy were used to treat 72 subjects resulting in a total of 222 treated lesions. Subjects returned for 3 to 4 follow-up evaluations with photographs. Results At the final study visit, 99.6% of treated SGH lesions were rated clear or mostly clear and 79.3% of the subjects were satisfied or mostly satisfied with the outcome. At 60 days after nsPEF treatment, 55% of the lesions were judged to have no hyperpigmentation and 31% exhibited mild post-treatment hyperpigmentation. At the last observation for all lesions, 32% of the 222 lesions were noted as having slight volume loss. Conclusion Nanosecond pulsed electric field procedure is well tolerated and is very effective in the removal of SGHs. Trial registration ClinicalTrials.gov NCT03612570.
TL;DR: Skin grafting is a dynamic technique of dermal reconstruction that can be successful with comprehensive knowledge of skin bioprinting methods and future directions for regenerative medical skin constructs are reviewed.
Abstract: Background Tissue engineering is used to fabricate 3-dimensional (3D) artificial scaffolds to create a microenvironment that mimics human tissue. Bioprinting uses biomaterials, cells, and/or bioink to fabricate prospective scaffolds to mirror the structural, compositional, and functional aspects of the skin. Various bioprinting methods (inkjet-based bioprinting, pressure-assisted bioprinting, and laser-assisted bioprinting) have been used for regenerative wound repair and have been characterized based on biocompatibility, cellular microenvironment, cell proliferation, vitality, and morphology. Objective This article reviews the basic principles of 3D printing, current 3D skin bioprinting applications and approaches, and future directions for regenerative medical skin constructs. Methods A comprehensive literature review was conducted using PubMed with keywords "three-dimensional printing," "dermatologic surgery," "bioprinting," "reconstructive surgical procedures," "wound healing," "skin grafts," "skin scaffolds," "tissue reconstruction," and "tissue engineering." Results A summary of the different applications and 3-dimensional skin bioprinting techniques is presented. In addition, synthetic, natural, and combination polymers are reviewed. Advantages, disadvantages, indications, and approaches are discussed in depth. Conclusion Skin grafting is a dynamic technique of dermal reconstruction that can be successful with comprehensive knowledge of skin bioprinting methods.
TL;DR: A high-yield, in-depth analysis of PRP in procedural dermatology is created by reviewing available data on its role in hair restoration, soft-tissue remodeling, resurfacing, and rejuvenation; identifying practice gaps and controversies; and making suggestions for future research that will establish dermatologists as pioneers of regenerative medicine.
Abstract: Background Platelet-rich plasma (PRP) is an increasingly popular treatment modality for various dermatologic conditions, but there are limitations in both the published literature and clinician knowledge. Objective To create a high-yield, in-depth analysis of PRP in procedural dermatology by reviewing available data on its role in hair restoration, soft-tissue remodeling, resurfacing, and rejuvenation; identifying practice gaps and controversies; and making suggestions for future research that will establish dermatologists as pioneers of regenerative medicine. Materials and methods A two-part systematic review and expert analysis of publications before October 2018. Results and conclusion Most studies on PRP report favorable outcomes with the strongest level of evidence existing for androgenetic alopecia followed by postprocedure wound healing, scar revision, striae, rejuvenation, and dermal filling. There is a dearth of large randomized controlled trials, considerable heterogeneity in the variables studied, and lack of specificity in the preparatory protocols, which may influence clinical outcomes. Future investigations should use consistent nomenclature, find ideal solution parameters for each cutaneous indication, determine significant outcome metrics, and follow double-blinded, randomized, controlled methodologies. Addressing these deficiencies will take sound scientific inquiry but ultimately has the potential to benefit the authors' specialty greatly.
TL;DR: Results of this early experience showed that DCA injections were safe and effective for nonsurgical jowl reduction and reduction in mild/moderate jowl fat.
Abstract: Background The study proposes a novel protocol for targeting the jowls using deoxycholic acid (DCA) injections, with emphasis on safety and feasibility of the procedure. Methods This prospective study was conducted at a cosmetic practice between June 2016 and May 2017. Twelve consecutive patients seeking reduction/improvement in mild/moderate jowl fat were injected with DCA subcutaneously in a predefined circular area 1.0 cm above the mandibular border. Treatment response was assessed using physician-evaluated Global Aesthetic Improvement Scale (GAIS) and Subject GAIS. Results Twelve patients (11 women and 1 man) with mild (n = 8) or moderate (n = 4) jowls were treated. After the first treatment, GAIS responses for 24 jowls showed 5 jowls with vast improvement, 15 with moderate improvement, and 4 with no change. After the second session for 5 jowls in 3 patients, GAIS responses showed vast improvement in 4 jowls and moderate improvement in 1. Adverse events included induration (n = 4), bruising (n = 6), numbness (n = 2), pain (n = 5), redness (n = 3), edema (n = 9), and dysphagia (n = 1). Conclusion Results of this early experience showed that DCA injections were safe and effective for nonsurgical jowl reduction.
TL;DR: Gluteal augmentation with fillers can safely and effectively improve gluteal firmness, shape, proportion, and projection and practitioners must be aware of appropriate patient selection, regional anatomy, and safe injection techniques.
Abstract: BACKGROUNDThere is increased emphasis on the importance of the gluteal region in the perception of beauty. Biodegradable fillers provide a nonsurgical method of augmenting and rejuvenating this area.OBJECTIVETo review pertinent aspects of anatomy, patient evaluation, injection technique, and complic
TL;DR: Microneedling improves acne scarring, and further studies are needed to compare microneedled with other minimally invasive treatments.
Abstract: BACKGROUNDMicroneedling is a popular, minimally invasive skin rejuvenation modality for acne scarring. Recent reports have evaluated the efficacy and safety of microneedling monotherapy and combination treatment for scarring.OBJECTIVEThis review aims to systematically analyze the current literature
TL;DR: This systematic review showed higher recurrence rates when it was not intended to resect affected HS tissue with a radical margin, and there is a need for more RCT's and uniformly reported treatment outcomes.
Abstract: BACKGROUND: Surgery is considered to be the best treatment for recurrent hidradenitis suppurativa (HS). Varying recurrence rates have been reported in the literature. OBJECTIVE: To provide an up-to-date systematic review of the complete literature for different excision strategies and their recurrence rates in HS. METHODS: A systematic literature search of the complete available literature and a meta-analysis of proportions were performed on the included studies. RESULTS: Of a total of 1,593 retrieved articles, 125 were included in the analysis. Most of these studies were retrospective with 8 prospective analyses and one randomized controlled trial (RCT). The techniques described were divided into partial excision (PE) and wide excision (WE), described in 33 and 97 included studies, respectively. The average estimated recurrences were 26.0% (95% confidence interval [CI], 16.0%-37.0%) for PE and 5.0% (95% CI, 3.0%-9.0%) for WE (p < .01). Female sex (p = .016) and HS caudal of the umbilicus (p = .001) were significantly associated with the overall recurrence rate. Quality of evidence was poor, and the reporting of results was mostly heterogeneous. CONCLUSION: This systematic review showed higher recurrence rates when it was not intended to resect affected HS tissue with a radical margin. There is a need for more RCT's and uniformly reported treatment outcomes.
TL;DR: High-intensity focused ultrasound is an effective and safe treatment modality for reducing waist circumference in nonobese individuals with focal fat accumulation with a steady decrease in waist circumference and fat thickness.
Abstract: BACKGROUNDDemand for noninvasive body contouring has increased.OBJECTIVEWe evaluated the efficacy and safety of a thermal high-intensity focused ultrasound (HIFU) device for abdominal body shaping.PATIENTS AND METHODSAdults with a body mass index ≤30 kg/m2 and an abdominal subcutaneous fat tissue th
TL;DR: This research presents a novel probabilistic approach that allows us to assess the importance of knowing the carrier and removal status of canine coronavirus as a source of infection in animals and its role in the immune system is investigated.
Abstract: Background The Clinician Reported Photonumeric Cellulite Severity Scale (CR-PCSS) and Patient Reported PCSS (PR-PCSS) are newly developed tools for assessing cellulite severity. Objective To report on the reliability, validity, and ability to detect a change in cellulite severity on the buttocks of adult women with the CR-PCSS and PR-PCSS. Materials and methods Content validity of both scales was established through concept elicitation and cognitive interviews. Test-retest reliability was evaluated, and intra-rater (both scales) and inter-rater (CR-PCSS only) reliability were estimated using intraclass correlation coefficients (ICCs) for agreement and consistency. Ability to detect a change was determined using the Subject-Global Aesthetic Improvement Scale (GAIS) or Investigator-GAIS as anchors. Results For the CR-PCSS (n = 6) at baseline and Day 2, the mean interrater ICCs were ≥0.70 and mean intrarater ICCs (95% confidence interval [CI]) were ≥0.81 (0.72-0.90) for both buttocks. For the PR-PCSS (n = 99) at baseline and Day 14, the mean test-retest reliability ICCs (95% CI) were ≥0.86 (0.79-0.91) for both buttocks. A clinically meaningful change was 1.0 point on the PR-PCSS and 1.0 on the CR-PCSS. Conclusion The CR-PCSS and PR-PCSS reliably assess cellulite severity of the buttocks and can detect a clinically meaningful change after treatment for cellulite.
TL;DR: Nonsurgical rhinoplasty combining PDO threads and fillers can be safe and effective, maintaining good results at 6 months after the procedure, and modifying the columella-labial angle.
Abstract: BACKGROUNDAbsorbable wedge-shaped polydioxanone (PDO) sutures are currently available for facial rejuvenation, and they are extremely popular in the aesthetic clinics in Korea. Other than face lifting, threads also can be used for nonsurgical rhinoplasty. The Asian nose is typified by a flat nasal b
TL;DR: Poly-L-lactic acid is safe and effective for overall aesthetic enhancement of the buttocks if used in adequate quantity (minimum 20 vials) for all women, independent of age or the number of sessions.
Abstract: Background Poly-L-lactic acid (PLLA) is a well-established biostimulator that induces neocollagenesis, allowing for volume loss correction. Although PLLA is FDA approved to treat mid-to-lower facial wrinkling, it has grown increasingly popular as a nonsurgical, minimally invasive procedure for soft-tissue volume augmentation of other extremities. However, research detailing PLLA buttock injections is still lacking. Objective The purpose of this study is to determine the safety and efficacy of PLLA for buttock augmentation. Materials and methods A clinical retrospective review of 60 patients (ages 23-54 years) were followed for 2 years by 2 investigators. Patients underwent 1 to 3 treatments, spaced 4 to 6 weeks apart, and received 2 to 12 vials per session (based on the patient budget). Pretreatment and post-treatment photographs were assessed by the primary and secondary investigator in blinded and double-blinded surveys, respectively. The Global Aesthetic Improvement Scale was used to quantify improvements in volume, skin texture, and cellulite dimpling. Results Poly-L-lactic acid allows for visible volume amplification, improved skin texture, and softened cellulite dimpling in the buttocks when at least 20 vials are used. Conclusion Poly-L-lactic acid is safe and effective for overall aesthetic enhancement of the buttocks if used in adequate quantity (minimum 20 vials) for all women, independent of age or the number of sessions.
TL;DR: Combination treatment with FMRF and AFL is an effective and well-tolerated treatment modality for acne scars and inflammatory acne.
Abstract: Background Fractional microneedle radiofrequency (FMRF) systems are popular options for treating acne scars. However, treatment efficacy when used in combination with traditional ablative fractional laser (AFL) and the safety profile with concomitant use of isotretinoin remain unknown. Objective The aim of this study was to assess the safety and efficacy of an early intervention combination treatment protocol for inflammatory acne and acne scars. Materials and methods The electronic records of 71 patients with inflammatory acne and acne scars were included in this retrospective observational study. Data were collected for all patients who received combination FMRF and AFL. Within the study group, 43 patients were receiving low-dose isotretinoin or had completed isotretinoin within the past 3 weeks. Results The mean Scar Global Assessment score significantly decreased after 3 sessions of combination treatment (n = 71). Patients with inflammatory acne showed a significant decrease in the number of inflammatory lesions (n = 30). Patients with concomitant low-dose isotretinoin use reported a further decrease in Scar Global Assessment score (n = 43). There were no reported persistent side effects, including prolonged inflammatory reaction or scarring. Conclusion Combination treatment with FMRF and AFL is an effective and well-tolerated treatment modality for acne scars and inflammatory acne.
TL;DR: Combination therapy with topical poly-lactic acid and microneedle fractional radiofrequency for acne scars resulted in significantly better clinical outcomes, including better scar smoothness and smaller scar size.
Abstract: BACKGROUNDAcne scarring occurs at a young age and causes distress for many patients. Various treatment modalities have been tried.OBJECTIVEThis study investigated the efficacy of combination therapy with topical poly-lactic acid and microneedle fractional radiofrequency (MFRF) for acne scars.MATERIA