Medesthetics

JUL-AUG 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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BEST PR ACTICES 12 JULY/AUGUST 2018 | Med Esthetics © GETTY IMAGES LASER-ASSISTED DELIVERY OF PLLA PLUMPS LIP LINES Researchers from Kobe University Graduate School of Medicine in Kobe, Japan, are advocating the use of two tools that may help reduce the risk of vascular embolism and skin necrosis following hyaluronic acid (HA) fi ller injec- tions: ultrasound to help identify blood vessels during deep injections and 2-dimensional laser speckle fl owgraphy (LSFG) to noninvasively measure blood fl ow to the skin. Takanori Iwayama, MD, et al, performed multiple HA fi ller injections (Juvederm Vista) in the face of a 38-year- old man. They injected fi ller on the left side of the face without the use of ultrasound guidance using a traditional, more superfi cial technique. The fi ller was deposited into the region just under the dermis in the left nasolabial fold and alar base. On the right side of the face, they injected the same fi ller into the periosteum in the nasolabial fold and alar base using an ultrasonography-guided cannula method. Following treatment, skin blood fl ow was evalu- ated with LSFG. The injector was able to detect both the cannula tip and blood vessels with the ultrasonography. LSFG revealed a reduction in skin blood fl ow in both sides of the face following treatment with the fi ller, but there was less reduction in blood fl ow on the right side where the ultrasonography-guided cannula method was used. The study was published on April 20, 2018 in Plastic and Reconstructive Surgery – Global Open. Reducing Risks in Deep Filler Injections Topical application of diluted poly-L-lactic acid (PLLA) following fractional CO 2 laser treatment signifi cantly reduces the depth and severity of perioral rhytides. Omar Ibrahim, MD, presented the outcomes of 10 patients during the 2018 American Society for Lasers in Surgery and Medicine (ASLMS) conference in Dallas. He treated subjects with one pass of a fractional CO 2 laser at 70mJ with a 135 micron spot size and density of 10 percent. Immediately following laser treatment, he applied a topical PLLA solution. At baseline, after the fi rst treatment and three months after the second treatment, depth and severity of the wrinkles were measured us- ing the Visia Complexion Analysis system (Canfi eld Scientifi c). Blinded evaluators also reviewed pre-treatment and post-treatment photos. The evaluators correctly identifi ed the before-and-after images for all subjects. Visia analysis revealed 25 percent improvement after the fi rst treatment and 52 percent improvement three months after the last treatment. Patients experienced fi ve to seven days of redness fol- lowing each treatment, and there were no nodules. Co-transplantation of fat with nanofat promotes neovascularization and improves fat graft survival, according to the results of a mouse study performed by Qian Yu, PhD, et al, of the department of plastic and re- constructive surgery at Shanghai 9 th People's Hospital in Shanghai, China. The researchers grafted fat under the scalps of nude mice. They added nanofat—prepared via mechanical emulsifi cation and fi ltration—to the harvested fat in two groups. One group received fat with no nanofat to act as a control. Twelve weeks after transplantation, they dissected the grafted fat and measured graft weight and volume. Capillary density was measured through histological evaluation. Both groups that underwent co-transplantation of fat with nanofat showed higher graft weight and volume retention and higher capillary density compared to controls. There were no signifi cant differences in outcomes between the two nanofat volumes. The study was published in the June 2018 issue of Aesthetic Surgery. NANOFAT ENHANCES FAT GRAFT NEOVASCULARIZATION

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