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Objective: The robust safety and efficacy profile associated with the use of biodegradable fillers such as poly-L-lactic acid (PLLA) for facial rejuvenation has resulted in a growing interest in off-label use for various aesthetic applications, including gluteal augmentation. The authors describe a novel targeted and individualized technique of PLLA injection into the buttock region. Methods: The technique involves clinical and anatomical evaluations of the gluteal region, and there are three distinct approaches for injecting PLLA in the gluteal region based on the most important factor to be improved: (1) skin quality, (2) contour and lifting, or (3) projection and volume. Results: This novel technique is associated with favorable patient outcomes in terms of improvements across all key areas of gluteal augmentation; improvement in skin quality and laxity, contour improvement and lifting, and gluteal volume and projection. Since its initiation, this technique has been found to be both cost-effective and clinically efficacious, with demonstratable benefits achieved with a lower volume of PLLA compared to other PLLA injection techniques. Limitations: Assessment of patient outcomes with this technique have, to date, been subjective clinical observations, which does not include quantitative outcomes such as patient satisfaction data or safety outcomes. Conclusion: We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient.
RESUMEN
BACKGROUND: Calcium hydroxyapatite (CaHA) is a well-established collagen stimulator. In recent years, it has been increasingly used in hyperdiluted form as a biostimulatory agent rather than a volumizing filler to improve skin quality and firmness in both facial and corporal areas. However, guidelines on the techniques required to achieve optimal results are still lacking. The objective of this study was to develop a consensus recommendation for the safe and effective use of hyperdiluted CaHA for face and body biostimulation. METHODS: A team of 10 experts with extensive experience in dermal fillers and biostimulatory treatments for facial and body rejuvenation convened for a live meeting. Consensus was defined as approval by 70%-89% of all participants, whereas agreement of ≥90% denoted strong consensus. RESULTS: For most items, the group achieved a majority consensus. Recommendations have been provided for the face, neck, décolletage, buttocks, thighs, arms, abdomen, knees, and elbows with detailed injection techniques, providing information on insertion points, dosages, and volumes for both needle and cannula injections as well as the number of treatment sessions and intervals. CONCLUSIONS: The expert consensus supports and provides guidance for the use of CaHA as a biostimulatory agent for face and body rejuvenation. However, further clinical studies are necessary to provide physicians with the best evidence for the best treatment practices.
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O conceito de rejuvenescimento facial abrange atualmente visão tridimensional, que reconhece como sinais de envelhecimento não só a perda da textura cutânea e as rugas de expressão, mas também as perdas volumétricas secundárias à remodelação óssea e a redistribuição da gordura facial. O objetivo do presente artigo é apresentar uma revisão da literatura sobre o ácido poli-l-láctico para rejuvenescimento facial, incluindo suas indicações, técnicas de injeção, resultados esperados e possíveis efeitos adversos.
The concept of facial rejuvenation currently includes a three-dimensional perspective, which recognizes as signs of aging not only the loss of the skin's texture and the emergence of expression wrinkles, but also the volumetric losses secondary to bone remodeling and redistribution of facial fat. This article was aimed at reviewing the literature on poly-L-lactic acid for facial rejuvenation including its indications, injection techniques, expected results and possible adverse effects and offer practical guidelines, based on the authors' 12-year experience with the product.
RESUMEN
Os autores estudaram os fatores epidemiologicos relacionados ao melanoma maligno, ressaltando a influencia dos esteroides sexuais nesta doenca