RESUMO
Foi realizada uma revisão de literatura narrativa, sobre a associação de enxerto de gordura e transplante de cabelos com a técnica FUE (Follicular Unit Extraction) em cicatrizes do couro cabeludo. Os dados foram coletados a partir de estudos encontrados nas bases Medline, Lilacs e IBECS. Foram citados registros bibliográficos de vários autores que pesquisaram as células mesenquimais do tecido gorduroso, com descrição das técnicas utilizadas. A conclusão foi de que a técnica de transplante capilar em duas etapas, com transplante prévio de gordura é eficaz, segundo os artigos revisados.
We developed a narrative literature review on the association of fat grafting and hair transplantation using the Follicular Unit Extraction (FUE) technique in scalp scars. Data were collected from studies found in Medline, Lilacs, and IBECS databases. Bibliographical records of several authors who researched mesenchymal cells in adipose tissue were cited, describing the techniques used. The conclusion was that the two-stage hair transplantation technique, with previous fat transplantation, is effective, according to the reviewed articles.
Assuntos
Humanos , Associação , Tecido Adiposo/transplante , Cicatriz , Cabelo/transplante , Couro Cabeludo/cirurgiaRESUMO
Paciente do sexo feminino, com diabetes tipo I e tireoidite de Hashimoto, apresentou necrobiose lipoídica aos 15 anos de idade. Foi tratada com 100mg/dia de ciclosporina, porém um abscesso na região inguinal levou à interrupção do tratamento. Posteriormente, utilizou dimetil fumarato em doses crescentes até 120mg/dia por três meses e, devido à ausência de resultados, cessou o uso do medicamento. A terceira tentativa foi com isotretinoína 40mg/dia por oito meses, com cicatrização da ferida. Recentemente, após cirurgia reparadora de cicatriz no joelho, houve aparecimento de lesões de necrobiose lipoídica no local da sutura. Tomou novamente 40mg/dia de isotretinoína, e a lesão regrediu em três meses
A woman with type I diabetes and Hashimoto's disease presented necrobiosis lipoidica at 15 years of age. Cyclosporine 100 mg/day was prescribed; however, an abscess in the inguinal region led to treatment interruption. Then, she tried dimethyl fumarate at increasing doses up to 120 mg/day. The lack of results led to the discontinuation of the therapy. The third attempt was isotretinoin 40 mg/day for eight months, with wound healing. Recently, after a knee scar repair surgery, necrobiosis lipoidica lesions appeared at the suture site. The patient received isotretinoin 40 mg/day again, and the lesion regressed in three months.
RESUMO
BACKGROUND: Human cell cultures are being developed to replace various body tissues. OBJECTIVE: To assess the safety and efficacy of dermal regeneration with the injection of young autologous fibroblasts obtained from culture containing serum from patients themselves. MATERIALS AND METHODS: Dermal tissue from the groin of five patients was cultivated in M199 medium supplemented with 10% human serum. Four population doublings were obtained. The fibroblasts were injected intradermally into forehead wrinkles and periorbital and paranasal areas. RESULT: At the fourth population doubling, a mean of 3.85 × 10(6) cells/mL was obtained; viability was 98%. Sixty days after completing treatment, with four injections given at 15-day intervals, periorbital tonicity had improved significantly, although the quantity of fibroblasts used resulted in little improvement to surface lines and no improvement at all in deeper wrinkles. After 6 months, no further changes were found beyond the initial results obtained. CONCLUSION: Injection of skin fibroblasts cultivated in medium supplemented with human serum is a viable technique and provokes no side effects. Four injections given at 15-day intervals containing a total of 6.4 × 10(6) fibroblasts/mL resulted in significant improvement in periorbital skin flaccidity. Further studies should be conducted with larger sample sizes.
Assuntos
Técnicas Cosméticas , Face , Fibroblastos/transplante , Rejuvenescimento , Envelhecimento da Pele , Pele/citologia , Adulto , Idoso , Células Cultivadas , Feminino , Humanos , Injeções Intradérmicas , Pessoa de Meia-Idade , Transplante AutólogoAssuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Fogachos/prevenção & controle , Neurotoxinas/uso terapêutico , Toxinas Botulínicas Tipo A/administração & dosagem , Feminino , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Neurotoxinas/administração & dosagem , Projetos Piloto , Sudorese/efeitos dos fármacosRESUMO
Introdução: As rugas peri orbitárias constituem importante componente do envelhecimento facial e podem ser minimizadas através do tratamento com toxina botulínica. Objetivo: Tratamento de rugas periorbitárias através de injeções de toxina botulínica do músculo periorbicular, abrangendo os pontos laterais clássicos e outros adicionais na pálpebra inferior, desenvolvidos a partir da classificação destas rugas. Métodos: Foram revisados dados clínicos e fotográficos de 530 pacientes, no período de2001 a 2007, que tiveram suas rugas periorbitárias classificadas e tratadas com toxina botulínica. Resultados: 30% dos pacientes com idade superior a 45 anos e 80% daqueles com idade inferior a 45 anos apresentaram melhora total das rugas após tratamento nos pontos clás-sicos. Os demais necessitaram tratamento nos pontos adicionais da pálpebra inferior. Conclusão: A classificação das rugas facilitou o encaminhamento ao melhor tratamento. Apesar do grande benefício trazido pelos pontos clássicos, verificamos a necessidade dotratamento com toxina botulínica nos pontos adicionais. Devem ser também levadas em consideração a presença de tecido celular subcutâneo e a idade do paciente.
RESUMO
As cicatrizes inestéticas alargadas ou hipertróficas periauriculares podem ser decorrentes da tensão sobre a sutura das incisões da ritidoplastia. Em estudo retrospectivo de cinco anos, 10 pacientes do sexo feminino portadoras de cicatrizes inestéticas foram tratadas com a técnica do anel periauricular. Utilizou-se o fio de politetrafluoretileno em seis casos e o de mononylon 2-0 duplo em quatro casos, introduzidos com agulha de fáscia lata sem bisel. Após a exerese da cicatriz, as bordas foram aproximadas, e o anel amarrado e fixado na fáscia do músculo temporal. O resultado foi satisfatório. Em dois casos os fios foram removidos sem alteração do resultado estético final das cicatrizes.
Assuntos
Lasers de Estado Sólido , Terapia com Luz de Baixa Intensidade , Pele/imunologia , Pele/efeitos da radiação , Antígenos CD1/metabolismo , Humanos , Células de Langerhans/efeitos dos fármacos , Células de Langerhans/imunologia , Células de Langerhans/metabolismo , Pele/metabolismo , Receptores Toll-Like/metabolismoRESUMO
BACKGROUND: Phosphatidylcholine injections have been used as a nonsurgical alternative to the surgical removal of undesired fat. Studies in cell culture suggest that sodium deoxycholate (SD) has a detergent action in fat reduction. OBJECTIVE: The objective was to study SD in subcutaneous human tissue. METHODS AND MATERIALS: Thirty volunteers underwent four sessions of subcutaneous abdominal injections of diluted 2.5 or 1% SD stock solutions or placebo. Clinical, hematologic, and ultrasonographic evaluations were performed for 3 months and histology at 3 and 6 months. RESULTS: Both concentrations of SD induced an inflammatory response at the injection site, with dose-dependent adipocyte lysis. Patients reported mild, localized heat, erythema, swelling, and intense pain. Microscopic evaluation revealed necrosis of adipose tissue with adipocyte lysis, fat dissolution, acute lymphomononuclear inflammatory reaction, and intense phagocytosis of fat cells by macrophages. Fibrosis was observed only at the 6-month biopsy. Nodules at the injection sites, compatible with areas of inflammation, were detected by ultrasonography 2 weeks after the first injection. Placebo injections induced no histologic changes. CONCLUSIONS: SD induces an inflammatory reaction in subcutaneous human fat and dose-dependent adipocyte lysis with acute pain and fibrosis. No systemic effects were detected. Further studies will establish the best dose-result ratio, frequency of application, and long-term safety.
Assuntos
Tecido Adiposo/efeitos dos fármacos , Ácido Desoxicólico/farmacologia , Detergentes/farmacologia , Tela Subcutânea/efeitos dos fármacos , Tecido Adiposo/diagnóstico por imagem , Adulto , Idoso , Ácido Desoxicólico/administração & dosagem , Detergentes/administração & dosagem , Feminino , Humanos , Injeções Subcutâneas , Pessoa de Meia-Idade , Tela Subcutânea/diagnóstico por imagem , Inquéritos e Questionários , Resultado do Tratamento , UltrassonografiaRESUMO
BACKGROUND: Nasal wrinkles on the dorsum of the nose can frequently be treated with botulinum toxin type A by injecting a few units into the nasalis muscle. Between 2 and 5 U of botulinum toxin have commonly been used. However, clinicians have observed that some nasal wrinkles persist following nasalis treatment. OBJECTIVE: To detail remaining nasal and perinasal rhytids and further injection sites, which can lead to improvement. METHODS: Two hundred fifty patients with nasal rhytids were treated between 1997 and 2004. Three units of botulinum toxin type A were injected bilaterally into the nasalis muscle. Patients were seen at 1 month for follow-up, and the remaining rhytids were documented. RESULTS: Forty percent of patients had satisfactory treatment of nasal wrinkles with the initial bilateral 3 U injections. Sixty percent of subjects had remaining nasal rhytids following the nasalis muscle injections. Thirty percent o f subjects hadpersistent wrinkles at the root of the nose (nasal orbicular wrinkles), and 30% had wrinkles at the nasal root and between the eyes (nasociliary wrinkles). The injection of botulinum toxin into additional locations according to the anatomic differences of each person showed excellent resolution of the rhytids without complications. CONCLUSION: Understanding nasal wrinkle patterns allows for complete wrinkle treatment of the nose beyond simple bilateral treatment of the nasalis. New points of botulinum toxin application improve not only wrinkles at the root of the nose but also wrinkles in the nasoalar area.