RESUMO
Objetivos: Definir el término cosmecéutica, presentar los ingredientes activos más comúnmente utilizados, sus indicaciones y ventajas. Evaluar nuestros productos para el cuidado y rejuvenecimiento de la piel, teniendo en cuenta variables como pigmentación, líneas de expresión y ritides finas, hidratación, brillo y envejecimiento. Diseño: Serie de Casos Materiales y métodos: Se realizó un estudio retrospectivo mediante análisis fotográfico ciego de 50 casos de rejuvenecimiento facial usando únicamente cosmecéutica seleccionados al azar durante el periodo Agosto 2015 Julio 2016. Se utilizó un régimen cosmecéutico personalizado incluyendo: limpieza y exfoliación, hidratación, reparación, despigmentantes, antienvejecimiento y fotoprotección, dos veces al día durante 6 meses. Las variables evaluadas mediante una escala semi-cuantitativa de 5 puntos fueron: pigmentación, ritides finas, envejecimiento en general, hidratación, brillo cutáneo y mejoría estética. La prueba no paramétrica de Wilcoxon fue seleccionada para evaluar significancia estadística. Resultados: Las lesiones pigmentadas, las ritides finas y el envejecimiento en general disminuyeron 32.7, 26.3 y 22%, respectivamente. Alcanzando significancia estadística (p<0,05). El brillo y la hidratación mejoraron en 47.5 y 55.3%, respectivamente. Se encontró una mejoría estética del 58%. La escala analógica visual reveló un rejuvenecimiento del 16,5% (p=0,0018). Conclusiones: La incorporación de cosmecéuticos en la práctica de la otorrinolaringología y la cirugía plástica facial mejora la apariencia de los pacientes, rejuvenece la piel y puede contribuir potenciando los resultados posoperatorios.
Objectives: To define cosmeceuticals, introduce common active ingredients, their indications and advantages, and to assess our skin care protocol anti-aging effects, improving dyschromia, wrinkles, hydration and other signs of aging. Design: Case Series Materials and methods: We developed a retrospective photographic analysis of 50 facial rejuvenation patients using our cosmeceuticals. A blind photographic analysis of dyschromia, fine wrinkles, overall aging, skin light reflection, hydration and aesthetic improvement using 5-point grading scales was carried out. The nonparametric Wilcoxon test was selected to evaluate statistical significance. A tailored cosmeceutical regimen including: cleaning and exfoliating, moisturizing, repairing, pigment lightening, anti-aging formulations and photo-protection was applied twice a day for 6 months. Results: Dyschromia, fine wrinkles and overall aging decreased 32.7, 26.3 and 22 percent, respectively. Reaching statistical significance (p<0,05). Luminosity, hydration and overall aesthetic change improved 47.5, 55.3 and 58 percent, respectively. The visual analog aging severity scale revealed a statistically significant 16,5% of rejuvenation (p=0,0018). Conclusions: Incorporating cosmeceuticals in the facial plastic surgery practice can promote a better overall patient experience by rejuvenating the skin, hastening postoperative healing and reducing common postoperative side effects.
Assuntos
Humanos , Cosmecêuticos , Cicatrização , Envelhecimento da PeleRESUMO
To determine if there are aesthetic differences in patients who have undergone a SMAS lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical vectors. To determine if there are aesthetic differences in the results of the neck using sutures placed in specific areas of the platysmal muscle versus randomly placed sutures for platysmal plication to the mastoid. Comparative, retrospective, blind, and randomized study. Evaluation of preoperative and postoperative photographs of 54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53 patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed by three external, unbiased facial plastic surgeons in a blind study. A 7-point scale was used to grade the improvement of the face and the neck. In the face, SMAS lifting with predominantly oblique-vertical vectors used during the procedure offer statistically better results (p ≤ 0.001) in comparison to predominantly oblique-horizontal vectors in the aesthetical improvement of the malar eminence, melolabial fold and jowls. In the neck, both techniques offer excellent results, but the sutures used for platysmal plication in specific areas offer no statistical differences in aesthetical results from those sutures that are randomly placed in the platysmal muscle. In our study of 107 patients, SMAS lifting using predominantly oblique-vertical vectors seem to have better results than using predominantly oblique-horizontal vectors. For the neck, we do not find statistical differences between randomly placed sutures for platysmal plication versus sutures placed in specific areas of the muscle.
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Estética , Ritidoplastia/métodos , Técnicas de Sutura , Adulto , Idoso , Face , Feminino , Humanos , Lipectomia , Masculino , Pessoa de Meia-Idade , Pescoço , Fotografação , Estudos Retrospectivos , Método Simples-Cego , Resultado do TratamentoRESUMO
IMPORTANCE Nasal tip revision remains one of the most challenging surgical procedures for facial plastic surgeons to perform. OBJECTIVE To describe preoperative and postoperative findings related to nasal tip functional and aesthetic aspects following revision rhinoplasty using the "tripod" technique. DESIGN, SETTING, AND PARTICIPANTS A retrospective descriptive study was performed in patients who underwent revision rhinoplasty between 2007 and 2012 at a clinic in Bogota, Colombia. A preoperative diagnosis of nasal tip deformity was made on the basis of photographic records and compared with postoperative nasal tip findings in patients who required the tripod technique. Photographs were evaluated before and after surgery every month for the first 3 months, and after 6, 9, and 12 months postoperatively. MAIN OUTCOMES AND MEASURES Nasal projection, tip rotation, columellar and alar retraction, alar pinch, lack of tip definition, and nasal tip asymmetry. RESULTS Sixty-four of the 69 patients who received revision rhinoplasty using the tripod technique during the study period were enrolled in the study. The tripod technique improved all of the following aesthetic and functional parameters (all P < .001). Nasal tip definition improved in 43 of 49 patients (88%). After surgery, projection was normal in 28 of 40 patients (70%) who had underprojection and overprojection preoperatively, and rotation improved in 29 of 38 patients (76%) who had overrotation or underrotation preoperatively. Columellar retraction improved after surgery in 18 of 24 patients (75%). The alar region improved in 41 of 52 patients (79%) who had alar retraction and/or pinch preoperatively, and inspiratory collapse improved in 49 of 50 patients (98%). CONCLUSIONS AND RELEVANCE The tripod technique is an efficient surgical alternative for nasal tip reconstruction during revision rhinoplasty. This technique allows the destroyed cartilaginous framework to be recreated and returns original nasal tip appearance with stable results. LEVEL OF EVIDENCE 4.
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Cartilagem da Orelha/transplante , Cartilagens Nasais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Rinoplastia/efeitos adversos , Retalhos Cirúrgicos , Adolescente , Adulto , Estudos de Coortes , Estética , Feminino , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação/métodos , Estudos Retrospectivos , Rinoplastia/métodos , Medição de Risco , Coleta de Tecidos e Órgãos/métodos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: Presentation and evaluation of results of the surgical technique of cervicofacial rhytidectomy used by the senior author (F.P.), using the classification of facial aging to determine the stage of pre- and postsurgical age. METHODS: The surgical technique was used in 1,181 patients operated on in the past 29 years, starting in 1983. We analyzed retrospectively 318 patients operated on between the years 2001 and 2008, of whom 71 patients met the selection criteria. Postoperative follow-up period was from 6 months to 5 years. RESULTS: All patients in stage I showed clinically visible rejuvenation postoperatively. Significant improvement in facial rejuvenation in stages II and III of aging was shown, with a postoperative change of stage. CONCLUSION: The technique of cervicofacial rhytidectomy with short flap, facial superficial musculoaponeurotic system (SMAS) imbrication, cervical SMAS plication, inconspicuous incisions, and postauricular z-plasty allows for successful and sustainable results over time, with short recovery time and minimal complications. The classification of facial aging pre- and postsurgery has been useful for the assessment of surgical results.