Dermatologic Surgery最新文献

Background: Thread lifting, a minimally invasive alternative to facial rhytidectomy, has shifted from using nonabsorbable to absorbable sutures. Although many thread lift options exist, the impact of these different properties on complication rates remains unclear.

Objective: To systematically compare thread lift complication rates across different suture materials, textures, fixation methods, and lift locations.

Materials/methods: A systematic review was conducted through February 2024, following PRISMA guidelines, using multiple databases. The study focused on absorbable sutures, excluding nonabsorbable materials. Statistical analysis used Chi-Square tests with Bonferroni correction.

Results: Nineteen studies, encompassing 1,406 patients, met inclusion criteria. A total of 876 complications were reported. Ecchymosis (19.49%), swelling (16.79%), and tenderness (9.96%) were the most frequent complications, while hematoma (0.64%), paresthesia (1.14%), and infection (2.49%) were least frequent. Complications varied significantly among the studied factors. Swelling and ecchymosis were more associated with polycaprolactone sutures, barbed threads, and midface lifts. Barbed threads were associated with more complications than smooth or coned threads, as were floating threads compared with fixed threads.

Conclusion: Variations in thread lift suture materials and fixation technique were associated with different complication rates. Thread lifts using absorbable sutures exhibited complication rates under 5%, suggesting a generally favorable safety profile.

Background: Among the treatment modalities for post-acne scars, microneedling is considered a safe and effective method.

Objective: To compare the efficacy and safety of combined microneedling with topical insulin versus microneedling with placebo (topical saline) in treating atrophic acne scars.

Methods and materials: Twenty-one patients with atrophic post-acne scars were randomized and treated in a split face manner with 4 sessions at 3-week intervals of microneedling using dermapen, followed by application of insulin on one side of the face and saline (placebo) on the other side. Evaluation of response was done before the sessions and after 1 month of the last session using the Global Scarring Grading System of Goodman & Baron and Lipper & Perez scores, Patient reported acne scar improvement using a 4-point scale, patient satisfaction, and the facial acne scar quality of life tools.

Results: Both therapeutic modalities yielded a statistically significant improvement of atrophic acne scars. By comparing both modalities, there was no statistical significance regarding clinical improvement and side effects.

Conclusion: Using topical insulin combined with microneedling may have a value in improving atrophic acne scars, suggesting further evaluation using different delivery systems, insulin formulations, and assessment modalities.

Background: Correction of cheek wrinkles using poly-l-lactic acid (PLLA-SCA) was demonstrated in a 12-month study.

Objective: This analysis assessed change from baseline in lifting effect of PLLA-SCA using a 3D camera to provide additional quantified data.

Methods: Subjects received PLLA-SCA (reconstituted in 8 mL of sterile water + 1 mL of 2% lidocaine) in both cheeks or no treatment (control). Assessments included the Galderma Cheek Wrinkle Scale (GCWS), aesthetic improvement, and 3D photography. In subjects with severe GCWS at baseline, Canfield software analyzed 3D images for change from baseline in midface volume projection and volume change of both cheeks at Month 9.

Results: The primary study showed a statistically significant higher at-rest GCWS responder rate at Month 12 for PLLA-SCA, 71.6%, versus control, 26.1% (p < .0001). In this Month 9 analysis, mean midface volume projection demonstrated a positive volume shift for PLLA-SCA (left: 0.45 mm; right: 0.34 mm; n = 46) versus control (left: 0.25 mm; right: -0.01 mm; n = 21). Midface volume and max projection changes for PLLA-SCA were +4.88 mL/+1.62 mm (left), +2.84 mL/+1.12 mm (right) versus +0.26 mL/+0.34 mm (left), +0.68 mL/+0.37 mm (right) for control.

Conclusion: Poly-l-lactic acid-treatment of subjects with severe GCWS had a clinically meaningful lifting effect in both cheeks (positive volume shift, positive volume change, and max projection) in the midface.

Clinical trial registry number: NCT04124692.

Background: Periorbital dyschromia (POD) is a prevalent dermatologic problem with multifactorial etiology, making treatment outcomes inconsistent and unclear.

Objective: To evaluate and compose a comprehensive review of topical ingredients proven to be effective in the treatment of POD.

Materials and methods: Scopus, PubMed, and OVID databases were searched in a span of 30 years through December 31, 2023, to identify articles with original findings of topical therapies for the treatment of POD. Findings of interest were objectively and subjectively measured regarding pigmentation, skin texture, aesthetic improvement, elasticity, hydration, and eye-bag volume.

Results: The database searches yielded 339 unique studies. After screening and review, 22 studies were included totaling 13 nonrandomized control trials, 7 randomized clinical trials, 1 retrospective case series, and 1 prospective single-arm study. Studies included all reported statistically significant results with topical therapies inclusive of acids, bark extract, bicyclic monoterpene diols, caffeine, combo ingredient serums, ethyl ximenynate, gentiopicroside, glycosaminoglycans, growth factors, topical PRP, and vitamins.

Conclusion: The findings of this review suggest that topical therapies can be effective in the treatment of POD. Future trials should focus on delineating specific etiology of POD and evaluation of therapies specific to their cause.