Remodeling of the middle third of the face with fillers / Remodelamento do terço médio da face com preenchedores

Facial aging is a consequence of multiple intrinsic and extrinsic interactive factors, leading to loss of volume and repositioning of facial fat and bone remodeling. Breakthroughs have been seen in recent decades in the ability to reduce the signs of aging. Filling techniques and numerous products available on the market have generated new interest in the study of facial anatomy. Fillers are able to restore volume in limited areas and are suitable for treating facial wrinkles and loss of subcutaneous volume. The gold standard remains hyaluronic acid because it is more biocompatible and has greater permanence in the skin, without being definitive. The objective of this report is to review the anatomy of the middle third of the face and the main indications for filling and the techniques used for rejuvenation.

O envelhecimento facial é consequência de múltiplos fatores intrínsecos e extrínsecos que interagem entre si, levando à perda de volume e reposicionamento da gordura facial, assim como o remodelamento ósseo. Nas últimas décadas, houve um grande avanço na Medicina em reduzir os sinais do envelhecimento. As técnicas de preenchimento e os inúmeros produtos disponíveis no mercado trouxeram novo interesse no estudo da anatomia da face. Os preenchedores têm como função restaurar o volume de áreas restritas, portanto, são adequados para tratar rugas faciais e perda de volume subcutâneo. O padrão ouro atualmente é o ácido hialurônico, por ser mais biocompatível e ter uma permanência maior na pele, sem ser definitivo. O objetivo desse artigo é revisar a anatomia do terço médio da face, assim como as principais indicações de preenchimento e técnicas utilizadas para o rejuvenescimento.

Experience with the first Internet-based course at the Faculty of Medicine, University of Säo Paulo

PURPOSE: The Internet expands the range and flexibility of teaching options and enhances the ability to process the ever-increasing volume of medical knowledge. The aim of this study is to describe and discuss our experience with transforming a traditional medical training course into an Internet-based course. METHOD: Sixty-nine students were enrolled for a one-month course. They answered pre- and post-course questionnaires and took a multiple-choice test to evaluate the acquired knowledge. RESULTS: Students reported that the primary value for them of this Internet-based course was that they could choose the time of their class attendance (67 percent). The vast majority (94 percent) had a private computer and were used to visiting the Internet (75 percent) before the course. During the course, visits were mainly during the weekends (35 percent) and on the last week before the test (29 percent). Thirty-one percent reported that they could learn by reading only from the computer screen, without the necessity of printed material. Students were satisfied with this teaching method as evidenced by the 89 percent who reported enjoying the experience and the 88 percent who said they would enroll for another course via the Internet. The most positive aspect was freedom of scheduling, and the most negative was the lack of personal contact with the teacher. From the 80 multiple-choice questions, the mean of correct answers was 45.5, and of incorrect, 34.5. CONCLUSIONS: This study demonstrates that students can successfully learn with distance learning. It provides useful information for developing other Internet-based courses. The importance of this new tool for education in a large country like Brazil seems clear