Minimally invasive facial rejuvenation endolaser mid-face lift.

Endolaser mid-face lift was performed on patients in a multi-center study over a 36-month period (Feb. 1998 to Feb. 2001). It permits significant facial rejuvenation through small incisions. This technique achieves aesthetic results and wider rejuvenation while being less traumatic and creating minimal morbidity. Combined with other procedures, it rejuvenates the face by three strategic methods: soft tissue suspension, reversal of photo aging, and correction of the depletion of volume. To achieve this triple result, the mid-face lift is performed by endoscopic approach, and in every case is combined with the endoscopic lift of the frontal area. Laser resurfacing was used to reverse skin photo damage. The Ultrapulse CO2 laser and/or the Ultrafine Erbium YAG(Coherent, Inc, Palo Alto, CA) were used. The third combined procedure was the introduction of fat graft to compensate the atrophy/ptosis of fat and the depletion of bone mass (other filling materials besides fat may be used, depending on the preference of the surgeon). Our method of fixation using the Casagrande Needle (an evolution of Reverdin Needle) makes the mechanical purchase on the tissues to be suspended much easier, permitting the intra-oral and/or infra-orbital incisions to be eliminated. The present study of the technical evolution of the endolaser mid-face lift method allows us to conclude that a very satisfactory outcome has been reached, offering patients a minimally invasive procedure, which can be performed under local anesthesia, with low morbidity, imperceptible incisions, and an excellent long-term result.

Augmentation of the buttocks by micro fat grafting.

BACKGROUND: Requests for buttock augmentation are increasing in the United States because of changes in lifestyle and fashion that emphasize the "gluteal aesthetic unit." OBJECTIVES: We review the use of micro fat grafting for enhancing the buttocks in a series of 566 patients. METHODS: Tumescent solution (1 mg epinephrine per 1000 mL saline solution) was infiltrated; for small cases the volume used was less than half the amount of expected fat to be harvested. Harvesting was accomplished either manually with a syringe or with a liposuction pump that allowed precise control of the vacuum. The fat was injected both intramuscularly and subcutaneously into all levels of the desired area for augmentation of the buttocks. The typical augmentation averaged 300 to 400 mL per side but ranged from 175 mL to about 800 mL, depending on the patient's desires and the amount of donor fat available. RESULTS: Patient and physician satisfaction with the results was high. Approximately 50% to 75% of the fat grafted remains in the long term. Complications included cellulitis (1.9% of cases), which responded promptly to treatment with cephalosporin, and infrequent seromas and hematomas (0.8% of cases). CONCLUSIONS: Buttock augmentation by micro fat grafting is a safe, simple procedure. Compared with implant placement, the advantages of micro fat grafting include greater flexibility in the size and placement of augmentations, less pain and faster recovery for the patient, and less risk of complications. The technique is limited only by the amount of donor fat available. (Aesthetic Surg J 2001;21:311-319.).