Comparison between fibroblasts and mesenchymal stem cells derived from dermal and adipose tissue.

OBJECTIVE: Stem cells have the ability to renew themselves and differentiate into various cell types. For this reason, numerous research groups have been studying these cells for their therapeutic potential. Some of the therapies, however, are not producing the expected results because of contamination by other cell types, especially by fibroblasts. In the cosmetic industry, stem cells are used to test the efficacy of anti-ageing and rejuvenation products. The purpose of this work was to gain a better understanding of the differences in phenotype, in gene expression associated with stem cells, in the pattern of cell surface proteins and in the differentiation capacity of adipose-derived stem cells, of skin-derived stem cells and of commercially available fibroblasts. METHODS: In this study, we compared fibroblasts with mesenchymal stem cells derived from bone marrow, skin (dermis) and adipose tissue, to assess the differentiation potential of fibroblasts. Dermal and adipose stem cells were isolated from aesthetic surgery patients, and fibroblasts were obtained from a commercial source. The following parameters were used in this study: immunophenotypic profile (positive: CD29, CD73, CD90 and CD105; negative: CD14, CD45 and HLA-DR); differentiation into osteoblastic, chondrogenic and adipogenic cell types; and PCR array to analyse the gene expression of cells isolated from different culture passages. RESULTS: Fibroblasts express the same cell immunophenotypic markers, as well as the genes that are known to be expressed in stem cells, and were shown to be expressed also in adipose and dermis stem cells. Fibroblasts are also able to differentiate into the three cell lineages mentioned above, that is, adipocytes, osteocytes and chondrocytes. CONCLUSION: Human dermal fibroblasts have a potential to adhere to plastic surfaces and differentiate into other cell types. However, for stem cells intended to be used in cosmetics, experiments conducted with contaminated fibroblasts may produce poor or even falsely negative results for the efficacy of the active ingredient or formulation and thus conceal their promising effects as anti-ageing and skin rejuvenation products.

Inclusão de prótese mamária por via perimamilar: relato de caso / Mammary prostheses inclusion via perimammilar: case report

Mamaplastia de aumento é cirurgia amplamente realizada em todo o mundo, com tendência atual de redução de cicatrizes. Em casos onde a aréola é grande e não há ptose mamária, pode-se utilizar a via transareolomamilar, com redução da aréola e cicatiz na base do mamilo. Apresentamos o relato de um caso de inclusão de prótese mamária com redução do complexo aréolo-mamilar e cicatriz perimamilarn.

Augmentation mammaplasty is a very common surgery performed around the world. This paper presents a case report where we used a surgical access positioning the scar around the nipple.

Lipoaspiração ultrassônica em ginecomastia / Ultra-sound assisted liposuction in gynecomastias

A lipoaspiração ultrassônica vem se tornando bastante indicada no tratamento das ginecomastias, devi- do à boa qualidade dos resultados obtidos. O presente estudo relata 11 casos de ginecomastia glandular e glândulo-gordurosa, no período de 1999 a 2002, submetidos à lipoaspiração ultrassônica e lipoaspiração convencional complementar, com cânulas de médio e pequeno calibres. Foi utilizado o equipamento Lisonix 2000, numa amplitude de 5, ou seja, 50 da potência do aparelho, com cânulas de 32 cm de comprimento e 3 mm de diâmetro. O volume médio aspirado, pela lipoaspiração ultrassônica, foi de 222 ml na mama direita e de 225 ml na mama esquerda, enquanto que o volume aspirado por lipoaspiração convencional foi de 200 ml e de 205 ml, respectivamente, totalizando em média, 852 ml por paciente. O tempo médio de lipoaspiração ultrassônica foi de 7 minutos e 12 segundos. Podemos concluir que, a lipoaspiração ultrassônica tem sua indicação, tanto em ginecomastia gordurosa quanto glandular, com uma evolução pós- operatória mais rápida, sem a necessidade de uma incisão na aréola e ressecção cirúrgica da glândula ma- mária.

The ultrasound assisted liposuction is becoming more popular in treating gynecomastias. This paper reports 11 cases of fatty-glandular breasts treated from 1999 to 2002 at private clinic, which were undertaken to ultrasound-assisted lipoplasty and complementary conventional liposuction, with small and medium canulas. Lisonix 2000 was used with 32 cm length canulas and diameter of 3 mm.The medium volume aspirated by ultrasound- assisted lipoplasty in the right breast was 222 ml and 225 ml were aspirated from the left breast, while the volume aspirated by conventional liposuction was 200 ml and 205 ml, respectively, with a total of 852 ml per patient. The medium time of liposuction for each side was 7 minutes and 12 seconds. The ultrasound-assisted lipoplasty is indicated either in fatty or glandular gynecomastia, with better results when compared with conventional liposuction. It has a faster recovery period without the need for glandular tissue resection.

Subfascial endoscopic transaxillary augmentation mammaplasty.

Video endoscopy for breast hypoplasia and glabellar frown lines has been used since 1996 at our private clinic. Breast augmentation with an S-shape incision for transaxillary access is utilized to introduce the implant, in a submuscular or subglandular and, recently (since October 1998), in a subfascial location. From August 1998 through January 1999, 62 patients underwent endoscopic surgeries; 49 were submuscular, 5 subglandular, and 8 subfascial. McGhan 410, anatomical biodimensional implants 155 to 235 g, were used. We observed three cases of complications, two of them malpositioning (rotation), needing reoperation, and one hematoma, treated with drainage. Patient satisfaction was high, especially regarding the axillary incision. There have been no capsular contractions to date.

Full-face laser resurfacing and rhytidectomy.

The Ultrapulse CO2 laser (Coherent Inc., Palo Alto, CA, USA) was used in 239 patients, from March 1996 to July 1998, for full-face laser resurfacing. In 106 (43%) of these patients rhytidectomy was performed in the same procedure. All patients submitted to laser resurfacing were prepared for 1 to 2 months beforehand with retinoic acid and hydroquinone. The procedures were done under local anesthesia controlled by an anesthesiologist. A clear film dressing impregnated with silicone gel (Silon TSR; Bio-Med Sciences, Bethlehem, PA, USA) was used for 6 to 7 days and complete healing was observed in 7 to 10 days. Complications were exclusively dermatologic, without relation to surgery. No necrosis of the cutaneous flap was observed. Skin biopsies of 10 consecutive patients undergoing the combined procedures revealed no vascular impairment to the dermis. The patients were able to resume their activities 2 weeks after the procedure.

Utilizacao do retalho de lingua nas lesoes labio-palatinas. / Use of tongue flaps in cleft palate

Os autores apresentam quatro casos em que foi realizado retalho de lingua, sendo tres para fechamento de fistulas palatinas e um caso para correcao de atrofia de labio superior pos-irradiacao. Discutem a indicacao desta tecnica e a sua vantagem em relacao a outros metodos de tratamento destas patologias. O retalho e confeccionado na regiao dorsal mediana da lingua, com base anterior. O segundo tempo e realizado apos 15 dias, para liberacao do pediculo e modelagem do retalho, com os retoques necessarios para o completo fechamento da area a ser preenchida pelo retalho. Os autores acreditam que a imobilizacao da lingua com sua fixacao tanto a arcada dentaria como ao labio inferior sao necessarios somente quando nao houver compreensao por parte do paciente ou se este apresentar baixa idade. Finalmente apresentam e discutem os resultados obtidos com o metodo empregado