ABSTRACT
Background: While effective, DAc injections for submental fat (SMF) reduction carry risks, including vascular damage and skin necrosis when improperly administered. This study presents a novel approach to SMF reduction using blunt microcannulas for DAc injections, coupled with 3D stereophotogrammetry quantification (3D-SQ). Clinical presentation: A 47-year-old female with SMF underwent two DAc applications. 3D-SQ was performed before and after each treatment using a 3D-SQ system. The patient experienced a substantial total volume reduction of 14.81 mL in the submental area after two DAc applications. 3D-SQ analysis showed a gradual reduction in submental volume over time. Importantly, no serious adverse events were reported, with only minor pain and warmth at the treated site. The reduction of SMF through DAc injections involves adipocyte cell lysis, emphasizing the importance of proper injection technique to avoid adverse events. The use of blunt microcannulas offers a safer alternative, minimizing the risk of skin necrosis, ulceration, and intra-arterial injections. Additionally, cannulas reduce bruising due to their blunt design and fan technique, enhancing patient comfort and safety. Conclusion: This case report highlights the efficacy of a novel cannula approach for DAc SMF reduction, assessed by 3D-SQ. Blunt microcannulas may represent a safer option compared to hypodermic needles, reducing the likelihood of severe complications.
ABSTRACT
Myomodulation (MyoMo) using hyaluronic acid (HA) fillers can be considered as a novel aesthetic treatment for gummy smile (GS). However, literature is still lacking information about this procedure. For this reason, the aim of the present case report was to describe a technique for MyoMo with HA as an efficient alternative for the management of GS. A 36-year-old male patient attended to our clinic complaining about excessive gingival exposure when smiling. After a clinical and digital assessment, poor bone support was observed in the premaxilla area, resulting in an increasing contraction of the levator labii superioris alaeque nasi and levator anguli oris. A multilayer approach with HA filling was performed in order to impair muscle movement and limit excessive lip elevation. As a result, a reduction on the elevation of the upper lip while smiling was achieved, and an improvement on GS was achieved. Thus, it can be proposed that Myomo with HA acid may be an effective treatment for GS, with lasting and satisfactory results. However, high-quality studies are required in order to compare patient's satisfaction with this treatment and any other possible alternative.
ABSTRACT
Hereby, we objectively assessed the outcomes of a facial-lifting procedure with Botulinum toxin type A (BoNT-A) using a 3D stereophotogrammetry quantification (3D-SQ). A 46-year-old female patient received a full face BoNT-A treatment in a total dose of 180 Speywood Units (sU). Frontal, lateral and oblique photographs were taken before and 20 days after treatment, at rest and during mimic movements. Also, a facial scanning was performed before and 20 days after BoNT-A injections. The results were analyzed using a 3D-SQ software. The photographs showed a decrease in expression lines and dynamic wrinkles. In addition, a better-defined jawline and volume gain in the midface area with improvement of the profile appearance, due to the reduction of the sagging skin under the chin, was observed. The 3D-SQ showed volume gains of 1.17 ml on the right and of 1.59 ml on the left cheekbone areas, due to the cranially soft-tissue repositioning. In addition, a decrease in the volume of melomental folds areas (0.27ml on the right and 0.41 ml on the left side) was reported, compatible to the above-mentioned volume gain. Measurements considering cephalometric points showed a decrease in the total facial height (distance from Trichion to Mental points), suggesting a soft tissue dislocation in an upward direction. Finally, this case report showed quantitative results that can evidence the role of BoNT-A in facial- lifting procedures. These results reinforce the importance of using a 3D-SQ to assess the outcomes of BoNT-A and, probably, other aesthetic procedures.(AU)
No presente estudo avaliamos objetivamente os resultados de um procedimento de lifting facial com toxina botulínica tipo A (BoNT-A) usando uma quantificação de estereofotogrametria 3D (3D-SQ). Uma paciente do sexo feminino de 46 anos recebeu um tratamento facial completo com BoNT-A em uma dose total de 180 unidades Speywood (sU). Fotografias frontais, laterais e oblíquas foram tomadas antes e 20 dias após o tratamento, em repouso e durante os movimentos mímicos. Além disso, um escaneamento facial foi realizado antes e 20 dias após as injeções de BoNT-A. Os resultados foram analisados por meio de um software 3D-SQ. As fotografias mostraram uma diminuição das linhas de expressão e rugas dinâmicas. Além disso, observou-se um maxilar mais bem definido e ganho de volume na região média da face com melhora da aparência do perfil, devido à redução da flacidez da pele sob o queixo. O 3D-SQ apresentou ganho de volume de 1,17 ml à direita e 1,59 ml à esquerda, devido ao reposicionamento do tecido mole. Além disso, foi relatada diminuição do volume das áreas do sulco mentual (0,27 ml à direita e 0,41ml à esquerda), compatível com o ganho de volume acima citado. As medidas considerando os pontos cefalométricos mostraram uma diminuição da altura facial total (distância dos pontos Triquion ao Mentual), sugerindo um deslocamento superior dos tecidos moles. Em conclusão, este relato de caso mostrou resultados quantitativos que podem evidenciar o papel da BoNT-A em procedimentos de lifting facial. Esses resultados reforçam a importância da 3D-SQ para avaliar objetivamente os resultados de harmonização orofacial com BoNT-A e outros materiais. (AU)
