RESUMO
Incorporation of new technologies to assist the liposuction procedure is becoming increasingly common. These technologies allow for a softer technique, balanced shaping, elimination of excess adipose tissue, and skin tightening. Some of these technologies include ultrasound (US; US-assisted liposculpture, VASER-assisted liposuction), power suction (power-assisted liposuction), radiofrequency (RF; RF-assisted lipolysis), and laser (laser-assisted liposuction). In addition, some of these devices have been shown to reduce the incidence of hematomas/inflammation and shorten recovery time. We report our experience in high-definition liposculpture of the arms in addition to new technologies to improve skin retraction, comparing their results in terms of complications, satisfaction score, and aesthetic outcomes. We included patients with mild-to-moderate arm dermatochalasis (Duncan classification) fat deposits in the upper extremities who were considered candidates for third-generation US-assisted liposculpture, power-assisted liposuction, RF-assisted lipolysis/skin tightening, and laser-assisted liposuction. A total of 683 consecutive patients met the inclusion criteria for the study. Most of them were women (n = 605, 88%). Fat grafting was performed in 80 patients (11.7%). A significant portion of the patients were secondary cases (n = 223, 33%). Age ranged from 18 to 70 years (median = 38 years). BMI ranged from 17.8 to 34.8 kg/m2 (mean = 24.3 kg/m2). RF-assisted and laser-assisted high-definition liposculpture of the arms are both effective and reproducible techniques for patients who seek an athletic and slim arm contour. A low rate of complications and high satisfaction index support our findings.
RESUMO
Introducción y objetivo: El cirujano plástico que realiza rinoplastia se enfrenta a pacientes con diferentes características según su etnia. Entre las estrategias implementadas para pacientes sometidos a rinoplastia se ha descrito el uso de isotretinoina para el manejo de pieles gruesas. Actualmente existen diferentes vacíos en la literatura sobre el beneficio y las complicaciones asociadas a este tipo de tratamiento en rinoplastia. El objetivo del presente trabajo es revisar la evidencia disponible en la literatura sobre los beneficios y riesgos derivados del uso de isotretinoina y rinoplastia Material y método: Desarrollamos una revisión del alcance del conocimiento en las diferentes bases de datos: Cochrane, PubMed, Embase, SAGE, Sciencie Direct, Taylor and Francis, utilizando los términos Mesh Rhinoplasty AND Isotretinoin para posteriormente evaluar los diferentes criterios de inclusión y exclusión que permitieron filtrar artículos evaluados en inglés y español. Resultados: Recogimos en total 2621 artículos publicados entre enero del 2005 y junio del 2022, de los cuales 13 cumplieron con los criterios establecidos por los investigadores para su análisis: 5 reportes de caso, 2 revisiones narrativas, 2 artículos tipo experimental, 1 consenso de expertos, 1 de casos y controles, 1 estudio multicéntrico y 1 revisión sistemática de la literatura. Conclusiones: La isotretinoina es un medicamento que, en diferentes artículos revisados, se demuestra seguro en su uso concomitante con procedimientos faciales como la rinoplastia y genera resultados favorables estéticos en paciente con nariz de piel gruesa en los 6 primeros meses de postoperatorio. Sin embargo, su uso debe ser analizado de manera individual puesto que puede llegar a producir efectos adversos tales como piel seca y adelgazamiento excesivo de la piel nasal. (AU)
Background and objective: Plastic surgeons who perform rhinoplasty face with patients with different characteristics depending on their ethnicity. Among the strategies implemented for these patients, the use of isotretinoin has been described for the management of thick skin. Currently, there are multiple gaps in the literature regarding the benefit and associated complications of this type of treatment in rhinoplasty. The objective of this study is to review the evidence available in the literature on the benefits and risks derived from the use of isotretinoin and rhinoplasty. Methods: A scoping review of the literature was developed on data base: PubMed Central (PMC), Cochrane, Sciencie Direct, Taylor and Francis Databases using Mesh terms Rhinoplsaty AND Isotretinoin. The articles were evaluated and classified to identify the available evidence in English and Spanish. Results: A review of 2621 articles published on different databases between January 2005 and June 2022 was performed, and 13 articles met the criteria established by the researchers for their analysis: 5 case reports, 2 narrative reviews, 2 controlled trials, 1 expert consensus, 1 case and control, 1 multicenter study, and 1 systematic review of the literature. Conclusions: Isotretinoin is a safe drug in concomitant use with facial procedures such as rhinoplasty and generates favorable aesthetic results in patients with a thick-skinned nose in the first 6 postoperative months. However, its use must be analyzed individually in every case since it can produce adverse effects such as dry skin and excessive thinning of the nasal skin. (AU)
