Injerto graso con factores de crecimiento y células madre / Fat graft with growth factors and stem cells

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Injerto de grasa y Ritidectomía / Fat injection and rhytidectomy

En este trabajo se expone por los autores, la importancia que tiene la inyección de grasa para el rejuvenecimiento facial, citando la técnica e instrumental, de diseño personal que emplean. Este tratamiento puede asociarse al "lifting" de cara y cuello según las necesidades del caso, lográndose modificar el contorno facial y una mejoría de la zona peribucal y peripalpebral dando un aspecto de juventud al rostro (AU)

This paper present our four years experience with the treatment by fat injection into the nasolabial folds and facial wrinkles. In the 90 % of our face lift surgery we perform this method. There are many teechniques describing the treatment of the facial atrophic defects with the employment of skin flaps and dermofat flaps. Also there are repleishing material like silicone and collagen that gives variable results. With the new treatment of fat injection we improve different facial and body areas, including acne scars, nasolabial folds, perioral zone and the secondary liposuction depressions. Fat injection used in combination with the face lifting gives the surgeon the possibility of improving facial areas difficult to correct with the common procedure. We consider that the fat injection has won recntly great popularity in the treatment of some soft tissue defects because until now it has been totally innocuos to the patient, adding a very short time to the surgical procedure.The physician´s expreince, the goog technique and the correct patient selection and methodology assist the surgeon to obtain the best results (AU)

Un nuevo enfoque de la remodelación del contorno corporal mediante el uso de lipoaspiración asistida con láser de diodo 1210 / A new approach to contour remodeling body through the use of assisted liposuction diode laser 1210

RESUMEN La lipoaspiración, técnica tradicional usada para el tratamiento de las lipodistrofi as con cicatrices mínimas, ha sido a través de los años mejorada con los avances anestésicos, farmacológicos y de instrumental. A su vez han aparecido otras técnicas que han publicitado ventajas respecto del tiempo de recuperación, sintomatología y resultados estéticos. Una de estas técnicas es la lipoaspiración asistida con láser, a la que se atribuye menos dolor, menos equimosis y rápido posoperatorio, pero lo más importante que se le atribuye a esta técnica es la gran retracción dermoepidermica. Hay que hacer notar que para ello es necesario la correcta elección del paciente, ya que las resecciones y dermolipectomías no van a ser reemplazadas por esta técnica. Ya existen trabajos que acreditan estos benefi cios, por lo que decidimos estudiar si existen ventajas de la lipoaspiración asistida con láser asociadas a la longitud de onda que se utiliza. Para esto presentamos nuestra experiencia con el empleo de la lipoaspiración asistida con láser de DIODO 1210, con una muestra de 50 pacientes, a los cuales se aplicó dicha técnica en diferentes areas. Se evaluó el dolor en el posoperatorio inmediato, a las 24 horas y a las 48 horas. Los resultados mostraron que la lipoaspiración asistida con DIODO 1210 presenta menos dolor, rápida inserción laboral posoperatoria, menos equimosis y gran retracción de los tejidos

The liposuction, traditional technique used for the treatment of lipodystrophy with minimal scarring, has been improved over the years with advances anesthetics, pharmacological and instrumentation. In turn, other techniques have emerged that have publicized advantages over recovery time, symptomatology and aesthetic results. One such technique is the laser-assisted liposuction attributed to less pain, less bruising and faster postoperative, and most importantly it is attributed to this technique is the large dermoepidermal retraction, and it should be noted that this requires the correct choice of the patient, as dermolipectomy resections and will not be replaced by this técnica.Ya see work substantiating these benefi ts, so we decided to study whether there are advantages of laser assisted liposuction over the wavelength used. For this we present our experience with using assisted liposuction laser diode 1210, with a sample of 50 patients for whom this technique was applied in diff erent areas. We assessed postoperative pain at 24 hours and at 48 hours. The results showed that 1210 DIODO assisted liposuction include less pain, postoperative rapid job placement, less bruising and large tissue retraction.

Novel topical BoNTA (CosmeTox, toxin type A) cream used to treat hyperfunctional wrinkles of the face, mouth, and neck.

BACKGROUND: This study aimed to compare the effect of the stabilized novel topical botulinum neurotoxin type A (BoNTA) cream (CosmeTox) and a placebo cream on subjects, to compare clinician-reported outcomes, and to assess the safety and utility of the novel topical BoNTA cream for treating the entire upper face, chin, and neck areas. METHODS: This study randomized 40 female subjects to receive either topical BoNTA (CosmeTox) cream (2 U/ml) or an identical placebo cream (without BoNTA) on the face, chin, and neck areas. The subjects were followed for 12 weeks. The main outcome measures were the Facial Line Outcomes questionnaire scores and results from the Self-Perception of Age instrument, which assesses age of appearance relative to actual age. RESULTS: The BoNTA topical cream (CosmeTox) treatment produced significant improvements in the Facial Lines Outcome scores, which were maintained throughout the study period and lasted more than 3 months. The BoNTA topical cream treatment also reduced the age of appearance for a majority of subjects. The placebo had no effect on any measure. No serious adverse events occurred during the entire study period. CONCLUSION: Topical treatment with the stabilized BoNTA cream (CosmeTox) to the entire upper facial lines resulted in significantly improved facial features and age appearance, as measured by the subjects and clinicians. The BoNTA cream (CosmeTox) resulted in a significantly younger, more satisfying, relaxed appearance.

Endoscopic facelift: two years' experience.

In the upcoming Twenty-first Century, we will find many surgical methods and devices that come to fulfill one of the main objectives of the aesthetic plastic surgery: to reduce scars, especially in facial surgery. Endoscopy is one of those methods. In my experience of the last two years, I have used this technique, sometimes combined with CO2 laser to partially remove glabellar muscles and the platysma fibers of the middle part of the neck. This work shows the results from 160 patients undergoing endoscopic forehead lift and neck contouring, using specially designed instruments. The results are highly significant and satisfactory.

Fat injection: long-term follow-Up.

We used this procedure of fat injection to correct soft tissue defects, using the patient's own fatty tissue obtained by liposuction. We show the results of long-term follow up from 1984 to 1994. The main idea was to find a successful procedure in order to attain good specimen graft and long-term results. It was not an easy goal because of the high reabsortion of fatty tissue.

Endoscopic augmentation mastoplasty.

The authors present their experience with breast augmentation using endoscopy. They use an axillary approach to insert inflatable breast implants above the pectoralis muscle. The advantages of this method are that it is more comfortable to the patient, recovery is faster, it leaves no scars on the breasts, and there is no change in sensation.

Endoscopic subperiosteal forehead lift.

The author evaluates the new endoscopic treatment of the upper part of the face. The application of the endoscopic method for treating the effects of aging introduces great expectation for aesthetic plastic surgery. The procedure is performed under the periosteum, through tiny incisions near the hairline. The technique consists of releasing the periosteum from the orbital rim and the resection of the muscles: corrugators, procerus, orbicularis, and eventually the frontal muscle. The author reviews 61 cases over a period of ten months.

Comparative experimental study of autologous adipose tissue processed by different techniques.

Different techniques for processing adipose tissue were tested in 40 Swiss Albino female mice. Our study established that the use of insulin did not show any positive effect on survival of adipocytes during their transplantation. Likewise, the use of a centrifuge machine, at high or low speed, for separating the adipose tissue components, completely destroyed the adipose cells and did not allow their survival.

A new scalp flap for baldness.

The technique and results of a new scalp flap that solves frontal baldness are described. As a bipediculate flap it offers a great amount of hair when advanced and has a low rate of complications. This kind of flap has been used by us for four years in 36 patients in the age group between 20 and 60 years. The results obtained with the flap have been very satisfactory.

Fat injection.

The results of grafts of fat obtained through liposuction are presented. They are the outcome of the current revitalization of the old technique of fat extraction and transplant. Both doctor and patient should be aware that a successful treatment is achieved through continuity. Fat grafts evolve with respect to time and permanence with reabsorption a part of the normal evolutionary process. Fat reinjection is a consequence of tissue reabsorption or a complement of the preceding injection. There is no complication associated with repeated reinjection. All cases reported here include patients with two or more reinjections, depending on their pathology and evolution.

Fat-grafting injection for soft-tissue augmentation.

Autogenous graft tissue is better than homologous and heterologous tissue for the improvement of body contour to eliminate deep defects in the skin surface. This paper presents techniques for fat-graft injection obtained from liposuction and the instruments specially designed for this procedure. An analytical study is presented, and the final results obtained with this method are compared with different filling materials used for aesthetic and reconstructive purposes. A statistical study of 253 operated patients in a long-term follow-up (1984-1988) is registered. Special comments have been included relative to patient recovery, the amount of fat absorption and the amount of fat tissue remaining, and fat injection revisions and complications.

[Comparative study on lipoinjection and other methods]. / Estudio comparativo de la lipoinyección con otros métodos.

This paper present the method and technical description of the fat graft injection with the material obtained from the same patient (donor area) to correct the affected area (receptor), and also have the finality to remark the good aesthetic results and the patient acceptance. A comparative of the procedure advantage with other filling materials is effected, providing the highly permanence and minimal complications. An evaluation since 1984 is made, referring the innocuousness and facility of the method. We employ the autogenous tissue to make the aesthetic correction of the face wrinkles, nasolabial folds, and depression. With this technique we improve defects like facial atrophy, radiodystrophies, acne, scars, etc. In the same way we use the fat injection in combined procedures with lipoplasty, blepharoplasty, rhinoplasty and facelift. We made this histological study taking postoperative biopsies in some patients.

Palmar subcutaneous lipoma.

We report the case of a patient with a large palmar subcutaneous lipoma. The unusual site of the lesion and the importance of a differential diagnosis to rule out angiolipoma are stressed.

Liposuction fat grafts in face wrinkles and hemifacial atrophy.

We present the idea of correcting soft tissue defects with an injection of fat obtained by liposuction. Our method has great advantages, with few serious complications. The technique is described and the results are demonstrated in several patients treated over a period of one year.

[Surgical treatment of baldness. 20 years' experience]. / Tratamiento quirúrgico de la calvicie. Veinte años de experiencia.

After giving an introduction on the surgical treatment of alopecia in the last years, we talk about our experience with more than 2,500 patients. We discussed in individual chapters each one of the four major methods for the surgical management of male pattern alopecia: punch grafts, strip grafts, scalp reduction, flaps and combined techniques. In general more than the half of those patients have been seen and controlled for long time, because the most of them have continued with the clinic treatment in correspondence with the skin-hair pathology.

A new model of liposuction cannula.

A new design for the suction cannula used in suction curettage is presented. Based on several years' experience in patients from 17 to 63 years of age, the new device allows softer movements intraoperatively, a correct grasp, and excellent suction.

Suction curettage lipectomy.

In 1981, we started performing minor suction curettage with the elements available at that time. In the course of surgical practice, we have modified the suction system and devised a new pattern of suction cannulas adapted for this kind of operation, with all possible variants. During this period, we have treated 150 patients, ranging in age from 17 to 63 years. In the light of present knowledge, we consider it time to provide a systematization of this technique.