Efficacy and Safety of an Anti-aging Technology for the Treatment of Facial Wrinkles and Skin Moisturization.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of five topical test products intended to reduce the appearance of lines and wrinkles, increase skin moisturization, and reduce transepidermal water loss. DESIGN: Two studies-a controlled clinical trial for each individual test product and an experience trial involving more than 200 patients using a strategic combination of products-were done. Test products included a day facial cream, a night facial cream, an eye cream, a day lip cream, and a night lip cream. SETTING: The setting for the first study was AMA Laboratories (New York, New York)and 19 physician practices for the second. PARTICIPANTS: For the first study, participants were recruited via advertisements, phone solicitation, or electronic media. Patients of the second study (N=222) were from 19 physician practices. MEASUREMENTS: For the first study, efficacies of the facial and eye creams were determined by measuring the surface evaluation of living skin, transepidermal water loss, and electroconductivity. Efficacy of the lip creams was evaluated by measuring surface evaluation of living skin and electroconductivity. These evaluation parameters were measured at the test sites prior to initial application of test product,15 minutes after the initial application, and at seven, 14, 28, and 56 days of test product use. For the second study, each subject completed an assessment of the topical product(s) effects after four weeks of use. RESULTS: With each of the five topical test products, an improvement in surface evaluation of living skin became apparent within 15 minutes of initial application of test products and continued for at least 56 days of regular use. Electroconductivity data showed that each product dramatically increased the moisture content in the skin almost immediately after application and for at least 56 days. Improvement in transepidermal water loss was nearly immediate and continued over time with the day and night facial creams and eye cream. For the experience trial, a significant majority of subjects achieved one or more endpoints within 30 days or less. CONCLUSION: The facial, eye, and lip creams are effective anti-aging products that reduce the appearance of both fine and coarse lines and wrinkles, dramatically increase the moisturization of the skin, and, in the case of the face and eye products, reduces transepidermal water loss. These changes last for at least 56 days without significant adverse effects.

Juvéderm injectable gel: a multicenter, double-blind, randomized study of safety and effectiveness.

BACKGROUND: A high concentration of crosslinked hyaluronic acid (HA) in a smooth, malleable formulation is the hallmark of the new Juvéderm dermal fillers. OBJECTIVE: To determine the long-term effectiveness and safety of Juvéderm Ultra and Ultra Plus injectable gel. METHODS: In the multicenter study approved by the Food and Drug Administration, subjects were randomized to treatment with Juvéderm Ultra or Ultra Plus in one nasolabial fold (NLF) and Zyplast collagen in the other. After optimal correction was achieved (treatment plus up to 2 touch-ups at 2-week intervals), effectiveness was assessed on a 5-point scale through the 6-month study period. An additional poststudy visit provided long-term effectiveness data. Safety was evaluated through subjects' daily diaries for 14 days after treatment. RESULTS: A total of 292 subjects were randomized and treated, 146 in each cohort. A total of 280 subjects completed the 6-month study, and 227 attended the poststudy visit. Clinically significant mean wrinkle correction (>or= 1 point improvement) was still in evidence at >9 months for both Juvéderm formulations but not for the Zyplast control. At >9 months, 75% of Juvéderm Ultra- and 81% of Juvéderm Ultra Plus-treated NLFs maintained a clinically significant correction. Moreover, 78% of NLFs treated with Juvéderm Ultra Plus still had a clinically significant improvement beyond 1 year. Local treatment site reactions were comparable for Juvéderm and Zyplast. CONCLUSIONS: These next-generation HA dermal fillers can be reliably expected to provide long-term correction, with Juvéderm Ultra lasting more than 9 months and Juvéderm Ultra Plus lasting for a year or more.

Radial plication in concentric mastopexy.

Concentric mastopexy presents many challenges to the plastic surgeon, especially when breast augmentation is part of the treatment plan. Radial plication is a reproducible and accurate technique for elevating the nipple-areolar complex and shaping the breast mound. Patient selection is important to the success of the radial plication procedure and concentric mastopexy in general. Although most surgeons agree that patients with smaller degrees of nipple ptosis and smaller breasts have better results than patients with greater degrees of nipple ptosis and larger breasts, there has never been an algorithm for patient selection. Regnault's classification of breast ptosis addresses the degree of nipple ptosis, but no consideration is given to breast volume. Radial placation proved to be a valuable tool in the treatment of 87 patients undergoing concentric mastopexy in the author's practice over the past 30 months. An algorithm addressing degrees of breast ptosis and breast volume is provided. The plastic surgeon can anticipate gratifying results if the algorithm provided is incorporated into his or her patient selection for concentric mastopexy. The concentric mastopexy technique is similar to the tailor tack procedure for standard mastopexy, allowing the plastic surgeon to mold and shape the breast before making a critical incision.