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1.
Dermatol Surg ; 46(1): 70-77, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30883481

RESUMO

BACKGROUND: ATX-101 is approved for submental fat reduction. OBJECTIVE: To characterize the histological effect of ATX-101 injection into subcutaneous fat. METHODS: This Phase 1 open-label study enrolled 14 adults to receive injections of ATX-101 into abdominal fat at varying concentrations (0.5%, 1.0%, 2.0%, or 4.0%), volumes (0.2 or 0.4 mL), spacing (0.7, 1.0, or 1.5 cm), and time points before scheduled abdominoplasty (1, 3, 7, or 28 days). During abdominoplasty, tissue was excised and preserved for histology. RESULTS: All injection paradigms resulted in histological changes confined to the subcutaneous layer, which were more prominent at higher concentrations and independent of volume and spacing. Key features at Day 1 after injection were adipocytolysis, blood vessel injury, neutrophilic inflammation, and lysis of locally present neutrophils. At Day 3, inflammation was reduced versus Day 1, and hemorrhage and lipid lake formation (at higher concentrations) were observed. Day 7 samples exhibited prominent adipocytolysis, mild inflammation, lipid-laden macrophages in the septae, and repair of vascular injury. At Day 28, inflammation was largely resolved and prominent features were septal thickening, neovascularization, and atrophy of fat lobules. CONCLUSION: Subcutaneous injection of ATX-101 induces adipocytolysis and local inflammation with septal thickening and resolution of inflammation by 28 days after injection.


Assuntos
Colagogos e Coleréticos/farmacologia , Técnicas Cosméticas , Ácido Desoxicólico/farmacologia , Gordura Subcutânea Abdominal/efeitos dos fármacos , Gordura Subcutânea Abdominal/patologia , Adulto , Feminino , Humanos , Injeções Subcutâneas , Pessoa de Meia-Idade , Fatores de Tempo
2.
Plast Reconstr Surg Glob Open ; 7(8): e2344, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31592039

RESUMO

Dual-plane augmentation mammaplasty has gained wide popularity in treating breast ptosis. However, in our experience, dual-plane augmentation mastopexy fails to treat severe cases of ptosis (grade 3) and glandular ptosis. Therefore, we conceived a method to manage these cases effectively. The aim was to achieve harmonious, natural fullness, better projection, and appropriate size with limited scarring. We named this technique triple-plane augmentation mastopexy as three planes are used: the first plane is the subfascial plane, the second is the subglandular plane, and the third is the subpectoral plane. METHODS: A retrospective review was performed of 75 consecutive cases of grade 3 or glandular ptosis treated in a single clinic by three separate surgeons adopting the same technique from January 2010 to January 2017. Triple-plane augmentation mastopexy begins by undermining the breast tissue through a tunnel until the second rib is in the prepectoral plane. Then, the subpectoral pocket for the implant is dissected with release of the lower border of the pectoralis major and avoiding release of the sternal border. Subsequently, the breast tissue is suspended at the lower border of the second rib, followed by subpectoral insertion of the implant and skin envelope excision. RESULTS: Surgical follow-up varied from a minimum of 6 months to a maximum of 6 years, with an average of 3 years. Among a total of 75 patients, 64 patients (85.3%) complied with follow-up and 49 (76.5%) of these patients were satisfied. Complications varied from early complications (14.6%) to late complications (21.5%). CONCLUSIONS: Grade 3 and glandular ptosis represent a challenge to plastic surgeons. Traditional techniques may fail to achieve optimized results. Triple-plane augmentation mastopexy is a safe, reliable procedure that ensures long-term desired aesthetic outcomes with limited scarring.

4.
Plast Reconstr Surg ; 139(4): 839-845, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28002252

RESUMO

BACKGROUND: In aesthetic clinical practice, surgical outcome is best measured by patient satisfaction and quality of life. For many years, there has been a lack of validated questionnaires. Recently, the FACE-Q was introduced, and the authors present the largest series of face-lift patients evaluated by the FACE-Q with the longest follow-up to date. METHODS: Two hundred consecutive patients were identified who underwent high-superficial musculoaponeurotic system face lifts, with or without additional facial rejuvenation procedures, between January of 2005 and January of 2015. Patients were sent eight FACE-Q scales and were asked to answer questions with regard to their satisfaction. Rank analysis of covariance was used to compare different subgroups. RESULTS: The response rate was 38 percent. Combination of face lift with other procedures resulted in higher satisfaction than face lift alone (p < 0.05). Patients who underwent lipofilling as part of their face lift showed higher satisfaction than patients without lipofilling in three subscales (p < 0.05). CONCLUSIONS: Facial rejuvenation surgery, combining a high-superficial musculoaponeurotic system face lift with lipofilling and/or other facial rejuvenation procedures, resulted in a high level of patient satisfaction. The authors recommend the implementation of the FACE-Q by physicians involved in aesthetic facial surgery, to validate their clinical outcomes from a patient's perspective.


Assuntos
Técnicas Cosméticas , Face/cirurgia , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Ritidoplastia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos
8.
Plast Reconstr Surg ; 115(5): 73e-75e, 2005 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-15809576

RESUMO

Fire is a rare but potentially disastrous operating room misadventure. In this article, the authors describe the elements of operating room fires and present an illustrative case. The risk of fire can be minimized when the operating room team understands the interactions among the three sides of the classic fire triangle: oxidizers, fuels, and ignition sources. Lists of fire prevention techniques and steps to take in the event of an operating room fire are provided.


Assuntos
Incêndios , Salas Cirúrgicas , Adulto , Cateterismo , Calázio/cirurgia , Eletrocoagulação , Feminino , Incêndios/prevenção & controle , Incêndios/estatística & dados numéricos , Humanos , Terapia a Laser , Gestão da Segurança , Estados Unidos
9.
Ann Plast Surg ; 52(3): 293-6, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15156985

RESUMO

A simplified approach to subperiosteal midface lifting with suspension is described, which has been performed on 75 patients since 1986. In comparison with standard facelifting, this technique results in long-lasting vertical resuspension of ptotic midfacial tissues. To date there has been a high rate of patient satisfaction with no cases of nerve injury or hematoma. There is a rare incidence of minor complications.


Assuntos
Blefaroplastia/métodos , Periósteo/cirurgia , Ritidoplastia/métodos , Adulto , Blefaroplastia/normas , Ossos Faciais/anatomia & histologia , Músculos Faciais/anatomia & histologia , Músculos Faciais/cirurgia , Nervo Facial/anatomia & histologia , Fáscia/anatomia & histologia , Fasciotomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Ritidoplastia/normas , Fatores de Tempo , Resultado do Tratamento
12.
Surg Technol Int ; I: 339-343, 1991 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28581565

RESUMO

New developments in computerised tomography (CT) imaging technology have paralleled advances in craniofacial surgical techniques. The ability to reconstruct congenital, neoplastic, and traumatic deformities is dependent upon good pre-operative assessment. Understanding the spatial relationship of a given deformity is limited with conventional two-dimensional CT scans. A more precise, reproducible portrayal of the craniofacial problem has been' made possible with the development of three-dimensional CT scan capabilities.

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