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Introduction: We propose a new facial lifting protocol using polydioxanone (PDO) threads embedded in acetyl hexapeptide-8 (Argireline [Arg]). We assume that Arg reinforces the effects of PDO threads, as it is a mimetic of botulinum toxin. Because the PDO suture is hydrolyzable, this assumption is analyzed by instrumental analysis. Objective: To demonstrate the capacity of the PDO suture as a system for the controlled release of acetyl hexapeptide-8 to apply in deep wrinkles of the upper third. Materials and Methods: Three segments of 1-cm long 21G PDO threads immersed in 1 mL of Arg. PDO threads were observed under an optical, electron microscope at 24, 48, and 72 h later. They were also weighed before and after being soaked in Arg, and employing ultraviolet (UV)-visible spectroscopy, the release rate of Arg from the PDO suture was measured. Finally, was insert the thread PDO-Arg following a protocol designed especially for deep static wrinkles in the upper third. Results: The electronic weighing revealed that the PDO thread enjoys capillarity by the peptide, doubling its weight every 24 h. UV spectra revealed that PDO thread is a well-controlled release system for Arg, allowing its sustained release for 1 h. Optical and electronic photomicrographs confirm the swelling of the PDO thread by absorbing Arg by its capillarity, but this hydrophilicity does not lead to its premature physical degradation. Conclusions: The PDO thread system with Arg is an intelligent bioactive system useful in facial harmonization. It recommend conduct clinical trial to verify his superior lifting effect.
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INTRODUCTION: Epidermal Growth Factor (rhEGF) is a promising skin antiaging agent that successfully promotes skin wound repair, and it has been investigated in the past decade for these purposes. However, there are no updated systematic reviews, in English or English, that support the efficacy of rhEGF as a regenerative skin treatment or systematic reviews that compile the uses of rhEGF as facial aesthetic therapy and regenerative medicine. AIM: To describe the current state of facial aesthetic and regenerative medicine treatments in which rhEGF has been effectively used. MATERIALS AND METHODS: An exhaustive search was carried out in "Medline" (via "PubMed"), "Cochrane," "Bireme" through the Virtual Health Library (VHL), "Elsevier" via "Science Direct," "Springer," "SciELo," "ResearchGate," and Google Scholar. Studies related to the use of rhEGF in addressing skin disorders or skin aging are included. RESULTS: Overall, 49 articles were found, which described the use of rhEGF for skin regeneration and restructuring. Efficacy in the regeneration of skin wounds was verified through the intradermal and topical application of formulations with rhEGF. Most clinical trials in aesthetics point to an effective inversion of skin aging. However, uncontrolled or randomized trials abound, so that does not represent enough evidence to establish its efficiency. There are transient adverse effects for both cases. CONCLUSION: The rhEGF considers an effective therapeutic alternative for patients with recalcitrant skin wounds and skin aging, as it is a potent and specific mitogenic factor for the skin.
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The diagnosis of aging based on the morphogeometric changes experienced by the face, measured by the application of facial stratigraphic semiology by thirds, could become a novel approach that guarantees an efficient replacement of aged tissues through minimally invasive aesthetic medicine strategies. Facial aging should be analyzed by thirds, because not all thirds grow old at the same time. Owing to this is necessary go giving solve the aging problems each one of them, by means of therapies of the facial restructuring into sequential treatment appointments, with the purpose of being go giving time to the tissues rearrangement of the face, so that it is perceived as a subtle progressive reversal of aging and so generate a comfortable social acceptance of the resulting changes of said facial rejuvenation. This article intends to present the practical approach of the concepts and guidelines illustrated in the routine aesthetic diagnosis, the anatomical changes in the various tissue layers that are externally appreciated, but detailing them under a regional approach (upper, middle, and lower thirds). Our paradigm seeks that as professionals of aesthetic and regenerative medicine we identify facial aging not only as the obvious wrinkles and other changes in the skin, but that we diagnose according to the proposed parameters, so that when considering the rejuvenation treatment, we identify which are facial tissues that have changed due to aging and must therefore be restored to harmonize the face according to the ideal forms and proportions that must prevail (morphometry).
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Recently, some clinicians have proposed implanting polydioxanone (PDO) threads imbibed in hyaluronic acid (HA), arguing that this may reinforce the lifting effects. However, this is controversial because PDO sutures are hydrophilic and the presence of HA could increase the rate of hydrolysis. The aim of this study was to demonstrate the degradation of PDO lifting threads in HA through ultramicroscopy. It was a qualitative research and preclinical trial. Three, 1-cm-long, segments of 23-G PDO threads were immersed in 1.5-mL non-crosslinked HA in previously labeled, sterile microcentrifuge tubes. These were observed by ultramicroscopy at 4× and 10× after 24, 48, and 72 h. Microphotographs taken after 24 h show structural changes in the fibers, presenting an increase in interlaminar spaces and dilution of violet pigmentation. At 48 h, degradation continues. PDO hygroscopy is observed as aqueous content between the peripheral layers and the central core of the thread. At 72 h, as the pigment is released, larger empty spaces are observed in the central column of the thread, and there is disorganization of the peripheral fibrils with fraying all along the fiber. HA induces rapid biodegradation of the PDO thread by hydrolysis beginning 24 h after contact of the thread with the biomaterial. The non-crosslinked HA is a powerful catalyzing agent for hydrolytic degradation of the PDO thread, because this thread is highly hydrophilic. Clinically, embedding PDO threads in HA accelerates biodegradation of the suture.
