Aplicación orbitaria de productos de relleno para optimización de simetría en pacientes con microftalmia o cavidades anoftálmicas adquiridas: revisión de la literatura / Aplicación orbitaria de productos de relleno para optimización de simetría en pacientes con microftalmia o cavidades anoftálmicas adquiridas: revisión de la literatura Orbital administration of fillers for optimization of symmetry in patients with microphthalmos or acquired anophthalmic sockets: A review

El tratamiento de la asimetría facial en pacientes con microftalmos o cavidades anoftálmicas adquiridas suele requerir cirugías reconstructivas agresivas. En los últimos años se han publicado trabajos sobre el uso de rellenos para optimizar la simetría del tejido orbitario, como técnicas mínimamente invasivas.Por este motivo, hemos realizado una revisión sistemática de la literatura publicada hasta el momento sobre la administración orbitaria de rellenos para el tratamiento de la pérdida de volumen. Se identificaron 14 artículos que cumplían con los criterios de selección; en los que se analizó el material utilizado, la técnica de inyección, el estudio anatómico de los pacientes antes del procedimiento y la presencia de complicaciones asociadas. Los materiales utilizados como relleno son: la grasa autóloga, la hidroxiapatita cálcica, el colágeno, el ácido hialurónico o el gel de poliacrilamida. Se aplicaron técnicas estándar de inyección peribulbar y retrobulbar, con escasas complicaciones asociadas, siendo la má grave el desarrollo de cuadros vaso-vagales. El seguimiento de los pacientes suele limitarse en la mayoría de los estudios a 12 meses, con variaciones significativas en la exoftalmometría posprocedimiento. En conclusión, la utilización de rellenos parece una práctica segura y con buenos resultados, aunque se precisan estudios con tiempo de seguimiento más prolongado que los publicados hasta el momento. (AU)

The treatment of facial asymmetry in patients with microphthalmos or acquired anophthalmic cavities usually requires aggressive reconstructive surgeries. In recent years, studies have been published on the use of fillers to optimize orbital tissue symmetry, as minimally invasive techniques.For this reason, we performed a systematic review of the literature published to date on the use of fillers for the treatment of volume loss in acquired anophthalmic or microphthalmic cavities. Fourteen articles were reviewed in which the material used, the injection technique, the anatomical study of the patients before the procedure and the presence of associated complications were analyzed.Various materials have been used as fillers, including autologous fat, calcium hydroxyapatite, collagen, hyaluronic acid, or polyacrylamide gel. Standard peribulbar and retrobulbar injection techniques were applied, with few associated complications, the most serious being the development of vasovagal symptoms. Patient follow-up is usually limited in most studies to 12 months.In Conclusion, the use of fillers seems to be a safe practice, with good results and few complications, although studies with longer follow-up times than those published to date would be required. (AU)

Calcinosis cutis / Calcinosis cutis

Caso clínico: presentamos el caso de una mujer de 48 años con dolor en senos maxilares y zonas temporales, en la que se apreciaron placas cálcicas subcutáneas faciales al realizar una tomografía axial computarizada (TC). La exploración física y los datos del laboratorio fueron normales. Reinterrogando a la paciente, comentó que un año antes se le había administrado un producto de relleno facial que contiene hidroxiapatita cálcica (CaHA) (Radiesse®). Discusión: las microesferas de CaHA son radiopacas por lo que pueden observarse en las radiografías convencionales, y sobre todo en la TC. Las características de las imágenes, habitualmente bilaterales, separadas del hueso, junto con el antecedente de inyección previa de este material, debe orientar al clínico para reconocer este hallazgo y diferenciarlo de otras condiciones patológicas. Dada la popularidad que ha adquirido esta técnica de rejuvenecimiento facial, conviene que los clínicos conozcamos las características de las imágenes producidas por el depósito de esta sustancia. (AU)

Case report: we report the case of a 48-year-old woman with pain in the maxillary sinuses and temporal areas. The presence of subcutaneous facial calcific plaques was confirmed in computed tomography (CT). Both the physical examination and the lab test results were within normal limits. Upon further questioning, the patient mentioned that she had been administered a facial filler product containing calcium hydroxyapatite (CaHA) (Radiesse®) the year before. Discussion: CaHA microspheres are radiopaque, making them visible through conventional x-rays, especially CT scans. The characteristic imaging features, typically bilateral and separate from the bone, along with the history of previous injection of this material, should help the clinician recognize this finding and isolate it from other conditions and diseases. Because of the popularity of this facial rejuvenation technique, clinicians should be familiar with the imaging characteristics associated with the deposition of this substance. (AU)

Orbital administration of fillers for optimization of symmetry in patients with microphthalmos or acquired anophthalmic sockets: A review.

The treatment of facial asymmetry in patients with microphthalmos or acquired anophthalmic sockets usually requires aggressive reconstructive surgeries. In recent years, studies have been published on the use of fillers to optimize orbital tissue symmetry, as minimally invasive techniques. For this reason, we performed a systematic review of the literature published to date on the use of fillers for the treatment of volume loss in acquired anophthalmic or microphthalmic cavities. Fourteen articles were reviewed in which the material used, the injection technique, the anatomical study of the patients before the procedure and the presence of associated complications were analyzed. Various materials have been used as fillers, including autologous fat, calcium hydroxyapatite, collagen, hyaluronic acid, or polyacrylamide gel. Standard peribulbar and retrobulbar injection techniques were applied, with few associated complications, the most serious being the development of vasovagal symptoms. Patient follow-up is usually limited in most studies to 12 months. In Conclusion, the use of fillers seems to be a safe practice, with good results and few complications, although studies with longer follow-up times than those published to date would be required.

Integral Facial Management of the Aesthetic Patient: The Skin Age Management Protocol. / Abordaje facial global del paciente estético: protocolo Skin Age Management.

Aesthetic dermatology includes many minimally invasive therapies that can help our patients age gracefully and discreetly. Because it is hard to systematize these treatments to make patients aware of the options they have for the area of the face they want to improve, at Clínica Dermatológica Internacional, we have developed the Skin Age Management (SAM) protocol. In this article, we describe the protocol, which is aimed at helping doctors and patients to better understand and plan available treatments, underlining the advisability of combining techniques with the goal of achieving discreet changes to obtain what we consider to be optimum results, based on our experience at our center.