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PubMed2004

Microcoblation: nonablative skin rejuvenation.

Microcoblation is the application of a controlled high-energy plasma field to intact aging skin. The treatment is nonablative and yields predictable, reversible histological changes in the epidermis, which result in skin rejuvenation. Recovery time and side effects are minimal. Although the mechanism of action is different, patient satisfaction with microcoblation compares very favorably with microdermabrasion, the traditional method of superficial skin rejuvenation.

Adult↗
PubMed2004

Rejuvenation of ageing bean leaves under the effect of low-dose stressors.

The effect of low concentrations of some stress-inducing compounds like Cd, Pb, Ni, and Ti salts and DCMU on the senescence of chloroplasts was investigated in detached primary leaves of bean. After the petioles of ageing leaves had developed roots, these low-dose stressors stimulated chlorophyll synthesis and photosynthetic activity, as compared to the control, thus causing rejuvenation in treated leaves. The amount of photosystem I (lowest in DCMU-treated leaves) and light-harvesting complex II increased, while that of photosystem II decreased or remained unchanged. Fluorescence induction parameters indicated unchanged electron transport (except for DCMU treatment). CO2 fixation and, in some cases, starch accumulation was stimulated. In parallel, the occurrence of large plastoglobuli seemed to decrease in plastids of heavy metal-treated leaves. A cytokinin bioassay of leaf extracts confirmed the cytokinin-mediated effect of low-dose stressors, as the slopes of Chl and cytokinin curves were similar during the rejuvenation process. It is assumed that these stressors generate non-specific alarm reactions, which involve changes in the hormonal balance by increasing the synthesis of cytokinins.

Chlorophyll↗
PubMed2005

Rejuvenation of the lower eyelid complex.

Blepharoplasty is one of the most common cosmetic surgeries performed on the male patient. Whereas in the past the male patient would present later in life for eyelid surgery to address functional issues, he now presents earlier in life with an interest in aesthetic improvement as the primary motivating factor. This article reviews the approach of the senior author (SWP) to rejuvenation of the lower eyelid complex. Specifically, we discuss the indications for and techniques of the transcutaneous and transconjunctival approaches for blepharoplasty. As well, adjunctive procedures for rejuvenation of the lower eyelid complex, including fat transposition, lateral canthoplasty, and skin resurfacing, are reviewed.

Adipose Tissue↗
PubMed2005

The lamellar peel: a sequential nonablative and ablative laser treatment for facial skin rejuvenation.

OBJECTIVES: Ablative and nonablative laser treatments have established themselves independently in the rejuvenation of aging skin. This study was designed to determine the effects of sequential nonablative and ablative laser treatments on facial skin. MATERIALS AND METHODS: Twelve patients, ages 32-56 years, with skin phototypes I-IV, received three treatments spaced six weeks apart. Each treatment consisted of one pass with 1319-nm Nd:YAG laser at 16 J/cm(2), 50 ms pulse duration. This was immediately followed by one pass of 2940-nm Er:YAG laser at 5 J/cm(2). Photographs and biopsies were taken prior to the first treatment and following the third treatment. RESULTS: Clinical improvements in facial skin tone and texture, acne scarring and dyschromia were noted in all patients. Histologic changes included a more compact epidermal granular layer and lamellar collagen formation with decreased solar elastosis in the dermis. Compared to controls, treated skin had a thicker, more homogeneous papillary dermis. CONCLUSION: The sequential use of nonablative and superficial ablative laser treatments clinically and histologically improved photodamaged and chronologically aged skin. This occurred with minimal recovery and little morbidity, demonstrating this laser application to be a safe and effective method for facial rejuvenation.

Adult↗
PubMed2006

Facial rejuvenation.

Nonsurgical facial rejuvenation is often used as an alternative to more invasive procedures. Topical agents improve cell maturation and cell turnover, chemical peels and microdermabrasion improve poorly textured skin and pigment anomalies. Surgical facial rejuvenation provides dramatic changes but requires more recovery time.

Antioxidants↗
PubMed2002

Advanced rejuvenative upper blepharoplasty: enhancing aesthetics of the upper periorbita.

The surgical approach to rejuvenation of the periorbita continues to evolve with the application of procedures that are safe and effective with a greater sensitivity of aesthetics. Most of the topics in the recent literature discuss improvements with techniques relating to the lower eyelid and midface. Improved surgical techniques of the upper periorbita have been mostly limited to advances in brow lifting. The most common and traditional approach to upper blepharoplasty has remained essentially unchanged and has not considered, to the same degree as in the lower periorbita, the actual changes that occur with age or more accurate surgical approaches toward rejuvenation. The author presents an overview of his personal view of the concepts relating to the aging upper periorbita and discusses his experiences with this procedure.

Adolescent↗
PubMed2002

Hand rejuvenation with structural fat grafting.

A simple, reliable technique of autologous fat grafting for long-lasting rejuvenation of the dorsum of the hand is presented. With this technique, small intact parcels of fatty tissue are harvested with a syringe and a blunt 3-mm cannula. Then, most of the nonviable components are removed from the harvested subcutaneous material by centrifugation, decanting, and wicking. Finally, a 17-gauge blunt cannula places the fat in minuscule parcels of tissue with many passes through five or six tiny incisions in the hand. Separation of the tiny parcels of fat maximizes contact between the surfaces of the transplanted fat and surrounding recipient tissues to encourage integration, anchoring, and long-term survival. Structured, purposeful placement of a thin layer of transplanted fat rejuvenates the dorsal hand by restoring a slight fullness to atrophic subcutaneous tissue, by softening the color and definition of exposed extensor tendons and dorsal hand veins, and by supporting the aging skin.

Adipose Tissue↗
PubMed2006

ACP gel: a new hyaluronic acid-based injectable for facial rejuvenation. Preclinical data in a rabbit model.

BACKGROUND: Facial aging results from reduced biosynthetic activity of dermal fibroblasts and decreased deposition of extracellular matrix components, such as hyaluronic acid, a glycosaminoglycan responsible for skin hydration and turgidity. Exogenous hyaluronic acid injections provide a safe though short-term solution for facial rejuvenation. Using a rabbit model, the authors investigated residence time and tolerability of ACP gel, a new hyaluronic acid cross-linked derivative, compared with high-molecular-weight native hyaluronic acid currently used for facial rejuvenation (Ial System). METHODS: ACP gel 1% and 2%, Ial System, and saline were intradermally injected into the backs of 12 New Zealand rabbits: six animals were used to follow volume maintenance and redness up to 10 days and the other six animals were euthanized at days 2, 6, 8, 10, 14, and 21 (one animal per time point) to histologically assess biocompatibility. RESULTS: ACP gel 2% had the longest residence time, showing a significantly better volume maintenance than the other samples, especially in the initial study period (71 percent of original volume versus 23 percent and 21 percent of ACP gel 1% and Ial System, respectively, at day 2). Macroscopically, no adverse events were observed in the treated animals. Histologic examination confirmed the absence of adverse events, persistent inflammation, tissue degeneration, or necrosis. ACP gel macrophage-mediated phagocytosis was more persistent with respect to the Ial System, consistent with its longer residence time. CONCLUSION: ACP gel 2% is a promising dermal biorevitalizer, characterized by a high safety profile and prolonged residence time in relation to native high-molecular-weight hyaluronic acid.

Animals↗
PubMed2006

Periorbital rejuvenation and the African American patient: a survey approach.

BACKGROUND: The number of African Americans pursuing cosmetic plastic surgery is increasing. Nonetheless, the authors postulate that the African American patients pursuing certain cosmetic procedures still have preconceived notions and concerns distinct from their Caucasian counterparts, thereby demanding a different surgical strategy. A questionnaire approach was used to determine the concerns, expectations, and desires of African American patients regarding periorbital rejuvenation and to compare these outcomes with those of Caucasian patients. METHODS: One hundred five African American female subjects and 30 Caucasian female subjects affiliated with the senior surgeon's cosmetic practice were contacted. Of these, 85 African American and 26 Caucasian subjects were administered a survey of 18 standardized questions. Patients were stratified in terms of age and race to dissect generational and ethnologic concepts toward oculoplastic surgery and features of the African American eyelid. The Caucasian subjects served as the control group. RESULTS: Of the African American subjects, 85.9 percent had a favorable or neutral opinion of plastic surgery, and 72.9 percent did not feel plastic surgery was exclusively for Caucasians. Nearly half of all African American subjects interviewed likened African American periorbital characteristics to those of Asians, whereas only 19.2 percent of Caucasian subjects acknowledged such similarities in African Americans. CONCLUSIONS: This study demonstrates the idea that a directed approach to blepharoplasty is necessary to help African American patients achieve their desire to maintain their ethnic identity while rejuvenating their appearance.

Adult↗
PubMed2004

Combined nonablative skin rejuvenation with the 595- and 1450-nm lasers.

BACKGROUND: Histologic findings are not echoed in the visible effect in the epidermis after skin rejuvenation. SUBJECTS AND METHODS: Ten women (Group A) received five treatment sessions with a 595-nm pulsed dye laser immediately followed by a 1450-nm diode laser. Two other demographically similar groups of 10 patients each, Groups B and C, were treated with the 595-nm pulsed dye laser or the 1450-nm diode laser alone, respectively. RESULTS: Good dermal collagen remodeling was observed in Group A. Overall better and faster results were seen in Group A. The 6-month clinical outcome was best in Group A followed by Group C and Group B. CONCLUSIONS: Wavelengths of 595 plus 1450 nm for skin rejuvenation produced good results with much higher patient satisfaction than those obtained with the 595- or 1450-nm wavelengths alone.

Adult↗
PubMed2006

Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation.

BACKGROUND AND OBJECTIVE: Mesotherapy, as broadly defined, represents a variety of minimally invasive techniques in which medications are directly injected into the skin and underlying tissue in order to improve musculoskeletal, neurologic, and cosmetic conditions. There are few clinical studies evaluating the efficacy and safety of mesotherapy in any form. This study evaluates the histologic and clinical changes associated with one of the simplest formulations of mesotheraphy commonly used for skin rejuvenation. STUDY DESIGN: Ten subjects underwent four sessions of mesotherapy involving multiple injections of a multivitamin and hyaluronic acid solution. Treatment was conducted at 4 monthly intervals. All subjects had pre- and post-treatment photographs and skin biopsies. Skin biopsies were evaluated with routine histology, mucin and elastin stains, and electron microscopy. Patient surveys were also evaluated. RESULTS: Evaluation of photographs at 0, 3, and 6 months revealed no significant clinical differences. Light microscopic examination of pre- and posttreatment specimens showed no significant changes. Electron microscopic analysis of collagen fibers measurements did show smaller diameter fibres posttreatment. CONCLUSION: No significant clinical or histologic changes were observed after multivitamin mesotherapy for skin rejuvenation. Multivitamin and hyaluronic acid solution facial mesotherapy does not appear to provide any significant benefit.

Adult↗
PubMed2006

Processing, lysis, and elimination of brain lipopigments in rejuvenation therapies.

Cerebral lipopigments (LPs)--lipofuscin and ceroid--represent a significant marker in postmitotic normal and pathologic aging, connected with causal and associated neuropathologic damage. Therefore, LP processing, lysis, and elimination may be the main targets in anti-aging and rejuvenation therapies. The regenerative neuroactive factors improve neuron supply with specific nutrients from plasma. They enhance the antioxidative defense, have anti-LP-poietic actions, stimulate brain anabolism, support energetic metabolism, and elevate the reduced lysosomal enzymes. In the second stage, by cytoplasm rehydration, they initiate the breaking up of the neuronal aggregated LP conglomerates, by consecutive disintegration. Then, possibly by the localized exo-endocytosis process between neurons and adjacent glia (especially microglia), intercellular LP transfer can be realized. So, therapeutically activated glia turn into brain garbage collectors and transporters. Therapeutic processing of glial LPs increases in the capillary neighborhood. Highly processed LPs, by glio-endothelial transfer, reach capillary walls before being eliminated. Consequently, neuroactive therapies having these synergistic rejuvenative actions represent new prospects in deceleration of normal and pathological cerebral aging.

Aging↗
PubMed2003

Lasers for facial rejuvenation.

Laser and laser-like assisted facial rejuvenation has become very popular during the last decade. Although a myriad of techniques are available, such approaches can be divided into four basic approaches. There are those that (i) ablate the epidermis, cause dermal wounding, and provide a significant thermal effect (CO(2) lasers); (ii) ablate the epidermis, cause dermal wounding, and minimal thermal effects (short pulsed Erbium:Ytrrium-Aluminum-Garnet [Er:YAG] lasers); (iii) ablate the epidermis, cause dermal wounding, and provide variable thermal effects (combined CO(2)/Er:YAG lasers, variable pulsed Er:YAG lasers, and ablative radiofrequency devices); and (iv) do not ablate the epidermis, cause dermal wounding, and provide minimal thermal effects (non-ablative lasers and light sources). Each of the four modalities has now been shown to be effective in promoting facial rejuvenation. As would be expected, each has some advantages and disadvantages.CO(2) lasers, because they ablate the epidermis, cause a dermal wound, and provide a significant thermal effect, appear to be most useful for those individuals with advanced photoaged skin. Such lasers provide the greatest degree of skin tightening for these individuals. However, it is that very same thermal effect that leads to the possibility of delays in healing sometimes noted with these systems. Short pulsed Er:YAG lasers, because they promote so little thermal damage, when used in a superficial manner, lead to the possibility of quicker healing than is seen with CO(2) lasers. However, less clinical improvement and more bleeding may be noted. Combined CO(2)/Er:YAG lasers, variable pulsed Er:YAG lasers, and ablative radiofrequency devices lead to an effect somewhere in between that of pulsed CO(2) lasers and short pulsed Er:YAG lasers. The newest group of systems includes the non-ablative devices that do not ablate the epidermis, cause dermal wounding, and provide for a minimal thermal effect. This area of technology is still evolving. Although such techniques, because they do not ablate the epidermis, are cosmetically elegant, the clinical results are usually not quite as good as the more aggressive ablative techniques.

Humans↗
PubMed2005

Levator anguli oris: a cadaver study implicating its role in perioral rejuvenation.

The purpose of this study was to investigate the role of the levator anguli oris in perioral rejuvenation by delineating the detailed anatomy of this muscle and illustrating a new technique to elevate the oral commissure using this muscle. Fresh cadaver dissection was carried out in 9 facial halves specifically examining the anatomy of and surrounding the levator anguli oris. This muscle was identified in each cadaver to coalesce with the zygomaticus major muscle at the modiolus, thus elevating the oral commissure. In 3 facial halves, an intraoral incision from the canine to the modiolus was performed. This allowed easy access to the levator anguli oris muscle for plication and successful elevation of the oral commissure. This procedure could be applied in combination with traditional face lifts to enhance facial rejuvenation or potentially used to reanimate the partially paralyzed face.

Cadaver↗
PubMedDate not supplied

The S.O.F.T. Cheek method: an approach to lower eyelid and midface rejuvenation.

Procedures to rejuvenate the lower eyelids and cheek are amongst the most common aesthetic surgeries performed today. Rejuvenation should be individualized based on the patients concerns, anatomic deformity, and medical condition. A balanced and natural clinical result often requires a combination of techniques designed to address each patient's individual pattern of aging, while maximizing patient safety. We present the S.O.F.T. Cheek method of analysis and treatment, which utilizes well-developed principles and techniques, to consistently maximize clinical results and patient satisfaction.

Adipose Tissue↗
PubMed1989

Combination of facial rejuvenation and lipoplasty of the torso.

Older women seeking facial rejuvenation often exhibit another sign of middle age--the accumulation of subcutaneous fat in the torso. In the author's practice a total body evaluation approach is used. It is often suggested that the patient combine facial rejuvenation with lipoplasty of the torso if the patient is a good surgical candidate and the procedures can be performed jointly in less than six hours. The advantages are many, including a single convalescent period, decreased costs, and very high patient satisfaction with the degree of makeover in one session.

Abdominal Muscles↗
PubMedDate not supplied

The RSVP facelift: a highly vascular flap permitting safe, simultaneous, comprehensive facial rejuvenation in one operative setting.

This study describes our effort to develop a reliably safe method for combining currently available treatment modalities in an effort to obtain comprehensive facial rejuvenation in one operative setting. Detailed evaluation of 101 available consecutive patients, their per- and postoperative photos and charts was undertaken. Five groups of patients were studied: (1) traditional facelift with wide subcutaneous undermining and SMAS plication. (2) Similar traditional facelift with regional laser resurfacing. (3) RSVP (rejuvenation with sparing of vascular perforators) facelift. Subcutaneous undermining stops 3 cm lateral to the nasolabial fold to preserve the rich angular/facial arterial supply and venous drainage, still permitting lateral SMASectomy or SMAS plication. Subcutaneous neck undermining is discontinuous, the posterior dissection being limited to that which is necessary for identification of the posterior edge of the platysma and its plication to the mastoid and SCM muscle. The anterior dissection is limited to that necessary for anterior platysmal repair leaving intact a vertical subcutaneous non-undermined zone 4-6 cm in width, preserving the submental perforating artery. If indicated, gentle liposuction with a fine cannula is performed through this area. (4) RSVP facelift and regional laser resurfacing. (5) RSVP facelift with total facial laser resurfacing. Mean follow-up was 13.6 months, minimum 6 months. There were no additional major complications associated with the addition of laser resurfacing or fat grafting to the RSVP group. The patients with laser resurfacing were pleased with their result, and estimated that their apparent age had been reduced by a mean of 10.4 years, compared with 6.6 years for the non-lased group. We conclude that the RSVP flap is a hardy, vascular flap permitting simultaneous laser resurfacing, fat grafting, and other adjunctive procedures without significant fear of flap loss.

Adipose Tissue↗