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Introducción: La creciente necesidad de una piel de aspecto juvenil impulsa innovaciones continuas con procedimientos mínimamente invasivos. El plasma rico en plaquetas autólogo representa una terapéutica regenerativa incluida en el novedoso arsenal de intervenciones que buscan este efecto. Objetivo: Evaluar los resultados de la terapéutica con plasma rico en plaquetas autólogo en pacientes con envejecimiento facial. Métodos: La muestra estuvo constituida por 68 pacientes valorados con la escala para valoración clínica de fotoenvejecimiento cutáneo al inicio del tratamiento. Se sometieron a cuatro sesiones de plasma rico en plaquetas cada 15 días y una sesión adicional a los 3 meses de concluir el tratamiento inicial. Los pacientes fueron seguidos durante 6 meses al cabo de los cuales se volvieron a evaluar con el mismo instrumento. Resultados: Las edades estuvieron comprendidas entre 21 y 73 años con una media de 46,80 años, predominó el sexo femenino (89,9 %). Los resultados significativos en el tratamiento de las arrugas, los surcos, la textura de la piel y las lesiones cutáneas estuvieron relacionados con la mesoterapia con plasma rico en plaquetas. El procedimiento produjo una mejoría valorada a través de la escala para valoración clínica de fotoenvejecimiento cutáneo. Conclusiones: La terapia con plasma rico en plaquetas tiene buenos resultados en el tratamiento de pacientes con envejecimiento facial.

Introduction: The growing need for youthful looking skin drives continued innovations with minimally invasive procedures. Autologous platelet-rich plasma represents a regenerative therapeutic included in the new arsenal of interventions that seek this effect. Objective: Assess the results of platelet-rich plasma therapy in patients with facial aging. Methods: The sample consisted of 68 patients assessed with the scale for the clinical assessment of cutaneous photoaging (SCACPH). They underwent four PRP sessions every 15 days and an additional session 3 months after completing the initial treatment. The patients were followed up for 6 months, after which they were reevaluated which the same instrument. Results: The ages of the patients were between 21 and 73 years with a mean of 46.80 years, the female sex predominated (89.9%). Significant results in the treatment of wrinkles, furrows, and skin texture and skin lesions were related to PRP mesotherapy. The procedure produced an improvement assessed with the SCACPH. Conclusions: Autologous PRP therapy has good results in the treatment of patients with facial aging.

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Las arrugas son surcos o pliegues en la piel, que aparecen principalmente por efecto del envejecimiento. Este artículo describe el caso de un paciente masculino de 47 años de edad, piel blanca, que acudió a consulta de cirugía plástica ocular por inconformidad con el aspecto envejecido de su rostro a causa de las arrugas perioculares. Se le aplicó plasma rico en plaquetas intradérmico en el trayecto de las arrugas a razón de 3 dosis con intervalo promedio de 30 días entre cada una. Se logró la corrección total de las arrugas, con buenos resultados estéticos. No se encontró reacción adversa. Se reafirma el criterio planteado por estudios de que el plasma rico en plaquetas es una opción terapéutica de primera línea para rejuvenecer la región periocular(AU)

Wrinkles are a creases or folds which appear in the skin mainly as a result of aging. A case is described of a male 47-year-old patient of white skin color who attended ocular plastic surgery consultation for dissatisfaction with the periocular wrinkles on his face, which gave it an aged appearance. Intradermal platelet-rich plasma was applied along the course of the wrinkles at three doses with an average separation of 30 days between them. Total wrinkle correction was achieved, with good esthetic results. There was not any adverse reaction. The case confirms the criterion contained in previous studies that platelet-rich plasma is a first-line therapeutic option to rejuvenate the periocular region(AU)

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Platelet-rich plasma (PRP) showed positive results in the improvement of skin aging. Lyophilized PRP can be interesting in clinical practice due to the facility to obtain many samples in a single blood collection and can be used in multiple injections. To evaluate the effect of lyophilized PRP in the treatment of skin aging, through a Phase II pilot study. Nineteen women (54 years ± 7 years) with Glogau photoaging II and III types were select for this non-randomized, split-face controlled study. They received monthly intradermal injections of lyophilized PRP and saline solution (as control) into the facial skin, during a period of 2 months. The evaluation was performed by imaging method, histological techniques, and multiphoton microscopy. Although lyophilized PRP presented 10 times the platelet baseline value (P < .0001) and growth factors in adequate levels, only saline solution showed an increase of dermis thickness (p = .0009). Collagen pre and post-application remained the same for both types of treatments. The use of lyophilized PRP by mesotherapy showed no improvement on skin aging. TRIAL REGISTRATION APPROVAL: RBR-3n9wxw, UTN U1111-1226-6093-retrospectively registered.

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In Mexico there is a proliferation of "centers for aesthetic medicine" that offer different treatments with laser beam, mesotherapy and hyaluronic acid and botulinum toxin injections. In numerous centers of this type, offered and performed by medical personnel that are neither trained or certified to ensure the quality of services. The National Academy of Medicine of Mexico and the National Normative Council for Medical Specialties (CONACEM) communicate their posture on this matter.

En México existe una proliferación de "centros de medicina estética" que ofrecen tratamientos diversos con rayos láser, mesoterapia, ácido hialurónico e inyecciones con toxina botulínica por personal médico que no está capacitado ni certificado para asegurar la calidad de los servicios. La Academia Nacional de Medicina y el Comité Normativo Nacional de Consejos de Especialidades Médicas (CONACEM) comunican su postura al respecto.

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BACKGROUND: Volume loss and muscular hyperactivity are two major components of the aging process that contribute to the formation of the folds and wrinkles. Tear trough deformity is one of the most difficult depressions to correct surgically. PURPOSE: The aim of this study was to evaluate the results of ten patients submitted to periorbital filling with hyaluronic acid gel filler. METHODS: Between June and August, 2008, 10 patients have had their tears troughs treated with hyaluronic acid gel filler. The filler was introduced by a serial puncture technique and approximately 0.1 ml was injected at each pass. The filler was placed in the pre-periosteal tissue. Patients photographs before and after the procedure were reviewed to assess the outcomes. RESULTS: The mean volume per side needed to achieve correction was on the right side 0.61 ml (SD=0.25) and on the left side 0.65 ml (SD=0.26). The most common complications were bruising, erythema, local swelling, and pain at the injection site. The effect of treatment lasted up to 12 months. CONCLUSIONS: This pilot study showed that the treatment of tear trough deformity with hyaluronic acid gel filler was feasible, predictable and effective. All patients were very satisfied with their results.

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OBJETIVO: Verificar a eficácia do preenchimento dos sulcos nasojugal e palpebromalar deprimidos através da injeção de ácido hialurônico e analisar as complicações observadas. MÉTODOS: Foi realizado um estudo piloto, prospectivo, aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo, com pacientes recrutados no Serviço de Plástica Ocular do Departamento de Oftalmologia da UNIFESP/EPM. Foram selecionados pacientes de ambos os sexos, com idade entre 25 e 60 anos, que apresentavam os sulcos nasojugal e/ou palpebromalar deprimidos, que não haviam sido submetidos à cirurgia na pálpebra inferior nem apresentavam histórico de trauma nesse local. O ácido hialurônico foi aplicado via transcutânea e depositado na região supraperiosteal em pequenos volumes. Todo paciente foi tratado pelo mesmo cirurgião (GAPV), tendo sido examinado no pós-operatório em intervalos regulares e fotografado no pré-operatório, no pós-operatório imediato, na 4ª semana, no 6º e no 12º mês após o procedimento. Ao final deste período todas as fotos foram analisadas por profissional não ligado a esta pesquisa, visando verificar a eficiência da técnica em atingir seus objetivos. RESULTADOS: Entre junho e agosto de 2008, 10 pacientes foram incluídos neste estudo piloto. Oito pacientes foram tratadas uma única vez, enquanto duas precisaram de retoque na 4ª semana após a aplicação inicial. O volume injetado foi em média de 0,61 ml (DP=0,25) no lado direito e de 0,65 ml (DP=0,26) no lado esquerdo. As complicações observadas foram equimose em 6 casos, edema local maior que 48 horas em um paciente e lesão cutânea semelhante à acne em um participante. CONCLUSÕES: O estudo piloto demonstrou que o tratamento dos sulcos nasojugal e pálpebro-malar com uso de ácido hialurônico se mostrou eficaz e previsível, com alto nível de satisfação dos pacientes e com resultado duradouro.

BACKGROUND: Volume loss and muscular hyperactivity are two major components of the aging process that contribute to the formation of the folds and wrinkles. Tear trough deformity is one of the most difficult depressions to correct surgically. PURPOSE: The aim of this study was to evaluate the results of ten patients submitted to periorbital filling with hyaluronic acid gel filler. METHODS: Between June and August, 2008, 10 patients have had their tears troughs treated with hyaluronic acid gel filler. The filler was introduced by a serial puncture technique and approximately 0.1 ml was injected at each pass. The filler was placed in the pre-periosteal tissue. Patients photographs before and after the procedure were reviewed to assess the outcomes. RESULTS: The mean volume per side needed to achieve correction was on the right side 0.61 ml (SD=0.25) and on the left side 0.65 ml (SD=0.26). The most common complications were bruising, erythema, local swelling, and pain at the injection site. The effect of treatment lasted up to 12 months. CONCLUSIONS: This pilot study showed that the treatment of tear trough deformity with hyaluronic acid gel filler was feasible, predictable and effective. All patients were very satisfied with their results.

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Las cicatrices extensas son lesiones que condicionan la vida de los pacientes que las padecen, produciendo retracción social o como en este caso condicionando la vestimenta de una joven adolescente de 15 años. Se realiza el tratamiento de cicatrices postquemadura que padece desde los 2 meses de edad, combinando diversos métodos como peeling, mesoterapia, dermoabrasión y ultrasonido, obteniendo como resultado la mejoría clínica, estética y psicológica, brindándole una calidad de vida superior.

Extensive scars modify the patient's life. Significant scarring causes functional and cosmetic deformities, discomfort and psychological stress. We report a teenager, who suffered from burning when she was two months old. She has been under scar treatment combining several methods such as peeling, mesotherapy, manual dermoabrasion and ultrasound. Up to now, we improved the patient's life quality, obtaining a clinical improvement, such as aesthetic and psychological one.

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