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Facial aesthetic and prevention of skin aging

Temporary or permanent correction of all types of skin depressions, primarily wrinkles, furrows and scars. They also allow increase or remodeling of certain facial areas (cheeks, chin, lips, nose, etc.).

Facial implants and lip reshaping:


Indications: Temporary or permanent correction of all types of skin depressions, primarily wrinkles, furrows and scars. They also allow increase or remodeling of certain facial areas (cheeks, chin, lips, nose, etc.).

Method: different substances can be used as skin filler. They can be classified according to different aspects (fluid or solid, heterologous or autologous). Below the most used ones are described. These are the heterologous fluids, and two stick out in particular:



• a resorbable fluid: recombinant hyaluronic acid, which depending on where implemented, takes from 6 to 12 months to be reabsorbed.
• a nonabsorbable fluid: polyacrylamide gel, which remains unchanged for years.

Liquid materials are implanted via injection, with a syringe and a very fine needle. Generally it is sufficient to use topical anesthesia (cream), local or regional.

The chosen material is implanted into the bed of the wrinkle, furrow or depression to be filled; or conforming the previous design of the area you wish to remodel.

Each material has a specific technique of use, including the manner of implantation, the amount, depth, subsequent handling, etc.

Treatment
Depending on the filler chosen and the quantity implanted, one or more sessions may be necessary, frequently spaced in time.

Another important consideration is that some of these materials simply act as a filler: they simply occupy a space. But most of them also stimulate some tissue response (neoformation of collagen) or simply induce a fibrotic reaction around them; in any case, one or another should be known and taken into account, since they will determine the final outcome, which is probably not appreciably in the first instants after treatment.

A basic rule is that, in all cases, the correction must be obtained in time and not in space, meaning that it is better to correct gradually than to produce an over-correction which may not be well accepted by the client, and also depending on implanted material, irreversible. Is it therefore normal that the end result can only be seen after a few weeks or months.

Duration of treatment
15 to thirty 30 minutes each session.

Disadvantages
In the case of the heterologous protein materials, as obtained by bacterial synthesis in laboratory, it is no longer necessary to perform allergy tests previously, as it occurs with the hyaluronic acid of non-animal origin.

After implantation redness and hematomas may occur which disappear spontaneously, and which, can be hidden with makeup. There will be some swelling for a few days.

In the case of adding resorbable materials, the inconvenience is the need to periodically repeat the implants to maintain the achieved results, but these occurrences are part of the treatment protocol that the patient should know and accept.

With both treatments, resorbable as especially non-absorbable materials, the small possibility to have granulomatous reactions to the foreign body with a more or less delayed appearance exists.

After implantation redness may occur, and even hematomas which disappear spontaneous, and which, in any case, can be hidden with makeup. There will be some swelling for a few days. Comment: Implants used for lip reshaping, facial remodeling and/or treatment of wrinkles and other skin depressions represent a simple procedure and are adaptable to all circumstances. The exact knowledge of the materials which can be used and proper management of those ensure immediate and noticeable results. In many cases it is advisable to combine several materials together, at different levels, or even for the treatment of facial aging combine implants with other techniques (peels, botulinum toxin, surgery, etc.).

Comment:
Implants used for lip reshaping, facial remodeling and/or treatment of wrinkles and other skin depressions represent a simple procedure and are adaptable to all circumstances.

The exact knowledge of the materials which can be used, and proper management of those, ensure immediate and noticeable results. In many cases it is advisable to combine several materials together, at different levels, or even for the treatment of facial aging combine implants with other techniques (peels, botulinum toxin, surgery, etc.).

Supra-selective micro-denervation with Botulinum Toxin A (Vistabel®):

The Vistabel®, commonly known as Botox® for years, is a natural protein derived from bacteria. Small doses of such protein are microinjected into the muscles, which determine the appearance of dynamic wrinkles of frown, forehead and crow's feet. This way it is achieved that no nerve signals arrive to the muscle during some time, whereby it is relaxed, and thus the skin stretches.


Indications:

Treatment for the temporary improvement in the appearance of vertical lines; of moderate to severe intensity, which appear between the eyebrows at frown, in adults under 65 years of age, when the severity of these lines has an important impact to the patient.


Method:
It consists in the infiltration of small amounts of a specific drug, the type A botulinum toxin sold under the name of Vistabel® to the muscles in the aforementioned region. Infiltration is performed with a syringe and a very fine needle, which generally makes the discomfort of the injection more tolerated by patient. Nevertheless, for the treatment of facial wrinkles, an “a frigore” anesthesia (cubes of ice or frozen sacs) or a topical anesthesia (cream) is commonly utilized. Treatment: The treatment is performed in one session. The patient generally rejoins normal activities immediately. The effect appears around the 3rd to 4th day, and is complete within 7 to 10 days.

Duration of treatment
Between 10 and 30 minutes.

Disadvantages
The microinjections can be unpleasant. A small hematoma could appear which disappears spontaneously in a few days; in any case, it can be immediately hidden with makeup. Some patients report symptoms of headache during 24 - 48 hours after treatment.

Unfortunately, selective denervation and its effects are not definitive and tend to reduce from 3 - 4 months onwards and disappear in 5 - 6 months; treatment can then be repeated. It is observed that the effective period is greater with successive infiltrations.



Homeopathic anti-aging mesotherapy, vitamins and hyaluronic acid.

This is a type of "anti aging" procedure, which, combined or not with cryotherapy, leverages the strengths of mesotherapy to improve the skin tone to combat the deterioration of them and their sagging in a preventive manner, acting on the dermis of shallow and superficial wrinkles.

Indications:
Prevention of skin aging in the treated areas. Intense rehydration of those. Areas which can be treated are mainly the face and neck, but also the neckline and back of hands.

This treatment can be applied for therapeutic purposes (to treat skin and aging) or preventive (if not obvious yet the effects of the passage of time and the natural production of collagen by the body is still acceptable, their utility to keep the youth of these tissues is very important).

Composition

The drugs used are injectable homeopathic medicines authorized by the Spanish Medicines Agency of the Ministry of Health and Consumer Affairs, or injections with a high content of hyaluronic acid can be administered subcutaneously or intradermally.

Modo de acción
It aims at stimulating the tissues, so that they themselves recover their natural biological function, and not the restitution of what has been already lost. Therefore by using the homeomeso therapy, the intent is not to refill ruts and make wrinkles disappear completely. The result will be a comprehensive skin rejuvenation, which also acts preventively, giving you a better look.

Method
Depending on the cases it may be interesting to include in the same session, but before the homeo-mesotherapy, a superficial chemical peel and a prior stimulation of the skin to optimize the meso-therapeutic effect. This consists in performing a kind of skin over lock, depositing via microinjection with short and fine needles, a minimal amount of the medication, favoring the skin tension lines in the region, finally applying a regenerating gel to the skin.


Contraindications
Injection of these products is contraindicated if infections or evolutional skin changes exist. It should not be used in patients with expectations that are difficult to reach. It is unknown if there are side effects during pregnancy or breastfeeding or for children.

Treatment
At the beginning 4 to 8 sessions are needed (depending each case), on a weekly or fortnightly basis, depending on the product used. Completing this initial protocol, according to the evolution maintenance sessions are established more or less spaced in time.


Duration of treatment
Each session lasts 10 to 20 minutes. Normally, patients can return immediately to their normal activities.

Disadvantages

Microinjections and cryotherapy may have results which appear unpleasant. The skin may appear red, which usually disappears within 2 hours. Very rarely cryotherapy can cause the appearance of some soft obscured crusts in very sensitive skin or skin very exposed to treatments with self-tanning creams which, in the days after, will peel off until it completely disappears. In addition an altered pigmentation usually controlled, with topical depigmenting appears. You should not be exposed to the sun until complete remission and consequent medical treatment to prevent residual stains.

Physical and chemical peels (cryotherapy):

    • The term applies to all peeling treatments that produce a skin peel, to improve or correct particular problems of skin (color, texture, relief, etc.). Also used in clinical dermatology for the treatment of skin diseases. Also used in clinical dermatology for the treatment of skin diseases.

      According to the procedure applied they are classified as:
      • Mechanical: those induced by a mechanical element, usually friction or abrasion of the skin with an abrasive material: sandpaper, a grindstone or a cutter, a jet of aluminum hydroxide crystals, or simply a cream with granules suspension.

      • Physical: those induced by the application of certain chemicals on the skin. According to the depth of its performance they are classified as:

      • Chemicals: those induced by the application of certain chemicals on the skin. According to the depth of its performance they are classified as:

          • Surface: They act at the level of the epidermis.

          • Media: They act at the level of the junction between the epidermis and dermis, and at a level of the superficial dermis.

          • Deep: They act at the level of the middle and deep dermis.

      The described peels are of MEDIA-SURFACE PENETRATION.


      Indications:

      Overall skin aging: wrinkled skin (appearance, color, texture and/or touch), pigmentation spots or seniles, fine or moderate wrinkles, large pores, small scars and/or acne lesions, etc. ; in any region of the body: face, neck, chest, back, forearms, hands, ... Treatment of active acne and folliculitis.


      Method
      Consists in applying a chemical to the skin (chemical peels) or the completion of a cutaneous sweep using a device which mixes dimethyl ether and propane (cryotherapy), through which the peeling is produced. This action relates to the composition and concentration of the product/s used, the mode of application and the time of contact with the surface of the skin, skin type, etc. The peeling can be an imperceptible flaking or a full epidermal turnover.

      Thus a simple exfoliation up to an overall resurfacing is obtained, with attenuation or disappearance of skin defects and lesions, and recovering a better color and texture; As a result of the natural healing process, subsequent skin tone improvement.

      Treatment
      It usually develops over several sessions, more or less spaced in time. In most cases, it is essential before the first session to properly prepare the skin using specific creams. Between sessions an adequate dermo-cosmetic treatment is established: hydration, repair and sunscreen.

      After treatment, appropriate support guidelines are established, which may lead to some peeling sessions and the dermocosmetic care: cleansing, hydration, nutrition and protection.

      Duration of treatment
      Each session can last between 30 and 60 minutes.

      Disadvantages
      The importance of the peeling produced (which obviously depends on the lesion or lesions treated, and therefore, the selected product and how to use it) depends on the cutaneous reset which may occur within hours, one or several days, but usually no more than four or five. This, in turn, depends on the time required for the patient to resume their normal social activities.

      This treatment should preferably not be done during summer, as sun exposure must be avoided during treatment.

      Commentary
      The superficial and medium peeling is the moderate treatment of facial skin resurfacing, since, in addition to remove skin blemishes and wrinkles, it restores skin color, texture and tone lost with the passage of time and the interference of harmful agents like the sun, tobacco, alcohol and stress.

      It is, in many cases, a necessary complement to other facial treatments: lifting, filling implants, facial mesotherapy stimulation, etc. As noted above, skin resurfacing is also possible in other body regions: neck and chest, hands and forearms, etc.

      The type of peeling chosen depends on the nature and intensity of the lesions that want to be treated and the particular characteristics of each patient (their desires, their social and labour conditions, etc.).

      In the case of active acne and folliculitis, in addition other local treatments (mesotherapy, high frequency, ozone therapy, etc.), specific drug treatments (antibiotics, hormones, vitamin A) and topical home treatments will be needed.


Nonablative facial rejuvenation:

Indications:
The so-called facial photo rejuvenation is one of the latest treatments in the field of aesthetic medicine. It is based on the application of intense pulsed light that enables skin rejuvenation, treatment of spots, hyperpigmentation, etc. It is also indicated for patients suffering from rosacea, those which present face and cheek reddened, with telangiectasia or spider veins, etc. One characteristic of this treatment is that it can be done as much as on the face as on the neck, chest and back of hands.

Method
This involves the use of an intense pulsed light source directly on the skin surface area to be treated, which is previously protected by a cold gel, which at the same time favors the light conduction, achieving greater effectiveness. At a cellular level this energy is transformed into heat, ultimately responsible for the therapeutic effect, but without destruction-removal, only with stimulation-repair.

This type of energy, by its own technical characteristics and mode of use, allows surface treatments (skin color and appearance) with little apparent damage to the skin, which will go away gradually flaking and clarifying. This is the reason why it is referred to as NONABLATIVE. Furthermore, it achieves stimulation to the collagen and connective tissue, which will result in healthier skin and a younger look.

Duration of treatment
Depends on the imperfection/s to be treated, and also on the technology (equipment and/or method of use) that is being used, but rarely exceeds 60 minutes. Treatment usually consists of 5 or 6 sessions spaced one month apart from each other.

Disadvantages
The side effects, if present, are minimal and temporary consisting of mild redness and swelling, and also the emergence of a darkening of skin pigmentation that resolves within a few days. The subsequent process is fully compatible with the immediate reinstatement of social and labor activities, requiring only the application of some specific dermocosmetic treatment and sunscreen.

Commentary
At present, the non-ablative facial rejuvenation represents one of the main facial skin aging treatments; being a procedure supported by a constantly evolving, leading technology, a nonsurgical method and comprehensive therapy with very significant results, this makes it a compulsory reference when possible therapeutic alternatives are established.