Freytag, Lysander

AbstractBackgroundAn increasing demand for in‐office aesthetic procedures aiming to improve collagen stimulation has been reported.ObjectiveTo analyze the effects of combinations of different aesthetic collagen stimulation procedures using histological analysis.MethodsHistological analysis was performed on skin samples of the excess skin of a 60‐year‐old patient after sub‐superficial musculo‐aponeurotic system facelift surgery. The excess skin before facelift surgery was divided into three areas per hemiface. Each area—with exception of area A as a control—received an isolated or combined treatment of microfocused ultrasound (MFU), injections of calcium‐hydroxylapatite/hyaluronic‐acid‐based soft tissue filler, and microneedling. The effect of the treatments was analyzed using histological analysis with H&E coloration and PAS staining.ResultsA threefold increase of epidermal and dermal thickness was achieved by treating the skin with the proposed combined treatment comprising MFU and injections of calcium‐hydroxylapatite‐ and hyaluronic‐acid‐based soft tissue fillers.ConclusionThe investigated treatments act synergistically in the production of collagen and combining these treatments allows for an increase in collagen production.

AbstractBackgroundWith an increasing demand of aesthetic soft‐tissue filler treatments, the occurrence of adverse events rises likewise. An optimized injection algorithm adapted to product characteristics (eg, rheology) of the soft‐tissue filler is crucial in order to ensure satisfying clinical outcomes and high patient safety.ObjectiveTo identify a subjective feedback mechanism for the avoidance of adverse events after soft‐tissue filler injection procedures.MethodsA retrospective data analysis of n = 387 aesthetic treatments performed on n = 291 patients (4 males, 287 females) with different soft‐tissue fillers with regard to loss of volume (filling effect), injected layer, injectability (“ease of injection”), injected volume, and injection technique was conducted.ResultsThe subjectively perceived injectability during the injection process was statistically significantly related to G‐Prime value with rs = 0.101 with p = 0.048, indicating an increased difficulty while injecting products with higher G‐Prime. The occurrence of adverse events was also statistically significantly related to the injectability: injections with increased subjectively perceived difficulty showed increasing odds of developing adverse events by OR 0.157 with p = 0.002.ConclusionInjections that were subjectively more difficult to perform are more likely to develop adverse events. Respecting the layered arrangement of the face, the recommended and approved depth and facial region for each specific treatment enable practitioners to achieve satisfying outcomes while keeping the rate of adverse events low.