Efficacy of a Biorevitalizing-Filler Solution on All Skin Aspects: 10 Years Approach through <i>in Vitro</i>Studies and Clinical Trials

Introduction: Skin aging is the result of many cellular dysfunctions over time particularly the fibroblasts and the keratinocytes. These dysfunctions could be decelerated by the preventive effects of some skin treatments such as Intradermal injections. NCTF 135HA has a polycomponent formulation designed to improve the efficacy of non-cross linked hyaluronic acid (as a micro-filler) on fibroblasts function. Although NCTF 135HA has been used by aesthetic practitioners since 20 years, we have analyzed all in vitro, ex vivo and in vivo studies during past 10 years in order to summarized its anti-aging effect. Methods: In these series of studies, the known effects of HA have been evaluated with this boosted formula. Collagen I synthesis, antiglycation effect and contractile forces developed by fibroblasts were studied. Fibroblasts and keratinocytes proliferations were evaluated in monolayer cells culture. The filling effect thanks to NCTF 135HA injection was ex vivo performed by fringe projection and the protective effect of NCTF 135HA against solar irradiation was performed ex vivo to study proliferation rate, elastin and collagen expression. Two clinical trials were performed on women to evaluate the anti-aging effect of NCTF 135HA injection. Hydration, firmness, radiance, wrinkles size, pore size, thickness and density of the dermis were analyzed. Results: Collagen I, anti-AGE products, cell proliferation and contractile forces were significantly increased with NCTF 135HA in culture medium. Ex vivo studies showed that NCTF 135HA increased, cells proliferation rate, elastin and collagen production. In addition, the filling effect of the NCTF 135HA is significantly superior to placebo. The first clinical trial shows that NCTF 135HA injection significantly increased tonicity, hydration and radiance of the skin and significantly decreased wrinkle score. The second clinical trial demonstrated that NCTF 135HA injection significantly increased dermis density and thickness, skin homogeneity and skin radiance and significantly decreased pore size and wrinkle depth and volume. Conclusion: In vitro, ex vivo and in vivo studies showed that this minimally invasive technique could be used in order to improve the skin quality which could have a visual effect on preventing the aging signs.

An overview of aesthetic surgery of the breast

Aesthetic surgery for the breast is one of the common procedure performed by an aesthetic plastic surgeon today.The surgery is frequently performed for aesthetic as well reconstructive reasons.Breast itself is a uniquely important part of the female body and as such embodies in itself anatomical,physiological and aesthetic role.A proportionately developed breast is an important feminine feature,a sign for fertility and sexuality.It is not surprising that breasts are extremely important for women’s self-confidence especially when their role in society has expanded immensely.

Augmentation mastopexy and augmentation mammoplasty:an analysis of 1,406 consecutive cases

Aim:Simultaneous augmentation mastopexy is a challenging operation for esthetic plastic surgeons.Complication and revision rates following augmentation mammoplasty or mastopexy are less commonly seen when these two procedures are performed separately.However,when the two procedures are combined,the complication rate is reported exponentially higher when compared with its individual component carried out separately.The current retrospective chart review is a comparative analysis of the two procedures performed by a single surgeon.Methods:Retrospective data were collected using patient’s charts.All patients who had augmentation mammoplasty(Group A)or simultaneous augmentation with mastopexy(Group B)in muscle splitting biplane using round cohesive gel textured silicone implants by a single surgeon were included.Results:A total of 1,406 patients had consecutive augmentation mammoplasty or simultaneous augmentation mastopexy.Augmentation mammoplasty(Group A)included 1,298 and simultaneous augmentation with mastopexy(Group B)had 108 patients,respectively.The mean age of the patients in Group A and B was 29.6 years and 32.2 years,respectively(P=0.006).The mean size of the implants in Group A and B was 340 mL and 308 mL(P=0.001),respectively.Wound infection in Group A and B was seen in 0.6%and 3.7%,respectively.Wound breakdown was seen in 1.1%in Group A as compared to 6.5%in Group B(P=0.001).Revision surgeries were performed in 1.4%and 11.1%of Group A and B,respectively(P=0.001).Conclusion:There was a statistically and clinically significant higher rate of complications and revision rate noted in simultaneous augmentation with mastopexy(Group B)as compared to augmentation mammoplasty alone(Group A).However,the rise in complications rate is sum of the complications of the two individual components performed and not exponential.

Pathogenesis,presentation and classification of late autoinflation of the breasts:case report and literature search

Aim:Autoinflation of the breast following mammoplasty using breast implants can be divided into early and late.Early autoinflation of the breast is commonly due to haematoma.Late autoinflation of the breast is an uncommon complication and its true incidence is not known due to the paucity of its reporting.Methods:A retrospective review was performed of the available charts for 2,772 consecutive bilateral primary,secondary augmentation mammoplasties and mastopexy with augmentation mammoplasties by the author between April 1999 and February 2015.Each breast was taken as a single unit for a total of 5,544 breasts.Results:There were 2,334 patients in primary augmentation mammoplasty,258 in secondary augmentation mammoplasty and 180 in simultaneous mastopexy with augmentation mammoplasty.There were three autoinflation of breasts due to late seromas identified in the series.All patients presented at least six months following augmentation mammoplasty and all had textured implants place in muscle splitting submuscular pocket.There was no late seroma noted in secondary augmentation mammoplasty or simultaneous mastopexy with augmentation mammoplasty.All patients were treated conservatively without a recurrence.Conclusion:Late autoinflation of the breast due to seroma is an uncommon clinical complication and can be treated conservatively in the first instance.

A long term review of augmentation mastopexy in muscle splitting biplane

Aim:Simultaneous or single stage mastopexy with augmentation is challenging,unique and commonly performed by a plastic surgeon.In this procedure pocket for implant placement,marking for envelope reduction and type of implants used can affect the outcome of the procedure.Muscle splitting pocket for mastopexy is a plane described by the author for implant placement with a short term follow up.The use and outcome of the technique is presented with a larger series and a long term follows up to evaluate the efficacy of the procedure.Methods:Retrospective data was collected.Augmentation was performed using muscle splitting technique and periareolar,vertical scar and wise pattern were used for skin reduction and mastopexy.A single surgeon performed all procedures.Results:In total 108 patients mastopexy with augmentation in muscle splitting technique.The mean age of the patient was 32.2 years(range:18-67 years)with an average follow up of 4.5 years(range:3 months to 10 years).All patients had round textured cohesive gel silicone implants with a mean size of 308 cc(range:200-555 cc).Wound infection was seen in 4(3.7%),wound breakdown in 7(6.5%)patients.Drains were used in 25(23.1%).All patients were treated as day cases and revision surgery was performed in 12(11.1%).There was no hematoma,deep venous thrombosis(DVT)or nipple areolar complex in the series.Conclusion:Simultaneous augmentation mastopexy in muscle splitting pocket can be performed with good aesthetic results along with an acceptable revision rate.