Effect of Microfocused Ultrasound on Facial Rejuvenation: Clinical and Histological Evaluation

Introduction: Micro focused ultrasound (MFU) is formed by mechanical waves emitted in a focused manner, concentrating thermal energy on a certain point or region, promoting a clinical improvement in wrinkles. Objective: evaluate the effects of micro focused ultrasound on facial rejuvenation. Methodology: This is an experimental study. The sample consisted of 30 volunteers, who were evaluated before treatment, 45 and 90 days after its beginning. A single application of the MFU was performed across the facial region. The parameters used were: 10 MHz cartridge with depth of 1.5 mm, 7 MHz with depth of 3 mm, and 4 MHz with focal depth of 4.5 mm;doses ranged from 0.1 to 2.0 J, according to the sensitivity of the volunteers treated, and the application time was of approximately 90 minutes. Clinical photographic analysis and facial symmetry analysis using Dolphin Imaging software were performed, and validated questionnaires. Two volunteers were submitted to blepharoplasty surgery, and one to rhytidoplasty surgery 45 days after the application of the MFU. Samples of the treated skin were taken after the surgical procedures and submitted to histological and immunohistochemical analyses. The volunteers answered a questionnaire to assess adverse reactions and satisfaction. Results: We observed a visible clinical improvement on the images by photography, and an improvement of facial symmetry in the measurements of the paralateronasal projection (p = 0.007), left lateral mandibular (p = 0.01), and right lateral mandibular (p = 0.008). The histological analysis showed an increase in the amount of fibroblasts (p = 0.02), blood vessels (p = 0.0062) and inflammatory cells (p = 0.0036), in addition to the production of type 1 collagen. In the immunohistochemical analysis, we observed the presence of the macrophage marker IHQ: CD68, indicating phagocytosis of adipose tissue and the presence of fibrosis. In the analysis of adverse reactions, only transient hyperemia was observed with the presence of pain during application. Additionally, the volunteers expressed high level of satisfaction (93%) with the treatment Conclusion: The MFU promoted the production of collagen, reorganization of the dermis and, clinically, a reduction of sagging and wrinkles, with increased facial symmetry.

Localization of Voltage Regulators in Distribution Systems by a Mixed Genetic–Tabu Search Algorithm

The optimal allocation of regulators banks in distribution systems is a merely combinatorial problem in which the best points of installation correspond to the best benefit, considering the admitted objective function, without violating and operating limits. The objective function must be chosen so that its value represents the operation state of the system. As the problem possesses combinatorial nature, its complexity will increase exponentially with the number of possibilities. Systems with large numbers of nodes and / or with the possibility of installing more than one bank require a large number of calculations to find the solution. An additional issue is the fact that the problem does not have a continuous nature, presenting discontinuity points in the objective function, limiting the application of optimization methods based on gradients. Based on the nature of the problem two optimization methods were used to solve the problem: Genetic Algorithm (GA) and modified Tabu Search (TS). The GA function will scour the search space and find regions with local minima that are candidates to be the solution. On the other hand the TS provides local search in the regions defined by GA so that the overall optimum is achieved.

Effects of Cryofrequency in the Different Swine Skin Tissue Layers: <i>In Vitro</i>and <i>in Vivo</i>Study

Introduction: Cryofrequency is a novel therapy which was developed with the combination of cold (cryotherapy) and heat (radiofrequency) application, causing a thermal shock effect on skin tissue. The thermal shock is believed to alter local metabolism. Objective: To investigate the effect of cryofrequency on the skin tissue of a mini pig in an in vitro and in vivo experimental model. Methodology: A small swine of the S. domesticus species, a male mini-pig (30 kg weight) was elected for the in vivo procedure subject. The in vitro step was performed on the extracted abdominal part of another subject of the same species and breed. Then, after the application of cryofrequency in the monopolar and bipolar form in vivo, a histological analysis was performed. Results: A higher temperature variation was observed comparing the pilot study in vitro with respect to the experimental one in vivo. Microscopically, an increase of collagen fibers and blood supply and decreased adipose tissue was observed after cryofrequency application. Conclusion: With the bipolar cryofrequency, no reduction of adipose tissue was observed, but regarding the connective tissue, extensive areas of collagen deposition were observed, as well as a great amount of new-formed collagen fibers.

Effects of Cryofrequence on Localized Adiposity: Case Study

Cryofrequence is the combination of cryotherapy with radiofrequency, which promotes a “thermal shock” to the tissue, working simultaneously to skin flaccidity and localized adiposity. The efficacy of dermatological and hypodermic cryofrequency treatment was evaluated. This study reports the case of a 45-year-old woman with complaints of flaccidity and fat located in the infra-umbilical region in the preoperative period of abdominoplasty. The evaluation was performed before and after treatment through evaluation protocols, ultrasound examinations and histological findings through optic microscopy, microfocal and immunohistochemical analysis. The treatment was performed in 4 sessions, with a weekly application, using the BHS 156 FULL&reg;—BODY HEALTH BRASIL&reg;apparatus, the parameters were temperature of -10&deg;C, power in 70%, duration of 8 minutes. After the surgical procedure, parts of treated and untreated abdominal tissues were removed for evaluation. In the tests performed, significant destruction of adipocytes was detected, with consequent reduction of fat and greater expression of caspase-3 in the treated tissue, being constated the macrophage increase by CD68 expression. There was improvement in flaccidity, evidenced by the significant increase in the number of fibroblasts and inflammatory cells positive for Ki67, bringing more quantity and better quality to the collagen.

Effects of Tecar Therapy on Adipose Tissue: Clinical Trial

Introduction: Localised adiposity is one of the leading aesthetic alteration complaints. Tecar therapy has been used in clinical practice for the treatment of fat located in the abdominal region. Objective: The objective is to analyse the effect of Tecar therapy on abdominal adiposity. Methodology: This is a clinical trial in which the participants were 32 female volunteers who have flaccidity and fat located in the abdominal region. The volunteers were divided into three groups, which respectively received applications of the capacitive mode, the resistive mode, and combined therapy of the two modalities. We have performed ten applications and analysed the anthropometric measures, the ultrasonography of the adipose layer, and the level of satisfaction. Results: All groups presented a reduction in perimetry compared to the baseline (p = 0.001). The ultrasonography showed a significant reduction in the combined therapy group compared to the baseline (p = 0.04 and p = 0.03). The level of satisfaction was good in all groups, with few adverse responses. In the bodyweight and percentage of fat analyses, we observed an increase in measurements, probably due to the restriction measures related to the new coronavirus pandemic in 2020. Conclusion: In this present study, we have concluded that Tecar therapy resulted in a reduction of the fat located in the abdominal region.

Comparative Study of Collagen Stimulation Using Semi-Ablative and Non-Ablative Radiofrequency

Objective: Comparison between semi-ablative and non-ablative radiofrequency for collagen stimulation. Method: Three volunteers with scheduled surgical procedures of abdominoplasty were selected. After the evaluation, the abdominal area was divided into three quadrants, with the right region receiving monopolar non-ablative radiofrequency (RF) application. In contrast, the left region received fractionated radiofrequency (FRF) application, using three different needle sizes (0.5, 1.5, and 3.0 mm), and the intermediate area was kept as a control. After 24 hours, surgery was performed, and the skin flaps were collected for histological and immunohistochemical analyses. Results: An increase in total collagen and type I collagen was observed in the treated groups. There was also an increase in the expression of COX-2, CD68 positive cells (macrophages), and lymphocyte markers (CD3, CD20, and NK-CD57). Furthermore, it was seen that only the use of 3.0-mm needles kept the channels open in the superficial tissue after 24 hours. There were no significant differences between the modalities. Conclusion: Non-ablative and sub-ablative radiofrequency have positive and effective results for flaccidity, demonstrating the success in collagen production. Furthermore, this study is the first to present channel opening and permanence time, which are important to optimize the action of drug delivery.

Effects of Semi-Ablative Fractional Radiofrequency Associated with Growth Factors in Stretch Marks: A Randomized Controlled Trial

Background: To investigate the effects of the association of semi-ablative fractional radiofrequency (RFF) with growth factors in stretch marks. Methods: This is a randomized controlled trial. The sample consisted of 28 female patients with complaints of gluteus or abdomen striae and divided into 2 equitable groups, named G1 (semi-ablative RFF without active principle association) and G2 (semi-ablative RFF with active principle association), being subdivided into G-1A and G-2A (abdominal applications) and G-1B and G-2B (gluteus applications). A photographic and histological analysis was performed using questionnaires about inflammation, presence of adverse effects and satisfaction of volunteers. Photographic analysis showed a reduction in the amount of striae alba in all groups. Results: The histological analysis showed an increase in fibroblast activity, collagen type I, and blood vessels, especially in the groups that associated the RFF with the active principle. In the inflammation analysis, the groups that performed intervention with active ingredients showed lower inflammatory signal. All groups had a reasonable level of satisfaction after the interventions;however, the group that used active ingredients reported greater results. Conclusion: The association of semi ablative RFF with growth factors showed a reduction in clinical inflammatory signs, mainly in the first 15 days, as well as higher collagen production, verified in 30 days, with satisfactory clinical results in all groups.

Effects of Hydrolysed Collagen Associated or Not with Physical Agents on Tissue and Muscle Flaccidity—Firmez Method: Case Study

The combination of therapies may be the promising future for the treatment of esthetic alterations more efficiently and in less time, in order to obtain an excellent result. Our objective was to evaluate the effectiveness of hydrolysed collagen associated with radiofrequency and electrostimulation in the treatment of flaccidity in the abdominal and gluteal regions. The sample consisted of 6 women, evaluated through evaluation protocols, questionnaires, dynamometry, ultrasound exams, and histological analysis. The volunteers were distributed into three subgroups: hydrolysed collagen group (G-1), radiofrequency + hydrolysed collagen group (G-2) and radiofrequency + hydrolysed collagen + electrostimulation group (G-3). The ultrasound analysis of the abdominal muscles showed an increase in muscle thickness in all groups, but not significant (p > 0.05). The histological analysis showed an evident increase in type I collagen in groups G-2 and G-3, with proliferating cells (Ki67+). The results of dynamometry showed significant values in different times (p < 0.05). There was a significant result in the infraumbilical perimetry analysis, when compared between the groups with 30 days (p = 0.03) and with 60 days (p = 0.04). All participants rated the treatment positively. The use of combined therapies has shown superior results for the treatment of abdominal and gluteal flaccidity when compared with its isolated use, being the combination of therapies important in the treatment of flaccidity.