The use of fillers based on hyaluronic acid in correcting deficits in the upper part of the face, especially in the temporal area, can significantly improve the balance and appearance of the face. Such a procedure, apart from unquestionable aesthetic advantages, carries significant risks, including contour irregularities, vascular occlusion, skin necrosis, hair loss, blindness, stroke, and non-thrombotic pulmonary embolism. To increase the safety and precision of the volumization of the temple area, the technique of administration of the preparation, as well as the product itself, should be carefully selected.

Climacteric keratoderma is a specific cutaneous disorder often underreported, potentially misdiagnosed, or undervalued. Although the pathogenesis remains undetermined, hormonal changes during menopause heavily affect the trophism and normal cellular function of the epidermis and dermis of the palmoplantar regions. We present the case of a 55-year-old woman referred to the Dermatological Clinic of Cagliari for acquired bilateral palmoplantar hyperkeratosis not responding to common topical treatments. Based on the medical history, clinical appearance of the lesions, and laboratory tests, keratoderma climactericum was diagnosed, as confirmed by histopathological examination. An overlap with allergic contact dermatitis was also detected through patch testing, and its synergic effect contributed to the perpetuation of the dermatosis on the hands. A daily high-potency corticosteroidal topical therapy, combined with a 50% urea-based cream at night, was only partially effective. However, adding estriol-based cream at a concentration of 0.125% led to a significant clinical improvement. Climacteric keratoderma is an acquired condition that deserves further clinical trials to assess topical hormonal treatment protocols, as the current approach is largely empirical.

In recent years, the demand for non-invasive methodologies in aesthetic medicine for treating localized adiposity, cellulite, and sagging skin has increased significantly, particularly the demand for massage techniques with mechanical vibrations. The aim of the present study is to evaluate the effectiveness of Compressive Microvibration® in reducing the expression of cellulite and improving skin conditions in women of different ages under ultrasound control during 60 days of observation. A prospective, single-center, nonrandomized study enrolled 27 women with mild to moderate gynoid lipodystrophy, aged 40 to 69 years, who have been subject to twelve sessions of Compressive Microvibration® (Endospheres®). A specialized high-resolution digital ultrasound system, the DUB SkinScanner (tpm GmbH, Germany), has been used to visualize the skin. Also, the sample anthropometric parameters have been measured, the body mass index has been calculated, and photographs have been taken. In the patients included in the study, in all age groups, after complete treatment of Endospheres®, a decrease in BM has been noted, with a reduction of the bitrochanteric and hip circumference. An improvement in the morphological topography of the skin in terms of regularization of skin irregularities, leveling of reliefs, reduction of depressions, and increase in skin elasticity and density has also been recorded. After a cycle of therapy on the anterior surface of the abdomen and the thigh anterior and posterior surfaces, the scannograms revealed a decrease in the thickness of the epidermis at various levels, the resolution of the phenomenon of hyperkeratosis, a compaction of the dermis, and an increase in its homogeneity and echogenicity. The effect obtained was still present during a control examination two months after the conclusion of the treatment. The analysis of the dynamics of ultrasound criteria demonstrated the effectiveness of the Compressive Microvibration® in women with mild to moderate gynoid lipodystrophy to improve their skin conditions and maintain the obtained effect for 2 months of observation without unwanted side complications.

Cancer is not only the leading cause of mortality but also has serious negative consequences related to the sexual, mental, and social life not only of the patients themselves but also of their families. Among women who survived cancer, treatment consequences and sexual dysfunctions are serious problems affecting sexual well-being. The aim of this article was to evaluate the effectiveness of the use of non-hormonal bipolar radiofrequency in combination with hyaluronic acid filler in the treatment of vaginal atrophy-induced sexual dysfunction in cancer survivors. We described 3 cases that reported beneficial results with bipolar radiofrequency in combination with hyaluronic acid filler in the treatment of vaginal atrophy-induced sexual dysfunction in cancer survivors. The validated tool, The Female Sexual Function Index (FSFI), before and after treatment was used to assess the progress and effectiveness of the method used. The procedure used for each patient consists of 4 sessions. During the first one, a treatment using bipolar radiofrequency and hyaluronic acid filler injection was performed. The following 3 sessions with intervals – between 3 to 4 days were only RF treatments. Our case series showed that combined therapy of hyaluronic acid and bipolar radiofrequency was effective and significantly improved overall sexual function (FSFI). The treatment turned out to be safe and painless with no side effects.

The integrity of blood vessels is critical to vascular homeostasis, whose disruption is involved in atherosclerosis (AS), causing stroke and myocardial infarction. Therefore, detecting early AS is essential to avoid severe complications. An arteriograph is the best device for detecting early AS by measuring the rigidity of the blood vessels. To date, there are no safe and effective treatments to clean the blood vessels from lipid accumulation and calcium deposition, which are involved in the onset of AS. For this purpose, we have developed a 4-weeks non-pharmacological protocol, consisting of intravenous laser blood irradiation, injections of glutathione and carnosine, and oral supplementation with phosphatidylcholine, aimed at patients with risk factors for early AS. We observed a significant amelioration of lipids parameters and PWVao, an indicator of the existence of asymptomatic AS, confirming the efficacy of our protocol. Besides, all other health issues must be improved.

Rosacea is a common chronic dermatosis which occurs mainly in middle-aged patients. The etiology of the disease remains unknown but immune and vascular factors are seen to play a crucial role. Diagnosis is established based on clinical manifestation. We present four case reports of rosacea therapy using a medical device emitting near-infrared light.

Facial volume deficits, providing long-term facial aesthetic enhancement outcomes for the signs of aging and/or facial contouring. Numerous hyaluronic acid (HA) fillers seem to have similar characteristics, although their properties regarding rheology, viscoelasticity, heat resistance are different in many ways. The resistance heat degradation is important when hyaluronic acid fillers and energy-based devices are going to be used sequentially. Our objective was to determine the characteristics of HA gels in terms of heat resistance. Degradation of the gels was measured as a change of surface area of the sample. Five types of HA fillers, chosen from most common products on the market for temporary correction of congenital and acquired soft tissue deficits of the face via intradermal or subcutaneous injection: 20mg/ml HA-BDDE, 20mg/ml HA-BDDE, 20mg/ml HA-BDDE, 25 mg/ml HA-BDDE, 28mg/ml HA-PEG were tested in this study. Even though the three dermal fillers contained the same concentration of HA and were cross-linked with the same cross-linking agent, they were produced by different manufacturers using different technologies developed by individual companies. We tested in vitro resistance to heat degradation using Celltibator GT (Medikan Co., LTD, Seoul, Rep. of Korea) and Autoclave (Medotti 22L PRO, Poland). All of the HA fillers samples (0,3 ml) were placed on the petri dishes and put into the autoclave for 10 minutes (temp. 72,4°C). Three of the gels samples (20mg/ml HA-BDDE, 25mg/ml HA-BDDE, 28mg/ml HA-PEG) each 0,3ml were placed into Celltibator for 10 min, temp. 55,2°C degree, centrifugation: 30 RPM. Centrifugation was used to imitate the behaviour of the fillers under the conditions of forces acting on it in the tissue (stress under the influence of facial expressions, exercises, etc.). The temperatures used during this test correspond with commonly used heat-based devices, such as radio-frequency devices (about 45°C), infrared (about 55-65°C) and HiFU (about 70-75°C). Before and after each test pictures of the samples were taken. Heat degradation of the HA samples was measured by comparing (before and after) the changes of the surface area of samples on the petri dishes (on the graph paper). The 28-mg/ml HA-PEG gel filler demonstrated greater resistance to heat versus the 20- mg/ml and 25-mg/ml BDDE gel fillers. The 28-mg/ml HA-PEG, demonstrated in both test (celltibator with/without rotation and autoclave) greater resistance to heat in terms of deformation / thermal degradation and change of surface area. Selection of dermal filler with the right rheological properties is a key factor in achieving a natural-looking long-lasting desired aesthetic outcome. Hyaluronic acid fillers combined with energy-based devices are frequently used sequentially during the same session, however, in some cases it might cause thermal damage of HA. Caution is advised in using IR over recently injected filler (selection of dermal fillers is crucial in this case). Study limitations include use of in vitro model and lack of inflammatory response in an ex-vivo model.

Microneedling is a minimally invasive procedure based on collagen induction therapy and helps reduce the appearance of acne scars. The aim of the present study is to evaluate and compare skin firmness, elasticity, and improvement of skin texture and reduction of facial erythema after sessions of microneedling procedure performed by using two different devices, i.e., the manual microneedle roller and automated microneedle stamp. A randomized comparative clinical study was conducted. Research subjects in one group were applied with the manual microneedle roller, and those in the other group were applied with the automated microneedle stamp. They were subjected to four months of treatment (4 sessions with a microneedling procedure at 28-day intervals). Skin firmness and elasticity were performed by Cutometry measurement. Subjects were photographed for skin texture and erythema evaluation. It was observed that the microneedling procedure using both devices - microneedle roller and stamp- significantly improved skin firmness and elasticity. The treatment also promoted reductions in the intensity of scar and erythema, respectively. The devices promoted similar beneficial results without significant differences between them. The present study demonstrates that both the manual microneedle roller and automated microneedle stamp comparably resulted in an improvement of skin firmness, elasticity, reduction of facial scar, and erythema.

Our nose is a very important and sometimes an essential element of facial beauty. The nose, located in the centre of the face, should be in harmony with the other features of the face. Rhinoplasty is one of the most frequently performed aesthetic operations today. Below, we present the case of a 29-year-old patient with a complication after surgical rhinoplasty. The patient underwent surgical rhinoplasty twice - the first time (2011) with terrible results and the second time (2017) only with gentle improvements. Twelve years after the first surgery, the patient was still looking for a way to improve the outcome of her nose; we proposed the treatment plan with the use of novel PEG-cross-linked hyaluronic acid to improve the appearance of the nose area, with significant visual effect and no side effects.

Of the several dermal fillers developed in recent decades, hyaluronic acid fillers have become the material of choice. They are safe, long-lasting, non-immunogenic, available to most patients, and can be removed with hyaluronidase. Unfortunately, early and delayed complications can also occur after HA filler injection. Below, we present the case of a 42-year-old patient who had complications after the aesthetic procedure using hyaluronic acid dermal fillers in the past. Surprisingly, the treatment performed with hyaluronic acid cross-linked with another cross-linking agent was without complications. The affected places were the chin and malar area. In 2021, after performing augmentation with hyaluronic acid in the chin area, a patient developed swelling, which subsided after using hyaluronidase (Hylase Dessau 300 I.E.) and corticosteroids. The patient repeated the procedure in 2022, where she was administered 2 ml of hyaluronic acid in July 2022. About 3 weeks after injection, oedema and nodules appeared at the injection site in the zygomatic/malar area; after using Prednisone, the changes subsided. In September 2022, 3 ml of PEG-cross-linked hyaluronic acid was successfully performed with no side effects. In the described case, an important role was played by the ability of the hyaluronic acid hydrogel to modulate human immunological functions, which was associated with a very low risk of immune-related side effects and accompanying cellulitic processes.