Rejuvenation Treatment Research Articles

620 RNase L is a regeneration repressor gene

Mammalian injury responses are characterized by fibrosis and scarring rather than functional regeneration. Limited regenerative capacity in mammals could reflect a loss of pro-regeneration programs or active suppression by genes functioning akin to tumor suppressors. To uncover programs governing regeneration in mammals, we performed comprehensive transcript screening in human subjects after laser rejuvenation treatment and cross-referenced these transcripts to those found in mice with enhanced Wound Induced Hair Neogenesis (WIHN), a rare example of mammalian organogenesis. We find the anti-viral endoribonuclease RNase L to be a powerful suppressor of regeneration. Rnasel-/- mice exhibit remarkable regenerative capacity, with elevated WIHN (n=10, p<0.0001) through enhanced IL-36α (n=3, p<0.01). Consistent with the known role of RNase L to stimulate caspase-1, we find that pharmacologic inhibition of caspases promotes regeneration (n=3 versus 4, p<0.001) in a novel IL-36-dependent manner (n=4, n.s.= not significant). Additionally, these responses are not limited to skin but extend to other organs, such as the colon (n=4, p<0.05), suggesting that suppression of regeneration is a fundamental characteristic of epithelial wound healing. Taken together, this work suggests that RNaseL functions as a regeneration repressor gene in a functional tradeoff that prioritizes host antiviral abilities and is a target to enhance healing in multiple epithelial organs, perhaps even during viral infection.

THE 4T REJUVENATION: ASSOCIATION OF PAN-FACIAL PMMA FILLING, FRACTIONAL CARBON DIOXIDE LASER, RADIOFREQUENCY, AND BOTULINUM TOXIN

Introduction: The use of associated less invasive techniques can be an alternative skin rejuvenation treatment. Objective: To demonstrate the efcacy and safety of the 4T treatment. Methods: Retrospective study of patients that underwent rejuvenation treatment using 4 different techniques simultaneously: polymethylmethacrylate (PMMA) lling, fractional CO laser, 2 radiofrequency, and botulinum toxin. More than 1,400 patients who underwent this treatment between December 2009 and July 2019 were analyzed. Results were very good in all patients submitted to the 4T technique as documented by pic Results: tures, assessment of the medical team and by the patients. Follow-up was similar to the single use of CO2 laser with edema for 2-3 days, additional 3-4 days until complete skin scaling and decrease of the swelling (downtime 5-7 days). It was possible to reestablish the natural volumetric loss caused by ageing and there were no complications in any patient. Conclusion: Treatment with the 4T technique is effective and safe for facial rejuvenation and can enhance a good aesthetic result as assessed by physicians and patients.

Anatomy and Aging of the Perioral Region.

Perioral region, although severely impacted by facial aging, is often overlooked in texts on facial rejuvenation. Sun exposure, bone resorption, dynamic contraction of the sphincteric and nonsphincteric oral musculature, gravitational pull, histological changes of the skin, and unhealthy habits all take their toll in this area. Fine wrinkling on the lips, deep nasolabial and mentolabial folds, elongation and flattening of the upper lip, downturned corners of the mouth, marionette lines, diminished vermillion and upper teeth show and chin irregularities are the main signs of this process, raising great concern amongst patients and making the perioral region the most demanded area for facial rejuvenation treatment. A huge armamentarium of surgical and nonsurgical techniques, with or without complex technology, are available to tailor patient's specific needs, from chemodenervation and mild chemical peels to operations designed to restore the size and shape of the lips. In this article we perform a comprehensive review of the contemporary treatment of the aging perioral area, detailing the most common techniques and their nuances.

Protocolo para rejuvenescimento facial minimamente invasivo em idosos

Objetivo: relatar o caso clínico de tratamento de rejuvenescimento facial em paciente idosa por meio da indução percutânea de colágeno, uso de fios de polidioxanona (PDO), preenchimento com ácido hialurônico e aplicação de toxina botulínica. Esses procedimentos são minimamente invasivos, utilizados para amenizar as alterações faciais decorrentes do envelhecimento. Descrição do Caso: paciente de 76 anos, apresentou interesse por procedimentos estéticos faciais e os mesmos foram realizados sequencialmente, conforme o plano de tratamento. Iniciou-se com microagulhamento seguida da máscara de ácido retinóico e orientações de home care. Após 28 dias, foi realizada aplicação de 50U de toxina botulínica no terço superior da face, nos músculos prócero (6u), corrugadores de supercílio (8u), frontal (14u), orbicular dos olhos (18u) e nasal (6u). Seguido um mês, foi realizada a inserção de 8 fios de PDO no terço médio da face para lifiting facial, e após mais 30 dias a paciente foi submetida a aplicação de ácido hialurônico para preenchimento labial, de olheiras, região malar/zigomático e de bossa canina. Após 6 meses da realização da toxina botulínica, uma nova aplicação de 50U foi realizada nas mesmas regiões aplicadas anteriormente. Todos os procedimentos foram bem sucedidos e proporcionaram bem estar e rejuvenescimento para a paciente. Conclusão: os procedimentos estéticos sequenciais propostos restabeleceram características de jovialidade e resultaram em bem estar físico e emocional, repercutindo na melhora na qualidade de vida da paciente.&#x0D;

Edith Wharton and the Modern Privileges of Age

Edith Wharton and the Modern Privileges of Age

Fractional 1064 nm Picosecond Laser in Treatment of Melasma and Skin Rejuvenation in Asians, A Prospective Study.

Facial melasma is a disfiguring pigmentation and occurs frequently with aging skin. Topical treatment alone was often suboptimal. A recent study showed that fractional picosecond laser has promising result in benign pigmentary lesions. This study aims to investigate the efficacy and safety of 1064 nm picosecond laser in treatment of facial melasma and skin rejuvenation in Asian skin. Patients of Asian descent seeking treatment for facial melasma and skin rejuvenation were screened and recruited. Each patient received up to nine laser treatments at 4-6 weeks intervals with a fractionated nonablative 1064 nm picosecond laser. Baseline and posttreatment modified Melasma Area Severity Index (mMASI) and Global Aesthetic Improvement Scale (IGAS) were assessed by blinded investigators based on the clinical photographs. Subject overall satisfaction was assessed by the questionnaires after treatment. All adverse events were documented. Twenty patients were recruited with a median age of 52.7 ± 8.2 years. Three subjects had Fitzpatrick skin type III and 17 had skin type IV. All subjects received nine laser sessions. Over 70% of patients were satisfied with the treatment outcomes. There was a statistically significant improvement in mMASI which reduced from 10.8 at baseline to 2.7 and 3.6 at 6 and 12 weeks post-treatment, respectively (both P < 0.01). For skin rejuvenation, 70% reported at least a moderate improvement at 6 weeks of post-treatment. No major side-effect was reported. Erythema was the most frequent transient response, while some reported edema (1.1%). Both resolved spontaneously. None reported hypo- or hyperpigmentation after treatment. The overall mean pain scare (VAS) was 1.92. Fractionated non-ablative 1064 nm picosecond laser was effective in treatment of melasma and skin rejuvenation. It was also safe and well tolerated. Importantly, there was no hypo or hyperpigmentation reported. Lasers Surg. Med. 00:00-00, 2021. © 2021 Wiley Periodicals LLC.

Synergistic Effects of Autologous Platelet-Rich Plasma and Hyaluronic Acid Injections on Facial Skin Rejuvenation.

Many therapeutic options are currently available for facial skin rejuvenation, but little evidence exists about the efficacy of combining such procedures. The aim of this study was to assess and investigate the synergistic effect of hyaluronic acid (HA) and autologous platelet-rich plasma (a-PRP) injections on facial skin rejuvenation. For this randomized controlled prospective study, 93 eligible patients were enrolled and randomized into 3 intervention groups to undergo a series of 3 treatment sessions with either a-PRP, HA, or a mixture of a-PRP and HA (Cellular Matrix; Regen Lab) injected into facial cheeks. A total of 93 patients were included. Treatment with Cellular Matrix led to a very significant improvement in the overall facial appearance compared with treatment with a-PRP or HA alone (P < 0.0001). Participants treated with Cellular Matrix showed a 20%, 24%, and 17% increase in FACE-Q score at 1, 3, and 6 months posttreatment, respectively. For the HA group, the improvement in FACE-Q score was 12%, 11%, and 6% at 1, 3, and 6 months posttreatment, respectively, whereas for the a-PRP group the improvement was 9%, 11%, and 8% at 1, 3, and 6 months posttreatment, respectively. Biophysical measurements showed significantly improved skin elasticity for the Cellular Matrix group compared with the groups receiving a-PRP or HA alone. No serious adverse events were reported. Combining a-PRP and HA seems to be a promising treatment for facial rejuvenation with a highly significant improvement in facial appearance and skin elasticity compared with a-PRP or HA alone.

1540‐nm fractional erbium: Glass laser is a safe and effective modality for nonablative facial rejuvenation

Laser treatments for facial rejuvenation are common, with ablative modalities being of more common use for this indication. Efficient nonablative modalities are of rising demand. Our aim was to determine the safety and efficacy of high-fluence, nonablative 1540-nm fractional Erbium:glass laser for facial rejuvenation. A retrospective study of patients treated with 3-4 treatments using the 1540-nm fractional Erbium:glass laser for facial rejuvenation, using 2500-3000mJ/stacked pulses (51-61mJ per pixel). Patients were followed-up for 3months following their last treatment. Before and after photos were independently blindly evaluated by 2 dermatologists, who graded them using a scale from 0 (exacerbation) to 4 (76%-100% improvement) for 2 different facial regions (frontal face region and lateral canthal region). Pain perception and adverse effects as well as patient satisfaction were documented throughout the study. Sixteen patients completed both treatment and follow-up period. At the 3-months posttreatment follow-up visit, moderate-to-significant improvement in rhytids appearance (mean grade of improvement: 2.93 for frontal face and 3 for lateral canthal region) was observed. Patients' satisfaction was high (4.25). Patients reported mild and transient erythema posttreatment with no other adverse effects. The high-fluence 1540-nm fractional Erbium:glass laser is a safe and effective nonablative modality for facial rejuvenation.

A combination of 1064nm Q-switched fractional ND-YAG laser with a nonfractional microsecond pulsed technology has a synergistic effect for nonablative facial rejuvenation.

Non-ablative fractionated lasers for facial rejuvenation are increasingly preferred over ablative lasers due to their minimal downtime and fewer adverse events. The synergistic effect of the Q-switched fractional (QSF) 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, in combination with the non-fractional microsecond pulsed technology has yet to be fully evaluated. Our objective was to determine the safety and efficacy of this combination treatment for skin rejuvenation. Patients who underwent treatment using the QSF-Nd:YAG laser, followed by the non-fractional microsecond pulsed Nd:YAG were evaluated retrospectively using a novel 3D imaging modality for degree of facial erythema, wrinkles surface area, and wrinkle depth. Pain perception, adverse effects, and patient satisfaction were assessed at the 2-month post-treatment follow-up visit, graded on a scale of 1- 5 (1=not satisfied, 5=very satisfied). Ten female patients' ages 44-67 (mean 55years) completed both treatment and follow-up period, with an overall mild improvement in facial erythema and wrinkle surface area (mean improvement of 18% and 19.5% accordingly), as well as a mild improvement in overall wrinkle depth. Pain and adverse effects were mild and transient. Patients' satisfaction was high. The combination of the QSF-Nd:YAG laser and non-fractional microsecond pulsed technology, using a single Nd:YAG 1064nm laser platform, was found safe and effective as a non-ablative modality for facial rejuvenation, as demonstrated by a novel 3D imaging modality.

Platelet-Rich Plasma: Evolving Role in Plastic Surgery

The use of platelet-rich plasma has emerged as one of the most desired nonsurgical treatments for facial rejuvenation and hair restoration. It has grown to encompass a wide variety of applications within the field of plastic surgery, including its use in combination with microneedling, laser, and fat-grafting procedures. In this article, the authors aim to (1) describe the preparation process of platelet-rich plasma; (2) discuss the proposed science behind platelet-rich plasma with regard to its evolving role in hair restoration and facial rejuvenation; and (3) highlight the recent literature examining its widespread use. Based on the available literature, there is a therapeutic advantage to the use of platelet-rich plasma as a single treatment modality for alopecia and skin rejuvenation and in combination with laser skin treatment and fat grafting. There is, however, a considerable amount of variability in the processing, preparation, and treatment modalities. Despite a lack of standardized protocols for platelet-rich plasma preparation and a scarcity of large-scale studies with long-term follow-up, there is convincing evidence with objective measurement modalities that display positive outcomes after treatment for skin rejuvenation, hair regrowth, wound healing, and fat graft take.

Analysis of the Columellar-Labial Angle in Perioral Aging.

The young face presents a convex and rounded aspect; with aging, this changes to a more concave and flattened aspect, with the angles of the face undergoing changes through soft tissue repositioning and bone remodeling. The columellar-labial angle is one of the features that change. The objective of the present study was to analyze the columellar-labial angle at different stages of adult life and assess its contribution to facial changes during aging. We analyzed a database (December 2017-March 2018) of 722 female patients, aged 21 to 88 years, and obtained anthropometric measurements of the columellar-labial angle with a Canfield Vectra 3D image analysis system. Our database originates from a private clinic where all patients were registered and photographed. Our analysis showed a decrease in the columellar-labial angle, mainly observed from patients aged 60 years and older. This decrease can be explained by the absorption of body structures that occurs during aging. The columellar-labial angle decreases with age, and this finding may provide a better understanding of the transformation that occurs with aging. Obtaining a clearer view of the changes that occur in the face will improve treatments for facial rejuvenation, either conservative or surgical, and provide a basis for future studies and knowledge expansion.

At-home Cosmeceutical Application and Outpatient Treatments: A 3D Stepwise Facial Rejuvenation Approach

BACKGROUND: Aging affects the 3-dimensional structure of all the facial tissues: Bones, muscles, ligaments, adipose tissue, and skin.&#x0D; AIM: To customize minimally invasive treatments for facial rejuvenation, we present a standardized holistic approach characterized by at-home treatments in associations with outpatient procedures.&#x0D; METHODS: Forty-four patients underwent 3-dimensional stepwise facial rejuvenation and were evaluated prospectively. Each patient received a customized treatment plan based on a clinical examination and consultation. Treatment outcomes were evaluated from patient photographs with and skin analysis was performed with an A-One Smart automated skin analysis system.&#x0D; RESULTS: The mean age of the patients was 41.7 years and the approximate mean duration of treatment was 160 days. Patients applied cosmeceuticals such as retinoic acid. Outpatient procedures included the delivery of botulinum toxin or dermal fillers, thread lifting, chemical peels, etc. Upon treatment completion, significant improvements were noted in multiple domains: Skin elasticity and hydration increased, areas of hyper-pigmentation were less extensive, and there were fewer visible wrinkles and pores.&#x0D; CONCLUSION: Outcomes of the present article suggest how important is to customize facial anti-aging treatments. Nonsurgical treatments carried out progressively, involving the patient to perform at-home treatments in associations with outpatient procedures, let to achieve facial improvements in terms of increased skin elasticity and hydration, reduction of hyperpigmentation, wrinkles, and pores.

Effect of Platelet-Rich Plasma (PRP) in the treatment of patients with androgenic alopecia

Background: Platelet-rich plasma (PRP) is one of the most important derivatives of blood. Over the past several years, the use of PRP has focused on the medical treatment in conditions such as skin rejuvenation and chronic ulcer treatment and hair loss. Also, PRP has been transmitted to the peripheral environment of the hair follicle through several intradermal injections to treat hair loss. The objective of this clinical trial was the evaluation of the effect of Platelet-Rich Plasma (PRP) in treatment of patients with androgenic alopecia. Methods: In this randomized clinical trial, 20 patients with androgenic alopecia referring to dermatology clinic of Sina Hospital in Tabriz were assigned into the study. Interfollicular injections of Platelet-Rich Plasma (PRP), 0.1 ml/cm2 were performed 2 times in each patient in selected areas of the scalp at intervals of 30 days. The clinical manifestations and dermoscopy were used to evaluate the patients with androgenic alopecia. Before the intervention, 1 month, 3 months after the intervention were followed up, respectively. Results: Twenty patients (16 males and 4 females) were examined. The mean age of the patients was 32.88 ± 1.3 and in range of 24 to 48 years. The results of this study showed a significant increase in the mean number of hair in treated areas in the third month compared with the beginning of the study. In the treated areas there was an average increase of 13.9 after first month and 33.6 hairs per cm2 after 3 months. Conclusion: According to the results of this study, PRP has a positive effect on the treatment of patients with androgenic alopecia.

Musclerelaxant Local Injection as an Useful Test Before Botulinum Toxin a Treatment for Facial Rejuvenation

Musclerelaxant Local Injection as an Useful Test Before Botulinum Toxin a Treatment for Facial Rejuvenation

Fusidic acid cream comparatively minimizes signs of inflammation and postinflammatory hyperpigmentation after ablative fractional CO2 laser resurfacing in Chinese patients: A randomized controlled trial.

Inflammation and postinflammatory hyperpigmentation (PIH) are two adverse side effects of ablative fractional CO2 laser (ablative Fr CO2 ) treatment for both rejuvenation and acne scars. To evaluate the efficacy of fusidic acid cream versus erythromycin ointment as postoperative therapy in patients who underwent ablative Fr CO2 treatment for atrophic acne scars. Sixty Chinese patients who fulfilled the study criteria were recruited and randomly assigned to an experimental group treated with fusidic acid cream or a control group treated with erythromycin ointment. Postoperative treatment lasted for 7days in each group. Each patient had two follow-up visits at 8 and 12weeks. In total, three patients dropped out of the study, one in the experimental group at week 8 and two in the control group at weeks 8 and 12. Baseline and postoperative inflammation and PIH were assessed by facial examination, photographs, and questionnaires. Besides, PIH was evaluated by the Hyperpigmentation Activity and Severity Index (HASI) and a five-point grading system. Moderate-to-severe PIH was observed in both groups. However, the mean HASI score and severity of PIH in the experimental group were lower than those of the control group at weeks 8 and 12 (P<0.05). In the control group, one patient developed postoperative abscesses and one had papules, whereas no inflammation was observed in the experimental group participants. Fusidic acid cream shows promise as a common treatment after ablative Fr CO2 therapy to reduce postoperative inflammation and PIH.

Consensus report on the use of PN‐HPT™ (polynucleotides highly purified technology) in aesthetic medicine

BackgroundInjective procedures using polynucleotides‐based products to promote dermal rejuvenation and revitalization are steadily evolving, yet no structured protocols are available that discuss and provide guidance in aesthetic treatments with highly purified polynucleotides. The goal of this document was to provide consensus‐based recommendations for the safe and effective use of Polynucleotides Highly Purified Technology™ (PN‐HPT™) devices for skin rejuvenation.Patients/MethodsA team of eight experts with extensive experience in treatments for skin rejuvenation and revitalization integrated the best available evidence and clinical judgment and devised a series of practical guidance to support dermatologists, plastic surgeons, and aesthetic physician in the use of PN‐HPT™ products, alone and in combination, in aesthetic medicine.ResultsFor most items, the expert group achieved a majority consensus. “Recommendations” (consensus >80%) were reached for the face, periocular area, décolleté and neck, hands, scalp, and stretch marks. Recommendations include details of techniques, information on dosage, volumes to be injected, and the ideal number of required treatment sessions, as well as time intervals between them for different areas of face and body. A lower agreement level of 60% was reached on but one item related to the initial treatment cycle for the face, leading to a “Consensus statement” for that area instead of a full “Recommendation.”ConclusionThe expert consensus illustrates the value of natural‐origin, highly purified polynucleotides (PN‐HPT™) as biostimulatory booster strategy for skin priming and revitalization of face and body and provides a detailed guide for the use.

Enhanced Pulsed Dye Laser for Facial Rejuvenation.

To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial-dyschromia. Thirteen patients were enrolled in the study. Nine patients were female, four were male, with a mean age of 61 years. All patients presented with either facial telangiectasia, rosacea, pigment, or a combination thereof. At the initial evaluation, test spots were performed to determine the subject's response to selected treatment parameters. In the study, the enhanced 595 nm PDL deployed a spot size range of 5-12 mm with fluences ranging from 8 to 18 J/cm2 . Pulse duration was 10 milliseconds. Enhancements in this device included the option for contact or cryogen spray cooling, increased maximum pulse energy, increased repetition rate, option for addition of radiofrequency (RF), an option for a 15 mm spot size, and longer dye life. The smaller spots were used only for focal low contrast pigmented lesions that persisted after overall facial treatment with the larger spot. Smaller fluences were applied for general rejuvenation with the 12 mm spot (mean ~9 J/cm2 ). Sapphire contact cooling was applied at 10°C. A smaller area of the skin was reserved (typically pre-auricular area) for addition of RF energy just before the pulse (40-70 J/cm3 ) over 100 milliseconds with a 20 milliseconds delay between the end of the RF pulse and beginning of the laser pulse. The minimum fluence that achieved vessel closure/vessel bluing and/or slight immediate pigment darkening was applied based on test spots performed just before treatment to the entire face. Determinations of improvement were made by evaluation of photographs with standard settings using polarized and nonpolarized images. Up to three treatments were performed approximately 1 month apart with follow-up visits 1 and 3 months after the final treatment. Evaluation by a panel of blind observers determined a mean clearance of at least 50% in all lesions, while 77% of lesions had 50-75% clearance, and 23% of lesions had 76-100% clearance. Pain was approximately 4/10. Subjective lesion improvement and satisfaction rates were 3 out of 4 and 3.6 out 4, respectively. An enhanced PDL is effective in one pass treatments for facial rejuvenation with considerably less operative time than previous commercially available systems. A second pass applied to focal challenging lesions results in even more improvement, in a single treatment session. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Ultrasound assessment of tissue integration of the crosslinked hyaluronic acid filler VYC-25L in facial lower-third aesthetic treatment: A prospective multicenter study.

BackgroundDermal fillers have become an integral part of any aesthetic physician's intervention.AimsTo assess, by means of ultrasounds, the tissue integration of the hyaluronic acid (HA) dermal filler VYC‐25L in chin and jaw.MethodsProspective, noncomparative, open‐label, and multicenter study conducted on healthy subjects, with age comprised between 30 and 60 years old, who attended to the clinic to perform a facial rejuvenation treatment of the lower third of the face. VYC‐25L was injected using a 27G needle (supraperiosteal bolus, from 0.2 to 0.3 mL per bolus) in the chin and with canula (retrograde threads, from 0.4 to 0.6 mL) in the jaw. Ultrasound examinations (UE) were performed at each study center by the same experienced observer at baseline, immediately after injection, 48 hours, and 30 days after treatment.ResultsThirty patients (10 per center) were included in the study. At baseline, UE found a characteristic heterogeneous pattern of subcutaneous cellular tissue, with alternation of soft anechoic and hyperechoic images. The UE, performed immediately after treatment, showed a poorly defined globular ultrasound pattern, with anechoic images indicative of liquid content. Forty‐eight hours after treatment, UE are still showing a globular pattern, with well‐defined anechoic areas. Thirty days after treatment, a thickening of the subcutaneous cellular tissue was observed in all the evaluated zones, with a total integration of the HA into the tissue.ConclusionVYC‐25L might represent a significant advance in volumization/restoration of the lower face. Its biointegration was total at day 30 and practically complete at 48 hours of treatment.

Efficacy of home-use light-emitting diode device at 637 and 854-nm for facial rejuvenation: A split-face pilot study.

The use of light-emitting diode (LED) in combination wavelength for facial rejuvenation has been previously reported. Nowadays, there has been a growing market for home-use cosmetic devices because of its low cost and convenience. To evaluate the efficacy and safety of home-use LED device on facial rejuvenation. This was a prospective split-face clinical trial with a total of 24 subjects, who presented with photo aging skin. All subjects were treated with the home-use LED device on the left side of their face, twice a week for 8weeks. Primary outcomes measured in the study were the changes in the biophysical properties of the skin assessed with the following parameters: skin elasticity, skin hydration, texture, and wrinkles. Evaluations were done at baseline, 2-, 4-, 6-, and 8-week follow-up. Subjects' self-improvement scores and adverse reactions were also recorded. All 24 subjects completed the study and attended all follow-up. Skin elasticity was significantly higher in the LED group compared to the control during the 6- and 8-week follow-up (P<.05). In the LED group, an image of the treated skin captured using Visioscan® showed improvement of the skin texture at 8-week follow-up. Majority of the subjects in the LED group scored good improvement on all follow-ups (37.5%, 41.7%, 58.3%, and 62.5%) when compared to the baseline. No adverse reactions or pain were recorded in the study. The home-use LED device, with a combination wavelength of 637 and 854nm, is safe and can be used as an adjunctive treatment for self-administered facial rejuvenation.

Manual therapy in the treatment of facial wrinkles and sagging: a quantitative-qualitative randomized clinical trial

Background: Manual therapy has emerged as an option for facial rejuvenation treatment due to its effects on connective tissue. Objectives: The aim of the study was to verify the effectiveness of the manual therapy protocol in attenuating wrinkles and facial sagging. Methods: This is a quantitative-qualitative, randomized clinical trial. The study included female volunteers, aged between 40 and 50 years, distributed in 2 groups: Manual therapy group (MTG) and Control group (CG). The protocol used consisted of: lymph node decongestion, sliding massages, fast and vigorous movements, and traction on the fasciae. The evaluation instrument was through photos, in which they were analyzed by Dermato-functional specialists through a scale that graduates the wrinkles. The Shapiro-Wilk normality test was used to analyze the symmetry of the results by the Gauss curve. Pre- and post-intervention differences between the groups were determined using the non-parametric Wilcoxon test. Results: The average score obtained in the graduation of wrinkles and signs of aging in the manual therapy group showed significant differences in all regions of the face before and after treatment. And there was a decrease in the score, which shows improvement in the reduction of wrinkles and signs of aging, especially in the upper third. In contrast, in the control group, the average remained before and after the follow-up by the research, showing that there were no significant changes in this group. Conclusion: The manual therapy protocol showed significant results in reducing the signs of aging, such as fine lines and wrinkles, being another option to be applied in clinics.