Polynucleotides, complex molecules composed of nucleotides, have gained attention in aesthetic medicine for their potential to regulate gene expression and promote tissue regeneration. This review aims to provide an overview of the current practices and perceived effectiveness of polynucleotides in aesthetic medicine. A comprehensive search of the literature was conducted using keywords related to polynucleotides, cosmetic application, and aesthetic application. Studies were selected based on their relevance to aesthetic medicine and the inclusion of human subjects. The review found that polynucleotides have been used to improve skin texture, reduce wrinkle depth, and enhance facial appearance. The studies reported varying degrees of efficacy and safety, with some studies demonstrating significant improvements in skin elasticity and hydration. However, others reported limited or no benefits. The review also highlighted the need for further research to establish the optimal use and efficacy of polynucleotides in aesthetic medicine. While the existing literature suggests that polynucleotides may have potential benefits in aesthetic medicine, more research is needed to fully understand their mechanisms of action and optimal use. Clinicians should be aware of the current limitations and potential risks associated with the use of polynucleotides in aesthetic medicine.
Hyaluronic acid (HA) fillers are extensively utilized in aesthetic medicine due to their biocompatibility, reversibility, and effectiveness in enhancing skin hydration, volume, and overall appearance. These fillers are predominantly produced through microbial fermentation, followed by a critical cross-linking process that enhances their longevity by resisting enzymatic degradation. This review provides a thorough examination of the manufacturing processes that differentiate HA fillers, with particular attention to the distinctions between biphasic and monophasic variants. Unlike previous studies, this review emphasizes the specific cross-linking techniques and their substantial impact on the fillers’ rheological properties, such as elasticity and cohesiveness, which are crucial to their clinical performance and patient outcomes. Additionally, the review offers a comprehensive comparison of HA fillers with non-HA alternatives, including calcium hydroxylapatite, poly-l-lactic acid, and polymethyl methacrylate, highlighting the unique advantages and potential complications associated with each type. By presenting novel insights into the latest advancements and challenges in filler technology, this review aims to provide clinicians with a deeper understanding of filler properties, thereby guiding them in making informed decisions to optimize patient safety and aesthetic results.
The classification of nasolabial folds into three types, each with distinct causative factors and mechanisms, is explored. Age-related changes in facial skin and connective tissues are examined in detail, revealing variations across different facial regions due to variances in tissue firmness and thickness. The innovative ‘Reverse Technique,’ involving cog threads to enhance tissue traction and effectiveness in thread-lifting procedures, is introduced. Detailed technical guidelines, anatomical considerations, and safety measures are provided, emphasizing the importance of identifying optimal vectors and fixing points to achieve maximum lifting effects while minimizing potential risks, particularly those associated with vascular structures. Additionally, the ‘Cross Technique using volumizing thread’ is discussed, designed to smooth tissue boundaries and rejuvenate sagging areas. Facial anatomy, including the positioning of arteries and ligaments, is underscored as essential for ensuring the safety and efficacy of procedures. In conclusion, this review stands as a comprehensive guide for practitioners, offering insights into innovative thread-lifting methods and their applications in addressing nasolabial folds. The primary focus is on achieving optimal aesthetic results while prioritizing patient safety.
1 May 2024 in Clinical, Cosmetic and Investigational Dermatology
Thread lifting involves the use of slender materials, reminiscent of threads, for aesthetic procedures. These materials are distinct from traditional sutures and vary in composition, purpose, and performance. The introduction delves into the literal and material significance of threads, establishing the broad concept of thread lifting materials. The article revisits the evolution of thread lifting materials, emphasizing the preexistence of cog threads for tissue manipulation before their widespread adoption in plastic surgery. Observations regarding the efficacy and longevity of absorbable versus non-absorbable threads are discussed, stressing the efficiency of high-quality absorbable cog threads. The conclusion underlines the proliferation of thread lifting materials beyond PDO, highlighting the importance of considering multiple factors beyond duration when selecting threads for lifting procedures.
Hyaluronic acid (HA) fillers are widely used in esthetic medicine and are categorized into biphasic and monophasic types based on their manufacturing processes. To evaluate the quality of these fillers, it is essential to understand their rheological properties, which reflect their viscoelastic nature. Rheology, the study of material deformation and flow, reveals how fillers behave under stress, combining properties of solids and liquids. This study explores the fundamental principles of elasticity and viscosity, rooted in Hooke’s law of elasticity and Newton’s law of viscosity, to explain the complex behavior of viscoelastic substances like HA fillers. The distinction between biphasic and monophasic fillers lies in their chemical cross-linking processes, which impact their molecular weight, structure, and ultimately, their clinical performance. Biphasic fillers with minimal cross-linking rely on natural molecular entanglements, exhibiting lower modification efficiency and greater elasticity. Conversely, monophasic fillers, which undergo extensive chemical cross-linking, demonstrate higher modification efficiency, firmer texture, and enhanced resistance to enzymatic degradation. The study emphasizes the importance of thoroughly removing residual cross-linking agents to ensure filler safety. Understanding these rheological characteristics aids clinicians in selecting appropriate fillers based on injection sites, tissue conditions, and desired outcomes, balancing viscoelastic properties and safety for optimal esthetic results.