Perda de definição do contorno do submento: correto diagnóstico e algoritmo de tratamento Loss of definition of the submental contouring: correct diagnosis and treatment algorithm RESUMOA busca por procedimentos estéticos voltados para a perda de definição do submento é crescente. Um correto diagnóstico é imperativo para o sucesso do tratamento e redução das complicações. Adiposidade localizada, flacidez cutânea e perda da estrutura óssea são os principais achados. Um algoritmo de tratamento foi discutido nesta revisão, lembrando-se, claro, da possibilidade de tratamentos combinados e sequenciais para melhores resultados.
Background: Sagging neck skin is a common complaint, and the use of calcium hydroxyapatite injection is a traditional treatment approach for this region. The published literature is limited concerning the possible interference in imaging exams of hyperdiluted product, which presents radiopaque features, for the assessment of deep structures to the application. Objective: To assess possible interferences in the ultrasonographic evaluation of thyroid after application of hyperdiluted CaHA on the neck region. Methods: This was a prospective, blinded, and controlled study. Patients had their cervical regions treated with diluted CaHA (1:4). Ultrasonographic evaluations of thyroid were conducted on day 0 (pre-procedure), day 15, and day 60 by two radiologists blinded to the application. Results: On day 0 no exclusion criteria were observed. On day 15 technical artifacts that difficulted the evaluation but did not make the complete assessment of the thyroid unable, were seen. On day 60 the artifacts of posterior acoustic shadowing were considerably reduced, not bringing any difficulty whatsoever for evaluation of the gland. Conclusion: Treatment of sagging neck skin with diluted CaHA in 1:4 does not negatively impact the ultrasonographic evaluation of the thyroid as early as 15 days, and particularly after 60 days from the procedure.
The hopes for achieving excellent results with low incidence of adverse effects has led cosmetic doctors to refine their anatomical knowledge and develop injection techniques which are more and more effective and safe. In this new landscape, the temporal region has become increasingly relevant, due to the important changes it goes through during the aging process and the subsequent complexity of its treatment. 1 The temple is comprised of the following 11 distinct layers: skin, subcutaneous cellular tissue, superficial temporal fascia, loose areolar tissue, superficial layer of deep temporal fascia, superficial temporal fat pad, deep layer of deep temporal fascia, deep temporal fat pad (temporal extension of the buccal fat pad), temporal muscle, pericranium, and bone (Figure 1). Its blood supply comes from the superficial temporal, middle temporal, deep temporal, posterior auricular, zygomatic-orbital, zygomatic-temporal, and zygomatic-facial. 2 Recent research articles have suggested temple treatment through fat injections, hyaluronic acid, calcium hydroxyapatite, and poly-L-lactic acid, among other substances. Different devices, such as needles and cannulas of varying sizes have been employed
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