Keloids are benign fibrous tumors derived by excessive proliferation of fibroblasts and collagen synthesis after an injury. The term originates from the Greek word χηλή (chele, crab's claw), and it is used to describe the lateral growth of tissue, extending beyond the margins of the original skin wound, into unaffected skin. 1,2 They can arise potentially on every wound after major or minor injuries (such as trauma, burns, piercing, surgical procedures), without difference between age or gender, in predisposed individuals, even though darker skin and range age between 10 and 30 years seem to be the most affected categories. Keloids can affect each body site, with a predilection for shoulder, chest, and above all, ears; as a matter of fact, keloids are particularly

Botulinum toxin typeA (BoNTA) is widely used in aesthetic medicine as primary treatment to reduce facial wrinkles. Major unmet needs in the field of the injection techniques include dilution factor, injected volume and site. Since 2013, an innovative protocol has been developed in our clinic that works on a double dilution volume,

Background As a consequence of the COVID-19 emergency, Italian physicians working in the field of aesthetic medicine and surgery considered appropriate to stop their activity in order to preserve patients’ safety. This drastic measure obviously had an important impact on the medical aesthetic market causing growing concerns. Objectives To catch the current attitudes of the Italian consumers towards the aesthetic medicine and surgery, a medical advisory board devised an online survey. Methods 216 clinicians finally participated in this survey and sent the online link via e-mail. Results 8080/8640 (93.5%) questionnaires were returned, while 70 were removed. 49.2% (n=3944) did not feel influenced in their desire for aesthetic treatments in spite of the pandemic emergency. Being influenced was not correlated with the uneven situation experienced on the Italian territory (r=-0.30, p=0.196). 45.4% (n=3636) declared to be ready for rescheduling their visit. 60.5% (n=4844) declared that they want to allocate the same amount of resources as before. The most missed aesthetic treatment was the face (71.1% (n=5696)). 46.9% (n=3759) and 45.9% (n=3679) will back to their physician without any request or with the need for explanation about the security protocols, respectively. About 40% (n=3314) declared that their physical appearance affects their mood fairly, 27.0% (n=2168) strongly or very strongly. 71.3% (n=5708) declared physical and/or psychological decline. Conclusions Looked at together, our results give us some optimistic predictions, and therefore we are confident that our patients will back to our clinics without any particular issues. However, ensuring patient safety must be our paramount task.

BACKGROUND: Aging affects the 3-dimensional structure of all the facial tissues: Bones, muscles, ligaments, adipose tissue, and skin. 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. 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. 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. 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.

Background: The ageing process starts in the center of the face, in the periocular region and around the mouth, with a combination of volume loss and tissue descent, wrinkles deepen, and loss of skin structure and quality. Recently, several studies proved the efficacy of therapies based on the autologous adipose tissue grafting that leverages the properties of stromal vascular fraction (SVF) and adipose derived mesenchymal stem cells (ADSCs) to accelerate the regenerative processes of the skin. This study aimed to verify the ability of the guided Superficial Enhanced Fluid Fat Injection (SEFFI) in the facial area to correct volume loss and skin aging and proved the very low rate of complications of this standardized procedure . Methods: we retrospectively collected data from 2,365 procedures performed in Italian centers between 2019 and 2021. Guided SEFFI was performed alone or combined with cosmetic treatments, including the use of hyaluronic acid filler, suspension threads, synthetic calcium hydroxylapatite, botulin toxin, and microneedling. Results: SEFFI was used alone in more than 60% of the patients, and in all face areas. In about one tenth of patients SEFFI was combined with botulin toxin treatment or hyaluronic acid filling. Other procedures were used more rarely. Ecchymosis in the donor or injection sites was the most frequent event, and yet observed in only 14.2% and 38.6% of patients, respectively. Conclusions: The SEFFI technique is standardized and minimally invasive, leading to very few complications. It can be a promising antiaging medical treatment that combines effectiveness, safety, and simplicity.