To assess effectiveness of intradermal injections of autologous fibroblasts for the treatment of facial rhytids and dermal depressions.Design: Six-month prospective pilot study. Photographs and silicone molds were taken of a prominent rhytid or dermal depression from each patient prior to treatment and at 6 months after treatment.Setting: Specialty clinic in academic medical center.Patients: Ten adults (age range, 24-69 years) who each exhibited a prominent rhytid or depressed facial scar.Intervention: A 3-mm postauricular skin biopsy specimen from each participant was sent to Isolagen Technologies, Inc, laboratories, where a fibroblast cell line was developed. Three injection sessions were performed at 2-week intervals; target areas were the study site as well as behind the ear.Main Outcome Measures: Subjective improvement scores were obtained by each patient and 2 clinicians at every follow-up visit. Skin surface topographical features were evaluated with optical profilometry by comparing silicone molds before and after injection. Histological analysis was performed on a biopsy specimen of the postauricular injection site.Results: Nine of 10 patients noted a 60% to 100% improvement with the treatment; clinicians made similar observations. Size reduction of 10% up to 85% of the study site was demonstrated by optical profilometry for every patient. Microscopically, there was evidence of increased thickness and density of dermal-layer collagen.Conclusions: Intradermal injection of autologous fibroblasts may be an effective treatment option for facial rhytids and depressed scars.

The ThermaCool TC RF system represents a promising non-invasive method of obtaining moderate facial rejuvenation in the appropriately selected patient. Long-term results are pending.

The Silktouch flashscanner is effective for the treatment of facial rhytides.

No abstract

To describe a simplified method of malar fat pad elevation to rejuvenate the midface, nasolabial folds, labiomental folds, infraorbital hollows, and jowls via a percutaneous approach.Patients and Design: One hundred eighteen patients were evaluated over a 12-month period in a prospective fashion by the operating surgeon. Preoperative and postoperative photographs were used for comparison.Setting: Private practice.Main Outcome Measures: Elevation of the malar fat pad by a measured amount.Results: At 3 months, all patients had a significant elevation of the malar fat pad (3-7 mm), with the exception of 2 early patients who underwent revision surgery, with satisfactory results.Conclusions: A simplified method of malar fat pad elevation is described. This method allows for elevation of the malar fat pad without extensive dissection. Excellent results are obtained with very little morbidity.

No abstract

This report describes the inactivation of lipid-containing viruses by several long-chain alcohols. A striking peak in antiviral activity was found for saturated alcohols having chain lengths from 10 to 14 carbons. Viruses having different membrane structure showed different susceptibilities to alcohols having different chain lengths and structural features. Decanol, dodecanol, and tetradecanol readily inactivated herpes simplex virus and the enveloped bacterial virus 46. The lipid-containing virus PM2 was susceptible to decanol and dodecanol but comparatively unsusceptible to tetradecanol. The branched-chain alcohol phytol, a naturally occurring component of chlorophyll, was active against 4)6 and herpes simplex virus but not against PM2. Polyoma virus and the bacteriophage 423-1-a, which do not contain lipids, were not susceptible to inactivation by any of the alcohols tested. Experiments were also carried out to determine the effects of these compounds on cells. At 0.5 mM, decanol lysed human embryonic lung cells, erythrocytes, and the bacterial hosts for 46 and PM2. Dodecanol, tetradecanol, and phytol at this concentration were less damaging to cells. At 0.05 mM, none of the alcohols caused observable cytopathic effects on human embryonic lung cells, although several of the alcohols at this concentration were active against herpes simplex virus. Our findings suggest that dodecanol, tetradecanol, and phytol may warrant further studies as potential antiviral agents, particularly for topical application to virus-infected areas of the skin.

e review herein our experience with subperiosteal midface-lifting under direct vision with a simple fixation technique. The technical aspects of the procedure are described in detail. A total of 121 patients underwent midface-lifting and meloplication with the 82/18 L-lactide/glycolide device (Coapt Endotine Midface ST 4.5; Coapt Technologies, Palo Alto, Calif) by both the senior (G.S.K.) and junior (R.N.H.) authors. The senior author's experience included 110 patients over a 26-month period. Thirtytwo of these cases were isolated procedures. The other 78 were performed in conjunction with various procedures, most commonly rhytidectomy. There were no revisions during this period. Two cases of "puckering" were noted. Both were immediately corrected, one with fat injection and one with poly-L-lactic acid injection (Sculptra; Dermik Aesthetics, distributed by Besse Medical Supply, West Chester, Ohio). The junior author's experience included 11 cases over an 8-month period. Two cases of asymmetry were noted. One was corrected with fat injection, and the other required revision. Subperiosteal midface-lifting and meloplication using the Coapt Endotine Midface ST 4.5 device is a simple, effective technique that can be quickly learned and applied.