Background: The shape and fullness of the lips are essential in facial aesthetics. We describe a safe injection technique of hyaluronic acid (HA), based on the well-known golden number Φ (phi), for lip augmentation. Methods: The name given to that procedure is “the step-by-step Φ technique.” Firstly, “step-by-step” because we never inject more than 1–1.5 ml of HA in 1 session, and “phi” because we apply the golden ratio 1.618—broadly known as Φ—to identify the proper points for injection. Using a specific caliper, we identified 3–4 points in each upper half of the lip. We injected 0.01–0.05 ml of lower concentration (25 mg/g) HA in these particular areas of the upper lip, from the vermillion border into the vermillion. We took into consideration the existing lip volume to decide the proper amount of HA to be injected in every single site, as lips are often asymmetric. On the lower lip, we use the same caliper to identify again the proper injection points. If necessary, the next 2 sessions are performed at an interval of 15–30 days. Results: Our technique was performed in 833 patients. Mean age was 30.2 years (range: 18–72 years), and most patients were very satisfied. With this technique, we avoid severe complications such as arterial embolism or venous occlusion and unnatural results. The most common side effects were swelling, redness, and mild pain. Conclusion: The step-by-step Φ technique is safe, easy to learn and perform, and can provide natural results in lip augmentation.
Summary: Median and lateral neck areas are quite challenging to improve. Three-dimensional cryolipolysis is a noninvasive technique for localized fat reduction. We investigated the efficacy and safety of the technique when applied to these areas. A prospective study of patients treated with one session of 3-dimensional (3D) cryolipolysis is performed. Clinical outcomes are assessed using caliper measurements, patient surveys, and independent, blinded plastic surgeons’ photographic evaluation. The studies are conducted using a commercially available noninvasive medical device for 3D cryolipolysis. All patients received gentle massage of the treated areas for 3 minutes, and the final follow-up is after 3 months. Thirty-nine patients are enrolled in our study from June 2018 to December 2018. All 39 subjects received treatment on at least one intended area (median, right, and left lateral neck). Comparison of the pre- and posttreatment caliper measurements demonstrated a significant reduction of the treated areas at 3 months. Posttreatment, 82.05% of patients marked the results of fat reduction as exceptional or very improved, 12.82% as improved, 5.13% as no result, and 0% as worse. Improved patients and the blinded plastic surgeons noticed at these patients’ groups a bonus tightening effect. No serious adverse reactions are observed; thus, 3D cryolipolysis considered as a safe and effective noninvasive localized fat reduction technique with an extra, almost regularly observed, tightening effect.
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