Introduction Lip augmentation is achieved mainly by using hyaluronic acid (HA) fillers. The injection procedures are performed either superficially or deeply with a needle or a cannula, and only one type of hyaluronic acid is used. The authors' objective was to evaluate the feasibility, safety, and satisfaction level of a procedure combining two anatomical injection plans, two injection modes (i.e., cannula and needle), and two types of hyaluronic acid fillers. Method The retrospective study included 30 patients who underwent the following procedure: Intramuscular retro‐trace injections of Stylage M (Vivacy® Laboratories) were conducted through a 27‐gauge cannula at the level of the upper and lower hemi‐lip. Then, intradermal injections of Stylage Lips (Vivacy® Laboratories) using a 33‐gauge needle were carried out on the entire lip border as well as the cupid's bow. During a post‐injection follow‐up, subjects were asked to evaluate satisfaction level and the effect of fillers over time. Elastic (G′) and viscosity (G″) moduli of HA fillers were measured with a rheometer (AR2000, TA Instruments) prior to and after extrusion through a 33‐gauge needle. Results Rheological assessment showed that passage through a 33‐gauge needle did not alter the viscoelastic properties of HA fillers. After the clinical procedure, no side effects were observed except for standard post‐treatment bruises and edema. No vascular incident occurred. Moreover, overall patient satisfaction was high (2.6/3) and there was a long‐lasting perception of the effect of the filler. Conclusion The current study demonstrated that dissociating the anatomical zones of the lip during the injection procedure by means of different hyaluronic acids in the muscular and dermal planes would efficiently and safely provide both lip projection and fullness for a natural and lasting effect.
This current retrospective study, including 98 patients aged 21 to 71 years, aims to assess the safety and the efficiency of a picosecond 755 nm/532 nm laser in the removal of complex eyebrows tattoos. Patients were treated with a picosecond laser at 755 nm with fluences ranging from 0.69 to 6.37 J/cm2 and at 532 nm with a fluence of 0.64 or 1.12 J/cm2. Analyses of Variance (ANOVA, single factor) and comparison tests (F-test) were conducted. A total of 70 subjects finished the full treatment. An average of three laser sessions were necessary to achieve the patients’ objective (total removal, attenuation for redo, or correction). The number of sessions was significantly higher if cosmetic tattoos contained visible warm pigments (red, orange, yellow). A total of 18 patients experienced immediate grey discoloration, although this was not found to significantly influence the number of laser sessions. The main side effects were redness, swelling, and bleeding points. One patient experienced a bruise immediately after laser shots. This retrospective study has shown the picosecond laser to be safe and efficient in removing complex cosmetic tattoos. Further investigation is ongoing to assess optimal parameters for treating red and white pigments.
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