PEER-REVIEW | COMBINATION THERAPIES |
not confirm a similar experience. Injections of non-stabilised hyaluronic acid to the face
Figure 5 Treatment to the chin. (A) after one side has been treated and (B) after treatment to both sides
Injections of non-stabilised
hyaluronic acid to the face and, especially,
vermilion and
perioral area, were administered to 10 patients.
Key points
■ When planning treatment for the menopausal or post-menopausal patient, it is necessary to consider the hormonal changes of the female organism
■ It is useful to consider the possibilties of non-surgical improvement before treating the tear trough
■ When working with facial contours, the aesthetic practitioner must remember that a bone deficiency is also present in the majority of patients
■ The perioral area, lips and vermilion require a special algorithm of treatment, as described in this article
■ The Global Assessment of Perioral Lines Severity (GAPOLS) Scale is proposed in this article
58 ❚
(Figures 3–6). After the recommended treatment was carried out for
Group 1, the reshaping of the contours was achieved and quality of the soft tissues becomes better. All patients were asked their opinions and the results analysed according to the Global Aesthetic Improvement Scale (GAIS) (Table 2). The results, analysed by the patients, were: ■ Exceptional improvement 50% ■ Very much improved 45% ■ Improved 5% ■ Unaltered 0% ■ Worsened condition 0%. In comparison, the analysis of Group 2 patients was as
follows: ■ Exceptional improvement 30% ■ Very much improved 30% ■ Improved 20% ■ Unaltered 10% ■ Worsened condition 10%. All patients from Group 1 confirmed that any
complaints with regard to dryness, flaking, and burning soon disappeared, and that the appearance of the lips met their expectations. The patients from Group 2 did
and, especially, vermilion and perioral area, were administered to 10 patients. PRP therapy, with papules injected into the face and, especially, the mucous of the mouth, lips and perioral area, was administered to the remaining 20 patients. The authors have achieved an interesting set of primary results comparing the use of non-stabilised hyaluronic acid and PRP, as well as a comparison of different manufacturers of PRP equipment, and hope to publish this in future. The authors have also started to develop their own assessment scale for the purposes of this treatment methodology; Global Assessment of Perioral Lines Severity (GAPOLS) Scale (Table 3). All patients and the results were further analysed
according to the GAPOLS Scale. In the both groups, the results before treatment were scored as: ■ 4 = Severe wrinkles 55% ■ 3 = Moderate wrinkles 45% ■ 2 = Mild wrinkles 0% ■ 1 = Minimal wrinkles 0% ■ 0 = Wrinkles absent 0%. In Group 1 following treatment, the results were 4 = 0%, 3 = 35%, 2 = 55%, 1 = 10%, and 0 = 0%. In Group 2 following treatment, the results were 4 = 30%, 3 = 45%, 2 = 25%, 1 = 0%, and 0 = 0%. The authors have decided to study this part of investigation in the near future and to the GAPOLS Scale, in line with the release of new dermal fillers, particularly for lips augmentation and rejuvenation (Figure 7).
Discussion The main impact of this treatment protocol is that when treating the menopausal or post-menopausal patient, it is necessary to take not only visible changes to the face into account, but also hormonal changes, as well as the
Figure 6 Treatment to the mid-face, (A) before treatment and (B) after treatment March 2013 |
prime-journal.com
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