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BOTOX PROLONGS LIFE OF HA FILLERS
Experimental evidence supports a simple technique for prolonging the effects of HA dermal fillers: using them together with botulinum toxin, reports a paper in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS). 'Chemodenervation' using botulinum
H
neurotoxin-A (BoNT-A) can prolong the life of the HA fillers by reducing muscle activity in the treated area, according to the study by Dr. Ismail Küçüker and colleagues of the Ondokuz Mayis University Faculty of Medicine in Samsun, Turkey.
BoNT-A muscle paralysis slows HA filler degradation Dermal filler injection is one of the most common minimally invasive cosmetic procedures, with 2.3 million procedures performed in 2014, according to ASPS statistics. Hyaluronic acid dermal fillers are most commonly used because they are natural, gel-based products that are highly compatible with the body. However, early degradation of HA fillers limits the duration of the cosmetic improvement. Longevity is affected not only by the properties of the HA fillers, but also by forces applied to them-including contraction of neighboring muscles. To reduce these forces, plastic surgeons sometimes use HA fillers in a combination procedure with BoNT-A-best known by the brand name Botox. This causes temporary paralysis of the muscles in the treated area, lasting a few months. Several studies have suggested that this chemodenervation procedure improves the clinical results of HA filler injection.
Study findings For a more objective demonstration, Dr Küçüker and colleagues designed a study in rabbits in which a small amount of HA filler was injected under the skin in front of each
10 January/February 2016 |
prime-journal.com
yaluronic acid (HA) fillers are a popular treatment for facial lines and wrinkles, but early degradation of fillers may limit how long their effects last.
VITAMIN D STATUS AND BARIATRIC SURGERY RESULTS
CHEMODENERVATION SHOWN TO SLOW HA FILLER DEGRADATION
ear. This area was chosen because it corresponds to the forehead region in humans-a common area for dermal filler treatment. On one side, HA filler alone was used. On the other side, HA filler was combined with BoNT-A to paralyze the muscle in that area. After 3 months, MRI scans were performed to compare the amount of filler remaining on the two sides. The follow-up scans confirmed that BoNT-A
slowed degradation of the injected filler. At 3 months, chemodenervation with BoNT-A decreased the degradation rate of the HA fillers by 42 %. At the same time, the remaining volume of HA
filler was 50 % greater on the side where BoNT-A was used. The difference was visible as well as measurable, supporting the clinical experience that BoNT-A injection provides longer-lasting outcomes in patients. 'This study showed that HA filler application in combination with BoNT-A significantly decreases the degradation process and increases the remaining volume at the end of the paralyzed period,' Dr. Küçüker and colleagues conclude. They believe their study provides objective evidence to support the use of this combination procedure in patients undergoing dermal filler treatments.
This study showed that HA filler application in combination with BoNT-A
significantly decreases the degradation process and increases the remaining volume at the end of the paralyzed period.
Low levels of vitamin D have long been identified as an unwanted hallmark of weight loss surgery, but now findings of a new study adds to evidence that seasonal sun exposure — a key factor in the body’s natural ability to make the 'sunshine vitamin' — plays a substantial role in how well people do after such operations. Results of the study, published online in the journal Obesity Science & Practice, reveal interplay among vitamin D status, seasons, geography, and surgery outcomes, according to Leigh Peterson, Ph.D., M.H.S., a nutritionist and postdoctoral research fellow at the Johns Hopkins Center for Bariatric Surgery, who led the research. Specifically, the researchers found that
patients undergoing bariatric surgery in the United States during winter — January to March, the time of lowest vitamin D levels — fared worse than patients who had procedures in the summer. Similarly, patients having surgery in the north seemed to have more complications than those in the south. For the study, researchers reviewed
records of more than 930,000 bariatric operations performed in the United States between 2001 and 2010. Overall, post procedural complications were rare, with fewer than 1% of patients developing infections. A more common outcome was spending a few extra days in the hospital, and this showed the strongest relationship with both season and geography. The researchers found, Peterson says, a
disproportionate number of those who fared worse hailed from areas north of latitude 37 degree than areas south of it. For example, areas north of latitude 37 degrees yielded almost 150,000 more patients who spent more than three days in the hospital after surgery than areas south of that latitude. Considering that more than 300,000 of the operations led to extended hospitalization, 71% of these surgical complications occurred north of 37 degrees. The researchers say they are next planning a study measuring patients’ vitamin D levels before and after surgery to help determine optimal doses for supplementation.
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