top of page



Quest’anno Agorà, con l’obiettivo della ricerca di un costante miglioramento e progresso scientifico, ha voluto approfondire la bibliografia di riferimento per le tematiche delle Sessioni Coordinate e metterle disposizione dei partecipanti alla Sessione in Sede Congressuale.

In questa pagina troverete a disposizione gli abstract degli articoli che Agorà ha selezionato come bibliografia di riferimento per la sessione coordinata "BIOSTIMOLAZIONE DEL CORPO: NOVITÀ E SINERGIE TERAPEUTICHE". I Soci Agorà avranno inoltre la possibilità di scaricare gli articoli originali in versione integrale.



Journal of Dermatological Treatment

2018 June; 29(4):400-404

PMID: 29098914

Neck rejuvenation using a multimodal approach in asians

Eun Jin Doh, Jiwon Kim, Dong Hun Lee, Je-Young Park

BACKGROUND: A multimodal approach is essential for neck rejuvenation because many factors contribute to the aging of the neck.

OBJECTIVES: We evaluated the effect of combined therapy using microfocused ultrasound with visualization (MFU-V), neuromodulator injection, and filler injection for neck rejuvenation.

METHODS: Subjects were sequentially treated with three kinds of interventions in a single session, as follows: (A) MFU-V or calcium hydroxyapatite injection for restoring skin laxity; (B) hyaluronic acid filler injection for horizontal neck lines; and (C) neuromodulator injection for platysmal bands.

RESULTS: All ten patients showed clinical improvement of neck aging after combined treatment. Patients with more aged neck at baseline were more likely to show greater improvement after treatment.

CONCLUSION: Neck rejuvenation using multimodal approach is effective in Asians.

Dermatologic Therapy

2020 May; 33(3):e13402

PMID: 32283568

Advanced fractional radiofrequency for the rejuvenation of face, neck, and décolleté

Paolo Amori, Gabriella Vitiello, Andrea Cancelli, Roxanna Sadoughifar, Mohammad Jafferany, Michael Tirant, Van Thoung Nguyen, Torello Lotti

ABSTRACT: Recently great attention has been paid to the rejuvenation of the face, neck, and décolleté of women with advanced radial fractional radiofrequency. We aimed to clinically evaluate the results obtained with this treatment method. We treated 10 women aged 42 to 62, suffering from skin aging. After carrying out the hydration and sebometry skin tests in each patient, collecting the medical history and taking photographs of the face and décolleté in the standard projections, a questionnaire was submitted to each patient. Finally, we have submitted the patients to one session of application of radiofrequency energy, by an Italian device named "Thuzzle" (GMV, Rome, Italy). The obtained results show a high effectiveness in improving the texture and tone of skin, decreasing micro wrinkles and spot reduction. Advanced radial fractional radiofrequency treatment method shows promising results. Further studies are required to confirm the findings.

Journal of Cosmetic Dermatology

2018 February; 17(1):66-72

PMID: 29285863

Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage

Gabriela Casabona, Diana Nogueira Teixeira

BACKGROUND: Skin laxity and wrinkling on the neck and décolletage reveal age as reliably as the face.

OBJECTIVE: To evaluate the combined use of microfocused ultrasound with visualization (MFU-V; Ultherapy® ) and diluted calcium hydroxylapatite (CaHA; Radiesse® ) for treating the neck and décolletage.

METHODS: Subjects with moderate-to-severe lines on the neck and/or décolletage were retrospectively enrolled. MFU-V was applied using 7 and 10 MHz transducers followed by subdermal injection of CaHA diluted 1:1 with lidocaine solution. Photographs at baseline and 90 days were assessed by two independent, blinded evaluators using three scales: Merz Aesthetics décolleté wrinkles, Fabi-Bolton chest wrinkle, and Allergan transverse neck lines scales.

RESULTS: A total of 47 subjects were treated as follows: 29 (neck only), five (décolletage only), and 13 (both areas). Mean neckline score improved from 2.6 (moderate-to-severe lines) at baseline to 1.3 (mild lines) 90 days after treatment (P < .001). Mean décolletage scores improved from 2.6 and 3.3 (moderate-to-severe wrinkles) on the Merz Aesthetics and Fabi-Bolton scales, respectively, to 1.1 and 1.8 (mild wrinkles), respectively, after treatment (both P < .001). Both procedures were well tolerated with high subject satisfaction.

CONCLUSIONS: Combining MFU-V with 1:1 diluted CaHA is effective for improving the appearance of neck and décolletage lines and wrinkles.

Journal of the European Academy of Dermatology and Venereology

2016 September; 30(9):1599-1602

PMID: 27306500

Tightening effects of high-intensity focused ultrasound on body skin and subdermal tissue: a pilot study

S. Y. Choi, Y. A. No, S. Y. Kim, B. J. Kim, M. N. Kim

BACKGROUND: High-intensity focused ultrasound (HIFU) has been introduced as a new treatment modality for skin tightening through application mainly to the face and neck.

OBJECTIVES: This pilot study assessed the efficacy and safety of HIFU for body tightening in Asian females.

METHODS: Six Asian female adults were enrolled in this pilot study. All subjects were treated with HIFU to the both cheek, upper arm, lower abdomen, thigh and calf using the following probes: 7 MHz, 1.5 mm focal depth; 2 MHz, 3.0 mm focal depth; 2 MHz, 4.5 mm focal depth; 2 MHz, 6.0 mm focal depth and 2 MHz, 9.0 mm focal depth. Three blinded independent dermatologists assessed results using the Investigator Global Aesthetic Improvement Scale (GAIS) using paired pre- and post-treatment (week 4) standardized photographs. Also, we evaluated skin elasticity at all treated sites using a cutometer. Participants used the subject GAIS to assess their clinical improvement after treatment and rated their pain using a visual analogue scale (VAS) immediately, 1 and 4 weeks after treatment.

RESULTS: The three blinded evaluators judged all treated sites as showing clinical improvement 4 weeks after treatment. Skin elasticity measured via cutometer was significantly improved 4 weeks after treatment at all treated sites (P < 0.05). All patients scored themselves subjectively as more than 'improved' on the GAIS. Immediately after treatment the mean VAS score was 5.17 ± 2.48, but no pain was reported at weeks 1 and 4. No permanent adverse effects were observed during the follow-up period.

CONCLUSION: For body tightening, we applied HIFU using transducers with a lower frequency and deep focal depth to effectively deliver ultrasound energy to skin tissues. HIFU appears to be a safe and effective treatment modality for dermal and subdermal tightening.

Annals of Dermatology

2014 August; 26(4):447-456

PMID: 25143672

PMCID: PMC4135098

The efficacy, longevity, and safety of combined radiofrequency treatment and hyaluronic acid filler for skin rejuvenation

Hyuk Kim, Kui Young Park, Sun Young Choi, Hyun-Ju Koh, Sun-Young Park, Won-Seok Park, Il-Hong Bae, Beom Joon Kim

BACKGROUND: Recent advances in hyaluronic acid (HA) fillers and radiofrequency (RF) devices have been made in the context of skin rejuvenation and cosmetic surgery. Moreover, combination regimens with both techniques are currently being developed.

OBJECTIVE: The present study was designed to examine the clinical and histologic effects of a new needle that incorporates an RF device for HA injections.

METHODS: A new intradermal needle RF device (INNOfill; Pacific Pharma, Korea) was assessed in the present study. In the animal arm, procollagen production was measured by using enzyme-linked immunosorbent assay, the filler volume was quantified by incorporating a dye with filler, and the filler distribution was assessed through the changes in tissue structure. In the human arm, the efficacy of the combination regimen was assessed by using the wrinkle severity rating scale (WSRS).

RESULTS: In the animal study, RF treatment increased procollagen production in a time-dependent fashion. The total volume was significantly increased with the RF treatment when compared with the filler injections alone, and lasted for up to 7 weeks after treatment. Additionally, the filler distribution was reduced in animals treated with RF when compared with the untreated group. In the human study, the nasolabial folds of subjects treated with RF before filler injections exhibited a significantly greater change in the WSRS score from baseline when compared with the nasolabial folds treated with filler injections alone.

CONCLUSION: A new device incorporating RF treatment before HA filler injection may represent a biocompatible and long-lasting advance in skin rejuvenation.

Dermatologic Surgery

2019 August; 45(1):S12-S21

PMID: 31246868

Validated assessment scales for skin laxity on the posterior thighs, buttocks, anterior thighs and knees in female patients

Michael S. Kaminer, Gabriela Casabona, Wouter Peeters, Rolf Bartsch, Kimberly Butterwick, Yates Yen-Yu Chao, Joana Costa, Joseph Eviatar, Sabrina Guillen Fabi, Thorin L. Geister, Kate Goldie, Jenny Grice, Doris Hexsel, Paul Lorenc, Mary Lupo, Rainer Pooth, Gerhard Sattler, Heidi A. Waldorf, Yana Yutskovskaya, Martina Kerscher

BACKGROUND: The demand for noninvasive skin-tightening body procedures is increasing.

OBJECTIVE: To develop a set of grading scales for the objective assessment of skin laxity and assess their reliability and validity.

MATERIALS AND METHODS: Two photonumeric grading scales were created and validated for skin laxity in female patients: Skin Laxity-Posterior Thighs/Buttocks, and Anterior Thighs/Knees. Fifteen aesthetic experts rated photographs of 50 women in 2 validation sessions. Responses were analyzed to assess inter-rater and intra-rater reliability.

RESULTS: Overall inter-rater reliability according to intraclass correlation efficient (ICC) 2.1 and weighted kappa was at least "substantial" for both scales in both sessions, and "almost perfect" (≥0.81) for the Anterior Thighs and Knees scale in session 2. Intra-rater reliability was "almost perfect" for both scales (ICC 2.1) and "substantial" to "almost perfect" by weighted kappa. A correlation between the skin laxity scales and body mass index, age, weight, sun exposure, and cellulite severity was observed.

CONCLUSION: The skin laxity photonumeric grading scales are valid and reliable instruments for assessing laxity on the posterior thighs and buttocks, and anterior thighs and knees. The scales will be of value for standardizing clinical evaluations and quantifying outcome measurements in research and clinical practice.

Journal of Ultrasonography

2021 December; 20(83):e273-e278

PMID: 33500794

PMCID: PMC7830143

The efficacy of high-frequency ultrasound-guided injection lipolysis in reducing fat deposits located on the inside of the knees

Robert Krzysztof Mlosek, Ewa Skrzypek, Bartosz Migda, Michal Migda, Witold Wozniak

INTRODUCTION: Many women consider local fat deposits unacceptable for aesthetic reasons as they have negative impact on appearance and thus, contribute to reduced self-esteem. Injection lipolysis (intralipotherapy) may be an alternative for conventional liposuction in reducing fat deposits.

AIM: The aim of this paper was to assess the efficacy of high-frequency ultrasound-guided injection of deoxycholic acid (intralipotherapy) to remove fat deposits on the inner side of knees.

MATERIALS AND METHODS: The procedure was performed in 7 women (14 inner sides of knees). The formulation was administered under high-frequency ultrasound guidance. The procedure was performed twice at 4-week intervals in each patient. High-frequency ultrasound guidance was used to monitor such parameters as the thickness of the dermis (DermaMed, Dramiński S.A.) or the subcutaneous tissue (Philips Epiq 5, USA). Ultrasound was performed both before and after treatment. Additionally, anthropometric measurements were taken, a questionnaire was performed, and a photographic documentation was recorded.

RESULTS: Reduction in knee circumference and subcutaneous tissue occurred in 71.42% of patients.

CONCLUSIONS: Intralipolysis with deoxycholic acid formulation is an effective method for reducing fat deposits on the inner part of the knees. Ultrasonography proved to be a useful method to monitor the procedure (correct administration of the preparation) and to assess treatment outcomes. A small sample size was a limitation of our study; therefore further studies are needed.

Journal of Cosmetic Dermatology

2021 June; 20(6):1655-1662

PMID: 33830621

Clinical experience of poly-L-lactic acid injections for body contouring treatment

Sachin M. Shridharani, Grace M. Tisch, Trina G. Ebersole, Teri N. Moak, Carolina Edwartz

INTRODUCTION: Clinical data on body contouring with injectable poly-L-lactic acid are sparsely reported in published literature. This study describes the lead author's clinical experience using injectable poly-L-lactic acid for body contouring in various anatomic locations.

METHODS: Twenty consecutive patients undergoing body contouring treatments with poly-L-lactic acid were prospectively followed. All treatments were performed at a single clinic between February 2017 and February 2019. Treatment details such as reconstitution, injection volume and dosage were documented. Treatment response was assessed independently by patients and the treating physician. Adverse events were recorded.

RESULTS: Twenty patients (85% women) received injectable poly-L-lactic acid for body contouring treatments such as buttocks volumization, cellulite and skin quality treatment. In most patients (65%), poly-L-lactic acid was administered to correct postsurgical soft tissue deformities. Overall, patients had a mean of 5.1 treatment sessions in a mean of 1.4 anatomic locations. The most commonly treated anatomic locations were buttocks (58% of treatment sessions), thighs (20%) and abdomen (9%). Dosage and injection volume varied between patients depending on anatomic location and desired outcome. Most treatment sessions (86%) resulted in improvement of the treated area. Adverse events included bruising, oedema, numbness and tenderness. Nodule formation was recorded for one patient (5%).

CONCLUSION: According to the lead author's clinical experience, poly-L-lactic acid injection is well tolerated and can achieve good aesthetic outcomes when used for body contouring in appropriate patients. Preliminary data suggest that poly-L-lactic acid injection may be a viable nonsurgical technique for correcting postsurgical soft tissue deformities.


2022 February; 14(2):450

PMID: 35214181

PMCID: PMC8880571

Cutaneous delivery of cosmeceutical peptides enhanced by picosecond and nanosecond domain Nd:YAG lasers with quick recovery of the skin barrier function: comparison with microsecond domain ablative lasers

Woan-Ruoh Lee, Chien-Yu Hsiao, Zi-Yu Chang, Pei-Wen Wang, Ibrahim A. Aljuffali, Jie-Yu Lin, Jia-You Fang

ABSTRACT: Picosecond or nanosecond-domain non-ablative lasers generate faster photothermal effects and cause less injury than microsecond lasers. In this study, we investigated the enhancing effect of 1064 nm picosecond- and nanosecond-domain neodymium (Nd):yttrium-aluminum-garnet (YAG) lasers on the cutaneous delivery of cosmeceutical peptides. Microsecond-domain fractional ablative CO2 and fully ablative erbium (Er):YAG lasers were also used for comparison. In the Franz diffusion cell study, pig or mouse skin was treated with a laser before exposure to palmitoyl tripeptide (PT)-1, PT-38, and copper tripeptide (CT)-1 at a concentration of 150 μM. Psoriasiform, atopic dermatitis (AD)-like, and photoaged skins were also developed as permeation barriers. The non-ablative laser elicited the ultrastructural disruption of the stratum corneum and epidermal vacuolation. All laser modalities significantly increased the skin permeation of peptides in vitro. The non-ablative laser chiefly enhanced peptide delivery to the receptor compartment, whereas the ablative laser mainly increased the intracutaneous peptide deposition. The picosecond- and nanosecond-domain Nd:YAG lasers elevated the amount of PT-1 in the receptor up to 40- and 22-fold compared with untreated skin, respectively. Laser treatment promoted peptide delivery in barrier-deficient and inflamed skins, although this enhancement effect was less than that observed in healthy skin. Fluorescence microscopy indicated the capability of the non-ablative laser to deliver peptides to deeper skin strata. The ablative laser confined the peptide distribution in the epidermis. Confocal microscopy showed that peptides penetrated the skin along the microdots created by the fractional Nd:YAG and CO2 lasers. The skin barrier function determined by transepidermal water loss suggested quick recovery when using a nanosecond-domain laser (within 4 h). A longer period was needed for the skin treated with the fully ablative Er:YAG laser (76-84 h). Nanosecond non-ablative laser-facilitated peptide delivery may become an efficient and safe approach for cosmeceutical applications.

Aesthetic Plastic Surgery

2021 June; 45(3):1020-1032

PMID: 33326047

PMCID: PMC8144134

Comparative study on the outcome of periorbital wrinkles treated with laser-assisted delivery of vitamin C or vitamin C plus growth factors: a randomized, double-blind, clinical trial

Barbara Helena Barcaro Machado, James Frame, Jufen Zhang, Mohammad Najlah

BACKGROUND: Despite promising results, laser-assisted drug delivery (LADD) is not yet considered as standard therapies and published data rely mainly on laboratory tests, animal experiments or cadaver skin.

OBJECTIVES: This double-blind, prospective, randomized clinical trial investigates the impact in topical application of vitamin C and a cosmeceutical containing growth factors (GFs) on periorbital wrinkles primarily treated with laser skin resurfacing.

MATERIALS AND METHODS: In total, 149 female patients with periorbital wrinkles were consented and randomized into two study groups, R-C (receiving vitamin C only) and R-CGF (receiving vitamin C and a cosmeceutical containing growth factors). The statistical analysis evaluated the efficacy of each treatment regimen using software readouts provided by a three-dimensional stereophotogrammetry system prior to treatment and three months after the procedure. Results were compared to confirm if there was a significant change in the skin roughness and the average depth of the wrinkles between the two groups after treatment.

RESULTS: There was a significant reduction in both skin roughness and average depth of the wrinkles in the group treated with vitamin C and growth factors (p <0.01) than those treated with LADD followed by topical application of vitamin C alone. There were no cutaneous reactions or adverse systemic reactions observed in this study related to LADD with vitamin C and GFs.

CONCLUSION: Controlled laser application might have a great potential to facilitate the absorption of exogenous macromolecules by the skin. Periorbital wrinkles were reduced in both groups, but LADD using vitamin C and GFs provided significantly better results.



Questo contenuto appartiene alla categoria riservata ai Soci Agorà:

clicca su "Punto di accesso sezione riservata ai Soci" per prendere visione dell'articolo in versione integrale.

Non sei ancora socio?

Clicca sull'immagine per prendere visione dei servizi associativi ed entrare a far parte della Società Scientifica Agorà

Gruppo di medici associati - Agorà Scuola di Medicina Estetica a Milano


bottom of page