The impact of active substance on skin firmness and elasticity as well as the degree of hydration and skin tone was more efficient after micro-needle mesotherapy.

Microneedling with vitamin C improves skin tone, hydratation and firmness, and decreases the visibility of hyperpigmentation.

other bleedings (n = 6); stroke during treatment with OACs or non-vitamin K antagonist oral anticoagulants (NOACs; n = 5); and other absolute contraindications to OAC or NOACs (n = 3). The most common LAA morphology was broccoli (n = 22), chicken-wing (n = 7), windsock (n = 7), and other (n = 3). All LAA closure procedures were done under general anesthesia with vascular access from the femoral vein. Transseptal puncture was undertaken under transesophageal echocardiography (TEE) guidance. Next, the Watchman True Seal access sheath was advanced over a stiff guidewire into the left upper pulmonary vein and then repositioned to the LAA over a 6F pigtail catheter. The morphology of LAA was analyzed on TEE and angiography for proper device selection. The Watchman delivery system was prepared and flushed, inserted into the access sheath, and advanced under fluoroscopic guidance. The device was then deployed into the LAA, first forming a "ball" and then using one of the following techniques: 1) unsheathe method (like with Watchman 2.5); 2) advancement method; or 3) a combination of both methods. A 10-second push forward on the distal knob maneuver was then carried out, which helped better engage fixation barbs and conform the implant to LAA walls. The proper position of the device was confirmed by TEE and fluoroscopy. If the position was not optimal, the device could be repositioned several times both proximally and distally using the "ball technique." The standard PASS criteria (position, anchoring, size, seal) for device release were then analyzed. The tug test was then carried out to confirm the stability before the final device release.

Background: Laxity and rhytides are manifestations of photodamage on the face and chest. Nonablative radiofrequency (RF) is one of the most common procedures used for skin rejuvenation.Aim: The aim of this study was to assess the elasticity of face and chest skin after multipolar radiofrequency.Patients/Methods: Thirty women, aged 43-68, were included in the study. Twenty women were postmenopausal and 10 were premenopausal. They received 4 treatment sessions with an application of nonablative radiofrequency in 2-week intervals.Biomechanical properties of the skin were measured with the use of a Cutometer. Results:The objective evaluation in a cutometric analysis showed a statistically significant improvement between measurements taken in the pretreatment period and 3 months after the treatment. Conclusions:The study is an objective confirmation that RF treatment improves skin elasticity. The method may appear to be beneficial for women of any age and skin types. It is a noninvasive treatment with a low risk of complications. K E Y W O R D S chest rejuvenation, face rejuvenation, nonablative radiofrequency 1 | BACKGROUND Aging of the face, neck, and chest (décolletage) is a multifactorial process caused by the cumulative effects of intrinsic and environmental factors. It results in wrinkles, skin laxity, dyschromia, teleangiectasias, atrophy, and roughness of the epidermis. The growing demand to maintain a youthful appearance has led to an increase in the number of dermatological and surgical procedures aiming at delaying the process of skin aging. Advances in understanding skin biology have led to the development of many skin rejuvenation technologies, but there is an increased interest in nonablative treatment which tend to have minimal downtime and almost no complications. One such method is radiofrequency (RF). A RF device generates heat by transferring electrical energy, in the form of electromagnetic waves, from the electric field of the RF device to electrically charged particles in the tissue. 1 The heat leads to thermal damage of the collagen by breaking some cross-links, making the triple helix structure unwind. Some collagen fibers undergo denaturation, but then neocollagenesis occurs, increasing dermal thickness. Remodeling of collagen bundles and formation of new collagen lasts for months after the treatment. 2-6 Zelickson et al 2 showed increased expression of messenger RNA for collagen type 1 after RF treatment on abdomen skin. Kaplan and Gat 3 noted an induction of new collagen synthesis (focal thickening of collagen fibers) in skin biopsies done after the RF therapy. Several types of RF devices are available on the esthetic market.Among the most common are monopolar, bipolar, multipolar, and fractional bipolar ones. A monopolar RF device has only one active electrode, which remains in contact with the skin, and one grounding

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