The use of onabotulinum toxin A in the aesthetic field requires careful initial assessment of the patient in its complexity and individuality. Moreover, this treatment needs the use of standardized procedures to achieve the effectiveness and safety of onabotulinum toxin A in clinical practice.
Background: Minimally invasive procedures, such as thread suspension techniques, are a growing trend for facial rejuvenation. However, not enough data are available on the efficacy, outcomes, and morbidity of suture suspension techniques in mid-face reshaping.Aims: Our goal was to assess treatment outcomes and patient satisfaction following mid-face reshaping using threads with bidirectional convergent barbs (Definisse TM free floating threads).Patients/Methods: We performed a retrospective analysis of 60 patients who underwent treatment for mid-face reshaping using Definisse TM free floating threads.Response to treatment was assessed at 6 months using the mid-face-specific Mid-Face Volume Deficit scale (Allergan ® ), Global Aesthetic Improvement and FACE-QTM scales.Results: Sixty patients underwent mid-face treatment with the suspension thread technique (mean age 51.3, 90% female). No concomitant procedures were done. A reduction by one point or more in the Mid-Face Volume Deficit Scale (MDFVS) score treatment was seen in all patients after 6 months. Mean overall MFVDS and FACE-Q TM scores were significantly improved. On the GAIS, most patients were rated as improved or better both by the evaluating investigators and during self-assessment. No major complications were observed, and none of the patients requested the removal of the threads (mean follow-up 9.8 months, range 6-14 months).
Conclusion:Our results suggest that mid-face reshaping with Definisse TM free floating threads is a safe and reliable procedure characterized by low complication rates and good esthetic results. This minimally invasive procedure is a good alternative for normal or combination skin patients who refuse or want to delay the need for traditional rhytidectomy.
The thread shape factor (TSF) to evaluate the relationships between geometrical characteristics and mechanical properties of the temporary anchorage devices (TADs) has recently been introduced. This in vitro experimental study evaluated in 30 different tests with three TADs: ORTHOImplant (1.8 mm diameter and 10 mm length; 3M Unitek), Tomas (1.6 mm diameter and 10 mm length; Dentaurum), and Orthoeasy (1.7 mm diameter and 10 mm length; Forestadent). Scanning electron microscopy images were acquired for each TAD to measure the TSF; afterwards, the maximum insertion torque (MIT) was evaluated and thereafter pull-out tests on two differently designed organic bone analogs were carried out using a testing machine with a crosshead speed of 2 mm/minute being applied. One-way analysis of variance with group as factor was performed. Post hoc multiple comparisons Bonferroni test was used. Rank-transformed data were used when asymmetry of data was shown. To assess correlation between characteristics, load, and MIT, Spearman's rank correlation coefficient was used. A P-value of 0.05 was considered statistically significant. Significant direct correlations were found between TSF and depth and both load and MIT. Particularly, a correlation of 0.90 (P < 0.001) was found between depth and MIT for 2.2 mm cortical thickness. The authors conclude that MIT and maximum load values of pull-out test are statistically related to depth of the thread of the screw and to TSF.
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