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Minimally Invasive Aesthetic Treatment of the Face and Neck Using Combinations of a PCL-Based Collagen Stimulator, PLLA/PLGA Suspension Sutures, and Cross-Linked Hyaluronic Acid

Authors de Melo F, Carrijo A, Hong K, Trumbic B, Vercesi F, Waldorf HA, Zenker S

Received 4 February 2020

Accepted for publication 9 April 2020

Published 5 May 2020 Volume 2020:13 Pages 333—344


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Jeffrey Weinberg

Francisco de Melo,1 Alieksiéi Carrijo,2 Kyungkook Hong,3 Bruno Trumbic,4 Franco Vercesi,5 Heidi A Waldorf,6 Sabine Zenker7

1Aesthetics International, Dubai, United Arab Emirates; 2Clínica Carrijo, São Paulo, Brazil; 3Hus-hu Dermatology Clinic, Seoul, South Korea; 4Cap Evidence, Paris, France; 5Aesthetic Surgery and Laser, Milan, Italy; 6Waldorf Dermatology Aesthetics, Nanuet, NY, USA; 7Dr Zenker Dermatology, Munich, Germany

Correspondence: Francisco de Melo Tel +971 56 175 3929

Background: Combinations of minimally invasive procedures (MIPs) are often used in aesthetic treatments and are increasingly considered as the new standard of care. Three agents with specific properties are available in this perspective: a polycaprolactone (PCL)-based collagen stimulator, a poly-L-lactic acid (PLLA)- and a poly-glycolic acid (PLGA)-based resorbable suspension suture with a 3D-cone technology, and a cross-linked hyaluronic acid (HA).
Objective: To develop the first practice guidelines on rejuvenation treatment of the face and the neck using combinations of these agents, whether associated or not with other widely used MIPs such as botulinum neurotoxins or energy-based devices.
Methods: A multi-disciplinary, multi-national board of plastic surgeons and dermatologists convened to develop guidelines using a predefined consensus method. The consensus was defined as ≥ 83% agreement rate between participants.
Results: Practice guidelines and algorithms, describing optimal procedure sequence and spacing, are proposed for the treatment of upper-, mid-, lower-face and neck, combining the PCL collagen stimulator, the PLLA/PLGA suspension sutures, and the cross-linked HA, whether associated or not with other MIPs.
Conclusion: These new guidelines provide general support to optimal management strategies. Individual treatment plans should be adapted according to the physician’s individual competence and the patient’s preferences.

Keywords: botulinum toxins, combined modality therapy, dermal fillers, energy-based device, practice guideline, rejuvenation

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