Rosenpark Klinik

Aesthetic medicine has traditionally relied on clinical scales for the objective assessment of baseline appearance and treatment outcomes. However, the scales focus on limited aesthetic areas mostly and subjective interpretation inherent in these scales can lead to variability, which undermines standardization efforts. The consensus meeting aimed to establish guidelines for AI application in aesthetic medicine. In February 2024, the AI Consensus Group, comprising international experts in various specialties, convened to deliberate on AI in aesthetic medicine. The methodology included a pre-consensus survey and an iterative consensus process during the meeting. AI's implementation in Aesthetic Medicine has achieved full consensus for enhancing patient assessment and consultation, ensuring standardized care. AI's role in preventing overcorrection is recognized, alongside the need for validated objective facial assessments. Emphasis is placed on comprehensive facial aesthetic evaluations using indices such as the Facial Aesthetic Index (FAI), Facial Youth Index (FYI), and Skin Quality Index (SQI). These evaluations are to be gender-specific and exclude makeup-covered skin at baseline. Age and gender, as well as patients' ancestral roots, are to be considered integral to the AI assessment process, underlining the move towards personalized, precise treatments. The consensus meeting established that AI will significantly improve aesthetic medicine by standardizing patient assessments and consultations, with a strong endorsement for preventing overcorrection and advocating for validated, objective facial assessments. Utilizing indices such as the FAI, FYI, and SQI allows for gender-specific, age adjusted evaluations and insists on a makeup-free baseline for accuracy.

Despite more than 80 years of use in a number of conditions, including in critically ill patients, comments have recently arisen regarding the safety and efficacy of human serum albumin (HSA) as a therapeutic product and stabilizer/excipient in botulinum neurotoxins. This review summarizes the literature on the safety of HSA. Beyond decades of safe use, the largest clinical dataset of HSA safety is a large meta-analysis of HSA supplier data, which found only an extremely remote risk of serious adverse events across millions of doses of therapeutic concentrations of HSA. There is a paucity of literature identifying HSA-specific adverse events when used as a stabilizer/excipient; however, studies of HSA-containing botulinum neurotoxins (BoNTs) suggest that adverse events are not related to HSA. Polysorbates, which are synthetically produced and not physiologically inert, are contained in pending or new-to-market BoNT formulations. In contrast to HSA, evidence exists to suggest that polysorbates (particularly PS20/PS80) can cause serious adverse events (e.g., hypersensitivity, anaphylaxis, and immunogenicity).

ZusammenfassungInjektionen mit Soft-Tissue-Fillern, insbesondere Hyaluronsäure, gehören heute zu den beliebtesten minimal-invasiven Behandlungsmethoden der Gesichtsverjüngung. Mit zunehmendem Verständnis der anatomischen Hautstrukturen und dem Wissen über die Physiologie der Hautalterung haben sich gezielt Behandlungsstrategien und -methoden entwickelt, um Patienten nach ihren Wünschen so optimal wie möglich zu behandeln. Grundlegend können Patienten entsprechend ihrem Behandlungswunsch in die Kategorien Prophylaxe, Optimierung oder Regeneration eingeteilt werden. Der Markt an Füllpräparaten liefert für jedes Behandlungsziel geeignete Präparate. Dieser Beitrag gibt einen grundlegenden Überblick zur Gewebeaugmentation mit Füllpräparaten und gibt Anregungen, um sichere Behandlungen mit optimalem Ergebnis strukturiert zu planen und durchzuführen.

Facial aging is characterized by volume loss and progressive hollowing of temples and cheeks. Biodegradable filler materials are preferred over nonabsorbable materials; of these, hyaluronic acid (HA) fillers are the most often used because of their favorable effectiveness and safety profile. To confirm the safety and effectiveness of Cohesive Polydensified Matrix (CPM)-HA26 gel in the treatment of volume deficiency. Subjects received up to 2 treatments in the temples and/or cheeks. A blinded investigator assessed improvement according to the Merz Temple Volume Scale (MTVS) and Merz Cheek Fullness Assessment Scale (MCFAS). Subjects were followed for 48 weeks after the last treatment. In total, 87 healthy subjects were enrolled. The proportion of subjects achieving at least a 1-grade improvement on MTVS and/or MCFAS was above 70% for each (MTVS: Weeks 4, 24, and 48 = 95.4%, 94.2%, and 77.0%; MCFAS: Weeks 4, 24, and 48 = 92.3%, 83.1%, and 71.8%). Based on MTVS and MCFAS scores at Visit 5, improvement remained visible at up to 48 weeks. No treatment-related serious AEs occurred. CPM-HA26 demonstrated both a favorable safety and effectiveness profile, with improvement in facial volume evident for up to 48 weeks. It was well tolerated and had a positive, long-lasting effect.

Cryolipolysis combined with shockwave therapy has been previously shown to have synergistic effects in body contouring results. This open-label, prospective, multicenter, comparative study investigated the safety and efficacy of combined cryolipolysis, shockwave therapy with cryolipolysis, shockwave therapy, and injection polyenylphosphatidylcholine-based lipolysis. Enrolled patients were treated in the abdominal or flank area with cryolipolysis, shockwave therapy and injection lipolysis (n=10) or cryolipolysis and shockwave therapy (n=4). All treatments were conducted the same day. Evaluations were conducted 3months after treatment and included histological analysis, standardized photography, blinded-investigator efficacy, and safety ratings, as well as patient ratings of satisfaction and tolerance. Compared to baseline, the 3-month follow-up histological analysis revealed a more profound subcutaneous adipose tissue reaction with the triple combination therapy (cryolipolysis, injection lipolysis, radial shock wave) than with the double combination with regard to adipocyte damage and grade of inflammation. Waist circumference was significantly reduced in patients of both groups, but patients in the triple combination group were shown to have a significantly more pronounced reduction in subcutaneous fat. Factors that were shown to influence treatment outcome included baseline BMI and waist circumference. Age and gender had no effect. The abdominal area reacted better to the treatment compared to flanks. No significant side effects or adverse events were reported. The procedure was well-tolerated, and the majority of patients were satisfied with the treatment results. Combination of cryolipolysis, radial shockwave, and injection lipolysis is a safe, well-tolerated treatment for reduction in subcutaneous fat.