Gladstone Eustaquio de Lima Faria, Daniel Boro Dos Santos, Aneta Hionia Vassiliadis, Andre Vieira Braz, Eliandre Palermo, Bruna Felix Bravo, Luiz Eduardo Toledo Avelar, Daniel Coimbra, Alessandra Haddad, Mariana Muniz, Ada Trindade de Almeida, Ricardo Frota Boggio
{"title":"治疗寺庙:巴西共识。","authors":"Gladstone Eustaquio de Lima Faria, Daniel Boro Dos Santos, Aneta Hionia Vassiliadis, Andre Vieira Braz, Eliandre Palermo, Bruna Felix Bravo, Luiz Eduardo Toledo Avelar, Daniel Coimbra, Alessandra Haddad, Mariana Muniz, Ada Trindade de Almeida, Ricardo Frota Boggio","doi":"10.1007/s00266-024-04614-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The temporal region is emblematic and challenging due to its structural and volumetric changes during aging, which significantly affect facial aesthetics. Despite the importance of addressing temporal aging, many injectors hesitate due to the region's anatomical complexity and risk of complications. This consensus aimed to provide expert guidance on the safest and most effective treatment strategies for the temple.</p><p><strong>Methodology: </strong>Twelve Brazilian dermatologists and plastic surgeons with expertise in cosmiatry participated in a survey of 54 objective and one open-ended question to identify best practices. The results were analyzed for consensus, with agreement categorized as a simple majority (50-75%), consensus (> 75%), or strong consensus (> 95%).</p><p><strong>Results: </strong>Participants agreed that volumization (100%), lifting (90%), and restructuring (82%) are essential for temporal rejuvenation. Hyaluronic acid (HA) was the preferred product for volumization and structuring, with the subcutaneous plane identified as the best option for both. There was no consensus on the product for lifting, though 45.5% favored poly-L-lactic acid (PLLA). Biostimulants such as PLLA and calcium hydroxyapatite were commonly used, with specific dilution strategies. Complications reported included hematomas and nodules, particularly with HA and PLLA.</p><p><strong>Conclusion: </strong>The consensus emphasized the importance of anatomical knowledge and product selection in achieving safe and long-lasting results in temporal rejuvenation. It provided clear recommendations for injection techniques and product choices, advocating for subcutaneous plane treatments for beginners. The findings highlight the need for expert-driven approaches to reduce the risk of complications and optimize patient outcomes in this sensitive region.</p><p><strong>Level of evidence v: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment of the Temples: Brazilian Consensus.\",\"authors\":\"Gladstone Eustaquio de Lima Faria, Daniel Boro Dos Santos, Aneta Hionia Vassiliadis, Andre Vieira Braz, Eliandre Palermo, Bruna Felix Bravo, Luiz Eduardo Toledo Avelar, Daniel Coimbra, Alessandra Haddad, Mariana Muniz, Ada Trindade de Almeida, Ricardo Frota Boggio\",\"doi\":\"10.1007/s00266-024-04614-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The temporal region is emblematic and challenging due to its structural and volumetric changes during aging, which significantly affect facial aesthetics. Despite the importance of addressing temporal aging, many injectors hesitate due to the region's anatomical complexity and risk of complications. This consensus aimed to provide expert guidance on the safest and most effective treatment strategies for the temple.</p><p><strong>Methodology: </strong>Twelve Brazilian dermatologists and plastic surgeons with expertise in cosmiatry participated in a survey of 54 objective and one open-ended question to identify best practices. The results were analyzed for consensus, with agreement categorized as a simple majority (50-75%), consensus (> 75%), or strong consensus (> 95%).</p><p><strong>Results: </strong>Participants agreed that volumization (100%), lifting (90%), and restructuring (82%) are essential for temporal rejuvenation. Hyaluronic acid (HA) was the preferred product for volumization and structuring, with the subcutaneous plane identified as the best option for both. There was no consensus on the product for lifting, though 45.5% favored poly-L-lactic acid (PLLA). Biostimulants such as PLLA and calcium hydroxyapatite were commonly used, with specific dilution strategies. Complications reported included hematomas and nodules, particularly with HA and PLLA.</p><p><strong>Conclusion: </strong>The consensus emphasized the importance of anatomical knowledge and product selection in achieving safe and long-lasting results in temporal rejuvenation. It provided clear recommendations for injection techniques and product choices, advocating for subcutaneous plane treatments for beginners. The findings highlight the need for expert-driven approaches to reduce the risk of complications and optimize patient outcomes in this sensitive region.</p><p><strong>Level of evidence v: </strong>This journal requires that authors assign a level of evidence to each article. 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Introduction: The temporal region is emblematic and challenging due to its structural and volumetric changes during aging, which significantly affect facial aesthetics. Despite the importance of addressing temporal aging, many injectors hesitate due to the region's anatomical complexity and risk of complications. This consensus aimed to provide expert guidance on the safest and most effective treatment strategies for the temple.
Methodology: Twelve Brazilian dermatologists and plastic surgeons with expertise in cosmiatry participated in a survey of 54 objective and one open-ended question to identify best practices. The results were analyzed for consensus, with agreement categorized as a simple majority (50-75%), consensus (> 75%), or strong consensus (> 95%).
Results: Participants agreed that volumization (100%), lifting (90%), and restructuring (82%) are essential for temporal rejuvenation. Hyaluronic acid (HA) was the preferred product for volumization and structuring, with the subcutaneous plane identified as the best option for both. There was no consensus on the product for lifting, though 45.5% favored poly-L-lactic acid (PLLA). Biostimulants such as PLLA and calcium hydroxyapatite were commonly used, with specific dilution strategies. Complications reported included hematomas and nodules, particularly with HA and PLLA.
Conclusion: The consensus emphasized the importance of anatomical knowledge and product selection in achieving safe and long-lasting results in temporal rejuvenation. It provided clear recommendations for injection techniques and product choices, advocating for subcutaneous plane treatments for beginners. The findings highlight the need for expert-driven approaches to reduce the risk of complications and optimize patient outcomes in this sensitive region.
Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍:
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.