14 research outputs found
Vaginal rejuvenation using energy-based devices
No full textAbstractPhysiologic changes in a woman’s life, such as childbirth, weight fluctuations, and hormonal changes due to aging and menopause, may alter the laxity of the vaginal canal, damage the pelvic floor, and devitalize the mucosal tone of the vaginal wall. These events often lead to the development of genitourinary conditions such as stress urinary incontinence; vaginal atrophy; dryness; and physiologic distress affecting a woman’s quality of life, self-confidence, and sexuality. Various treatment modalities are currently available to manage these indications, varying from invasive vaginal surgery to more benign treatments like topical vaginal hormonal gels or hormone-replacement therapy. A new trend gaining momentum is the advent of energy-based devices for vaginal rejuvenation that apply thermal or nonthermal energy to the various layers of the vaginal tissue, stimulating collagen regeneration contracture of elastin fibers, neovascularization, and improved vaginal lubrication. This review aims to present the available technologies offering vaginal rejuvenation and the scientific evidence that underlines their safety and efficacy for this indication
Treatment for cellulite
No full textCellulite is a multifactorial condition that is present in 80% to 90% of postpubertal women and is one of the most intolerable esthetic imperfections. There are several theories on the pathophysiology of cellulite, and a number of different therapeutic regimens have been developed, from topical treatments to mechanical or energy-based devices. In this brief review, we summarize the scientific landscape to determine the clinical evidence with regard to the safety and efficacy of cellulite treatment options. Clinical protocols and the author’s experience using a combination of internal and external procedures are also discussed. Studies using laser and light modalities along with radiofrequency have shown improvements in cellulite and a good safety profile, but acoustic wave therapy, subcision, and the 1440-nm Nd:YAG minimally invasive laser have demonstrated the most beneficial results in cellulite reduction. Although there is paucity of scientific evidence for treatments that improve cellulite, future emerging options and their combination may pave the way to eradicate this primarily cosmetic esthetic concern. Keywords: Cellulite, pathophysiology, adipocytes, radiofrequency, laser
Vaginal rejuvenation: From scalpel to wands
No full textVaginal rejuvenation procedures are increasing in popularity in terms of types of treatment offered, number of patients undergoing them, clinical studies, and in the controversy surrounding them. Both non-invasive and invasive solutions are being developed by pharmaceutical and technological companies. Radiofrequency devices and lasers are spearheading the energy-based device space, and fillers and platelet-rich plasma are used to address several concerns surrounding vaginal health. In this review, an overview of the growing field of vaginal rejuvenation is presented, as well as the authors’ personal view and analysis of this clinical space
Low-Level Laser-Assisted Liposuction: A Multicenter Side-by-Side Comparison Study
No full textIntroduction: Liposuction has undergone many revisions since 1980, the most notable being the introduction of the tumescent technique of local anesthesia by Jeffery Klein, MD. Since then, in an effort to improve the aesthetics of the technique and the ease and safety of the procedure, other techniques have been introduced. These include superficial liposuction, UAL, external ultrasonic liposuction, mechanically assisted liposuction, and, most recently, laser-assisted liposuction. Materials and Methods: Four centers in the United States, operating under an 1RB protocol, performed liposuction with the tumescent technique of local anesthesia on specified cosmetic units of the body. One side was exposed to 635-nm laser therapy after tumescence was achieved, whereas the contralateral side was not. Observations were recorded during surgery and at 2 weeks postoperatively. Results: Observations of intraoperative technique did not show an advantage to laser-assisted liposuction. Observations of the postoperative course were equivocal, though there was evidence of reduction of edema in certain patients. Discussion: The addition of laser therapy to liposuction technique is based on years of experience demonstrating improved wound healing using a technique of low-level laser therapy. Although the recorded observations did not support an advantage to the addition of laser therapy, there was a paradoxical difference of opinion among patients and surgeons who participated in the study. These individuals believed that, compared with patients not treated with low-level laser therapy, there was at least a reduction in degree and duration of postoperative pain and induration. As low-level laser therapy may have systemic effects on wound healing, comparing treated and untreated contralateral sides may not be valid because both sides experienced improvements in postoperative course. Laser-assisted liposuction has a potential advantage, not supported by this study, in the intraoperative and postoperative course of liposuction surgery. New studies using double-blind techniques will need to be conducted. </jats:sec
Low dose time-resolved CT-angiography in pediatric patients with venous malformations using 3rd generation dual-source CT: Initial experience
No full textAbstractObjectivesTo prospectively evaluate the diagnostic value and radiation dose of time-resolved CT-Angiography (4D-CTA) in pediatric patients with venous malformations using 3rd generation dual-source CT (DSCT) at 70kVp tube voltage.MethodsBetween November 2014 and August 2015, seven children (2 male, 5 female; median age, 9 years; range 3–12 years) with suspected peripheral, non-cerebral, venous malformations were included in this feasibility study and underwent US, MRI and 4D-CTA. All three imaging modalities were analyzed and compared individually by an experienced interventional radiologist and a pediatric surgeon using a 5-point Likert scale, with regard to diagnosis of the vascular anomaly, additional information like presence of thrombophlebitis and lesion extension, flow dynamics, localization, volume and significance for treatment planning. For quantitative statistical analysis, an unifactorial analysis of variance was performed for every parameter and all three imaging modalities. Radiation dose values as expressed by the volume CT dose index (CTDIvol) and dose-length product (DLP) were recorded for of all patients.ResultsThree out of six patients had isolated type I venous malformations without peripheral venous drainage which could be demonstrated on MRI and CT. In two out of six patients a type II venous malformation with drainage into normal veins was diagnosed. In one case, 4D-CT was the only imaging modality that revealed a slow-flow venous malformation with shunting supply by a hypodynamic arterial feeder.Treatment planning4D-CTA was rated as the best imaging modality for treatment planning with agreement between radiologist and surgeon, especially with respect to the hemodynamics of the venous malformation.Conclusions4D-CTA at 70kVp is a fast imaging modality that provides comprehensive diagnostic information of venous malformations in pediatric patients and is very valuable for therapy planning. Radiation dose of 4D-CTA must be weighted against the diagnostic information as well as the potential risk for sedation and contrast administration during MRI
