RU2644551C2 - Method for rejuvenating face and body skin by implantation of meso threads - Google Patents

Method for rejuvenating face and body skin by implantation of meso threads Download PDF

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RU2644551C2
RU2644551C2 RU2016128765A RU2016128765A RU2644551C2 RU 2644551 C2 RU2644551 C2 RU 2644551C2 RU 2016128765 A RU2016128765 A RU 2016128765A RU 2016128765 A RU2016128765 A RU 2016128765A RU 2644551 C2 RU2644551 C2 RU 2644551C2
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needle
skin
threads
face
tissue
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RU2016128765A
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Russian (ru)
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Елена Юрьевна Старкова
Татьяна Федоровна Перетолчина
Снежана Александровна Рыжакова
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Общество с ограниченной ответственностью "Бьюти Эксперт Клиник"
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents

Abstract

FIELD: medicine; cosmetology.
SUBSTANCE: invention relates to medicine, namely to plastic surgery and cosmetology. Meso threads on a polymer basis are administered into the soft tissues by means of a needle with a surgical sharpening from one end. In this case, polydioxanone threads are used which are administered into the dermis layer bordering on the fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the patient's individual anti-gravity vectors in the direction from bottom to top. Before the return stroke of the needle, the end part of the needle is deepened by 1.5–2 mm into a soft tissue and rotated to maximum 15° from the fixed position of the needle when it is inserted.
EFFECT: method allows to increase the safety, reliability and effectiveness of skin rejuvenation when using sutures.
1 cl, 1 ex, 1 tbl

Description

The invention relates to medicine, in particular plastic cosmetology, and is intended to eliminate soft tissue defects, such as age-related skin changes, wrinkles, facial ptosis.

There is a method of cosmetic tightening of the skin and soft tissues in the alkaline-zygomatic region of the face using surgical suture material, during which a puncture is performed and the needle is inserted into the subcutaneous tissue to the required depth, then the needles are separated into two and each needle is further guided in its own contour, and when turning, they are not completely punctured onto the skin surface, they are turned and continue to further advance with the other tip of the needle along a different contour, while tissue tightening is performed, and the needles are punctured tvlyayut at the initial puncture, where the fixed thread (patent RU 2400162, IPC A61B 17/04, 2010).

However, the method involves the introduction of a needle with a thread into the deep layers of soft tissues, which leads to its increased invasiveness and requires surgical intervention, it is necessary to use general anesthesia and, as a result, specialized equipment.

A known method of performing operations in plastic surgery using a surgical thread having a passage and many sharp protrusions on each side of the passage, and the passage has no protrusions, and the protrusions on both sides of the passage have a slope towards the passage, containing steps : incision in the tissue at the entry point defining the tissue tightening point; insertion of a cannula under the skin in the first passage between the entry point and the first exit point, from which the tissue must be pulled; threading one end of the surgical suture from the entry point through the cannula and out through the first exit point, until the passage part approaches the incision or enters it; removing the cannula and reinserting the cannula into the second passage between the entry point and the second exit point, located at some distance from the first exit point; passing the other end of the surgical thread through the cannula and out through the second exit point, thereby bending the thread in the opposite direction and creating a loop from the thread; removing the cannula and adjusting the thread tension from both ends of the thread to provide the desired tightening; cutting the ends of the thread and closing the cut at the entrance of the entry point (patent RU 2387392, IPC A61B 17/04, A61L 17/00; 2010).

The disadvantage of this method is its increased invasiveness, which is a consequence of the need for a skin incision to insert a needle, insert a needle into the deep layers of soft tissues and muscles, the configuration of surgical sutures, the use of anesthetic blockade, the need to detach tissue at the incision site, suturing at the incision site. In addition, the operation requires the use of a number of sterile instruments, which implies the presence of an operating room.

There is a method of cosmetic treatment of soft tissue defects of the face by skin tightening by means of a fixing transplant in the form of allotendin strings, which are carried out in the area of fascial angles, and the tissue bed of the graft is then chipped with an injection form of Alloplant biomaterial, a regeneration stimulator (patent RU 2288644, IPC A61B 17/00 , 2006).

The disadvantages of the method are the use of biomaterials for cosmetic skin treatment, which are characterized by heterogeneity, manifested in an unequal fiber size and the presence of impurities, as well as the ability to absorb moisture, which, in turn, leads to edema and, as a result, difficult to predict results.

Closest to the proposed method is a method of skin rejuvenation, including subcutaneous implantation of an inert material, which uses gold threads and / or biopolymer gel, while the gold threads are implanted at the level of the inner edge of the dermis, and the biopolymer gel is subdermal or intradermal. Moreover, the gold thread can be used together with absorbable polyglycol thread, also attached to the needle (prototype) (patent RU 2135122, IPC A61F 2/02, A61F 2/10, A61B 17/00; 1999).

The disadvantages of this method are, firstly, the possibility of autoimmune aseptic inflammation caused by the use of non-biodegradable threads; secondly, with continued ptosis of the tissues, the gold thread, making it heavier, contributes to a greater displacement of tissues, thread breaks are not ruled out, violating the fixation function. In addition, the procedure is quite aggressive, requiring local anesthesia and a long period of rehabilitation.

Thus, the authors were faced with the task of developing a safe, reliable and effective method of skin rejuvenation using modern suture materials, which excludes surgical intervention and is characterized by a short rehabilitation period.

The problem is solved in the proposed method of rejuvenating the skin of the face and body through implantation of mesothreads, including the introduction into the soft tissues of mesothreads on a polymer basis by means of a needle with surgical sharpening from one end, in which polydioxanone threads are inserted into the dermis layer bordering fatty tissue at a distance of 1 , 5 cm from each other parallel to the skin surface according to the individual anti-gravity vectors of the patient in the direction from the bottom up, with the end of the needle facing the needle back glublyayut 1.5-2 mm in the soft tissue and do not rotate more than 15 ° from a fixed position of the needle during its introduction.

Currently, from the patent and scientific literature there is no known method for rejuvenating the skin of the face and body by introducing polymer-based mesothreads, in particular polydioxanone, using a sequence of medical procedures in compliance with the conditions proposed by the authors.

One of the promising areas of modern cosmetology is the use of polydioxanone mesothreads for threadlifting soft tissues of the skin of the face and body (http://www.dermotonia.ru/articles/articles_33html). Polydioxanone absorbable sutures are primarily designed for aesthetic plastic surgery or dermatocosmetology. Indications for their use are: symptoms of age-related problems (gravitational ptosis against a background of decreased tone, wrinkles, changes in skin color / texture); cellulite; face contour correction (figures); surface leveling after lipoxation. Belonging to the category of self-absorbable suture materials, a thread made of polydioxanone undergoes strictly controlled decomposition into water and carbon dioxide (after 60-80 days it retains up to 50% of the strength properties, and after 180-240 days it is completely adsorbed). Polydioxanone filaments are characterized by small diameter, environmental friendliness and smoothness. Polydioxanone is compatible with body tissues, is delicate in its structure and does not create complications either during the process of implantation of threads or after it. Swelling of the face accompanying minimally invasive procedures is minimized. However, at present there is no reliable data describing the phased conduct of medical procedures with the introduction of mesothreads into soft tissues. Despite the fact that the threads are thin and almost atraumatic, their incorrect introduction can lead to a number of negative effects. So, firstly, when tightening the thread, the skin can turn into a weakly expressed "corrugation"; secondly, seals may form in the places of installation of the thread, noticeable if the thread is closer to the skin surface than necessary; thirdly, in connection with the wrong direction of input of the thread, microcirculation of the blood may be disturbed. Thus, despite the prominence of using polydioxanone yarns, research was needed to develop a method for introducing mesothreads from polydioxanone, which eliminated possible negative consequences, characterized by reliable performance with a high cosmetological effect. Based on the studies, the authors developed a method for introducing polydioxanone into mesothreads using soft needles with surgical sharpening, in which the proposed combination of medical procedures ensures the elimination of the above disadvantages. Thus, the introduction of the filament into the dermis layer, which is adjacent to the fatty tissue, which in this case is maximally involved in the filament’s coverage zone, proposed by the authors, allows a greater influence on the reduction of gravitational ptosis, since all structures of soft tissues, including fatty tissue, are involved in the formation of ptosis. . The obtained clinical data (see table) demonstrate the positive dynamics of the skin condition upon insertion of polydioxanone filaments into the dermis bordering fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the individual anti-gravity vectors of the patient in the direction from the bottom up. The obtained histological studies confirm the formation of a scaffold that holds the tissue in position, prevents sagging, and ensures skin elasticity due to the formation of a connecting capsule around the implanted thread in case of insertion of the thread in accordance with the conditions of the proposed medical procedure. At the same time, not only increased formation of new collagen is observed, which helps to strengthen the dermis, but also an increase in blood flow velocity and an improvement in microcirculation in subcutaneous fat, which, in turn, contributes to the breakdown of triglycerides in fat cells and a decrease in their volume. The proposed manipulations before the needle’s reverse motion, in which its end part is deepened by 1.5–2 mm into a soft tissue and rotates no more than 15 ° from the fixed position of the needle when it is inserted, provide not only improved reinforcement, but also enhanced response tissue reactions, including improved microcirculation due to angiogenesis and easy densification of one’s own connective tissue, which even after complete resorption of the implant enhances the revitalizing ("rejuvenating") action.

The proposed method of skin rejuvenation can be carried out as follows.

Before carrying out thread lifting, a clinical and dermatological examination of the patient’s skin condition is carried out:

- evaluate the type of facial aging using classification according to I. Kolgunenko (1974) (tired, small wrinkled, deformation, combined);

- determine the type of skin according to the anamnesis and during the clinical and dermatological examination (dry, combination, oily);

- visually assess the presence of dyschromia: hyperpigmentation, hypopigmentation (in dynamics);

- determine the skin turgor using the manual test of the skin fold and rotational compression test (reduced, normal);

- visually assess the manifestations of gravitational ptosis of tissues (which indirectly indicates the state of muscle tone) (yes, no);

- determine the severity of facial wrinkles by the facial expression method using the Lemperle G scale (Lemperle G., Holmes RE, Coher SR et al. A classification of facial wrinkles. Plast Recont Surg 2001, 108, 1735, with changes) (no wrinkles, slightly expressed, moderate, severe);

- they take photographs of patients fixed on the iPhone 4s photo table with a digital camera of 8 million pixels (video resolution 1920 × 1080, features: autofocus, flash, image format: MPEG-4, H.264).

In the conditions of a cosmetology treatment room on a couch in a prone position, they prepare for threadlifting. The patient is put on a hat, covering the scalp. After make-up removal, dry skin is treated with a chlorhexidine solution. Then, local application anesthesia with Emla cream is performed at the rate of 2 g / 10 cm 2 , the cream is applied in a thick layer and covered with an occlusive dressing for 30 minutes. The couch is placed in a semi-sitting position, the skin is again treated with chlorhexidine. For tissue threadlifting, sterile absorbable polydioxanone Lead Fine Lift threads on various size needle carriers made by MEDIFIRST Co., LTD (Republic of Korea) are used. The number of threads used depends on the volume of the medical procedure and in each case individually, as it is determined by the anatomical features of the patient and the direction of the tension lines (anti-gravity vectors). Polydioxanone filaments are introduced into the dermis layer bordering fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the individual anti-gravity vectors of the patient in the direction from the bottom up, with the needle end being deepened by 1.5-2 mm into a soft cloth and make a rotation no more than 15 ° from the fixed position of the needle when it is inserted. The protruding tip of the thread deepens with pressure on the skin and disappears in the done channel. After implantation of the threads, the skin surface is treated with a chlorhexidine solution and the Traumeel gel is applied. Patients are given recommendations on care and stipulate restrictions (restrictions on facial expressions, physical activity, visits to the sauna and solarium).

The obtained clinical results (see table) demonstrate the positive dynamics of the skin condition after implantation of polydioxanone filaments by the proposed method of their administration: skin turgor increases, wrinkles and gravitational ptosis are less pronounced. In this case, the muscles, ligamentous apparatus and bone structure are not changed.

Clinical studies were conducted on volunteer patients at the Department of Aesthetic Medicine of the State Budgetary Educational Institution of Higher Professional Education “Ural State Medical University” of the Ministry of Health of the Russian Federation (GBOU VPO USMU Ministry of Health of Russia). During the test period, 50 injection reinforcement procedures were performed on the face with Lead Fine Lift mesothreads by the proposed method, in which 50 patients aged 34 to 52 years were involved. The selection criterion was the presence of involutional changes in the soft tissues of the face, manifesting themselves with ptosis of varying severity, accompanied by initial or moderate signs of skin fading (discoloration, dryness, the appearance of fine / medium wrinkles, decreased turgor). On the eve of the procedure, an anamnesis was collected and a thorough examination was conducted with a questionnaire aimed at detecting contraindications, which include: the presence of acute / chronic dermatological pathology; any decompensated somatic conditions; epilepsy, hemophilia; the presence of malignant neoplasms; autoimmune diseases; mental disorders; high allergic mood; tendency to form keloid / hypertrophic scars; hyperthermia; pregnancy / lactation; the presence of a different implant at the site of the proposed injection; indication of taking anticoagulants and non-steroidal anti-inflammatory drugs. All medical procedures in accordance with the proposed method were performed on a voluntary free basis with the written consent of previously informed patients.

The proposed method is illustrated by the following clinical examples.

Example 1. Patient K. (52 years old). After the surgical face-lifting of the lower third of the face that was postponed at the beginning of February 2012, which did not completely solve the problem: omission of the corners of the mouth, the initial manifestations of ptosis of the middle third of the face and wrinkles of the temporal region.

After conducting a thorough inspection and obtaining written consent, the Lead Fine Lift mesothreads were threadlifted, and thirty-five Lead Fine Lift copies were used - 25 G / 150 mm (10 pieces); 29G / 70 mm (15 pieces); 29G / 50 mm (10 pieces). After preliminary processing of the facial skin, mesothreads were introduced by the proposed method by introducing polydioxanone filaments into the dermis layer bordering fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the individual anti-gravity vectors of the patient, obtained by visual examination, from the bottom up, in this case, before the needle’s reverse stroke, the end part of the needle was deepened by 2 mm into a soft tissue and made a rotation no more than 15 ° from the fixed position of the needle when it was inserted. The protruding tip of the thread deepens with pressure on the skin and disappears in the done channel. Then the final procedures were carried out.

The observation period was 58 days, after which the initial signs of skin revitalization (a clear decrease in the depth of wrinkles, an improvement in turgor) and the disappearance of the outlined ptosis in the middle third were noted.

Example 2. Patient I. (43 years old). Initial manifestations of ptosis in the lower third of the face, small / medium wrinkles, drooping mouth corners and decreased turgor.

After conducting a thorough inspection and obtaining written consent, the Lead Fine Lift mesothreads were threadlifted, and forty copies of the Lead Fine Lift were used up - 25 G / 150 mm (10 pieces); 29G / 70 mm (5 pieces); 29G / 50 mm (10 pieces); 27G / 90 mm (15 pieces). After preliminary processing of the facial skin, mesothreads were introduced by the proposed method by introducing polydioxanone filaments into the dermis layer bordering fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the individual anti-gravity vectors of the patient, obtained by visual examination, from the bottom up, In this case, before the needle’s reverse stroke, the end part of the needle was deepened by 1.5 mm into a soft tissue and made a rotation no more than 15 ° from the fixed position of the needle when it was inserted. The protruding tip of the thread deepens with pressure on the skin and disappears in the done channel. Then the final procedures were carried out.

The observation period was 51 days, during this period a gradual improvement in the texture and elasticity of the skin was noted.

In FIG. 1 shows a photograph of the patient before (a) and three weeks after (b) the procedure.

The table shows the morphological indicators for the correction of age skin using the proposed method for the introduction of mesothreads from polydioxanone.

Figure 00000001

Figure 00000002

Thus, the authors have developed a safe, reliable, minimally invasive and effective way to rejuvenate the skin using modern suture materials, excluding surgical intervention.

Claims (1)

  1. A method of rejuvenating the skin of the face and body by implanting mesothreads, including introducing into the soft tissues of mesothreads on a polymer basis by means of a needle with surgical sharpening from one end, characterized in that the polydioxanone filaments are introduced into the dermis layer bordering the fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the individual anti-gravity vectors of the patient in the direction from the bottom up, while before the return stroke of the needle, the end of the needle is deepened by 1.5-2 mm in soft tissue and do not rotate more than 15 ° from a fixed position of the needle during its introduction.
RU2016128765A 2016-07-14 2016-07-14 Method for rejuvenating face and body skin by implantation of meso threads RU2644551C2 (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2135122C1 (en) * 1998-12-17 1999-08-27 Закрытое акционерное общество "ОстМедКонсалт" Method for producing skin rejuvenascence
RU2186529C2 (en) * 1999-02-10 2002-08-10 Лантух Владимир Васильевич Method for correcting age alterations of facial and neck skin
WO2007089878A2 (en) * 2006-01-31 2007-08-09 Angiotech Pharmaceuticals, Inc. Sutures and anti-scarring agents
US8777988B2 (en) * 2001-06-29 2014-07-15 Ethicon, Inc. Methods for using self-retaining sutures in endoscopic procedures

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2135122C1 (en) * 1998-12-17 1999-08-27 Закрытое акционерное общество "ОстМедКонсалт" Method for producing skin rejuvenascence
RU2186529C2 (en) * 1999-02-10 2002-08-10 Лантух Владимир Васильевич Method for correcting age alterations of facial and neck skin
US8777988B2 (en) * 2001-06-29 2014-07-15 Ethicon, Inc. Methods for using self-retaining sutures in endoscopic procedures
WO2007089878A2 (en) * 2006-01-31 2007-08-09 Angiotech Pharmaceuticals, Inc. Sutures and anti-scarring agents

Non-Patent Citations (5)

* Cited by examiner, † Cited by third party
Title
ANTONELLA SAVOIA et al. Outcomes in Thread Lift for Facial Rejuvenation: a Study Performed with Happy Lift™ Revitalizing. Dermatol Ther (Heidelb). 2014 Jun, 4(1), P. 103-114. *
HELLING E.R., et al. Complications of facial suspension sutures. Aesthet Surg J. 2007,N7, P. 155-161. *
SUH DH et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatol Surg. 2015 Jun, 41(6), P. 720-725. *
ГРУЗДЕВ Д.А. и др. Особенности применения биостимулирующих нитей у пациентов разных возрастных групп. Вестник новых медицинских технологий. 2015, N1, с.2-12. *
ГРУЗДЕВ Д.А. и др. Особенности применения биостимулирующих нитей у пациентов разных возрастных групп. Вестник новых медицинских технологий. 2015, N1, с.2-12. SUH DH et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatol Surg. 2015 Jun, 41(6), P. 720-725. HELLING E.R., et al. Complications of facial suspension sutures. Aesthet Surg J. 2007,N7, P. 155-161. ANTONELLA SAVOIA et al. Outcomes in Thread Lift for Facial Rejuvenation: a Study Performed with Happy Lift™ Revitalizing. Dermatol Ther (Heidelb). 2014 Jun, 4(1), P. 103-114. *

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