RU2766798C1 - Method for decollete area skin rejuvenation - Google Patents

Abstract

FIELD: medicine; cosmetology.

SUBSTANCE: invention refers to plastic surgery and cosmetology. Monofilament threads are introduced into subcutaneous fat through skin punctures by means of a guide needle. Soft tissue frame of the decollete area is created. Four threads based on caprolactone and L-polylactic acid with notches diverging from the center, size 2/0 USP, are introduced, wherein the middle of the thread, free from notches, is placed in the central line of the neckline, which is located along the center of the sternum, so that the notches are on different sides of the central line of the neckline. First thread is placed 3.0 cm below the clavicles and perpendicular to the central line of the neckline. Next three threads are placed in parallel and below the first one, with a distance between threads of 1.0 cm.

EFFECT: method enables providing reliable and long-term fixation of neckline tissues due to creation of a dense frame in connective tissue structures, which increases reliability and prolongs fixation and, consequently, significant effect of neckline rejuvenation.

1 cl, 5 dwg, 1 ex

Description

The invention relates to the field of plastic surgery and cosmetology and can be used to eliminate and prevent wrinkles in the décolleté area for the purpose of rejuvenation.

Age-related changes occur in all areas of the life of cells and tissues, all of which lead to aging of the body.

The action of existing methods of rejuvenation is aimed only at the dermis, improving its structure and reducing the severity of wrinkles. The low efficiency and duration of the result is due to the lack of impact of existing methods on the mechanical factor of wrinkle formation in this area.

Therefore, the development of a method that affects both the structure of the dermis and the mechanical factor (compression) of the formation of wrinkles in the décolleté area is relevant.

A known method of rejuvenation of areas with thin skin "Redermaneurolifting", including intradermal injection of a solution consisting of hyaluronic acid and botulinum toxin on the thin skin of the face, neck, decollete (see patent RU No. 2729613, A61K 8/81, A61K 8/99, A61K 8/66, A61Q 19/08, 2020).

The disadvantages of this method are: low efficiency in severe wrinkles and thicker skin; short effect duration.

Also known is a composition for skin rejuvenation (options), consisting of various ingredients, including tissue preparation of the mucous membrane and integumentary epithelium of the muscular section of the stomach of a bird, hyaluronic acid, micellar gel and serum with hyaluronic acid (see patent RU No. 2629593, A61K 8/98 , A61K 8/73, A61Q 19/08, 2017).

The composition is applied to the skin of the face, neck and decollete in a course of 10 sessions.

The disadvantages of this method are: low efficiency in the elimination of wrinkles; the need for coursework.

There is also known a method of thread lifting of the superficial tissues of the neck, including a fan-shaped, uniform introduction of 5 threads from each subcutaneously through the fusion of the posterior edge of the platysma and the sternocleidomastoid muscle to the front side of the neck along the line from the chin to the jugular notch (see patent RU No. 2636879, A61B 17/ 04, 2017).

The disadvantage of this method is the limitation of its use only for the neck area.

The closest in technical essence to the claimed solution is a method of rejuvenating the skin of the face and body by implanting mesothreads, including the introduction of monofilament threads into the subcutaneous fat of the decollete through skin punctures (see patent RU No. 2644551, A61B 17/00, A61F 2/00 , 2018).

When implementing this method for tissue threadlifting, smooth sterile absorbable polydioxanone threads "Lead Fine Lift" are used on carrier needles of various sizes manufactured by "MEDIFIRST Co., LTD" (Republic of Korea).

The number of threads used depends on the volume of the medical procedure being performed 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 threads are introduced into the dermis layer bordering on fatty tissue at a distance of 1.5 cm from each other parallel to the skin surface according to the individual antigravity vectors of the patient in the upward direction.

The disadvantages of this method are: low efficiency, due to the small thickness of the threads and a short duration of the effect.

The technical result of the proposed solution is to increase the effectiveness of the elimination of décolleté wrinkles by improving the structure of the dermis with the simultaneous ability to resist the mechanical factor, namely, the compression of wrinkle formation.

To achieve this technical result in the method of skin rejuvenation of the décolleté area, which includes the introduction of monofilament threads into the subcutaneous fat through skin punctures by means of a guide needle, according to the invention, a framework of soft tissues of the décolleté area is created, four threads are introduced based on caprolactone and L-polylactic acid with notches diverging from the center, size 2/0 USP, while the middle of the thread, free from notches, is placed in the region of the center line of the neckline, which is located along the center of the sternum, so that the notches are on opposite sides of the center line of the neckline, with the first the thread is placed 3.0 cm below the collarbone and perpendicular to the center line of the neckline, and the next three threads are placed parallel and below the first, with a distance between the threads of 1.0 cm.

In the pathogenesis of the formation of décolleté wrinkles, two main factors can be distinguished - general involutional changes in the dermis and a mechanical factor. The mechanical factor is the displacement of tissues towards the middle during movements, as a result of which vertical wrinkles are formed in the central part of the neckline.

As mesothreads, as a rule, thin smooth (without notches) threads, 6/0, 8/0 USP in size, are used, which are able to have a histological effect aimed at rejuvenation, but are not capable of exerting a mechanical effect. Mechanical impact on soft tissues (creating a tissue skeleton) is capable of carrying out threads with notches of greater thickness: 2/0, 1/0 USP.

On the other hand, when supplying threads with notches directed towards the center (converging notches), it is known that soft tissues are assembled towards the center, which in the décolleté area can only worsen the condition of wrinkles, providing additional to the mechanical factor, tissue displacement towards the center, with the formation wrinkles. Threads of size 2/0 USP having notches diverging from the center (divergent) have the opposite effect, such threads are able to push the tissues away from the center, thus compensating for the mechanical factor in the formation of wrinkles in the décolleté area. In world practice, such threads are used to correct the lips and nose area, but their use for the décolleté area is unknown.

A feature of the invention is the creation of a soft tissue skeleton in the décolleté area, with a simultaneous improvement in the quality of the skin of the wrinkle area due to the histological effect of threads based on caprolactone and L-polylactic acid with notches with a mechanical effect - tissue stretching, to compensate for the mechanical pathogenetic factor of wrinkle formation.

A significant increase in the effectiveness of wrinkle removal is achieved by using four threads with notches diverging from the center. They are able to influence both the improvement of the structure of the dermis with a decrease in the severity of wrinkles, and to resist the mechanical factor (compression) of wrinkle formation. Such threads, installed subcutaneously, fix soft tissues due to notches, subsequently they are braided with collagen fibers. The threads have a long resorption (about 18 months).

A reliable and strong framework of soft tissues with long-term fixation of tissues is formed. Implantation of threads occurs only through a skin puncture, thus, a small total number of threads and the absence of the need for skin incisions reduce the trauma of the procedure.

A monofilament thread with bidirectional notches diverging from the center based on a copolymer of caprolactone and L-polylactic acid Dermafil Boca is used. The thread size is 2/0 USP, the notches are made by cutting, the notches on both sides of the thread are directed from the middle, the middle part of the thread has no notches (10.0 mm), the total length of the part with notches is 70.0 mm, the total length of the thread is 120.0 mm.

When installing the thread, a guide needle is required, the most suitable option for implementing this method is a guide needle 20G 90.0 mm. The middle of the thread is placed in the region of the center line of the neckline, so that the notches, having a direction from the center, are on opposite sides of the center line, providing a pronounced resistance to compression of the adjusted area.

Fixation of the thread at the level of the subcutaneous fat allows, due to the notches catching on the connective tissue fibers of the hypodermis in the décolleté area, to form a frame consisting of threads with the fibrous component of the subcutaneous fat intertwining them and to resist the compression force in this area, preventing the formation wrinkles.

In the proposed technical solution, it is proposed to install four threads simultaneously, so that the first thread is installed 3.0 cm below the clavicle, and the subsequent ones are parallel to the first at a distance of 1.0 cm.

From the foregoing, it follows that the introduced distinctive features affect the specified technical result, are in a causal relationship with it.

The method is illustrated in the drawings, where in Fig. 1 shows a diagram of the introduction of threads in the neckline; in fig. 2 shows the notched thread used; in fig. 3 shows the guide needle; in fig. 4 and 5 show a clinical example of the method.

The following positions are used in the drawings: 1 - midline of the neckline; 2 - area of corrected wrinkles; 3 - line of injections with a guide needle; 4 - line of punctures with a guide needle; 5 - point of injection of the first thread; 6 - point of vykola of the first thread; 7 - point of injection of the second thread; 8 - point of puncture of the second thread; 9 - injection point of the third thread; 10 - point of puncture of the third thread; 11 - injection point of the fourth thread; 12 - point of puncture of the fourth thread.

The method is carried out as follows.

The method of skin rejuvenation of the decollete area is performed in several stages.

Stage 1 - marking the area of introduction of threads (Fig. 1).

Marking is carried out in a horizontal or vertical position of the patient. First, the central line of the neckline 1 is found, it is located along the center of the sternum, then the wrinkle area 2 is marked - the target correction zone.

Parallel to the central line of the neckline 1, at a distance of 3.5 cm in both directions, the line of injections 3 and the line of injections 4 are marked.

The injection point of the first thread 5 is marked on the injection line 3 and 3.0 cm away from the collarbones, the trajectory of the first thread is drawn perpendicular to the central line of the neckline 1 to the injection point 6, which is marked on the injection line 4, 3.0 cm below the collarbones.

Next, mark the injection points 7, 9 and 11, located on the injection line 3, with a distance of 1.0 cm from the previous injections and the injection points 8, 10 and 12, located on the injection line 4, with a distance of 1.0 cm from the previous injections, connecting the points of injections and punctures, mark the course of the next three threads, located parallel to the first thread, at a distance of 1.0 cm from the previous threads.

Stage 2 - anesthesia.

In the marked area, at the points of injection and injection, local infiltration anesthesia is performed: a solution of 2% lidocaine is injected subcutaneously.

Stage 3 - implantation of threads.

The introduction of threads is carried out subcutaneously, in the marked area, according to the scheme of the introduction of threads (Fig. 1).

In total, four threads are placed subcutaneously on the décolleté area; for this purpose, monofilament threads with notches diverging from the center (Fig. 2) based on a copolymer of polycaprolactone and L-polylactic acid Dermafil Boca are used. The thread size is 2/0 USP, the notches are made by cutting, the notches on both sides of the thread are directed at an angle from the center, the middle part of the thread has no notches (1.0 cm), the total length of the part with notches is 7.0 cm. needle guide 20G 90 mm (Fig. 3).

The first injection with a guide needle (with a mandrin installed inside it) is carried out at the injection point 5 perpendicular to the skin surface. Then, a guide needle is passed parallel to the skin in the subcutaneous fat cell, to the point of puncture 6, where the guide needle is punctured perpendicular to the skin surface.

After installing the guide needle, the mandrin is removed from it, the thread is threaded inside the guide needle, the central position of the thread is controlled by measuring the equality of the ends of the threads emerging from the distal and proximal ends of the guide needle.

After centering the thread, with one hand the thread is fixed at the distal end of the guide needle, and with the other hand the guide needle is withdrawn, while the thread remains subcutaneous, so that its middle (without notches) is located in the region of the central line of the decollete 1, and diverging from the center of the notch in the corresponding areas of the neckline.

Next, install the second thread and subsequent threads from the injection points 7, 9 and 11 to the injection points 8, 10 and 12, parallel to the first thread, at a distance of 1.0 cm from the previous threads.

After installing all the threads, the ends of the threads are cut, for this the tip of the thread is lifted with one hand, and the second is sunk and the rest of the thread coming out of the skin is cut off with sterile scissors.

At the end of the procedure, the decollete area is smoothed with two hands with light movements, in the direction from the center to the periphery to straighten (and stretch) the zone, followed by fixing the soft tissues of the decollete area on the notches diverging from the center.

The method is illustrated by the following example.

Patient M., 65 years old, came to the clinic with complaints of flabbiness of the skin in the décolleté area, the presence of pronounced vertical wrinkles, especially aggravated by crossing the arms on the chest (Fig. 4).

From the anamnesis it is known that there were no previous procedures in this area. Allergy anamnesis is not burdened, there are no concomitant diseases.

Local status: the skin is normal, there is a decrease in skin tone and elasticity in the face, neck and decollete. In the central region of the decollete, pronounced wrinkles are noticeable, which intensify when crossing the arms.

1 procedure was performed according to the proposed method: 4 Dermafil Boca threads were implanted on the décolleté area.

To do this, after marking the area corresponding to antiseptic treatment and infiltration anesthesia with a solution of lidocaine 2%, a guide needle was used to puncture the skin for the first thread 3.0 cm below the clavicle at the injection point located on the line, retreating 3.5 cm from the center line neckline.

Next, the guide needle was passed subcutaneously, with a puncture at a point 3.0 cm below the clavicle, on a line 3.5 cm away from the central line of the neckline.

Then the thread was threaded into the guide needle and centered (uniform ends of the threads emerging from the guide needle were left), after which the guide needle was removed with the thread fixed, using the second hand.

In the same way, three more threads were installed, parallel to the first, at a distance of 1.0 cm from the previous threads. After the implantation of all the threads, all the tips emerging from the skin were cut off, and the area was smoothed with two hands with light movements, in the direction from the center to the periphery, the patient was given recommendations for care during the rehabilitation period.

In FIG. 5 shows a photo of the patient three months after skin rejuvenation of the décolleté area. There was a pronounced improvement in skin quality in the form of an increase in the tone and elasticity of the skin of the décolleté area, a decrease in the depth of wrinkles at rest, and a significant decrease in the intensification of wrinkles when crossing the arms on the chest. The rehabilitation period was 3 days (there was a slight swelling).

Thus, the method showed high efficiency in the elimination of décolleté wrinkles, with reliable fixation by forming a subcutaneous skeleton of soft tissues, a short rehabilitation period indicates a low invasiveness of the method.

12 operations were performed to rejuvenate the skin of the décolleté area using the claimed method and these technical means in patients with different severity of décolleté wrinkles. Postoperative periods were uneventful. The follow-up period is from 12 to 24 months. The effect was maintained in all patients.

The proposed method is maximally physiological, which expands the indications for the correction of age-related changes in the decollete area.

Also, this method is characterized by a significant injury safety and a reduction in the rehabilitation period, with high efficiency due to the impact on both pathogenetic factors in the formation of décolleté wrinkles (general involutional changes in the skin and the mechanical compression factor of the area).

When applying this method, reliable and long-term fixation of the tissues of the décolleté area is ensured by creating a dense frame in the connective tissue structures, which increases reliability and increases the duration of fixation and, consequently, a significant effect of rejuvenation of the décolleté.

Claims (1)

A method for rejuvenating the skin of the décolleté area, including the introduction of monofilament threads into the subcutaneous fat through skin punctures using a guide needle, characterized in that they create a skeleton of the soft tissues of the décolleté area, four threads are introduced based on caprolactone and L-polylactic acid with notches diverging from the center , size 2/0 USP, while the middle of the thread, free from notches, is placed in the region of the center line of the neckline, which is located along the center of the sternum, so that the notches are on opposite sides of the center line of the neckline, with the first thread located at 3, 0 cm below the collarbones and perpendicular to the center line of the neckline, and the next three threads are placed parallel and below the first, with a distance between the threads of 1.0 cm.

Images