Effects of the inclusion of alfacalcidol in complex rehabilitation programs for patients with age-related facial ptosis

Introduction. The sufficiency of vitamin D is important for slowing down the aging of the skin, maintaining its hydration, elasticity and the ability to regenerate. Biologically active forms of vitamin D (including alfacalcidol) promote the activation of genes whose function is directly related to the maintenance of the structure of the skin, subcutaneous tissue, fascia and muscle fibers.The aim of the work was to assess the prospects for the inclusion of alfacalcidol (“Alpha D3”, 0.25 μg, 1 caps/day) in the rehabilitation programs of patients with age-related ptosis of the face (n = 40, age 47 ± 5 years).Materials and methods. 4 groups of patients with age-related facial ptosis (n = 40, average age 47 ± 5 years) were observed for 60 days; measurements were made before and after clinical trials. Group 1A (first treatment, n = 12) received the daily dose of Alpha D3, 0.25 mg, in the morning, for 60 days, during this period the patients received 4 cosmetic procedures (2 plastic face massages and 2 stimulation current therapies). Group 1B (first control, n = 8) received only 4 cosmetic procedures over 60 days (2 plastic face massages and 2 stimulation current therapies). Group 2A (second treatment, n = 12) received the daily dose of ALFA D3, 0.25 mg, for 60 days, during this period the patients received 4 DMAE (diethylaminoethanol) mesotherapy procedures. Group 2B (second control, n = 8) only received 4 DMAE (diethylaminoethanol) mesotherapy procedures.Results. Alfacalcidol intake significantly increased the concentrations of 25 (OH) D (from 17 ± 5 ng/ml to 27 ± 8 ng/ml, P = 0.001) and calcium (from 86 ± 10 mg/L to 96 ± 6 mg/L, P = 0.01) in serum. The positive dynamics of the concentrations of 25 (OH) D and calcium when taking alfacalcidol corresponded to an increase in the total bone mineral density (+ 0.03 ± 0.03 g/cm3, control: + 0.006 ± 0.03, P = 0.016) and T-criterion (+0.4 ± 0.5, control: -0.07 ± 0.2, P = 0.0002), which indicates compensation for vitamin D deficiency and an improvement in bone metabolism. An increase in the levels of 25 (OH) D and calcium when taking alfacalcidol was accompanied by a positive trend in skin condition according to bioimpedance measurements. Taking the drug significantly increased the moisture content of the facial skin (from 17 ± 14 points to 29 ± 14 points, P = 0.055, without changes in the control) and increased the amplitude of the muscle motor response to the stimulus (+ 0.24 ± 0.22, P < 0.02).Conclusions. Within the framework of a randomized design, it was shown that the addition of massage, microcurrent therapy, mesotherapy with alfacalcidol led to a significant increase in serum 25 (OH) D levels, an increase in skin elasticity and hydration, a decrease in visceral fat according to bioimpedance measurements, and an improvement in indicators of muscle contractility and neuromuscular signal transmission according to electromyography data and an increase in bone mineral density.

Novel Non-Invasive Laser and Radio-Frequency (RF) Procedures for Vaginal Dystension and Vulvar Laxity Syndroma to Enhance Sexual Gratificaton

Childbirth vaginal trauma and process of ageing are fundamental in developing stress urinary incontinence (SUI) and sexual dysfunction related to vaginal and vulvar relaxation. Unpleasant aesthetic appearance of vulva is additional factor that deepens negative psychological response, embarrassment, anxiety and lack of confidence while postmenopausal vaginal dryness additionally deteriorates sexual gratification when estrogen is avoided. Thus far, experimental and clinical studies have reported significant success in the treatment of various disorders and conditions based on collagen damage. Most references arise from the fields of dermatology and aesthetic medicine. Facial ptosis, uvular and soft-palate relaxation in snoring disorders, and ligament trauma in orthopedics may be successfully treated with laser-generated thermal energy. The precise mechanisms underlining the normalization of some vaginal properties is not yet completely clear but collagen remodeling and increased vascularization have been documented by histology following laser application. The onset and mild disorder in SUI and vaginal relaxation syndrome (VRS) still remain underreported and problem remains hidden until severe symptomatology often results in surgery treatment. However, there is a risk of serious adverse effects resulting from surgery procedures. Complications such as bleeding, infection, poor wound healing and overcorrection may require de novo medical intervention, resulting in global rising trend of non-invasive procedures. There is a rising evidence for the effectiveness of non-invasive laser procedures in the treatment of SUI, VRS and vaginal atrophy, while novel RF procedure might play a significant role in vulvar laxity treatment.

Seamless Face-Lift with Aptos Thread: The Belo Medical Group Experience

Introduction: Aging is manifested on the face as loss of normal volume and contour in all dimensions. The classic methods of face lifting normally leave unsightly scars, especially on Asian skin. In 1999, M. A. Sulamanidze used Aptos thread to lift soft tissue in both the subcutaneous muscular aponeurotic system and in the supraorbital area, restoring the normal contours of the face with excellent results. Aptos threads are polypropelene sutures with dents or cogs along their surface. Here, we present the results of a study using the device introduced by Sulamanidze on patients in the Belo Medical Group. Materials and Methods: Our study group consisted of 257 patients ranging in age from 28 to 73 years. Women made up 91.5% of the population. The population was 98% Asian. From November 2002 to November 2003, surgical procedures using Aptos threads were performed on 257 patients, and 27 patients had additional procedures at the same time. Results: The immediate postoperative period was mostly uneventful. Most cases showed excellent improvement in the ptotic tissues. In 9 cases (3.5% of patients) a “blue pimple” was observed 2–3 weeks postoperatively. These were noted to be thread edges sticking out of the skin and required minimal trimming. In 1 case, the patient developed persistent infection at the puncture site. Wound exploration and removal of implanted thread was performed and antibiotics were shifted to a broader spectrum, which addressed the problem quickly. Five cases (1.9%) required unilateral or bilateral implantation of additional threads. Discussion: The earliest outcome was seen on the operating table. Rehabilitation time was as short as 5–7 days and, if patients comply with elementary recommendations (abstaining from abrupt mimicking and chewing movements, avoiding facial massages for 2–3 weeks), the lifting effect is expected to remain for a considerable length of time. Conclusion: Using the Aptos thread technique was as successful in treating facial ptosis in 257 patients at The Belo Medical Group facility as it was in the Russian study. It proved to be a simple, quick, safe, conservative, and time-saving procedure that did minimal tissue damage and left no visible scars, even on Asian skin.