Introduction: Melasma is the principal cause of facial hyperchromia and has a significant psychosocial impact. Wood´s lamp has been a useful device to estimate the depth of melanin determined by light-induced fluorescence. A dermatoscope enables a clear visualization of pigments distribution, and the color variation of melanin will depend on its location within the skin. Objective: Evaluate the classifi cation of melasma according to depth of melanin by dermatoscopy and to correlate the dermatoscopic findings with its classifi cation using Wood’s lamp. Material and methods: Analysis of concordance between dermatoscopy and Wood’s lamp in the classification of melasma. Forty patients were evaluated by expert examiners, using a Wood’s lamp (Burton® UVA 360nm LE T5 4W BLB) and dermoscopy (Bley Med-Skincam® 40x or 3Gen Dermlite II ProHR® 10x), in an independent manner. The epidermal type was considered as the presence of a regular pigment network, with a brownish homogeneous pigmentation; dermal type as an irregular and mixed network with bluish-gray pigmentation; and mixed type as areas presenting both features. Results: The degree of concordance between the methods was considered weak (k < 0.2) by statistical analysis. Conclusions: The authors consider the technique more suitable, since it has allowed the visualization of the pigmentary components in a more objective way.

Keywords: CLASSIFICATION, MELANOSIS, DERMOSCOPY

Introduction: Muscle activity at the glabella causes wrinkles that are perpendicular to muscle contraction. Such wrinkles are currently treated with botulinum toxin. However, interpersonal local contraction variations are revealed during facial animation. Although a great number of articles on this topic have been published, the patterns of glabellar contraction have not yet been adequately studied and classified. Objective: To identify and classify the glabellar contraction patterns found in the population undergoing cosmetic treatment with botulinum toxin. Methods: Retrospective photographic analysis of 30 patients receiving botulinum toxin for the treatment of glabellar wrinkles.The contraction patterns were identified and classified based on the prevalence of lowering, approximation, or lifting movements at the glabella. Results: Five patterns were identified: 1) "U," 2) "V," 3) "Omega," 4) "Converging Arrows,” and 5) "Inverted Omega." The classification method allowed indentifying the most important muscles in each contraction pattern. Conclusion: There are interpersonal variations in facial animation. The classification of glabellar wrinkles enables a more accurate, individualized treatment with botulinum toxin. The most heavily used muscles receive higher doses or are injected into a larger number of sites. Those less solicited muscles are left untreated or receive lower doses, allowing for more effective and natural results.

Keywords: CLASSIFICATION, BOTULINUM TOXINS, REJUVENATION

Introduction: Diverse anatomical characteristics and varied kinetic spectra determine the specific contraction patterns of individuals'''''''' frontal facial musculature.
Objective: To identify and classify the frontal facial musculature contraction patterns in patients who sought care for treating frontal facial wrinkles.
Methods: Retrospective analysis of pictures taken from 83 patients.The muscular contraction pattern was classified according to the predominant hyperkinetic area that was observed in the picture in the frontal muscle''''''''s maximum contraction.
Results: Three contraction patterns were identified: total, medial and lateral. In 50.6% of cases, the total pattern was observed: the horizontal rhytids present in the center of the forehead extend laterally beyond the mediopupillary line, up to the end of the brows.The medial pattern was observed in 25.3% of cases: the horizontal rhytids are concentrated in the central region of the forehead, predominantly contained between the mediopupillary lines.The lateral pattern was observed in 24% of the cases: the horizontal rhytids prevail on the sides of the forehead, mainly occurring laterallyto the mediopupillary line.
Conclusions: The identification and classification of Frontalis muscle contraction patterns provides an individualized approach for each patient, which is one of the most important pillars of a successful treatment plan.

Keywords: A BOTULINUM TOXIN TYPE, MUSCLE CONTRACTION, CLASSIFICATION

Introduction: Periorbital wrinkles are an important component of facial aging that can be minimized with botulinum toxin treatment.
Objective: To treat periorbital wrinkles through botulinum toxin injections in the orbicularis muscle, using classic lateral points and additional points in the lower eyelid, which were developed based on the classification of these wrinkles.
Methods: Clinical and photographic data from 530 patients who had periorbital wrin- kles classified and treated between 2002 and 2007 were analyzed.
Results: Thirty percent of patients over 45, and 80% of those under 45, demonstrated complete improvement of the wrinkles after treatment in the classic points. The remaining patients needed treatment in the additional points in the lower eyelids.
Conclusion: The classification of wrinkles helped improve treatment. Despite the considerable benefit offered by injecting in the classic points, the necessity of treating additional points in the lower eyelids with botulinum toxin was verified. The presence of subcutaneous cellular tissue and the patient''''''''s age should also be taken into consideration.

Keywords: AGING, EYELIDS, CLASSIFICATION

Introduction: Melasma can be classified as epidermal, dermal, or mixed using clinical measures such as Wood''''''''s lamp and dermoscopy. The Melasma Area Severity Index and the Melasma Quality of Life Scale are additional subjective classification methods. Objectives: To compare noninvasive melasma classification methods according to response to treatment. Methods: Ten women with melasma were treated with 4% hydroquinone + 0.05% tretinoin + 0.01% fluociolone acetate for 90 days. They were evaluated before and after treatment using dermoscopy, Wood''''''''s lamp, and both subjective measures. Results: No significant correlations were found between the Melasma Area Severity Index and dermoscopic classification, Wood''''''''s lamp examination and the Melasma Quality of Life Scale. The average percentage improvement after treatment was 60.6% in the severity index and 41.1% in the quality of life scale. Dermoscopy revealed telangiectasia in most patients (60%), including those without prior treatment. Conclusions: The subjective assessment tools best reflected the patients'''''''' response to treatment. The classification using Wood''''''''s lamp did correlate with improvement measured by the severity index. The use of dermoscopy for classifying melasma requires further research, since the findings were not correlated with the expected response to treatment.

Keywords: HYPERPIGMENTATION, CLASSIFICATION, THERAPEUTICS

INTRODUCTION: The search for minimally invasive aesthetic procedures to improve non-facial skin laxity has been increasing annually. The biostimulator poly-L-lactic acid stands out as one of the most versatile products for aesthetic procedures in this field.
OBJECTIVE: To develop a systematic assessment framework tool to guide treatment decision-making for skin laxity in extra-facial areas, since there are no reports regarding how to select the most appropriate patients for non-invasive body shaping with biostimulators to date.
METHODS: The authors developed the tool described herein based on their collective experience with treatment of extra-facial skin laxity with poly-L-lactic acid.
RESULTS: This assessment method collates input from four fundamental factors: somatotype/morphotype, skin quality/severity of laxity, distribution and quantity of adipose tissue, and nutritional and hormonal profile.
CONCLUSIONS: Each aspect of the framework has been developed to optimize decision-making and tailor the clinical experience for each patient, enabling clinicians to select the most favorable candidates for biostimulator use, leading to more predictable and optimized outcomes.

Keywords: Rejuvenation; Classification; Skin Aging.