This paper describes a lip filling technique that administers hyaluronic acid using microcannulas. This technique considerably reduces the number of punctures compared to the conventional method, which uses needles. In addition, the microcannula’s blunt tip reduces the risks of intravascular injection of the substance and of disrupting key structures such as vessels and nerves. The results obtained by the authors confirm the less frequent occurrence of adverse effects and a high degree of physician and patient satisfaction.

Keywords: HIALURONIC ACID, LIP, REJUVENATION

Systemic sclerosis (SE) is an autoimmune disease of the connective tissue. Of unknown etiology, it is characterized by sclerosis (fibrosis), which affects the skin, blood vessels and internal organs. The diagnosis is confirmed by a compatible clinical picture, autoantibody research and capillaroscopy of the nail bed. The present report highlights the importance of the dermatologist physician in the diagnosis of systemic diseases. Based on the observation of the skin – which is visible and palpable in all of its dimensions – and in the interpretation of all its signs, it is possible to conclude that it can reveal early internal disorders that could develop unnoticeably.

Keywords: Scleroderma, systemic; Fibrosis; Autoantibodies

Systemic sclerosis is a disease of unknown cause, is a rare pathology that, when not treated in time, produces severe damage to the facial aesthetic anatomy causing a significant impact on the quality of life. The case of a 54-year-old woman, with a history of systemic sclerosis of 25 years of evolution, and who was stable from her disease over four years ago. The patient consults for resolution of her facial deformity, which is why she proceeds to perform minimally invasive low-risk procedures such as transcutaneous blepharoplasty and fillings with hyaluronic acid obtaining aesthetically adequate results.

Keywords: Blepharoplasty; Hyaluronic acid; Scleroderma, diffuse

Facial surgeries are often challenging for surgeons due to their complex anatomy, aesthetic and functional importance. Interventions in the cosmetic subunit that comprises the eyebrows can be particularly difficult. This case report aims to demonstrate the use of island flap in this region. We performed the excision of melanocytic nevus, with a good outcome and absence of postoperative complications. This technique is commonly used for facial reconstruction; however, the literature describes only a few cases using this method for eyebrow reconstruction.

Keywords: Scleroderma, Systemic; Microstomia; Lasers; Laser Therapy; Intense Pulsed Light Therapy; Combined Modality Therapy

INTRODUCTION: Progressive Facial Hemiatrophy, also known as Parry Romberg Syndrome, is a rare form of linear scleroderma. The management of facial atrophy sequelae is challenging.
OBJECTIVE: This study aims to evaluate for the first time in literature the effectiveness of the calcium hydroxylapatite (CaHa) filler in the jawline reshaping of a patient with Parry Romberg Syndrome.
CASE REPORT: A 15-year-old woman with progressive atrophy of the right side of the face due to Parry Romberg Syndrome. After disease control, the patient’s main complaint was facial asymmetry, mainly in the jawline region.
DISCUSSION: CaHa is a biocompatible injectable filler that is gradually resorbed and replaced by fibrovascular stroma, mainly formed for new collagen, in a process that occurs without any immunological reaction. This safety profile makes CaHa a good choice for correcting stable scleroderma defects.
CONCLUSION: This report concludes that CaHa filler biocompatibility and suitability for the jawline correction are also applicable in reconstructive procedures for stable scleroderma, safely and minimally invasively, with optimal aesthetic results. The method must be programmed case-by-case, and a regular follow-up is also recommended.

Keywords: Scleroderma localized; Facial hemiatrophy; Dermal fillers

Localized scleroderma (linear morphea) is a rare disease that causes facial dystrophy and asymmetry in young women. We report the case of a 20-year-old female patient who was treated with novel composite fat grafts. After extracting lipoaspirate from deep subcutaneous fat, the microfat and the unfiltered nanofat were processed separately, and amalgamated, obtaining composite fat grafts. These were meticulously transplanted layer by layer to rebuild the subcutaneous tissue of the patient's face. After one year, a good volume of fat retention was observed with successful correction of asymmetry and restoration of facial balance.

Keywords: Ambulatory surgical procedures; Abdominal subcutaneous fat; Facial asymmetry; Subcutaneous injections; Localized scleroderma

INTRODUCTION: Parry-Romberg syndrome and linear scleroderma en coup de sabre are disorders within the scleroderma spectrum, a disease that presents therapeutic challenges.
OBJECTIVES: We treated three patients with this condition using poly-L-lactic acid (PLLA) with the aim of alleviating facial asymmetries and evaluated the real improvement of scleroderma lesions with high-resolution ultrasound.
METHODS: The patients underwent two to four sessions of biostimulation with PLLA over a 12-month period.
RESULTS: The results were promising, demonstrating favorable cosmetic outcomes with increased thickness of the dermis and hypodermis as evidenced by high-resolution ultrasound.
CONCLUSIONS: Biostimulation with PLLA is a safe and effective treatment option for these patients when administered by trained professionals.

Keywords: Facial Hemiatrophy; Scleroderma, Localized; Dermal Fillers; Ultrasonography.