Post-adjusted M-plasty can be used in any surgical defect that can be closed by direct approximation of the borders to avoid the formation of apical protrusions. It is performed without prior planning; the tissue is removed only if the surgeon detects a protrusion during surgery. This method offers the advantage of sparing healthy tissue by adjusting the incisions to each patient’s skin’s tension lines, wrinkles and junctions of cosmetic units, in addition to the possible use of the “M”s pedicle as a small advancement flap. This study describes the procedure step by step, highlighting the differences and advantages compared to traditional M-plasty.

Keywords: SURGICAL PROCEDURES, MINOR, AMBULATORY SURGICAL PROCEDURES, ABDOMINAL WOUND CLOSURE TECHNIQUES

Structural alterations resulting from the aging process of the face are related to muscular action, skin sagging, loss of bone support, and decrease in the volume of facial fat compartments-all inducing alterations in facial contour over the years. The authors have carried out a review of the main causes linked to the so-called facial contour alteration in aging and defined a new denomination for this process: "facial squaring", the process through which the shape of the face-which is that of an inverted trapezoid in youth-becomes that of a square over time.

Keywords: REJUVENATION; SKIN; FACIAL MUSCLES.

Introduction: Obesity is a major health problem worldwide due to its high morbidity and mortality. Objective: To evaluate the reduction of abdominal fat in volunteers who underwent low-frequency diode laser therapy. Methods: A total of 60 volunteers (18 to 50 years of age, with a BMI of between 18.5 kg/m2 and 30 kg/m2, and who had abdominal fat), underwent a treatment performed twice a week for 31 days and were then evaluated. The abdominal circumference was evaluated in three locations, with photographic and ultrasound images taken of the studied area. Results: There was a reduction in the abdominal circumference measurements in the evaluated sites, with dermal compression and a significant reduction of hypodermis verified through ultrasound. Conclusion: The low-frequency diode laser therapy showed significant results in the reduction of localized fat and abdominal circumference measurements.

Keywords: LASER; ABDOMINAL FAT; LYPOLISIS.

Endometriosis is a common dermatosis that most typically affects the pelvic organs. Extra-pelvic occurrences are reported in the literature. Umbilical endometriosis is rare and can be primary (spontaneous) or secondary (after surgery). The present study describes the case of a female patient with endometriosis lesions in the umbilical region, confirmed by histology. Treatment was carried out with wide surgical excision. It is important to note that differential diagnosis should be considered in the presence of umbilical tumors in women of reproductive age.

Keywords: ENDOMETRIOSIS; SISTER MARY JOSEPH'S NODULE; ABDOMINAL NEOPLASMS; ABDOMINAL WALL; ADENOMYOSIS

Introdução: A non-invasive alternative for the treatment of localized fat is cryolipolysis that, by freezing adipocytes, reduces fat volume in the region where the procedure was performed. Objective: To statistically describe the experience of a referral center for this procedure. Methods: A cross-sectional study with 251 patients undergoing cryolipolysis was carried out with the epidemiological analysis of patient data. Results: Thirty-eight males and 213 females underwent the procedure, with a total number of 740 treated areas. The anterior abdomen (lower third) was the most popular region, with 45.30% of cases. Eighty-eight percent were satisfied or very satisfied with the result. Nearly all cases required 2 or more sessions to achieve this degree of satisfaction. Conclusions: Cryolipolysis is a noninvasive method for the selective reduction of fat that has shown efficacy in reducing the subcutaneous tissue, with minimal and reversible side effects in this study.

Keywords: LASERS; ABDOMINAL FAT; LIPOLYSIS

Introduction: Introduction: Not focused ultrasound is a noninvasive alternative to improve body contour.
Methods: It's reported five cases treated with eight weekly sessions of not focused ultrasound on the abdomen.
Results: The treatment did not affect the routine of patients; it was comfortable and safe for most. There was a reduction in the thickness of the fat layer evaluated by ultrasound and in the circumferential measures in all patients, with clinical improvement evidenced in the photographic documentation especially in patients with lesser thickness of subcutaneous.
Conclusion: The device was safe, and was shown clear reduction in abdominal subcutaneous tissue.

Keywords: ADIPOSE TISSUE; ULTRASONIC THERAPY; ULTRASONOGRAPHY; ABDOMINAL SUBCUTANEOUS FAT

Introduction: Currently there is a growing demand for non-invasive therapies aimed at treating facial aging. Non-ablative fractional lasers lead to excellent outcomes, with reduced side effects. Objective: To evaluate the facial rejuvenation achieved by 1,340nm non-ablative fractional laser using a single pass at high energy versus three passes at medium energy, through a prospective comparative study. Methods: Twenty patients with facial aging were treated with 2 or 3 laser sessions with 4-week intervals. The right hemiface was treated with three passes of 1,340nm non-ablative fractional laser at a fluence of 90 mJ, pulse duration of 5ms and 100 mtz/ cm2. The left hemiface was treated with a single pass of the same laser at a fluence of 120 mJ, pulse duration of 5ms and 100 mtz/cm2. The evaluated variables were spots, wrinkles, porphyrins and overall appearance. Results: The patients (n = 20) were evaluated during 6 to 24 months. The photographic evaluations demonstrated a significant improvement of the spots on the right hand side and wrinkles on the right and left hand sides. Eighteen of the 20 patients reported satisfaction with the treatment. Conclusion: 1,340nm non-ablative fractional laser was proven as a modern, safe and effective alternative for facial rejuvenation. For spots, the triple passes at medium energy protocol led to a superior response. However, regarding wrinkles there was no difference between the single pass at high energy and triple pass at medium energy protocols.

Keywords: LASER; REJUVENATION; FACIAL AGING; FACE

The association of cysts and comedones in chronically sun-damaged skin characterizes the Favre-Racouchot syndrome. The authors report a case of a 64 year-old male patient with a history of smoking and tillage work activity. The patient had lesions in the malar, zygomatic and mandibular regions bilaterally, constituted by slightly erythematous cysts and large comedones in thickened skin with deep grooves. The condition was diagnosed as Favre-Racouchot syndrome, and treated by means of surgical excision. The objective of the present study is to describe an exuberant presentation of the syndrome, and its treatment via surgical excision.

Keywords: Facial dermatoses; Photosensitivity disorders; Skin aging

Facial hemiatrophy, or Parry-Romberg syndrome, is characterized by the progressive atrophy of the tissues of half of the face, affecting skin and subcutaneous tissue. Its clinical manifestations are very varied. Preferred therapeutic strategies for the treatment of the syndrome were not yet completely established. The authors describe a case of mild facial hemiatrophy, in which the patient underwent lipofilling (autologous fat grafting), progressing with satisfactory result. Treatment alternatives, its advantages and disadvantages are widely discussed in the study, with fat grafting emerging as an excellent therapeutic option due to its safety, low cost and replicability.

Keywords: Face; Facial hemiatrophy; Transplantation, autologous

Nodular fasciitis is a benign tumor resulting from the reactive proliferation of fibroblastic or myofibroblastic cells presenting rapid growth and rich cellularity. In adults, the extremities’ involvement is more frequent; however, other regions can be affected. In this report, we present the case of a 40-year-old woman with a nodular lesion on the forehead. The histopathology confirmed the diagnosis of nodular fasciitis. The reported case highlights its rare location and alerts the clinical dermatologist in its inclusion among the differential diagnoses of tumor lesions on the face.

Keywords: Facial Dermatoses; Fasciitis; Forehead

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

Autologous fat grafting is a common option for the correction of facial asymmetry. Recently, therapies using injectable substances that promote lipolysis have emerged to reduce undesired fat volume, offering an alternative to surgical removal of adipose tissue. We report an experimental case in which fat-dissolving injections were used to correct facial asymmetry following fat grafting, demonstrating satisfactory results with a minimally invasive procedure.

Keywords: Facial Asymmetry; Adipose Tissue, Subcutaneous; Mesotherapy.

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.

BACKGROUND: Reconstructive surgery remains the primary approach for treating facial skin cancer, aiming to restore both anatomy and aesthetics. Local flaps are commonly preferred for facial reconstruction.
OBJECTIVE: To describe the clinical and subclinical characteristics of facial skin cancer and evaluate treatment outcomes using local flaps.
METHODS: A descriptive cross-sectional study with clinical intervention, without a control group, was conducted on 84 patients diagnosed with facial skin cancer and treated at Can Tho City Oncology Hospital from May 2021 to April 2023.
RESULTS: Outcomes were assessed during hospitalization and 6 months postoperatively. Among the 84 patients, 68 had basal cell carcinoma, and 16 had squamous cell carcinoma. The nose was the most frequently treated site, accounting for 43 cases. Lesions smaller than 2 cm comprised 70.2% of cases. After 6 months, 65 out of 84 flap sites (77.4%) exhibited minimal scarring that could be concealed, with an aesthetic success rate of 73.8%.
CONCLUSIONS: Key factors influencing surgical outcomes include the surgeon's experience, lesion location and size, tumor invasion extent, and skin elasticity.

Keywords: Facial Dermatoses; Surgical Flaps; Southeast Asian People.