Introduction: Liposuction is one of the most common aesthetic procedures,and always has its safety questioned.
Objective: To verify the safety and operative complications of tumescent liposuction by analyzing demographic,anthropometrical and technical parameters,as well as the aspirated fat.
Methods: We retrospectively analyzed 543 patients (98% women) who received liposuction using the tumescent technique at the outpatient clinic''''''''s surgical center at the ABC Medical School between 2000 and 2005.Demographic and anthropometrical data were collected and analyzed,as well as data regarding the procedure – the site aspirated,the amount of tumescent solution infused,the total aspirate and aspirated fat volumes, and complications.
Results: The average patient age was 33 ±8,with a body mass index of 22 ±2 kg/m². The abdomen was the site with the highest number of procedures,and the aspirated fat as a percentage of body weight ranged from 0.43 to 1.66%,with an average of 0.97 ± 0.33%.Minor complications occurred in 1.2% of patients,and were promptly and appropriately treated.
Conclusions: The tumescent liposuction technique is a safe procedure when properly performed by dermatologists and plastic surgeons.

Keywords: PIPECTOMY, AMBULATORY SURGICAL PROCEDURES, POSTOPERATIVE COMPLICATIONS, INTRAOPERATIVE COMPLICATIONS

Introduction: The interest in minimally invasive procedures for facial rejuvenation fos- tered the development of the cutaneous filling technique to treat wrinkles and folds. Hyaluronic acid is one of the most popular fillers,as it is considered the least immuno- genic and safest in its category.
Objective: To evaluate and compare the efficacy,safety and duration of effect after the application of the filler CRMDex® in nasolabial folds,in one session versus two sessions.
Methods: Open clinical trial,with the randomization of nasolabial folds and comparison between two techniques.Women,aged 30 to 60 years old (n=30),presenting with accen- tuated symmetric nasolabial folds of minor to moderate degrees were subjected to intra- dermal injections of the same volume of CRMDex®.Three independent dermatologists evaluated the effectiveness of the treatment using the Wrinkle Severity Rating Scale.
Results: There was no difference in treatment effect for one versus two sessions.Both groups achieved a reduction of at least one degree according to the severity scale,and had a similar duration of the filling effect.The more frequent local adverse events (pain,ery- thema and edema) occurred during the injection and improved spontaneously.
Conclusions: There was no improvement in therapeutic response with the injection of smaller volumes per session.It seems that higher filler volumes may increase the risk of local adverse events.

Keywords: HYALURONIC ACID, BIOLOGICAL REACTIONS, DERMIS, CICATRIX

Introduction: Stretch marks are linear, atrophic, and well-defined cutaneous lesions, secondary to modifications in the conjunctive tissue.Their etiology is unclear.
Objective: To evaluate and compare risk factors for the occurrence of stretch marks during the first pregnancy of women who gave birth in public and private maternity hospitals.
Methods: Observational, transversal, and descriptive study with puerperae 48 hours after giving birth.Observations were carried out for 4 months in the maternity hospital of the public health sys- tem and at the private maternity hospital (n = 324).
Results: In both groups,maternal age and weight of the newborn were statistically significant risk fac- tors. Of women aged 25 or less, 70.1% developed stretch marks during pregnancy, compared to 29.0% of women over 25.Likewise, the greater the baby''''''''s weight, the greater the risk of stretch marks.
Conclusions: Women cared for in the public health system developed a greater number of stretch marks during pregnancy because they were younger.Among the study population, women aged 31 and older were less likely to develop stretch marks during pregnancy, as were those with babies weighing less than 3.5 kg.

Keywords: PREGNANCY, DERMIS, RISK FACTORS

Introduction: Melasma is a skin disorder characterized by acquired hyperpigmented macules,especially in the face,and more often affects women. Its incidence is unknown.Several treatment modalities are available to control the disorder.The MASI is a useful measure in the clinical evaluation of melasma,and MELASQoL is a tool to objectively evaluate the impact on patient''''''''s quality of life.
Objective:To evaluate the effectiveness of lactic acid peeling in patients with melasma,using MASI and MELASQoL. Methods: 33 patients,predominantly of phototype IV,were treated with 85% lactic acid peeling (hydroalcoholic solution,pH = 3.5).Clinical results and patients''''''''quality of life were evaluated using the Melasma Area and Severity Index - MELASQoL and the Melasma Quality of Life scale,respectively,before and after treatment.
Results: A significant reduction in both indices was verified after treatment,with an average decrease of seven points in the Severity Index.No correlation was observed between the changes in the two measures,meaning that clinical improvement did not always correspond with the patients''''''''expectations regarding the treatment.
Conclusions: Lactic acid peeling is an effective,safe treatment method for melasma.

Keywords: MELANOSIS, LACTIC ACID, THERAPEUTICS, QUALITY OF LIFE

Introduction: Onychocryptosis – or ingrown nail – is a painful condition caused by the nail plate''''''''s penetration into the soft surrounding tissue. Several surgical or more conservative therapeutic options are employed. In contrast with other invasive treatments, the combined technique of radioelectrosurgery and cryosurgery does not cause permanent damage to the nail matrix or fold, and presents several advantages when compared to more common treatments.
Objective: To evaluate the efficacy and safety of combined radioelectrosurgery and cryosurgery in the treatment of ingrown nails.
Methods: Retrospective observational study. Patients with onychocryptosis (n = 16) were administered radiofrequency-based electrosurgery to remove the granulation tissue to promote the accommodation of the nail plate, followed by freezing with liquid nitrogen.
Results: Ten days after treatment, patients described improvement in the discomfort caused by the condition and could start wearing shoes again. Only one patient presented a recurrence in one nail extremities during the 24-month follow-up period, and was treated again using the technique.
Conclusions: This technique is convenient for its easy execution, cost effectiveness, good cosmetic results and patient satisfaction.

Keywords: INGROWN NAILS, CRYOTERAPY, RADIOSURGERY, ELETROSURGERY, CRYOSURGERY

Introduction: Diode laser and intense pulsed light are among the most frequently used technologies for epilation.
Objective: To compare diode laser with intense pulsed light in axillary epilation.
Methods: Patients with phototypes II and III (n = 15) were subjected to 3 regular sessions of intense pulsed light (695 nm) - Quantum HR® Platform (Lumenis,Yokneam, Israel) in the right axilla and diode laser (810 nm) - Light Sheer ® (Lumenis,Yokneam, Israel) in the left axilla. The number of axillary hairs were counted before and after treatment, and patients were administered a questionnaire about adverse effects, pain and satisfaction.
Results: Both techniques provided a similar and significant reduction in hair density.The pain score and degree of inflammation were significantly higher for intense pulsed light (p < 0.01 and p = 0.03, respectively).There was a significant correlation between the fluence employed, the severity of pain, and the degree of inflammation for the two techniques (p < 0.05).The patients considered the final results to be similar, however more side effects were attributed to intense pulsed light.There was no difference in the proportion of preference between the two methods (p = 0.80).
Conclusion: The two techniques produced similar results, but the diode laser caused less pain and fewer side effects compared to intense pulsed light.

Keywords: HAIR REMOVAL, HAIR, LASERS

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

The use of botulinum toxin and cutaneous filling techniques has encouraged a renewed interest in the study of facial anatomy.An assessment of the influence of facial structures in the aging process requires an in-depth understanding of the constitution of the epidermis, dermis and subcutaneous tissue. It is also essential to study the boundaries of facial segments and bones, the musculature, vascularization, sensory and motor innervation, and the lymphatic drainage of the face.A broad understanding of facial anatomy will help perfect cutaneous filling and botulinum toxin techniques.

Keywords: ANATOMY, BOTULINUM TOXIN TYPE A, INTRADERMAL INJECTIONS

Acne is a multifactorial disease encountered on a daily basis by general medical practitioners and, especially, dermatologists. It has been a constant focus of studies that increasingly unveil details of its physiopathology and help refine treatments in order to address the majority - if not all - pathogenic factors.This article''''''''s objective is to draw attention to the therapeutic associations and combinations in acne management, highlighting its chronic disease character, typified by recurrence, and the requirement for continued treatment that is not only effective but also safe.

Keywords: ACNE VULGARIS, ACNE VULGARIS/PHYSIOPATHOLOGY, BACTERIAL DRUG RESISTENCE

Although the term cellulite is inadequate, since it does not refer to cellular subcutaneous tissue inflammations or infections, it is conventionally used to describe a female condition that is characterized by a wavy appearance of the skin''''''''s surface in some areas of the body. It constitutes a frequent complaint and an important concern for the majority of women and, due to its complex, multifactorial, and not completely known etiopathogenesis, there is still no effective and definitive treatment. Consequently, many therapeutic proposals, either based on poor quality publications or lacking sufficient scientific evidence, have been introduced.Topical treatments are not effective, though some can be indicated as adjuvant therapies.There is currently no technology able to correct the structural alterations of the female adipose tissue and deep dermis. That status clearly depends on the development of technolo gies based on the selective photothermolysis principle aimed at treating superficial hypodermal fat and the deep dermis.This article presents a review of the epidemiology, etiopathogeny, histology, clinical classification, and methods for the diagnosis, evaluation, and treatment of cellulite.

Keywords: CELLUTITIS, CELLULITE/HISTOPATHOLOGY, CELLULITIS/TREATMENT

Introduction:The treatment of cutaneous aging with fractional non-ablative lasers has been intensely studied in the last few years, yet the number of publications describing specific equipments is limited.
Objective: To describe patient and dermatologist satisfaction after treatment with the Lux 1540®laser.
Methods: Retrospective study of patients (n=16) who have undergone facial rejuvenation therapy with Lux 1540® laser. Photographic assessments were performed by a dermatologist not involved in the treatments. Patient satisfaction was analyzed before treatment and after three sessions. The study variables were spots, sagging, wrinkles, enlarged pores, telangiectasias, and general satisfaction.
Results: In the dermatologist''''''''s evaluation, good or excellent improvement was found in the majority of the patients, for all studied variables. Regarding the improvement in the patients'''''''' general appearance, 82% were rated good or excellent. Regarding patients'''''''' opinions, 63% expressed good to excellent general satisfaction.
Conclusions: Treating cutaneous aging with Lux 1540® laser yields satisfactory results and maybe a good option for patients that do not want or cannot undergo more aggressive treatments.

Keywords: LASERS, SKIN AGING, LASER THERAPY

A present a clinical case of a rare variant of dermatofibroma (aneurysmatic type), is presented in a 72-year-old female patient, the lesion was located in the right arm’s flexural fold, resulting from mesenchymal proliferation associated with blood vessels and tissular hemorrhage, with its own well defined histological characteristics. The objectives are to describe the rarity of the lesion and its histopathologic importance, when compared to other benign and malignant tumors in the differential diagnosis, in addition to the terminology currently used.

Keywords: BENIGN FIBROUS HISTIOCYTOMA, MALIGNANT FIBROUS HISTIOCYTOMA, HEMOSIDERIN

Capillary hemangioma is a benign tumor comprised of endothelial cells, common in childhood, which frequently disappears on its own. Port-wine stains are vascular malformations caused by capillary dilatation, initially characterized by macules with colors ranging from rose to violaceous red. Present at birth, they are usually permanent, and can thicken and cause deformities. Many treatments have been proposed: cryotherapy, surgery, corticotherapy, radiotherapy, and laser therapy. However, such treatments involve technical difficulties, high costs, complications, or unaesthetic results.This study proposes a new, easy to perform and cost effective association of techniques: percutaneous cerclage and radiofrequency electrosurgery for the treatment of hypertrophic lesions of vascular origin.

Keywords: HEMANGIOMA, SURGERY, THERAPEUTICS

Diverse techniques for rejuvenating the skin of the inferior periorbital region – ranging from chemical peels to more modern technologies, such as lasers – have been described in the literature. Although countless advances have been made, the results are not always satisfactory.We describe a new technique for rejuvenating this area: punctual electrocoagulation of the superficial layers of the skin.

Keywords: SKIN, ORBIT, REJUVENATION

Rosacea is a prevalent chronic cutaneous disorder that often presents relapsing course and is challenging to treat. It is frequently necessary to use off-label treatments to achieve satisfactory results.We report the use of a single session of medium depth peel with Jessner''''''''s solution and 35% trichloroacetic acid in fifteen patients, which achieved good clinical outcomes and histopathological improvement.The use of medium-depth peels must, therefore, be considered a therapeutic option for the treatment of rosacea.

Keywords: ROSACEA, CHEMEXFOLIATION, TRICHLOROACETIC ACID, RESORCINOLS, SALICYLIC ACID