Antonino Araco
Introduction: Recent studies have shown autologous
collagen regeneration, efficacy on face and neck lifting
and safety of transcutaneous micro-focused ultrasound
procedures (1-8). Despite this, guidelines on clinical indications
and technical aspects such as the proper number
of energy spots to be delivered to the patients are lacking.
For this reason, we have conducted an independent retrospective
study on these issues.
Materials and methods: We reviewed 925 women with
a mean age of 51,3 years (range 33 – 64 years), treated at
our cosmetic medical center in Milan (Italy), which presented
soft to severe skin ptosis of the face according to
APSS (Araco Ptosis Scale System), received and average
of 1.060 spots of micro-focused ultrasound as sole treatment.
The first statistical analysis was conducted on the
differences in the number of spots delivered in different
homogeneous groups. The first group of 56 patients received
an average of 486 lines; the second group of 73
patients received an average of 1.126 lines and the third
group of 66 patients received an average of 1460 lines.
The second analysis was conducted on the differences in
clinical indication according to APSS in three different
homogeneous groups.The first group of 175 patients was
on APSS 2; the second group of 193 patients on APSS
3 and the third group of 184 patients on APSS 3. Standardised
digital photographs and 3d reconstructions with
VectraH1, before and 6 months after treatment were assessed
by two blinded independent doctors (F.A.; M.A.)
which scored photographs from 1 to 20 according to the
SASS (Surgeon Assessment Scoring System). The reduction
of at least 4 set points was considered a significant
difference. A patient satisfaction questionnaire (PSQ)
were given to patients that scored they results from 0 to
10. The reduction of at least 2 set points was considered
a significant difference.
Result: All patients completed the follow- up after 6
months and no major side effects were reported. Result
on energy lines delivered: Only groups 2 and 3 reached
the statistical significative difference according to SASS
and PSQ. Result on face ptosis groups: Only groups 1 and
2 reached the statistical significative difference according
to SASS and PSQ.
Conclusion: Our retrospective study showed that in order
to stimulate collagen regeneration and tissue contraction
(lifting effect), it’s necessary to deliver a significant number
of energy micro-focused ultrasound lines and choose
the right patient indication