Beautiful. Medicine.

The hands are continuously exposed to environmental elements.  Women in Asia frequently wear gloves to protect their hands from sun damage. A loss of volume in the inter-metacarpal space combined with soft tissue thinning and sun damaged skin contribute to the appearance of aged hands.  The concept of harmonious rejuvenation among the thirds of the face, neck and body is well understood in aesthetic medicine. It is with great enthusiasm and tremendous patient satisfaction that we now include ”Stem Cell Hand Rejuvenation” with autologous fat transfer in our anti-aging armamentarium.

The technologies for adipose harvesting, processing and transplantation have evolved substantially over the past two decades.  Clinical advances have been supported by our improved understanding of molecular, cellular and immunobiologic events surrounding adipose derived progenitor cells and tissue transplantation. We have clearly identified stem cells within adipose tissue (fat) and have documented regeneration of surrounding structures related to autologous fat transfer. Research has confirms that progenitor cells contained in fat grafts trigger the induction of host derived remodeling and cellular morphogenesis, resulting in repair, regeneration and rejuvenation of surrounding tissue.

In addition to generating a youthful appearance as a filler, progenitor cells in fat grafts have been shown to improve the quality of overlying skin, soften wrinkles, decrease pore size and improve pigmentation irregularities.

The concept of regenerative medicine and stem cell therapies has led to widespread utilization of autologous fat grafts for rejuvenation of face and body.  Adipose has been described as an ideal soft tissue filler which can last forever. Other characteristics adding to it’s popularity include an abundant supply, availability and host compatibility with no allergic reactions in a procedure that can be repeated without difficulty. Successful engraftment and long-term survival of transplanted adipose tissue has established structural fat grafting as a safe, regenerative, long-lasting, natural approach to soft tissue augmentation.

”Stem Cell Hand Rejuvenation” can be performed as an outpatient procedure under local anesthesia with a recovery that has been described as “easy” by the patients.

Selphyl™, a completely natural autologous tissue regeneration technology which was developed by Aesthetic Factors, was recently performed by Dr Julio F. Gallo, Medical Director of The MIAMI Institute for Age Management and Intervention, on CBS.

During filming, Dr Gallo refers to Selphyl™ as a breakthrough new system to produce an injectable PRFM (Platelets Rich Fibrin Matrix) for the treatment of wrinkles and facial contouring.

A small volume of blood is drawn from the patient and, through a patented process, separates and concentrates the patients own platelets and fibrin into a matrix. The resulting Platelet Rich Fibrin Matrix is injected into a treatment area to stimulate cell proliferation which promotes the increase of volume and rejuvenation of the skin through a process of guided tissue re-generation.

Dr Gallo explained that pronounced effects occur as early as three weeks after the procedure. The effect of Selphyl™, now FDA approved, has been shown to last beyond a year and a half in clinical studies. It is thought that Selphyl™ treats the root cause of facial aging by triggering the production of new cells and collagen, a key structural element of the skin.

In this short segment, Dr Gallo showed that the entire procedure lasts less than twenty minutes in the physician’s office. Selphyl™ is highly cost effective since one draw of blood will produce four 1cc syringes of PRFM, allowing full facial rejuvenation to be performed at one visit.

Dr Gallo concludes that Selphyl™ offers a simple, reproducible, hypoallergenic, and cost effective method of growing a patient’s own tissue to fill skin depressions, wrinkles and folds, rather than using synthetic, plastic or animal derived materials.

For more information regarding Selphyl™ please visit our website: MIAMI-Institute.com

As we enter the second decade of our new century, we are living longer and more active lives. We maintain our bodies, eat well and exercise.  We want to feel healthy and look healthy too!  Lasers are now currently at the forefront of cosmetic technology - being used to remove unwanted imperfections along with smoothing and tightening the skin.

Wrinkles associated with aging and sun damage are caused by changes in the superficial (epidermal and dermal) layers of the skin. The most common areas of concern are the crow’s feet around the eyes and the lines around the mouth. These wrinkles are to be distinguished from laxity of facial tissues which in general requires surgery to retighten the underlying musculature and connective tissue. However, the fine lines in the skin are amenable to superficial treatments. Before lasers were introduced for this particular therapy, the two most common wrinkle removing procedures were dermabrasion and chemical peels. In dermabrasion a rotating, abrasive wire brush is used to scrape away the superficial layers of skin. Chemical peels use acids to remove skin layers. Both procedures can be painful and can damage the skin’s pigmentation and texture.

Lasers have been used for decades in other areas of medicine. New technology developed over the last few years now makes it possible to utilize lasers to lessen wrinkles on the face. Lasers are amplified light from one particular wavelength. The energy produced by lasers is thus powerful and because they are limited to a wavelength, there are certain properties associated with each of them. The gas or substance that produces the laser light used in skin resurfacing is carbon dioxide.

The newest version of the resurfacing lasers reduces untoward side effects by being distributed in a random fractional pattern and place in precise increments of time. With the help of a computer, one can control the laser’s on-surface time, density and depth. The lasers work by reacting with molecules of water, vaporizing precise areas of skin, thus smoothing out the wrinkles, and freshening the skin’s surface. The process requires only local and/or oral sedation.

It takes about 20 minutes to treat an area such as the eyes or mouth while a full facial treatment can take approximately 45 minutes. One of the advantages of the laser is the precise control of tissue penetration. Possible side effects of the laser include skin discoloration and scarring, but the risks are less than those associated with dermabrasion and deep chemical peels and older laser technology. Also, people with a propensity to developing cold sores should advise the doctor. Preoperative medication can prevent or lessen a postoperative outbreak of vesicles.

Postoperatively, the skin may feel as if you have sunburn but this dissipates quickly and pts report no pain. The facial skin may actually feel tight. Immediately afterwards an occlusive ointment is applied to assist in healing.  It is also important to avoid sun exposure because it can cause pigment changes. After it heals, the treated area will usually remain pink for anywhere from 1-2 weeks. This depends on the type of laser used and depth of treatment. This is easily covered with make-up. However, the sun should be avoided until the pink color resolves.

Anyone in good health can have the procedure. Those who are prone to heavy scarring should avoid it. Patients who commonly develop cold sores are given medication before the procedure. Patients with lighter skin color do very well. Those with darker skin are prone to discoloration of the skin; however, this is less frequent than with chemical peels and dermabrasion.

JUVÉDERM® XC, a new formulation of JUVÉDERM® and the latest advancement in hyaluronic acid dermal fillers was approved just by the FDA this week. The new JUVÉDERM® XC formulation contains the local anesthetic lidocaine to provide you with enhanced comfort during and after treatment. In a blind study, 9 out of 10 patients reported less pain with JUVÉDERM XC. JUVÉDERM XC is now available at The MIAMI Institute.

The disadvantage had long been suspected, but a recent study provides “irrefutable scientific evidence”.

The gender differences were most probably due to the amount of appendages [hair follicles, sebaceous glands] and the connections between the skin and muscle of the lips. We have always had the impression that male skin doesn’t age as rapidly as female skin. What was unknown is that one of the reasons that lines are deeper in women is because they have fewer sweat or sebaceous glands, the glands that make the oil that keeps our skin feeling soft … So women are producing less oil, which is protective and keeps the skin smoother.

Previous studies had not focused in on differences between men and women in the perioral area of the face. (The region around the mouth)

Women tend to go for procedures to remedy such wrinkles more often than men, although it hadn’t been clear if women were just worried about how they looked or if their wrinkles were actually worse.

Several key differences between men and women emerged: women had fewer sweat glands around the mouth than men; women had fewer blood vessels so less blood flow to that region; the muscles around the mouth are closer to the skin than in men, which may pull the skin in tighter, causing wrinkles; and, although the number of hair follicles were about the same in both genders, men had more sweat glands per hair follicle, again contributing to more relaxed skin throughout aging.

Hormones also seem to play a role in women’s dermatologic aging process.

For instance, estrogens promote healing, meaning that women tend to heal from wounds faster. And postmenopausal women have reduced blood flow, again contributing to lines and furrows. And they experience a decrease in the fat (sebum) secreted by sweat glands.

Meanwhile, women on hormone replacement therapy have been reported to have fewer wrinkles than those not taking the hormones.

Tissue also gets thinner as people age. Many existing cosmetic procedures, including fat transfers, are offered at The MIAMI Institute, which can remedy some of these changes.