Tatjana PAVICIC's publications (39)

Arterial Wall Penetration Forces in Needles versus Cannulas.

03, 2019

If safety is defined as the diminished ability to penetrate facial arteries, the goal of this study was to investigate whether different-sized cannulas are safer than correspondingly sized needles for the application of facial soft-tissue fillers. read more

Plastic and reconstructive surgery

Age and Gender Differences of the Frontal Bone: A Computed Tomographic (CT)-Based Study.

Jun, 2019

Age-related changes of the frontal bone in both males and females have received limited attention, although understanding these changes is crucial to developing the best surgical and nonsurgical treatment plans for this area. read more

Aesthetic surgery journal

The Anatomy behind Adverse Events in Hand Volumizing Procedures: Retrospective Evaluations of 11 Years of Experience.

05, 2018

To retrospectively evaluate the rate of adverse events after hand volumizing procedures using a calcium hydroxylapatite product and to investigate the relationship between injector used (i.e., needle versus cannula) and technique applied (i.e., bolus, tenting, proximal-to-distal fanning, distal-to-proximal single line). read more

Plastic and reconstructive surgery Load more  

Precision in Dermal Filling: A Comparison Between Needle and Cannula When Using Soft Tissue Fillers.

Sep, 2017

Precise implantation of soft tissue fillers to treat the signs of aging is crucial for patient safety and the best aesthetic outcome. Injections are performed commonly with either needles or cannulas, but quantitative comparative data on precise implantation are still elusive. read more

Journal of drugs in dermatology : JDD

Communication Concepts for Prevention and Early Intervention in Aesthetic Medicine: Consensus and Literature Review.

Sep, 2017

Communication concepts relating to prevention and early intervention (P&E) within aesthetic medicine are poorly understood and highly underexplored. However, effective communication is a key criterion for successful outcomes. read more

Journal of drugs in dermatology : JDD

First Consensus on Primary Prevention and Early Intervention in Aesthetic Medicine.

Sep, 2017

Facial aging is a complex interplay of extrinsic and intrinsic factors leading to progressive changes in the skin, subcutaneous tissue, and bone. Clinical experience suggests that early aesthetic intervention may slow the signs of aging, but treatment in the absence of symptoms or with minimal signs of aging has not yet been properly addressed. read more

Journal of drugs in dermatology : JDD

PAN-ASIAN CONSENSUS-Key Recommendations for Adapting the World Congress of Dermatology Consensus on Combination Treatment with Injectable Fillers, Toxins, and Ultrasound Devices in Asian Patients.

Aug, 2017

The demand for minimally invasive aesthetic procedures has driven requests by physicians for guidance on their use in Asian patients, who have unique cultural preferences, social trends, and anatomy. However, few guidelines exist, particularly on combination treatment strategies for different facial shapes or indications such as the modification of face shapes to the "oval ideal."Physicians must, therefore, apply Caucasian patient-optimized guidelines to their Asian patients. Eleven specialists developed a consensus on the use of botulinum toxin A (BoNT-A), calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) fillers, and microfocused ultrasound with visualization (MFU-V) devices in Asian patients on upper-, middle-, and lower-face indications, including strategies to modify different facial shapes to the oval shape. Approval from 70 to 90 percent of all participants led to moderate consensus, while 90 percent agreement denoted a strong consensus. For early intervention/enhancement and restoration, most combination strategies are similar between Asian and Caucasian patients. Compared to Caucasian patients, however, beautification is a more common focus in Asian patients. The "ideal" oval facial shape can be created using different interventions depending on the patient's baseline characteristics. Although treatments and treatment sequences for early intervention/enhancement and restoration for beautification in Asian patients are similar to those in Caucasian patients, different treatment strategies may be required. read more

The Journal of clinical and aesthetic dermatology

An Update on the Anatomy of the Forehead Compartments.

Apr, 2017

The forehead is one of the most frequent locations for neuromodulator and soft tissue filler applications; however, the underlying anatomy is still poorly understood. Thus far, the presence of deep forehead compartments has not been confirmed. read more

Plastic and reconstructive surgery

Consensus Recommendations for Combined Aesthetic Interventions Using Botulinum Toxin, Fillers, and Microfocused Ultrasound in the Neck, Décolletage, Hands, and Other Areas of the Body.

Oct, 2016

The popularity of aesthetic procedures in the face has led to greater disparity between treated areas and those that still show evidence of true age. Although many areas of the body often require multiple treatment procedures for optimal rejuvenation, combination therapy for specific areas is not yet well defined. read more

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Tempering Patient Expectations and Working With Budgetary Constraints When It Comes to a Single Versus a Multimodal Approach.

May, 2016

This article is a review of the literature and the authors' experience in managing patients seeking facial and nonfacial rejuvenation procedures with budgetary constraints. read more

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Consensus Recommendations for Combined Aesthetic Interventions in the Face Using Botulinum Toxin, Fillers, and Energy-Based Devices.

May, 2016

The aging process is a complex interplay of intrinsic and extrinsic factors across multiple layers of the face. Accordingly, combining aesthetic interventions targeting different manifestations of aging often leads to better results than single modalities alone. However, no guidelines for a pan-facial approach using multiple interventions have been published to date. read more

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

High-definition optical coherence tomography and reflectance confocal microscopy in the in vivo visualization of a reaction to permanent make-up.

Mar, 2015

After permanent make-up treatments, eczematous and granulomatous reactions may occur which need anti-inflammatory treatment. For the definite diagnosis oftentimes biopsies are recommended. In vivo imaging such as reflectance confocal microscopy (RCM) and high-definition optical coherence tomography (HD-OCT) has been successfully used in the non-invasive diagnosis of various dermatoses before. read more

Journal of the European Academy of Dermatology and Venereology : JEADV

Quantitative evaluation of the onset and longevity of the action of incobotulinumtoxinA by skin displacement analysis in the treatment of glabellar frown lines.

Sep, 2014

A quantitative numerical method for assessing the extent and duration of the inhibitory action of botulinum neurotoxin type A on mimetic muscles would potentially enable more detailed evaluation of the overall efficacy of this aesthetic treatment. read more

Journal of drugs in dermatology : JDD

Dermal fillers in aesthetics: an overview of adverse events and treatment approaches.

Dec, 2013

The ever-expanding range of dermal filler products for aesthetic soft tissue augmentation is of benefit for patients and physicians, but as indications and the number of procedures performed increase, the number of complications will likely also increase. read more

Clinical, cosmetic and investigational dermatology

Calcium hydroxylapatite filler: an overview of safety and tolerability.

Sep, 2013

Soft tissue fillers are becoming increasingly important as nonsurgical treatment options for facial rejuvenation. Calcium hydroxylapatite (CaHA) is an injectable dermal filler that contains uniform CaHA microspheres suspended in an aqueous carboxymethylcellulose gel carrier. It is considered a long-lasting, but non-permanent filler, and is highly biocompatible with human tissue. No osteogenesis has been reported in extensive literature describing the use of CaHA in a variety of soft tissue applications. Injection of CaHA into the oral mucosa and the lips is an unapproved indication and may result in nodule formation. This occurs soon after injection and is a result of accumulated particles and not a granulomatous reaction. As with all biodegradable dermal fillers, CaHA can be associated with rare incidences of foreign body reactions, but only a handful of case reports have been documented in 10 years of clinical use. CaHA can be associated with local, short-term, injection-related adverse events, which are generally mild and resolve within a few days. Clinical trials that have followed patients for up to 3 years post-injection report no long-term or delayed-onset adverse events. CaHA is an effective and safe treatment option for a variety of aesthetic indications. This paper focuses on common safety concerns of patients and aesthetic physicians, including unfounded fears of osteogenesis and foreign body granulomas, providing an up-to-date overview of the tolerability and long-term safety of CaHA for aesthetic indications. read more

Journal of drugs in dermatology : JDD

A novel, multistep, combination facial rejuvenation procedure for treatment of the whole face with incobotulinumtoxinA, and two dermal fillers- calcium hydroxylapatite and a monophasic, polydensified hyaluronic acid filler.

Sep, 2013

Facial aging is a three-dimensional process, and facial rejuvenation procedures intended to reverse the effects of aging need to address this by combining products that relax hyperkinetic musculature, volumize/fill, and recontour/lift the whole face. In line with the desire of patients to achieve an overall youthful facial appearance, we report for the first time three cases where patients have been successfully treated across the whole face with a novel, three-step approach, layering incobotulinumtoxinA and two dermal fillers (calcium hydroxylapatite and a monophasic hyaluronic acid filler with CPM Technology) injected at three separate treatment visits. The results suggest that this layering approach based on an understanding of the underlying causes of facial aging, where different products are used in combination to treat the entire face, can enable patients to achieve the desired outcome of a return to the characteristics of a more youthful face. read more

Journal of drugs in dermatology : JDD

Recommendations for the best possible use of botulinum neurotoxin type a (Speywood units) for aesthetic applications.

Jan, 2013

The botulinum neurotoxin (BoNT) product Azzalure (manufactured by Ipsen Biopharm Limited, Wrexham, UK; distributed by Galderma), measured in Speywood units (s.U) has been available since 2009 for temporary improvement in the appearance of moderate to severe glabellar lines. Although we know much about the use of Azzalure for aesthetic indications, some aspects of product use in the clinic still require an update based on continuing and prevailing misconceptions and new clinical data. Therefore, a group of experts experienced with the use of Azzalure convened to formulate the following recommendations: (1) The key to an optimal effect is adequate dosing per injection point. Ten s.U are indicated for strong muscular activity, 5 s.U for medium activity, and approximately 2 s.U for minor activity. (2) The main factor that influences the area of effectiveness is the dosage per injection point. (3) In contrast to former beliefs, we know now that Azzalure works very fast, with some patients reporting initial drug activity after hours. (4) Various volumes can be used for dilution. However, the first choice is the recommended volume, 0.63 mL per vial of 125 s.U. Nevertheless, for clinicians changing products, keeping the volume they are used to might be an option. (5) Clinicians changing products have to be very careful not to confuse the units between different products. (6) In aesthetic BoNT-A usage, the development of antibodies is very rare and is not the common reason for insufficient results. (7) Probably the most common reason when BoNT-A is not working is the absolute or relative underdosage. The present adjunctive recommendations elaborated in an informal expert meeting should help physicians to optimize their treatment with Speywood unit products. read more

Journal of drugs in dermatology : JDD

[Emerging strategies for the prevention and therapy of excessive scars].

Sep, 2012

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MMW Fortschritte der Medizin

[Modern soft tissue augmentation--away from treating the single fold to volume replacement in the whole face].

Sep, 2012

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MMW Fortschritte der Medizin

[Medicine for youth and beauty: smoothing folds and scars].

Sep, 2012

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MMW Fortschritte der Medizin

Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment.

Sep, 2011

Due to its strong water-binding potential, hyaluronic acid (HA) is a well-known active ingredient for cosmetic applications. Native HA is proposed to help the skin to retain and maintain elasticity, turgor and moisture. read more

Journal of drugs in dermatology : JDD

Efficacy and tolerability of a new monophasic, double-crosslinked hyaluronic acid filler for correction of deep lines and wrinkles.

Feb, 2011

A monophasic, highly crosslinked hyaluronic acid dermal filler offers further treatment options for deep lines. read more

Journal of drugs in dermatology : JDD

[Botulinum toxin--the all-rounder in medicine].

Jan, 2011

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MMW Fortschritte der Medizin

[Management of hypertrophic scars and keloids].

Oct, 2010

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MMW Fortschritte der Medizin

Monophasic, cohesive-polydensified-matrix crosslinking-technology-based hyaluronic acid filler for the treatment of facial lipoatrophy in HIV-infected patients.

Jun, 2010

Human immunodeficiency virus (HIV)-associated facial lipoatrophy (FLA) represents a common and highly stigmatizing side effect of retroviral therapy. By causing loss of subcutaneous adipose tissue mainly in the cheek, temple and periocular area, FLA can significantly affect the patient's quality of life, both physically and psychologically. A limited quantity of data has been published on various filling substances for the management of FLA. Here, the authors present two patients with HIV-associated FLA successfully treated with a novel HA filler over a period of 24 months. read more

Journal of drugs in dermatology : JDD

Expert guideline on the use of porcine collagen in aesthetic medicine.

Mar, 2010

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Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG

[Fillers. An overview].

Mar, 2009

The demand for minimally invasive cosmetic procedures is increasing rapidly every year. In addition to botulinum toxin and laser treatments, the injection of dermal fillers is one of the most relevant methods. Dermal fillers can be used for a multitude of indications: wrinkles (fine to deep), lip augmentation, facial deformities, sunken scars, and HIV-related lipoatrophy in hands, neck and décolleté. There are currently 160 dermal fillers on the market. They differ greatly in terms of origin (own or cadaveric-derived, animal, bacterial fermentation or synthesis), duration of the effect and breakdown properties (temporary, semi-permanent, permanent), injection depth (dermal, subcutaneous, supraperiosteal), and risk profile. Physicians who administer dermal fillers should have a thorough knowledge of their characteristics and of the anatomy of the area to be treated. This is essential for correct administration and optimal aesthetic results. Prior to any treatment, details of the procedure, the desired effects, durability, and potential risks of the filler to be injected should be discussed with the patient. The choice of dermal filler, the injection technique, and the volume to be administered are determined according to the anatomic site, the type of defect, the desired effect, and physician experience. read more

Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete

Pimecrolimus cream (1%) efficacy in perioral dermatitis - results of a randomized, double-blind, vehicle-controlled study in 40 patients.

Oct, 2007

Perioral dermatitis (POD) is a common skin disease and difficult to treat. Pimecrolimus cream (1%) successfully controls atopic eczema. read more

Journal of the European Academy of Dermatology and Venereology : JEADV

Anti-microbial and -inflammatory activity and efficacy of phytosphingosine: an in vitro and in vivo study addressing acne vulgaris.

Jun, 2007

Lipids are important constituents of the human epidermis. Either free and organized into broad lipid bilayers in the intercorneocytes spaces, or covalently bound to the corneocyte envelope, they play a crucial role in permeability barrier function and are major contributors to cutaneous anti-microbial defense. Free sphingoid bases are a recent addition to this family of active lipids, which emerged from studies of breakdown products from ceramides. Phytosphingosine (PS) is a lipid occurring naturally in the stratum corneum, both in its free form and as a part of the major fraction of ceramides. The biotechnological production of PS patented by Degussa yields to PS with the correct configuration present in the skin. So, application of a PS containing formulation leads to its integration into the natural lipid structures of the skin. In acne, different pathogenetic factors contribute to the inflammation process, defect in keratinization, increased sebaceous gland activity and increased colonization of Propionibacterium acnes. The results of in vitro and in vivo studies confirm the previous reports on strong anti-microbial effectiveness of skin-identical PS produced by Degussa in vitro and in vivo. In addition, PS shows excellent clinical results in the context of skin care in acne, based on both anti-inflammatory and anti-microbial activity. These results demonstrate the potential of PS to enhance or complement existing acne therapies acting as an active cosmetic ingredient. read more

International journal of cosmetic science

Xerosis and callus formation as a key to the diabetic foot syndrome: dermatologic view of the problem and its management.

Nov, 2006

The diabetic foot syndrome is a major complication of diabetes mellitus. The two most important pathophysiologic factors are peripheral arterial occlusion and peripheral neuropathy. The cutaneous lesion is a plantar ulcer, often accompanied by soft tissue and bone infections which can require amputation. Triggers include poorly fitting shoes, poor foot care, or overlooked foreign bodies, often coupled with a structural foot deformity. Increased plantar pressure, especially beneath the metatarsal heads, and the resultant callus play an important role. The patients often already have xerosis of the plantar skin with scales, fissures, erosions and impaired barrier function, complicating the situation. Prompt neurologic and vascular diagnostic studies, coupled with routine examination of the feet and primary prophylactic measures are most important. The most important therapeutic goals are optimal control of the diabetes mellitus, relieving pressure points and avoiding or reducing callus formation. read more

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG

Combined aesthetic interventions for prevention of facial ageing, and restoration and beautification of face and body.

2017

The Merz Institute of Advanced Aesthetics Expert Summit was held in Prague, Czech Republic, from 19-20 November 2016. The meeting had a distinct advisory board character and invited aesthetic practitioners from all over the world to hear an international faculty present a range of keynote lectures and conduct live injection sessions with an emphasis on recent developments in combination aesthetic interventions for face and body rejuvenation and beautification. Aging is associated with changes in bones, muscles, ligaments, adipose tissue, and skin and, moreover, involves interactions among these tissue types. To achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected, which generally involves treatment with more than a single agent or technology. Presentations described innovative treatment algorithms for the face and body and focused on patients' desires for natural-looking rejuvenation and how this requires a three-dimensional approach combining products that relax the musculature, volumize, and re-drape the skin. Besides treating the aging face, these procedures are increasingly used to enhance facial features as well as to delay facial aging in younger patients. The presentations covered patients from different ethnicities as well as the treatment of non-facial areas, with a particular focus on the use of Ultherapy for skin lifting and tightening, and new aesthetic procedures such as Cellfina and diluted Radiesse. The current report provides a summary of key presentations from the meeting. read more

Clinical, cosmetic and investigational dermatology

IncobotulinumtoxinA use in aesthetic indications in daily practice: a European multicenter, noninterventional, retrospective study.

2015

To characterize utilization patterns and treatment satisfaction with incobotulinumtoxinA for aesthetic indications and assess adherence to the Summary of Product Characteristics. read more

Clinical, cosmetic and investigational dermatology

Dermal fillers in aesthetics: an overview of adverse events and treatment approaches.

2015

The ever-expanding range of dermal filler products for aesthetic soft tissue augmentation is of benefit for patients and physicians, but as indications and the number of procedures performed increase, the number of complications will likely also increase. read more

Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses

Complete biodegradable nature of calcium hydroxylapatite after injection for malar enhancement: an MRI study.

2015

Radiesse(®) (Calcium hydroxylapatite [CaHA]) is a biocompatible, injectable gel for facial soft tissue augmentation. It is a completely biodegradable filler and this is well documented, but objective imaging methods to confirm this property are scarce. read more

Clinical, cosmetic and investigational dermatology

Botulinum toxin A for the treatment of keloids.

2012

Keloids are the result of excessive scar tissue formation. Besides their poor aesthetic appearance, keloids can be associated with severe clinical symptoms such as pain, itching, and rigidity. Unfortunately, most therapeutic approaches remain clinically unsatisfactory. Recently, injections with botulinum toxin A (BTA) were proposed for the treatment of established keloids in a clinical trial. In this study, we aimed to verify the effects of intralesional BTA for the treatment of therapy-resistant keloids using objective measurements. In addition, the underlying molecular mechanisms were investigated using cultured keloid-derived fibroblasts. read more

Skin pharmacology and physiology

Botulinum toxin type A treatment to the upper face: retrospective analysis of daily practice.

2012

Botulinum toxin type A treatment has been used for over 20 years to enhance the appearance of the face. There are several commercially available botulinum toxin type A products used in aesthetic clinical practice. The aim of this retrospective analysis was to compare the clinical efficacy of the most commonly used botulinum toxin type A preparations in daily practice. read more

Clinical, cosmetic and investigational dermatology

Fifty-kDa hyaluronic acid upregulates some epidermal genes without changing TNF-α expression in reconstituted epidermis.

2011

Due to its strong water binding potential, hyaluronic acid (HA) is a well-known active ingredient for cosmetic applications. However, based on its varying molecular size, skin penetration of HA may be limited. Recent studies have demonstrated that low-molecular-weight HA (LMW HA) may show a certain proinflammatory activity. We thus aimed to characterize an LMW-sized HA molecule that combines strong anti-aging abilities with efficient skin penetration but lacks potential proinflammatory effects. read more

Skin pharmacology and physiology

Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies.

2011

Excessive scars form as a result of aberrations of physiologic wound healing and may arise following any insult to the deep dermis. By causing pain, pruritus and contractures, excessive scarring significantly affects the patient's quality of life, both physically and psychologically. Multiple studies on hypertrophic scar and keloid formation have been conducted for decades and have led to a plethora of therapeutic strategies to prevent or attenuate excessive scar formation. However, most therapeutic approaches remain clinically unsatisfactory, most likely owing to poor understanding of the complex mechanisms underlying the processes of scarring and wound contraction. In this review we summarize the current understanding of the pathophysiology underlying keloid and hypertrophic scar formation and discuss established treatments and novel therapeutic strategies. read more

Molecular medicine (Cambridge, Mass.)

[Evidence-based cosmetics: concepts and applications in photoaging of the skin and xerosis].

2009

As well as for topically used dermatological agents, studies performed according to the rules of evidence-based medicine (EBM) are also needed for cosmetics. Although the concept of evidence-based cosmetics has been only partly developed so far, there are some agents and preparations available that can be considered as evidence-based. In this paper we present data from several studies that claim to have examined and demonstrated the efficacy of cosmetic preparations for the management of solar damage and aging skin as well as lentigo and melanosis according to EBM criteria. Certainly, further controlled studies are needed to cover the main application areas of dermocosmetics. Retinol and antioxidant agents such as vitamin C and coenzymes that positively act via several mechanisms on collagen biosynthesis can be considered evidence-based substances for the management of aging skin. According to the same criteria, the preventive effect of regularly applied dermocosmetic sun screens on the development of actinic keratosis could also be shown. Dermocosmetic sun screens should offer adequate protection against UV-B and UV-A light by combining compatible organic and/or non-organic UV-filters and at the same time be well tolerated. Furthermore, they may contain some additional agents such as antioxidants, DNA repair enzymes, dexpanthenol, glycerin or hamamelis distillate. In the treatment of melanosis, a substantial bleaching effect corresponding to that of 0.1% topical tretinoin can be achieved with 10% all-trans-retinol gel. Preparations containing urea, ammonium lactate or glycerol in different concentrations are considered the best characterized and most effective substances for the care of dry skin. However, the lack of controlled studies confirming the efficacy of dermocosmetic products as well as the superiority of the preparation incorporating the active agent over the corresponding base is a problem yet to be solved. Undoubtedly, the efficacy and the sustainability of the achieved effects have to be examined and proven accordingly to EBM criteria in further active cosmetic agents. Moreover, generally accepted guidelines for the examination of efficacy and tolerability of dermocosmetics have to be developed. read more

Wiener klinische Wochenschrift