Objectives: 9 soft tissue layers in dorsal hand were identified using sonography for the first time. After injection of HA filler, the changes of Thickness, Roughness, and Hydration on dorsal hand were evaluated.

Introduction: Using high resolution sonography, soft tissue thickness can be measured accurately to assess volumizing effects. Also the author tried to refined more detail soft tissue layers in sonography.

Materials / method: In this prospective study, 1cc of monophasic stabilized hyaluronic acid(mS-HA) filler was injected utilizing subdermal scrapping fanning injection technique(ssFIT) into the dorsal superficial lamina(DSL) and dorsal intermediate lamina(DIL) for 20 patients, and the results were measured utilizing sonographic evaluation of soft tissue thickness, topographic computer analysis(TCA) of skin roughness, stratum corneum hydration (SCH) at 1-week,1,2,3,6-months.

Results: The hand appearance and skin roughness improved in all patients. Soft tissue thickness in sonography was increased by 4.52mm(immediately-post-treatment), 5.52mm(1week), 4.89mm(1month), 4.25mm(2m), 4.08mm(3m), and 3.86mm(6m) from the pre-treatment baseline of 3.20mm. Roughness evaluated by TCA in 50(10) magnification dermascope photos, was reduced by 15.39(16.17)% at 1-month post-treatment, 21.5(18.12)% at 2-months, 22.7(23.91)% at 3-months, 27.16(38.12)% at 6-months, indicating improvements in fine wrinkles after the procedure. SCH on hand dorsum slightly improved during the study.

Conclusion: Detailed subdivided 9-layers of hand dorsum in sonography were established in this study for the first time. Soft tissue thickness was increased more than 32% after the treatment, and placed HA materials was confirmed mainly in DSL. The hand appearance and skin roughness improved in all patients. Veins and tendons became less apparent after the single injection showing volumizing effects lasting more than 6 months. All patients stated that their skin became more moisturized with increased SCH, youthful and smooth during the follow-up period after only one session.

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Objectives: I met many necrotic tissue patients after filler injection, cosmetic surgical operation and chronic wound disease.
After many doctors have been used the fillers, many common complications of the fillers also have been increased.
To treat these complication, I have been using many kinds of methods.
Among them, HBOT, SVF & PRP are effective and reproductive.

Introduction: Some doctors begin to use the SVF & PRP for treatment of epithelial pathologies such as wound healing, chronic wound, necrotizing wound.
In my clinic, using with fully automatic stem cell isolator, platelet rich plasma & hyperbaric oxygen chamber, epithelial pathologies have been treated.
Injecting PRP into the skin stimulates neoangiogenesis inducing microcapillary networks, induces an increase in ASCs, and promotes polymerization of the fibrin matrix, which aids to encapsulate grafted fat and stem cells.
Hyperbaric oxygen therapy’s using number is proportional to stem cell mobilization.

Materials / method: 1. HBOT-Hyperbaric oxygen therapy
2. SVF-Stromal vascular fraction
3. PRP-Platetet rich plasma

Results: Thus, adjuvant combination stem cell plus hyperbaric oxygen plus PRP make better wound healing, less complication, improve wound quality, minimize the scar and short healing time.
And, it need more experience and research.

Conclusion: At my clinic, I have been treating many side effects of fillers and cosmetic surgery using SVF, PRP & HBOT.
So far I have had good results.

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Objectives: Aging results in thinning of the dermis and epidermis. The underlying fat layer can be lost as well. The decrease in volume and overall effectiveness of all three skin layers results in a number of changes. The skin loses some of its elasticity. It becomes drier due to impaired barrier function and decreased production of essential oils such as sebum. The number of nerve endings in the skin decreases, so sensation diminishes. The number of sweat glands and blood vessels decreases as well, reducing the skin's ability to respond to heat exposure.

Introduction: Vaginal atrophy is a common condition among peri- and post-menopausal women. Symptoms of vaginal dryness, pruritus, irritation, loss of subcutaneous fat, sparse pubic hair and dyspareunia occur due to decreased estrogen level. We explored the efficacy of platelet-rich plasma (PRP) and lipofilling.

Materials / method: Psoriasis is a chronic and recurrent inflammatory skin disease and its histological features are characterized by epidermal hyperplasia, increased angiogenesis and immune cell infiltration.
Bone marrow mesenchymal stem cells (MSCs) has many advantages for the treatment of immune disease. Because it was demonstrated that BM-MSCs are effective in modulating immune cells and treating diseases and it has low immunogenicity, they could be applied for the treatment of cutaneous diseases such as wounds, burns, psoriasis, and scleroderma among others are common pathologies in skin.

Results: Lipofilling with PRP relieved symptoms, restored contour of the labia majora and achieved remission of lichen sclerosus on labia minora. As vulvar lesions were repaired and the aged appearance of genitalia was rejuvenated, both functional and cosmetic outcomes were satisfactory. Lipofilling with PRP can be effective for vaginal atrophy and lichen sclerosus.

Conclusion: It emerges that MSCs are involved in the immunoregulation and angiogenesis of psoriasis and that they are probably related to some modification occurring in psoriasis. Therapeutic application of BM-MSCs may be potentially superior to conventional clinical treatment modalities for severe psoriasis.

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